Paroxetine is sold under the brand name "Paxil".
Paroxetine was the second SSRI licensed for use in the US. It is FDA approved for Major Depression, PTSD, Social Phobia, Panic Disorder, OCD and GAD.
Paroxetine, like its cousins, fluoxetine (Prozac), citalopram (Celexa), sertraline (Zoloft), escitalopram (Lexapro) and fluvoxamine (Luvox), reversibly blocks the recycling of serotonin from outside the nerve to inside the nerve. This increase in serotonin in the gap between nerves in the central nervous system (the synapse) leads to alterations in serotonin function that have been associated with improvements in depression and anxiety. Each of these serotonin reuptake inhibitors (SSRIs for short) has its own personality, if you will. Paroxetine, like fluvoxamine, often causes patients to feel lethargic and “numb”. It tends to slow people down and leave them feeling “blah” when used to treat Major Depression. It may be less prone to do so when treating anxiety disorders, however.
Paroxetine is processed for elimination from the body (“metabolized”) in the liver to inactive compounds that are in turn eliminated by the kidneys. The half life of paroxetine is less than one day and consequently if stopped abruptly (not recommended) it is out of the body in about 3 days. It seems to be more likely than other SSRIs to cause withdrawal symptoms that can include dizziness, shock-like feelings in the head, dysphoria and others.
Paroxetine in combination with a monoamine oxidase inhibitor can cause serotonin syndrome that in turn can be fatal.
Possible adverse effects can include sexual dysfunction, nausea, insomnia, agitation, diarrhea, difficulty thinking and others. Often, in common with other SSRIs, it may leave a person feeling a bit numb emotionally rather than really well and “perky”.
Paroxetine significantly inhibits enzyme systems in the liver (CYP2D6, 4A2) that can increase the blood levels of other medications metabolized by those enzymatic systems. One must therefore be mindful of possible drug interactions when prescribing other medications with paroxetine.
Paroxetine carries a warning from the FDA, along with the other SSRIs, against neonatal pulmonary hypertension in neonates exposed to escitalopram in the final trimester of pregnancy. In addition, paroxetine has been associated with cardiac defects when the fetus has been exposed to paroxetine in the first trimester.
All antidepressants have a warning from the FDA against new onset suicidal “thoughts and behaviors”. There is no evidence children taking antidepressants are suiciding; quite otherwise, there is very good evidence that children treated for depression suicide less often than children who are depressed who are not treated with antidepressants.
If you miss a dose of paroxetine do not add it to your next dose. It is important to take paroxetine regularly as prescribed.
