ORIGINAL USES (ON-LABEL)
Depression, panic disorders with or without agoraphobia, obsessive-compulsive disorder, social anxiety disorder, generalized anxiety disorder, post-traumatic stress disorder (PTSD), premenstrual mood disorders.
BRAND NAME Paxil, Paxil CR
DRUG CLASS
Antidepressant (selective serotonin reuptake inhibitor)
DESCRIPTION
This drug inhibits the reuptake of serotonin at the neuron, increasing the levels of serotonin in the body and in the brain.
POTENTIAL SIDE EFFECTS
Increased sweating, headache, somnolence, dizziness, insomnia, nausea, dry mouth, constipation, diarrhea, ejaculatory disturbances, muscle weakness, sudden drop in blood pressure upon standing from a sitting or lying position, nervousness, anxiety, yawning, abnormal dreams, rash,
decreased libido, flatulence, vomiting, upset stomach, urinary frequency, impotence, tremor, muscle aches and pain, low sodium levels.
CAUTIONS
Use may be associated with the development of suicidal thinking and behavior (see special information section).
Do not use if you have been taking an MAO inhibitor (phenelzine, tranylcypromine, isocarboxazid) within the past 14 days. When used with MAO-Is fever, high blood pressure, increased heart rate, confusion, seizures, and deaths have been reported.
Gradually decrease in dosage upon discontinuation of paroxetine therapy.
Notify your doctor if you have a history of mania, seizures, or alcoholism.
Use caution if you have liver dysfunction, or kidney insufficiency, or in elderly patients.
Concurrent use of aspirin or other nonsteroidal anti-inflammatory drugs (NSAIDs) may increase the risk of bleeding.
DRUG INTERACTIONS
MAO inhibitors (such as phenelzine, isocarboxazid, or linezolid), selegiline, phenothiazines (thioridazine or mesoridazine; wait at least five weeks after discontinuation of paroxetine before starting phenothiazines), amphetamines, buspirone, meperidine, nefazodone, sumatriptan, sibutramine,
sympathomimetics, ritonavir, tramadol, venlafaxine, alprazolam, diazepam, carbamazepine, carvedilol, clozapine, cyclosporine, dextromethorphan, digoxin, haloperidol, lovastatin, simvastatin, phenytoin,
propafenone, theophylline, trazodone, tricyclic antidepressants, valproic acid, lithium, bumetanide, furosemide, torsemide, warfarin, sumatriptan, naratriptan, rizatriptan, and zolmitriptan, cyproheptadine.
This drug is metabolized by a specific set of liver enzymes. Several other drugs interfere with these liver enzymes, and thus may increase or decrease the clearance of paroxetine from the body,
potentially increasing the risk of side effects or decreasing effectiveness. When these drugs are given in combination with paroxetine, dosage adjustments may be needed.
As these are too numerous to list, you should always check with your doctor or pharmacist prior to starting a new medication, herbal, or nonprescription product.
FOOD INTERACTIONS
Alcohol
HERBAL INTERACTIONS
Valerian, St. John’s wort, SAMe, kava kava
PREGNANCY AND BREAST-FEEDING CAUTIONS
FDA Pregnancy Risk Category D. Excreted in breast milk. Not recommended during breast-feeding.
SPECIAL INFORMATION
In 2005, the FDA announced new labeling for antidepressants regarding the need to closely monitor for worsening of depression and for the potential of increased suicidal thinking or suicidal behavior during therapy. Although this recommendation applies to all patients (adults, children, adolescents)
treated with antidepressants for any indication, this is of particular importance in patients being treated for depression. Discuss the latest information regarding this safety issue with your doctor prior to initiating therapy.
Close observation may be especially important when antidepressant medicationsare started for the first time or when doses are changed.
More information on this topic can be found at the following web site: FDA
Combination with other SSRIs, SSNRIs, tricyclic antidepressants, amphetamines, sympathomimetics, ritonavir, serotonin agonists (sumatriptan), and certain opiates carries an increased risk of serotonin syndrome. While taking this medication, check with your pharmacist or doctor before starting any new medication, herbal, or nonprescription product.
In 2005, product labeling was revised regarding new information about the use of this drug during first trimester of pregnancy, suggesting increased risk of congenital malformations. Discuss these risks with your doctor.
