Paroxetine (Paxil): Uses, Warnings, and Key Facts
Quick summary Paroxetine is an oral medicine used for depression, anxiety disorders, and obsessive-compulsive disorder. It is available under brand names such as Paxil, Paxil CR, Brisdelle, and Pexeva. Medical disclaimer: This article is...
This content is for educational purposes only and does not replace medical advice, diagnosis or treatment from a qualified healthcare professional.
Quick summary
Paroxetine is an oral medicine used for depression, anxiety disorders, and obsessive-compulsive disorder. It is available under brand names such as Paxil, Paxil CR, Brisdelle, and Pexeva.
Medical disclaimer: This article is for general information only. It does not replace the official patient leaflet, prescribing information, or advice from a doctor or pharmacist. Do not use it to diagnose a condition or to change any treatment on your own.
What is paroxetine?
Paroxetine is a medicine used in the treatment of depression, anxiety, and obsessive-compulsive disorder. The content provided also lists the following ingredient forms: paroxetine hydrochloride, paroxetine hydrochloride hemihydrate, and paroxetine mesylate.
In the United States, brand names mentioned for paroxetine include Paxil, Paxil CR, Brisdelle, and Pexeva.
How paroxetine works
Paroxetine works by inhibiting the reuptake of 5-hydroxytryptamine by brain neurons. In simple terms, it affects serotonin signaling in the brain.
Uses and therapeutic indications
The original content lists paroxetine as being used for several mental health conditions. The exact use depends on the product, the patient, and the prescribing information.
| Condition | Dose information in the source |
|---|---|
| Major depressive episode | Recommended 20 mg/day; check after 3–4 weeks and adjust if needed; maximum 50 mg/day in 10 mg increases according to response. |
| Obsessive-compulsive disorder | Recommended 40 mg/day; start at 20 mg/day and increase gradually; maximum 60 mg/day. |
| Anxiety disorder with or without agoraphobia | Recommended 40 mg/day; start at 10 mg/day and increase gradually; maximum 60 mg/day. |
| Social anxiety disorder / social phobia, generalized anxiety disorder, post-traumatic stress disorder | Recommended 20 mg/day; if needed, increase to a maximum of 50 mg/day in 10 mg increments. |
The source also notes that treatment should continue for at least 6 months in major depressive episode, until the patient is free of symptoms.
How it is taken
Paroxetine is for oral use. The source describes once-daily administration, usually in the morning with food.
Forms mentioned in the source
- Tablets: swallow whole; do not chew.
- Oral drops in solution: dilute in a little water.
Important precautions
The original content highlights several situations that require caution, including:
- History of mania
- Severe renal failure or liver failure
- Diabetes
- Epilepsy or seizures
- Electroconvulsive therapy (ECT)
- Closed-angle or antecedent glaucoma
- Heart disease
- Situations that may lead to hyponatremia
- History of bleeding disorders or bleeding-prone states
- Older adults
The source also notes caution with medicines that affect platelet function or increase bleeding risk, and with serotonergic or neuroleptic combinations because of the risk of serotonin syndrome or neuroleptic malignant syndrome.
Contraindications listed in the source
- Hypersensitivity to paroxetine
- Use with MAO inhibitors, with the timing restrictions described in the source
- Use with thioridazine or pimozide
Kidney and liver impairment
The source says dose reduction may be needed in liver failure and in renal failure, especially when creatinine clearance is below 30 mL/min. It also states that the lower end of the therapeutic range should be used in these situations.
Drug interactions mentioned
Paroxetine may interact with several medicines and substances. The source specifically lists the following:
- Serotonergic medicines: MAOIs, L-tryptophan, triptans, tramadol, linezolid, methylthionine chloride, SSRIs, lithium, pethidine, and Hypericum perforatum
- Medicines with reduced levels: fosamprenavir/ritonavir
- Medicines with increased levels: procyclidine, clomipramine, nortriptyline, desipramine, perfenazine, thioridazine, risperidone, atomoxetine, propafenone, flecainide, and metoprolol
- Bleeding risk: oral anticoagulants, NSAIDs, and other antiplatelet agents
- Alcohol: the source advises avoiding alcohol consumption
- Tamoxifen: the source says paroxetine reduces its effectiveness and should be avoided whenever possible during breast cancer prevention with tamoxifen
- Fentanyl: caution is advised in general anesthesia or chronic pain treatment
- Pravastatin: the source notes possible increased blood glucose levels with co-administration
Pregnancy and breastfeeding
The source states that paroxetine should be used in pregnancy only when strictly indicated and notes a risk of cardiovascular malformations in neonates during the first trimester.
It also says newborns should be evaluated if the mother used paroxetine in late pregnancy because of possible neonatal symptoms such as respiratory failure, cyanosis, apnea, convulsions, feeding difficulties, temperature instability, tremors, irritability, lethargy, and sleep problems.
For breastfeeding, the source describes paroxetine as compatible, with small amounts excreted and undetectable serum concentrations reported.
Effects on driving and machinery
Paroxetine can cause sedation and dizziness. If these effects occur, the source advises avoiding activities such as driving or using machines.
Possible side effects
The source lists the following adverse reactions and side effects:
- Increased cholesterol levels
- Decreased appetite
- Drowsiness, insomnia, agitation, aggressiveness, abnormal dreams
- Decreased concentration, dizziness, tremors, headache
- Blurred vision
- Yawning
- Nausea, constipation, diarrhea, vomiting, dry mouth
- Sweating
- Sexual dysfunction
- Asthenia and weight gain
- Bruxism, with unknown frequency
The source also notes that short-term clinical trials in children and adolescents showed increased suicidal behaviour, self-harming behaviour, and hostility.
Safety reminder
If paroxetine has been prescribed or is being considered, the safest next step is to review the official medication guide and discuss the full medicine list, medical history, pregnancy status, and any new symptoms with a qualified healthcare professional.
FAQ
▸ What is paroxetine used for?
The source says paroxetine is used for depression, anxiety, and obsessive-compulsive disorder, and also lists social anxiety disorder, generalized anxiety disorder, and post-traumatic stress disorder.
▸ What are the brand names of paroxetine in the United States?
The brand names listed in the source are Paxil, Paxil CR, Brisdelle, and Pexeva.
▸ Can paroxetine be taken with food?
Yes. The source says it is taken once daily in the morning with food.
▸ What medicines should not be combined with paroxetine?
The source lists MAO inhibitors, thioridazine, and pimozide as contraindicated, and also warns about several serotonergic medicines and drugs that increase bleeding risk.
▸ Does paroxetine cause drowsiness?
The source says paroxetine can cause sedation and dizziness, so caution is advised with driving or machinery if these effects occur.
▸ Is paroxetine used in pregnancy?
The source says it should be used only when strictly indicated and notes a risk of neonatal effects, especially with late-pregnancy exposure.
Sources and references
- FDA Medication Guides
- UNII: 41VRH5220H
- ChemIDplus
- DrugPortal
- PubChem CID: 43815
- NCI Thesaurus: C61879
Medical disclaimer
This content is for educational purposes only. It should not be used as a substitute for professional medical advice, diagnosis or treatment. Always ask a doctor, pharmacist or qualified healthcare professional before starting, stopping or changing any medicine.
Sources and verification
The following sources or official references are listed to support verification of the medicine information discussed in this article.
Medicine information can change and may vary depending on country, product formulation, patient history and professional guidance. Always check official medicine information and ask a healthcare professional for personal medical questions.