Paroxetine hydrochloride (
Paxil®) is a prescription medicine that is used to treat a number of conditions within the brain.
Paxil is manufactured by GlaxoSmithKline.
Generic paroxetine is made by several manufacturers.
Paroxetine is licensed to treat a number of conditions, including:
Paroxetine is part of a class of drugs called selective serotonin reuptake inhibitors, or
SSRIs for short. SSRIs act on a specific chemical in the brain known as serotonin. Serotonin is one of several chemicals used to send messages from one nerve cell to another.
As a message travels down a nerve, it causes the end of the cell to release serotonin. The serotonin enters the gap between the first nerve cell and the one next to it. When enough serotonin reaches the second nerve cell, it activates receptors on the cell and the message continues on its way. The first cell then quickly absorbs any serotonin that remains in the gap between cells. This is called "reuptake."
Normally, this process works without any problems. But when the levels of serotonin become unbalanced, it can cause a variety of conditions, including
depression. Paroxetine helps to block the reuptake of serotonin so more serotonin remains in the space between the brain's nerve cells. This gives the serotonin a better chance of activating the receptors on the next nerve cell.
There have been several studies that looked at the effects of using paroxetine to treat various conditions.
Depression
Studies have shown paroxetine to be effective for
depression treatment in adults. People taking it had more improvement in their depression symptoms, compared to those not taking it. Also, long-term studies have shown that it can help prevent relapse (when depression comes back).
OCD
In studies, up to 24 percent of adults with
obsessive-compulsive disorder (
OCD) who took paroxetine felt their OCD was "much improved," compared to only 11 percent of those who were not taking it. Only 3 to 7 percent of people taking it felt that their OCD was worse, compared to 14 percent of people not on paroxetine.
Panic Disorder
Two studies looked at using paroxetine to treat adults with
panic disorder. Up to 76 percent of people taking paroxetine were free from
panic attacks, compared to only 44 percent of those not taking it. Paroxetine has not been studied in children or teens with panic disorder.
Social Anxiety Disorder
In studies of paroxetine for
social anxiety disorder, up to 77 percent of adults showed improvement while taking it, compared to only 42 percent of those not taking paroxetine.
Generalized Anxiety Disorder (GAD)
Studies have shown that more people with
generalized anxiety disorder taking paroxetine have more improvement in their
anxiety symptoms, compared to people not taking paroxetine. Also, long-term studies have shown that paroxetine can help prevent relapse (when
anxiety comes back).
Post-Traumatic Stress Disorder (PTSD)
Studies have shown paroxetine to be effective for the treatment of
PTSD in adults. More people taking it felt they were "much improved" or "very much improved," compared to people not taking it. Paroxetine was also shown to reduce PTSD symptoms.
When and How to Take Paroxetine
Some general considerations for when and how to take the medication include the following:
- It comes in tablet and suspension (liquid) form. You take the drug by mouth, usually once a day.
- Make sure to shake paroxetine suspension well before each dose.
- If the medicine makes you drowsy, try taking it before bedtime. If the medication causes insomnia for you, try taking it in the morning. Most people take it in the morning.
- You can take it with or without food. If paroxetine bothers your stomach, try taking it with food.
- Take paroxetine at the same time each day. This will help to maintain an even level of the drug in your blood.
- For the medication to work properly, it must be taken as prescribed. The drug will not work if you stop taking it.
The dosage your healthcare provider recommends will vary depending on a number of factors, including:
- Your age
- The medical condition being treated
- Other medical conditions you may have
- Other medications you may be taking.
As is always the case, do not adjust your dose unless your healthcare provider specifically instructs you to do so.
As with any medicine, there are possible side effects with this drug. However, not everyone who takes paroxetine will experience side effects. In fact, most people tolerate the drug well. When side effects do occur, in most cases they are minor and either require no treatment or can easily be treated by you or your healthcare provider. Serious side effects are less common.
The most common side effects of paroxetine include:
(Click Side Effects of Paroxetine to learn about specific side effects of the drug, including some of the more serious side effects that you should report to your healthcare provider. You can also read about possible paroxetine side effects by going to:
Paroxetine can potentially interact with a number of medicines.
What Should I Tell My Healthcare Provider?
You should talk with your healthcare provider prior to taking paroxetine if you have:
Also, let your healthcare provider know if you are:
Make sure to tell your healthcare provider about all the medicines you take, including prescription and non-prescription medicines, vitamins, and herbal supplements.
Alternatives to Paroxetine
Depression, even in its most severe form, is highly treatable. As with many illnesses, getting
depression treatment early is more effective and reduces the chance of recurrence.
The most common forms of treatment for depression are medication (
antidepressants) and psychotherapy ("talk therapy"). In some cases of severe depression, healthcare providers may recommend electroconvulsive therapy (ECT). Some people may also try complementary or alternative treatments for depression
(see Natural Remedies for Depression).
For most people, paroxetine is quite effective at treating depression. It is also generally well-tolerated. However, side effects can occur -- or the medicine may not work as well as needed. In such cases, your healthcare provider may recommend an alternative to paroxetine. Some examples of substitute depression medications include:
- Other selective serotonin reuptake inhibitors (SSRIs)
- Serotonin-norepinephrine reuptake inhibitors (SNRIs)
- Norepinephrine and dopamine reuptake inhibitors (NDRIs)
- Tricyclic antidepressants
- Monoamine oxidase inhibitors (MAOIs).
People who take too much paroxetine may have overdose symptoms that could include:
- Nausea and vomiting
- Shakiness (tremor)
- Rapid heart rate (tachycardia) or slow heart rate (bradycardia)
- Confusion
- Dizziness
- Seizures
- Irregular heart rhythm (arrhythmia)
- High blood pressure (hypertension) or low blood pressure (hypotension)
- Aggressiveness
- Fainting
- Muscle pain or muscle stiffness
- Liver problems, including hepatitis
- Kidney failure
- Coma
- Loss of life.
If you happen to overdose, seek medical attention immediately.
Paroxetine should be stored at room temperature, away from moisture or heat. It should be kept in an airtight container.
Keep paroxetine and all medications out of the reach of children.
What Should I Do If I Miss a Dose?
If you do not take your paroxetine as scheduled, take your missed dose as soon as you remember. If it is almost time for your next dose, skip the missed dose and continue with your regular schedule. Do not take a double dose.
Paroxetine tablets are available in four strengths:
- Paroxetine 10 mg tablets
- Paroxetine 20 mg tablets
- Paroxetine 30 mg tablets
- Paroxetine 40 mg tablets.
The liquid form of paroxetine is available in one strength -- Paroxetine oral suspension (liquid) 10 mg per 5 mL (10 mg per teaspoonful).
There are currently both brand-name and generic paroxetine tablets and paroxetine liquid licensed for sale.
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