Other names used:
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.
- Depression (also known as major depression or clinical depression)
- Obsessive-compulsive disorder (OCD)
- Panic disorder
- Social anxiety disorder
- Generalized anxiety disorder (GAD)
- Post-traumatic stress disorder (PTSD).
Contraindications and Cautions:
You should not use medication in:
- Children and adolescents under 18 years of age
- Manic episodes of bipolar affective disorder (manic depression)
- Uncontrolled epilepsy
- People who have taken a monoamine oxidase inhibitor antidepressant (MAOI) in the last 14 days
- People taking the antipsychotic medicines thioridazine or pimozide.
This medicine should not be used if you are allergic to one or any of its ingredients. Please inform your doctor or pharmacist if you have previously experienced such an allergy.
If you feel you have experienced an allergic reaction, stop using this medicine and inform your doctor or pharmacist immediately.
You should use this medication with caution in:
- Elderly people
- Young adults
- History of suicidal behaviour or thoughts
- History of mania or hypomania
- People receiving electroconvulsive therapy (ECT)
- People taking antipsychotic medicines
- Decreased kidney function
- Decreased liver function
- Heart disease
- History of bleeding disorders
- People taking medicine to prevent blood clotting (anticoagulants, eg warfarin)
- History of glaucoma.
- The safety of this medicine in pregnancy has not been established. It should be used with caution during pregnancy and only if the benefits to the mother outweigh any potential risks to the foetus. This is particularly important in the first and third trimesters where the medicine could have harmful effects on the baby. Symptoms that resemble side effects or withdrawal symptoms of paroxetine have been seen in new-born babies whose mothers took paroxetine in the third trimester. Seek medical advice from your doctor if you get pregnant or plan to have a baby while taking this medicine. If you get pregnant and decide to stop taking paroxetine you should not do so suddenly - see the warning above about withdrawal symptoms.
- Small amounts of paroxetine pass into breast milk, however the effect of this on the nursing infant is unknown. As a result, this medicine should only be used during breastfeeding if the expected benefits to the mother outweigh any risks to the nursing infant. Women who need to take this medicine could consider not breastfeeding. It is important to seek medical advice from your doctor.
- This medicine may reduce your ability to drive or operate machinery safely. Do not drive or operate machinery until you know how this medicine affects you and you are sure it won't affect your performance.
- It is recommended that you avoid drinking alcohol while taking this medicine.
- SSRI antidepressants have been associated with the development of unpleasant or distressing restlessness and the need to move, often accompanied by an inability to sit or stand still. This is most likely to occur within the first few weeks of treatment. If you experience these symptoms you should consult your doctor.
- Antidepressants may cause the amount of sodium in the blood to drop - a condition called hyponatraemia. This can cause symptoms such as drowsiness, confusion, muscle twitching or convulsions. Elderly people may be particularly susceptible to this effect. You should consult your doctor if you develop any of these symptoms while taking this medicine so that your blood sodium level can be checked if necessary.
- You should not suddenly stop taking this medicine, as this can cause withdrawal symptoms such as dizziness, pins and needles, anxiety, sleep disturbances (including intense dreams), agitation, tremor, nausea, diarrhoea, sweating, palpitations, irritability and confusion. Withdrawal symptoms are temporary and are not due to addiction or dependence on the medicine. They can usually be avoided by stopping the medicine gradually, usually over a period of weeks or months, depending on your individual situation. Follow the instructions given by your doctor when it is time to stop treatment with this medicine. On rare occasions some people have experienced withdrawal symptoms after accidentally missing a dose of this medicine.
Medicines and their possible side effects can affect individual people in different ways. The following are some of the side effects that are known to be associated with this medicine. Because a side effect is stated here, it does not mean that all people using this medicine will experience that or any side effect.
- difficulty concentrating
- sleepiness or feeling "drugged"
- stomach pain
- changes in ability to taste food
- decreased appetite
- weight loss or gain
- changes in sex drive or ability
- dry mouth
- sensitivity to light
- runny nose
- lump or tightness in throat
- pain in the back, muscles, joints, or anywhere in the body
- muscle weakness or tightness
- problems with teeth
- unusual dreams
- painful or irregular menstruation
Some side effects can be serious. If you experience any of the following symptoms o, call your doctor immediately:
- blurred vision
- rapid, pounding, or irregular heartbeat
- chest pain
- abnormal bleeding or bruising
- sore throat, fever, chills, and other signs of infection
- uncontrollable shaking of a part of the body
- sudden muscle twitching or jerking that you cannot control
- numbness or tingling in your hands, feet, arms, or legs
- difficult, frequent, or painful urination
- swelling, itching, burning, or infection in the vagina
- painful erection that lasts for hours
- sudden upset stomach, vomiting, weakness, cramping, bloating, swelling, tightness in hands and feet, dizziness, headache and/or confusion
- skin rash
- swelling of the face, throat, tongue, lips, eyes, hands, feet, ankles, or lower legs
- difficulty breathing or swallowing
- black and tarry stools
- red blood in stools
- bloody vomit
- vomiting material that looks like coffee grounds
The side effects listed above may not include all of the side effects reported by the drug's manufacturer. For more information about any other possible risks associated with this medicine, please read the information provided with the medicine or consult your doctor or pharmacist.
It is important to tell your doctor or pharmacist what medicines you are already taking, including those bought without a prescription and herbal medicines, before you start treatment with this medicine. Similarly, check with your doctor or pharmacist before taking any new medicines while taking this one, to ensure that the combination is safe.