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Paroxetine
Last reviewed: 03.07.2025
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Indications Paroxetine
It is used to treat the following conditions:
- generalized anxiety disorder;
- social phobia;
- panic disorders, including agoraphobia;
- OCD;
- any form of depression, including reactive, endogenous, and also accompanied by a feeling of anxiety.
Release form
The drug is released in tablets, in the amount of 10 pieces inside a blister pack. There are 3 such packs in a box.
Pharmacodynamics
The antidepressant effect and therapeutic efficacy of the drug during the treatment of panic disorders and OCD are developed by specifically slowing down the processes of 5-hydroxytryptamine uptake by brain neurons. The chemical structure of the drug differs from tricyclics, tetracyclics and other known antidepressants.
The drug has a weak affinity for cholinergic muscarine endings. Paroxetine differs from tricyclics in that it has a weak affinity for α1-, α2-, and also dopamine (D2), histamine (H1), 5-HT2- and 5-HT1-like endings, as well as for β-adrenergic receptors.
The drug does not affect the functioning of the cardiovascular system, and in addition, does not lead to the development of clinically significant changes in heart rate, blood pressure, and ECG values.
The drug also differs from antidepressants that slow down the process of norepinephrine uptake. It has a much weaker effect on the antihypertensive properties of guanethidine.
Pharmacokinetics
The active element of the drug is absorbed from the gastrointestinal tract at high speed, after which it undergoes intrahepatic metabolism. The substance undergoes extensive tissue distribution (only 1% of the drug is found in the plasma). Protein synthesis is 95%.
About 64% of the drug is excreted in the urine, and another 36% is excreted in the bile through the intestines. Less than 1% of the drug is excreted unchanged.
The levels of the active ingredient Paroxetine increase in elderly people and people with liver or kidney problems.
Dosing and administration
The medicine should be taken once a day, with food; the tablets are not chewed, but swallowed with plain water. Within the period of 14-21 days, the dosage is selected separately for each patient, adjusting it later.
In case of depression, the substance should be taken once a day, 20 mg. If necessary, the portion can be increased (+10 mg per day), but not more than 50 mg per day.
To treat OCD, at the initial stage, 20 mg of the substance is taken per day, and later the dose is increased - daily +10 mg, until the daily dosage is 40 mg.
In case of anxiety disorders of a generalized nature, 20 mg of the drug is taken per day. To prevent the occurrence of withdrawal syndrome, it is necessary to stop taking the drug gradually.
To treat social phobia or social anxiety disorder, take 20 mg of the drug daily. If there is no result after 14 days of taking the medication, the dose is increased (the daily maximum is 50 mg). The dosage is increased weekly by 10 mg.
For the treatment of panic disorders, 10 mg of the drug is initially taken per day, after which the dose is increased daily by 10 mg until it reaches 40 mg.
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Use Paroxetine during pregnancy
It is prohibited to use the medication during pregnancy.
Contraindications
Among the contraindications:
- the presence of severe sensitivity to the components of the drug;
- breastfeeding period;
- epilepsy of an unstable nature;
- combined use with MAOIs (and within 14 days after discontinuing their use).
Caution is required when using in the following cases:
- diseases that increase bleeding;
- combined use with medications that increase bleeding;
- during electropulse treatment;
- epileptic seizures or convulsions;
- prostate hyperplasia;
- heart disease;
- mania;
- closed-angle glaucoma;
- liver or kidney failure.
Side effects Paroxetine
The use of the drug may provoke the development of some side effects:
- disorders of the secretion of antidiuretic hormone, hyperhidrosis, and hyponatremia;
- urticaria, allergic rashes, Quincke's edema and ecchymosis;
- orthostatic collapse;
- constipation or diarrhea, vomiting, hepatitis, dry mouth, taste disorders, nausea, decreased or increased appetite;
- hyperprolactinemia or galactorrhea, as well as anorgasmia and sexual dysfunction, including impotence and problems with ejaculation;
- delay or increased frequency of urination;
- feeling of muscle weakness, myopathy, myoclonus, arthralgia or myalgia;
- visual impairment;
- feelings of anxiety, confusion, nervousness, fatigue or drowsiness. Amnesia, agitation, hallucinations, panic attacks and feelings of depersonalization, as well as mania, seizures, insomnia, extrapyramidal disturbances and dizziness. In addition, tremors, serotonin intoxication and asthenia.
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Overdose
Intoxication can cause vomiting with nausea, bradycardia, nodal rhythm, convulsions, hyperhidrosis, sinus tachycardia, as well as agitation, a feeling of drowsiness or irritability, nystagmus, mydriasis, dry mouth and increased blood pressure.
Occasionally (mainly in combination with other psychotropic drugs or alcoholic beverages), changes in ECG readings or a comatose state are observed.
Severe poisoning leads to the development of serotonin intoxication and, sometimes, rhabdomyolysis.
Interactions with other drugs
Combination with warfarin may cause hemorrhagic syndrome.
It is forbidden to drink alcoholic beverages during treatment with Paroxetine.
Combination with class 1 antiarrhythmic drugs (such as propafenone or flecainide), sumatriptan, fluoxetine and thioridazine increases the likelihood of adverse effects.
Phenobarbital with primidone reduce the level of bioavailability of the drug. The drug itself suppresses the metabolic processes of tricyclics (such as imipramine with desipramine, as well as amitriptyline) and astemizole, increasing their blood values and increasing the likelihood of side effects.
This drug is incompatible with tryptophan, lithium salts and MAOIs (including procarbazine and furazolide with selegiline). Antacids do not affect the degree of drug absorption.
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Storage conditions
Paroxetine should be kept in a place protected from sunlight. Temperature values are within 25°C.
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Shelf life
Paroxetine can be used within 36 months from the date of manufacture of the therapeutic agent.
Application for children
The use of Paroxetine in pediatrics is prohibited.
Analogues
Analogues of the drug are such drugs as Rexetin with Paxil and Adepress.
Reviews
Paroxetine is considered to be a fairly effective drug - reviews from specialists indicate a good result of its impact and the rare occurrence of negative symptoms. It is also recommended to take into account that the drug affects coordination, which is why it cannot be used by drivers and people with an active lifestyle.
Attention!
To simplify the perception of information, this instruction for use of the drug "Paroxetine" translated and presented in a special form on the basis of the official instructions for medical use of the drug. Before use read the annotation that came directly to medicines.
Description provided for informational purposes and is not a guide to self-healing. The need for this drug, the purpose of the treatment regimen, methods and dose of the drug is determined solely by the attending physician. Self-medication is dangerous for your health.