Paxil

The drug Paxil (synonyms - Paroxetine, Paroxetine hydrochloride, Paroxin, Adepress. Actaparoxetine, Seroxat, Rexetin, etc.) belongs to selective serotonin reuptake inhibitors - antidepressants of the SSRI group.

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Indications Paxil

Indications for the use of this drug are depressive states and mental disorders such as:

• reactive depression;
• atypical depression:
• postpsychotic (postschizophrenic) depression;
• post-traumatic depression;
• dysthymia (chronic subdepression);
• obsessive-compulsive disorder;
• mental disorders with attacks of anxiety and agoraphobia (fear of open spaces);
• panic attacks, social phobias.

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Release form

The drug is available in the form of film-coated tablets of 20 mg (on a blister).

Pharmacodynamics

The principle of action of Paxil, like all drugs of the SSRI group, is based on the theory of depression arising due to deficiency of the monoamine transmitter of the central nervous system serotonin in interneuronal synapses that conduct nerve impulses. The mechanism of therapeutic action of Paxil is due to the ability of the active substance of the drug - paroxetine hydrochloride - to selectively stop the reuptake of serotonin by presynaptic neurons that secrete it.

As a result, the level of free serotonin in the synaptic cleft between the presynaptic and postsynaptic membranes increases significantly. This stimulates serotonin receptors of the central and peripheral nervous systems, and the increase in serotonergic activity leads to thymoanaleptic and sedative effects - improvement of mood, sleep and cognitive functions in depressive states and mental disorders, including suicidal thoughts.

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Pharmacokinetics

The pharmacokinetics of Paxil (paroxetine hydrochloride) is nonlinear, meaning that increasing its dose results in a disproportionate increase in the blood level of the drug. However, long-term use of the drug does not cause a cumulative effect.

After oral administration of Paxil, it is absorbed from the gastrointestinal tract; up to 96% of the active substance actively binds to blood plasma proteins.

Paxil (paroxetine hydrochloride) is transformed in the liver to inactive metabolites, which are excreted through the kidneys. The average half-life is 15-24 hours. After 6-7 days of regular use of this drug, its steady state concentration is reached. It should be noted that the level of Paxil concentration in patients aged 65 years and older may be much higher than in younger patients.

Dosing and administration

The standard single dose of Paxil is one tablet (20 mg); the tablet is taken whole once a day - in the morning, regardless of food.

If the treatment does not give positive results, the doctor may increase the dose to 40-50 mg per day, increasing the dosage by 10 mg per week. The optimal duration of the treatment course is 4 months.

When stopping Paxil, the dose should be reduced gradually - by 10 mg per week.

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Use Paxil during pregnancy

The use of Paxil during pregnancy is permitted only in exceptional cases - as prescribed by a doctor and under his supervision. In the late stages of pregnancy, Paxil is strictly contraindicated.

Contraindications

Paxil is contraindicated in cases of hypersensitivity to paroxetine, in patients under 18 years of age, in women during breastfeeding, and in patients taking monoamine oxidase inhibitors (tryptophan, pimozide, thioridazine, etc.).

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Side effects Paxil

Side effects of Paxil include: nausea, vomiting, headaches, decreased blood pressure, tachycardia, sleep disturbances, loss of appetite, feelings of restlessness and anxiety, decreased libido, impotence.

Taking Paxil may also be accompanied by dry mouth, increased sweating, swelling of the face, fainting, convulsions, weight gain, and problems with stool.

There is a possibility of "serotonin syndrome", which is expressed in such symptoms as overexcitation, abnormal behavior, confusion, involuntary twitching of the muscles of the limbs, and an increase in body temperature. In this case, an urgent call to the doctor is necessary.

In addition, during the first weeks of therapy, the patient may experience suicidal thoughts, for this reason his condition should be constantly monitored.

Overdose

Overdose of Paxil leads to nausea, vomiting, dizziness, convulsions, urinary retention, cardiac arrhythmia. Coma is possible. There is no specific antidote for paroxetine hydrochloride. Measures to eliminate the consequences of an overdose include gastric lavage, inducing vomiting, and taking adsorbents.

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Interactions with other drugs

Paxil interacts with other drugs as follows:

• incompatible with antidepressants-MAO (monoamine oxidase) inhibitors,
• use simultaneously with St. John's wort, tramadol, lithium, dextromethorphan and dihydroergotamine leads to "serotonin syndrome"
• enhances the effect of drugs containing ethyl alcohol,
• increases the duration of bleeding when used concomitantly with anticoagulant drugs.

Paxil can be used simultaneously with anticonvulsants and sleeping pills (as indicated).

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Storage conditions

The optimal storage conditions for Paxil are: out of the reach of children, protected from light, at a temperature of +18 to +28°C.

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Shelf life

The shelf life is three years from the date of manufacture.

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