Paroxetine

The U.S. Food and Drug Administration (FDA) has authorized the medication (paroxetine) for the treatment of posttraumatic stress disorder, social anxiety disorder, panic disorder, obsessive-compulsive disorder (OCD), and major depressive disorder. The term “labeled use” refers to the administration of a drug for its authorized uses. In clinical settings, however, doctors frequently write prescriptions for unapproved (or “off-label”) uses of drugs when the safety and effectiveness of those therapies are supported by published clinical research, case reports, or their own clinical experiences. Other mental conditions that can be treated with paroxetine include premenstrual dysphoric disorder and eating disorders including bulimia nervosa, which is typified by symptoms of vomiting and binge eating.

Paroxetine is a medicine that specifically targets serotonin. It increases serotonin levels in the brain by preventing the neurotransmitter from being reabsorbed into brain cells. Abnormally decreased serotonin levels have been linked to depression and other mental illnesses. Affected brain regions may undergo modifications as a result of this anomaly so, giving rise to psychological symptoms like anxiety or sadness. Paroxetine and other selective serotonin reuptake inhibitors (SSRIs) are thought to work by raising serotonin levels which may aid in the return of normal function to particular brain regions.

What is the recommended dose of Paroxetine

Paroxetine is often started at a beginning dose of 20 mg once day, preferably in the morning, for treating depression. The starting dose for the controlled release pill paroxetine CR is 25 mg and to be taken once daily in the morning. The dosage is gradually increased to a maximum daily dosage of 50 mg for paroxetine and 62.5 mg for proxetine CR if no improvement is observed after 3–4 weeks. Lower initial dosages may be necessary for elderly patients and those with serious or long-term medical conditions.

Paroxetine or paroxetine CR doses may need to be started lower for the treatment of various mental illnesses like OCD or panic disorder but increased for the final dosages. the initial dosage for the treatment of panic disorder is 10 mg/day for Paroxetine and 12.5 mg/day for Paroxetine CR, while the recommended daily dosages for Paroxetine and Paroxetine CR are 60 mg and 75 mg, respectively. There is a liquid version of Paroxetine available for those who are unable to swallow tablets. Paroxetine CR is a formulation with controlled release rather than prolonged release. The tablet with controlled release does not act for as long as Paroxetine, but it absorbs more smoothly and causes less gastrointestinal adverse effects, such nausea.

It might take up to 2-4 weeks for the majority of people to feel the full benefits of the medicine. The length of a person’s pharmaceutical therapy is determined by their family history and own psychiatric history. For example, the duration of drug therapy will be greater for individuals who have experienced two or more prior periods attributed to serious depression. After the majority of patients’ depression improves with therapy, the drug may be reduced 6–9 months later. although, a tiny proportion of individuals may experience persistent depression symptoms even after their antidepressant dosage is lowered or discontinued. For a year or more, these people could benefit from continuing to take Paroxetine.

What are the common side effects of Paroxetine

When using Paroxetine, gastrointestinal side effects including as nausea, vomiting, cramps, diarrhea, and heartburn are most commonly reported. The controlled-release pill Paroxetine CR may significantly lessen these negative effects. Patients on Paroxetine may also frequently feel drowsiness and sleepiness during the day. However, due to the SSRIs’ activating effects on the central nervous system, jitteriness, anxiety, and sleeplessness are frequent side effects for many users of these antidepressant medications, including Paroxetine.

Sexual dysfunction is significantly more common in Paroxetine users, both male and female, when using the antidepressant. Men’s and women’s delayed ejaculation and delayed orgasm are the reported sexual adverse effects. Some persons could feel less interested in engaging in sexual activities or have less desire to do so. People occasionally report experiencing headaches, drowsiness, increased perspiration, cramping in the stomach, diarrhea, and constipation. Individuals on Paroxetine may gain weight as well. Patients should talk to their doctor about these adverse effects, particularly if they persist 2-4 weeks after starting treatment. In the event that a rash or other serious symptoms appear, patients should call their doctor right once. 

What are the precautions taken while using Paroxetine 

It’s possible for Paroxetine to make some people sleepy. Until they are convinced that the drug is not impairing their attention or coordination, patients should refrain from using machinery or driving. Paroxetine should not be used by anybody who has a known allergy to the drug or who has had a serious response to it.

Major depressive disorder may often be effectively treated with medication, psychotherapy, or both. When treating moderate to severe depression, the combination of psychotherapy and antidepressants is highly successful. While treatment builds coping skills, the drugs enhance mood, appetite, sleep, energy, and overall health addresses any potential underlying problems and enhances behavior and mental habits.

the majority of those who take antidepressants on their own report feeling better overall. Most people don’t notice any noticeable effects from their antidepressants until about 3–4 weeks, and it might occasionally take as long as that. minority of people may notice some improvement by the end of the first week. It takes eight weeks for the drug to have full effect. it is crucial that patients take their antidepressant for the whole recommended amount of time and that they do not give up and stop taking it too soon once they do not start feeling better right.

Antidepressants have been shown in short-term trials to raise the likelihood of suicidal thoughts and actions in kids and teenagers suffering from severe depressive illness and other mental health issues. When beginning antidepressant therapy in children and adolescents, the FDA mandates that the prescriber disclose this risk to the patient. According to FDA research, there is an age-related risk of suicide thoughts and actions when using antidepressants. This phenomenon is more likely to manifest early in the course of and is more common in the younger population. Antidepressant use did not seem to be associated with a higher incidence of suicidality in people over the age of 24, as compared to placebo use. The results demonstrated that antidepressants protected against suicide thoughts and actions in people over the age of 65.

Suicide risk is a part of depression and may not go away until the patient responds to therapy. Upon initiating or modifying antidepressant therapy, the individual particularly if they are a child or adolescent should have continuously monitored for growing symptoms of depression, and any concerns should be reported to the doctor by the caregiver or family.

If you have suicidal thoughts, you should always tell your doctor or your family. Notify your family doctor or psychiatrist if you feel like you can’t control your suicide thoughts or desires, or if your depression symptoms get worse.

•  Avoid stopping Paroxetine suddenly. It is best to reduce your dosage gradually to avoid the symptoms of abrupt withdrawal. If you forget to take a dosage, make sure to catch up by taking it two to three hours later than usual. If the next planned dosage is approaching, skip the missed one and go on with your usual dosing regimen. 
• Avoid taking two doses at once. 
• You can take Paroxetine with or without meals. 
• Paroxetine CR pills should be swallowed whole; do not chew or crush them.
• Keep the medication out of direct sunlight and dampness in the light-resistant container that came with it. Your drug may break down more quickly in hot and humid environments, losing its therapeutic benefits.
• Make sure kids can’t get to your medicine.

What is the effect of paroxetine on pregnancy and lactation

Paroxetine is pregnancy category C. Paroxetine’s safety during pregnancy has not been investigated in female subjects. It is uncertain how the drug will affect a growing fetus in a pregnant woman. But lately in the third trimester newborns exposed to antidepressants like SSRIs experienced difficulties that necessitated extended hospital stays, breathing assistance and tube feeding. Women who are or may become pregnant should talk to their doctor about this. When they stop taking their antidepressant, some women may have a relapse of depression. In these situations, it can be essential to resume the medicine or look for a different kind of drug or medical care.
Paroxetine should not be taken by nursing moms as minute quantities may find their way into breast milk and are consumed by the infant. Breastfeeding should not begin or should be stopped if quitting the medication is not an option.

What are the possible drug interactions associated with Paroxetine

Because one medicine may change the other’s blood levels, using Paroxetine with several other drugs may have unfavorable drug interactions. When starting any SSRI, Paroxetine may raise the levels of warfarin and its anticoagulant effects, which might lead to bleeding; warfarin medication should be continuously watched. 

Paroxetine may raise TCA concentrations and their potentially harmful effects. Paroxetine may raise blood levels of the antipsychotic drug thioridazine and raise the risk of cardiac arrhythmias. Phenobarbital may lower Paroxetine’s concentration and reduce its efficacy. Phenytoin may lower Paroxetine’s concentration and reduce its efficacy.
Cimetidine may raise Paroxetine levels and raise the risk of adverse effects. When Paroxetine was coupled with sumatriptan, a migraine drug, some individuals experienced jerkiness, weakness, and lack of coordination.

When used with paroxetine, other drugs that increase serotonin, such as herbal supplements like St. John’s wort may cause an excess of that neurotransmitter and cause serotonin syndrome which is a fatal condition. Serotonin syndrome’s initial symptoms include tremors, flushing, restlessness, and confusion and uncontrollably jerking muscles. If the drugs are not discontinued, the patient may experience further potentially fatal side effects such as muscular weakness, a high fever, breathing issues, blood clotting issues, and red blood cell decomposition, which might result in abrupt renal failure. Therefore, those on paroxetine should be aware of the potential symptoms of serotonin syndrome, which call for stopping the serotonin-boosting drugs and seeking quick medical assistance. 

Monoamine oxidase inhibitors (MAOIs), a class of antidepressants, should not be used with paroxetine, as a result of the possibility of a toxic response with a spike in body temperature, a rise in blood pressure, and intense excitement and agitation. It is recommended that patients contact with their doctor or pharmacist prior to starting any new medicine, including over-the-counter drugs and herbal supplements Using paroxetine. Alcohol should be avoided or used in moderation by patients on paroxetine since the combination may make depression worse.

What happens when you take an overdose of Paroxetine

Paroxetine like other SSRIs, is far less dangerous to overdose on than some of the more recent antidepressants and the older TCAs. There are no documented deaths from Paroxetine overdoses on its own. although, when Paroxetine was used alongside other drugs, tragic results have been documented. Treating any suspected overdose as an emergency is imperative. The individual has to be brought to the emergency space for care and observation. It is advisable to bring the prescription bottle of medicine (as well as any additional medication that may have been taken in excess) since the information on the label can be useful in helping the treating physician figure out how many tablets the patient has taken.