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Paxil (paroxetine)

What Are the Side Effects of Paxil

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Updated July 22, 2009

General Information

Paxil is an SSRI antidepressant introduced in 1992 by GlaxoSmithKline. Paxil was the first formally approved SSRI for the treatment of panic disorder in the United States. Paxil is available in a generic equivalent, paroxetine, and is indicated for the treatment of:

Dosage Information

Paxil, and its generic equivalent, paroxetine, are manufactured in scored tablets of 10, 20, 30 and 40 mg. It is also available in a liquid oral solution. Your doctor may begin therapy with a low dose that may be increased if your symptoms do not improve. Starting at a low dose can also minimize some of these side effects because it gives your body time to adjust to the medication. Paxil (paroxetine) is usually taken once each day and may be taken with or without food.

Paxil CR is a controlled-release formula that works by taking a single dose that processes in the body throughout the day. Paxil CR is manufactured in tablets of 12.5, 25 and 37.5 mg.

Side Effects

Some of the common side effects associated with Paxil (paroxetine) therapy include:

  • Weakness
  • Drowsiness
  • Dizziness
  • Nausea
  • Anxiety or nervousness
  • Dry mouth
  • Insomnia
  • Constipation or diarrhea
  • Increased sweating
  • Decreased libido, erectile dysfunction, ejaculatory/orgasmic inability or delay.

Some people experience a reduction in some of these side effects after being on the medication for a while. If they remain bothersome, though, you should consult with your doctor.

If you experience any of the following less common side effects, you should call your doctor right away:

  • Agitation or irritability
  • Restlessness
  • Impulsiveness
  • Hyperactivity
  • Tremors
  • Memory problems

You should get emergency medical attention if you experience any of the following rare, but serious, side effects:

  • Allergic reaction - difficulty breathing; swelling of your face, lips or tongue or difficulty swallowing.
  • Seizures
  • Problems with balance or coordination
  • Confusion
  • Hallucinations
  • Racing or abnormal heart rate
  • Fainting
  • Suicidal thoughts

These are not the only side effects that may be experienced with paroxetine. You should report any bothersome side effects to your doctor or other health care professional.

How Long Does Paxil Take to Work?

Some people experience some improvement of symptoms within one or two weeks of starting paroxetine. Full therapeutic effect, however, may not be achieved for about eight weeks.

Is Paxil Addictive?

Paxil is not believed to be addictive or habit-forming.

What If I Miss a Dose?

Take the missed dose as soon as you remember unless it’s nearly time to take your next dose. Do not take extra Paxil to make up the missed dose.

Precautions and Contraindications

Pregnancy. Recent studies have linked Paxil to an increased risk of birth defects, particularly heart defects, when taken during the first trimester of pregnancy. Some of these defects are mild and resolve without intervention, but some may be quite serious. It has also been suggested that exposure to SSRIs during late pregnancy may increase the risk of persistent pulmonary hypertension, a serious lung disorder, in a newborn.

If you are nursing or are pregnant, it is best to discuss the risks and benefits of SSRI therapy with your doctor.

NSAIDs or Aspirin. Use of Paxil with NSAIDs or aspirin may be associated with an increased risk of bleeding.

Liver Disease. Before taking Paxil, tell your doctor if you have impaired liver function. Depending on your condition, your doctor may need to adjust your dose and perform certain tests while on Paxil therapy.

Alcohol. Drinking alcohol with Paxil should be avoided.

This list is not all-inclusive. Other drug interactions should be avoided and medical issues your doctor may need to consider. Be sure to tell your doctor about all medications, including over-the-counter drugs and supplements, you are taking before beginning paroxetine.

Serotonin Syndrome

Any SSRI antidepressant has a risk of producing a potentially life-threatening condition called "serotonin syndrome." This rare condition is usually the result of an interaction of two or more drugs that affect brain serotonin levels. Even some over-the-counter supplements, such as St. John’s Wort, can result in serotonin syndrome if mixed with SSRIs.

A particularly troublesome interaction is mixing SSRIs with a class of antidepressants called "monoamine oxidase inhibitors" (MAOIs), which should not be taken with SSRIs. It is recommended that Paxil be avoided for two weeks before or after using an MAOI.

SSRI Discontinuation Syndrome

Before discontinuing Paxil, talk with your doctor. Some people have reported withdrawal-like symptoms when decreasing or stopping SSRI therapy. It is believed that these symptoms are the result of the brain trying to stabilize serotonin levels after an abrupt change.

Symptoms that may occur during discontinuation of any SSRI therapy include:

  • Nausea
  • Headache
  • Muscle Aches
  • Dizziness
  • Electric shock-like sensations in the neck and head

While all of these symptoms are not believed to be dangerous, they can be quite upsetting. When discontinuing an SSRI, your doctor may give you a gradual reduction schedule to avoid these withdrawal-like symptoms.

FDA Black Box Warning

The association of increased suicidal thoughts, especially among adolescents, with SSRI treatment has been a center of attention and controversy in recent years. In response to the concerns suggested in case studies and some research, the U.S. Food and Drug Administration (FDA) issued a statement in 2007. The FDA proposed that makers of all antidepressant medications indicate a warning on their products about a possible increased risk of suicidal thinking and behavior in young adults, ages 18 to 24, during initial treatment.

Sources:

Antidepressant Use in Children, Adolescents, and Adults. Revisions to Product Labeling. U.S. Food and Drug Administration. May 2, 2007.

RxList. Zoloft. 09 Oct 2008.

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