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Paroxetine HCL (Paxil)

 

Paroxetine HCL (generic Paxil) Review

brand names: Paxil CR, Pexeva, Paxil
generic name: Paroxetine

How does it work?

Seroxat tablets and liquid contain the active ingredient paroxetine, which is a type of antidepressant known as a selective serotonin reuptake inhibitor (SSRI) . This type of medicine acts on nerve cells in the brain. (NB. Paroxetine is also available without a brand name, ie as the generic medicine.)

In the brain there are numerous different chemical compounds called neurotransmitters. These act as chemical messengers between the nerve cells. Serotonin is one such neurotransmitter and has various functions that we know of.

When serotonin is released from nerve cells in the brain it acts to lighten mood. When it is reabsorbed into the nerve cells, it no longer has an effect on mood. It is thought that when depression occurs, there may be a decreased amount of serotonin released from nerve cells in the brain.

SSRIs work by preventing serotonin from being reabsorbed back into the nerve cells in the brain. This helps prolong the mood lightening effect of any released serotonin. In this way, paroxetine helps relieve depression, panic and fear.

Paroxetine may also be used in the treatment of anxiety disorders including obsessive-compulsive disorder, post-traumatic stress disorder and generalised anxiety disorder.

It may take between two to four weeks for the benefits of this medicine to appear, so it is very important that you keep taking it, even if it doesn't seem to make much difference at first. If you feel your depression or anxiety has got worse, or if you have any distressing thoughts or feelings in these first few weeks, then you should talk to your doctor.

It is recommended that you take your dose of this medicine in the morning, with or after food.

What drug(s) may interact with Paroxetine (Paxil)?

Paroxetine has the potential to interact with a variety of medications, check with your healthcare professional. The following list contains some of these interactions.

Do not take Paroxetine with any of the following medications:
•astemizole (Hismanal ® CR™ )

Paroxetine may also interact with the following medications:
•antacids (interacts with Paxil ® ), selegiline (Eldepryl ® ), isocarboxazid (Marplan ® ), tranylcypromine (Parnate ® )
•medicines called MAO inhibitors-phenelzine (Nardil ® )
•thioridazine (Mellaril ® )
•terfenadine (Seldane ® )
•pimozide (Orap ® )
•cisapride (Propulsid ® only)
•alcohol
•amphetamine
•certain diet drugs (dexfenfluramine, fenfluramine, phentermine, sibutramine)
•certain migraine headache medicines (almotriptan, eletriptan, frovatriptan, naratriptan, rizatriptan, sumatriptan, zolmitriptan)
•cimetidine
•dextroamphetamine
•dextromethorphan
•digoxin
•doxercalciferol
•fosphenytoin
•furazolidone
•linezolid
•lithium
•medicines for psychotic disturbances
•other medicines for mental depression, mania, anxiety, or difficulty sleeping
•medicines for regulating heart rhythm or blood pressure
•phenobarbital
•phenytoin
•prescription pain medications
•primidone
•procarbazine
•selegiline
•St. John's wort, nutritional supplements, including non-prescription medicines, Hypericum perforatum
•theophylline
•tramadol
•warfarin

Tell your prescriber or health care professional about all other medicines you are taking, and herbal products. Also tell your prescriber or health care professional if you are a frequent user of drinks with caffeine or alcohol, if you smoke, or if you use illegal drugs. These may affect the way your medicine works. Check with your health care professional before stopping or starting any of your medicines.

What is Paroxetine (Paxil)?

Paroxetine is an antidepressant in a group of drugs called selective serotonin reuptake inhibitors (SSRIs). Paroxetine (Paxil) affects chemicals in the brain that may become unbalanced.

Paroxetine (Paxil) may also be used for purposes other than those listed in this medication guide.

Paroxetine is used to treat depression, post-traumatic stress disorder (PTSD), anxiety disorders, obsessive-compulsive disorder, and premenstrual dysphoric disorder (PMDD).

Why is Paxil prescribed?

Paxil relieves a variety of emotional problems. It can be prescribed for serious, continuing depression that interferes with your ability to function. Symptoms of this type of depression often include changes in appetite and sleep patterns, difficulty concentrating, suicidal thoughts, feelings of guilt or worthlessness, decreased sex drive, loss of interest in people and activities, a persistent low mood, and slowed thinking.

Paxil is also used to treat obsessive-compulsive disorder (OCD), but stubbornly persistent thoughts, a disease marked by unwanted, or unreasonable rituals you feel compelled to repeat.

In addition, Paxil is prescribed for panic disorder, a crippling emotional problem characterized by sudden attacks of at least four of the following symptoms: palpitations, sweating, shaking, numbness, chills or hot flashes, shortness of breath, a feeling of choking, chest pain, nausea or abdominal distress, dizziness or faintness, feelings of unreality or detachment, fear of losing control, or fear of dying.

Paxil can be prescribed for generalized anxiety disorder, a disease marked by excessive anxiety and worry that persists for at least 6 months and can't be easily controlled. True cases of generalized anxiety disorder are accompanied by at least three of the following symptoms: restlessness or a keyed-up or on-edge feeling, a tendency to tire easily, difficulty concentrating or spells when the mind goes blank, irritability, muscle tension, or sleep disturbance.

Paxil can be used in the treatment of social anxiety disorder (also known as social phobia), a condition marked by shyness or stage fright so intense that it interferes with an individual's work and social life.

Paxil is also prescribed for post-traumatic stress disorder--a crippling condition that sometimes develops in reaction to a disastrous or horrifying experience. Symptoms, poor sleep, irritability, jumpiness, a general numbing of interest and enjoyment, intense distress when confronted with reminders of the event, include unwanted memories and dreams, which stubbornly refuse to abate, and loss of concentration.

How can this medicine affect other medicines?

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 .

Paroxetine should not be taken at the same time as monoamine oxidase inhibitor medicines (MAOIs). These include monoamine oxidase inhibitor antidepressants such as phenelzine and moclobemide, the antibiotic linezolid and the anti-Parkinson's medicine selegeline. Paroxetine (Paxil) should not be started until at least at least a day after stopping moclobemide or linezolid, and at least two weeks after stopping other monoamine oxidase inhibitors. Similarly, treatment with any MAOIs should not be started until at least one week after stopping treatment with Paroxetine.

The amount of Paroxetine (Paxil) in the blood may be decreased by antiepileptic medicines such as phenytoin, carbamazepine and phenobarbital. If you start taking any of these you should let your doctor know if you think your Paroxetine has become less effective.

Paroxetine (Paxil) may increase the blood levels of the following medicines:

• metoprolol.
  
  
• propafenone
  
  
• procyclidine
  
  
• atomoxetine
  
  
• some tricyclic antidepressants (clomipramine, imipramine, desipramine, trimipramine)
  
  
• antipsychotic medicines, such as thioridazine, risperidone, perphenazine, clozapine, aripiprazole, and pimozide (Paroxetine (Paxil) must not be taken by people taking thioridazine or pimozide)
  
  

There may be an increase in side effects if Paroxetine is taken with the herbal remedy St John's wort (Hypericum perforatum). St John's wort should not be taken with Paroxetine (Paxil).

If Paroxetine is taken with other medicines that enhance serotonin in the brain, there may be an increased risk of side effects such as restlessness and diarrhoea, agitation, known as the 'serotonin syndrome'. Other medicines that increase serotonin activity include the following:

• triptans for migraine, such as sumatriptan.
  
  
• tryptophan
  
  
• tramadol
  
  
• the herbal St John's wort (Hypericum perforatum) - you should not take this in combination with Paroxetine (Paxil)
  
  
• sibutramine
  
  
• rasagiline
  
  
• lithium
  
  
• certain other antidepressants
  
  

There may be an increased risk of bleeding if Paroxetine (Paxil) is taken by people who are taking any of the following medicines, which are known to affect the ability of the blood to clot:

• tricyclic antidepressants.
  
  
• some antisickness medicines, eg prochlorperazine
  
  
• some antipsychotic medicines, eg clozapine, chlorpromazine
  
  
• non-steroidal anti-inflammatory drugs (NSAIDs) eg ibuprofen, diclofenac
  
  
• antiplatelet medicines such as aspirin, dipyridamole or ticlopidine
  
  
• anticoagulants such as warfarin
  
  

People with diabetes may find that treatment with Paroxetine (Paxil) alters control of their blood sugar. As a result, they may need an adjustment in their dose of insulin or antidiabetic tablets. Ask your doctor or pharmacist for more information and advice.

What should I watch for while taking Paroxetine (Paxil)?

Visit your prescriber or health care professional for regular checks on your progress. Continue to take your tablets even if you do not immediately feel better. It can take several weeks before you feel the full effect of Paroxetine.

Patients and their families should watch out for worsening depression or thoughts of suicide. Also watch out for sudden or severe changes in feelings such as overly excited and hyperactive, severely restless, impulsive, aggressive, hostile, irritable, panicky, agitated, feeling anxious, or not being able to sleep. If this happens, especially at the beginning of antidepressant treatment or after a change in dose, call your health care professional.

If you have been taking Paroxetine (Paxil) regularly for some time, do not suddenly stop taking it. You must gradually reduce the dose or your symptoms may get worse. Ask your prescriber or health care professional for advice.

You may get drowsy or dizzy. Do not drive, use machinery, or do anything that needs mental alertness until you know how Paroxetine affects you. Do not stand or sit up quickly, especially if you are an older patient. This reduces the risk of dizzy or fainting spells. Alcohol can increase or decrease the effects of Paroxetine (Paxil). Avoid alcoholic drinks.

If you are pregnant or planning a pregnancy and receive Paroxetine, you should discuss other medication options with your health care provider. In some studies, Paroxetine (Paxil) has been shown to increase the risk for heart problems in infants born to women who received Paroxetine early in pregnancy.

Do not treat yourself for coughs, colds or allergies without asking your prescriber or health care professional for advice. Some ingredients can increase possible side effects.

Your mouth may get dry. Chewing sugarless gum or sucking hard candy, and drinking plenty of water will help.

If you are going to have surgery, tell your prescriber or health care professional that you are taking Paroxetine (Paxil).