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Paroxetine Medication: Uses, Dosage, Side Effects & Safety Tips
Summary of Key Points
Paroxetine is a prescription medication commonly used to treat various mental health conditions, including depression, anxiety disorders, and post-traumatic stress disorder (PTSD). It belongs to a class of medications known as selective serotonin reuptake inhibitors (SSRIs), which work by increasing serotonin levels in the brain. Paroxetine is available in different forms and strengths. Always consult your healthcare provider before starting or adjusting your dose, and consider scheduling a telemedicine appointment with one of our providers for personalized guidance.
Names of Paroxetine Medication
US Brand Names: Paxil, Paxil CR, Pexeva, Brisdelle
Generic Name: Paroxetine
The generic name refers to the active ingredient in the medication, while the brand name is assigned by the manufacturer. In this article, the generic name will be listed in parentheses.
Pharmacologic Category of Paroxetine
Selective Serotonin Reuptake Inhibitors (SSRIs)
Other medications in this category include fluoxetine (Prozac), sertraline (Zoloft), and citalopram (Celexa).
Paroxetine Dosage
Paroxetine is prescribed for several conditions. Your doctor will determine the appropriate dose based on your specific condition and how you respond to treatment. Always consult your healthcare provider before making any changes to your dosage. If you need to discuss your treatment plan, you can schedule a telemedicine appointment with one of our providers.
Paroxetine for Depression
Initial dose: 20 mg once daily
Maintenance dose: 20-50 mg once daily
Duration: Long-term treatment as directed by your doctor
Paroxetine for Generalized Anxiety Disorder (GAD)
Initial dose: 20 mg once daily
Maintenance dose: 20-50 mg once daily
Duration: Long-term treatment as directed by your doctor
Paroxetine for Social Anxiety Disorder
Initial dose: 10 mg once daily
Maintenance dose: 10-40 mg once daily
Duration: Long-term treatment as directed by your doctor
Paroxetine for Panic Disorder
Initial dose: 10 mg once daily
Maintenance dose: 10-60 mg once daily
Duration: Long-term treatment as directed by your doctor
Paroxetine for Obsessive-Compulsive Disorder (OCD)
Initial dose: 20 mg once daily
Maintenance dose: 20-60 mg once daily
Duration: Long-term treatment as directed by your doctor
Paroxetine for Post-Traumatic Stress Disorder (PTSD)
Initial dose: 20 mg once daily
Maintenance dose: 20-50 mg once daily
Duration: Long-term treatment as directed by your doctor
Paroxetine for Premenstrual Dysphoric Disorder (PMDD)
Initial dose: 12.5 mg once daily
Maintenance dose: 12.5-25 mg once daily
Duration: Taken continuously or during the luteal phase of the menstrual cycle, as directed by your doctor
Paroxetine for Chronic Pain
Initial dose: 20 mg once daily
Maintenance dose: 20-50 mg once daily
Duration: As directed by your doctor
Paroxetine for Eating Disorders
Initial dose: 20 mg once daily
Maintenance dose: 20-60 mg once daily
Duration: As directed by your doctor
Paroxetine for Insomnia
Initial dose: 10 mg once daily
Maintenance dose: 10-40 mg once daily
Duration: As directed by your doctor
Dosage Forms and Strengths of Paroxetine
Tablets: 10 mg, 20 mg, 30 mg, 40 mg
Controlled-release tablets (Paxil CR): 12.5 mg, 25 mg, 37.5 mg
Oral suspension: 10 mg/5 mL
How to Take Paroxetine Safely
Paroxetine should be taken once daily, preferably in the morning, with or without food. If you experience stomach discomfort, taking it with food may help. Swallow the tablets whole; do not crush or chew them. If you miss a dose, take it as soon as you remember, unless it is almost time for your next dose. In that case, skip the missed dose and continue with your regular schedule. Do not take two doses at once.
Contraindications for Paroxetine
A contraindication is a specific situation or condition where a medication should not be used because it may cause harm or worsen the condition. If you have any of the following conditions, taking Paroxetine may not be safe for you. Always consult with your healthcare provider before starting any new medication. If you are unsure, you can schedule a telemedicine visit with one of our providers.
Allergy to Paroxetine: If you have had an allergic reaction to Paroxetine or any of its ingredients, you should not take this medication. Allergic reactions can include rash, itching, swelling, or difficulty breathing.
Use of Monoamine Oxidase Inhibitors (MAOIs): Taking Paroxetine with MAOIs (such as phenelzine or tranylcypromine) can lead to a dangerous drug interaction called serotonin syndrome, which can cause confusion, high blood pressure, and even death. You must wait at least 14 days after stopping an MAOI before starting Paroxetine.
Thioridazine or Pimozide: These medications can cause serious heart rhythm problems when taken with Paroxetine. Combining these drugs can increase the risk of a life-threatening condition called QT prolongation.
Pregnancy (third trimester): Paroxetine has been associated with an increased risk of birth defects, particularly when taken during the third trimester. If you are pregnant or planning to become pregnant, discuss alternative treatments with your healthcare provider.
Severe Liver or Kidney Disease: Paroxetine is processed by the liver and kidneys. If you have severe liver or kidney disease, your body may not be able to clear the medication properly, leading to an increased risk of side effects.
Paroxetine Drug Interactions
Paroxetine can interact with other medications, which may increase the risk of side effects or reduce the effectiveness of either drug. Always inform your healthcare provider about all the medications you are taking, including over-the-counter drugs, supplements, and herbal products. Below are some common medications that may interact with Paroxetine:
Warfarin (Coumadin): Paroxetine may increase the risk of bleeding when taken with blood thinners like warfarin.
Aspirin and NSAIDs (e.g., ibuprofen, naproxen): These medications can increase the risk of gastrointestinal bleeding when combined with Paroxetine.
Triptans (e.g., sumatriptan, rizatriptan): These migraine medications can increase the risk of serotonin syndrome when taken with Paroxetine.
Other SSRIs or SNRIs (e.g., fluoxetine, sertraline, venlafaxine): Combining Paroxetine with other antidepressants that affect serotonin levels can increase the risk of serotonin syndrome.
St. John’s Wort: This herbal supplement can increase the risk of serotonin syndrome when taken with Paroxetine.
Linezolid (Zyvox): This antibiotic can increase serotonin levels and lead to serotonin syndrome when combined with Paroxetine.
Paroxetine in Pregnancy
Is it safe to take Paroxetine during pregnancy?
Paroxetine is generally not recommended during pregnancy, particularly in the third trimester, due to the potential risk of birth defects and complications such as persistent pulmonary hypertension of the newborn (PPHN). However, untreated depression or anxiety during pregnancy also carries risks for both the mother and baby. If you are pregnant or planning to become pregnant, it’s important to discuss the risks and benefits of continuing Paroxetine with your healthcare provider. They may suggest alternative treatments or adjust your dosage to ensure the best outcome for you and your baby. You can also schedule a telemedicine appointment with one of our providers to explore your options.
Paroxetine while Breastfeeding
Is it safe to take Paroxetine while breastfeeding?
Paroxetine does pass into breast milk in small amounts. While some studies suggest it may be safe during breastfeeding, there is a potential risk of side effects in the infant, such as irritability, poor feeding, or sleep disturbances. If you are breastfeeding or planning to breastfeed, it’s essential to consult your healthcare provider to weigh the risks and benefits. They may recommend monitoring your baby for any signs of side effects or suggest alternative treatments. Our providers are available via telemedicine to help you make the best decision for your situation.
Estimated Cost of Paroxetine Medication
The cost of a 30-day supply of Paroxetine can vary depending on the dosage and the pharmacy. Without insurance, the estimated cost for a 30-day supply of Paroxetine (20 mg) using a GoodRx coupon ranges from approximately $4 to $15. Prices may fluctuate, so it’s a good idea to check with your pharmacy or use a discount service like GoodRx to find the best price available.
Possible Alternatives to Paroxetine
If Paroxetine is not the right medication for you, there are alternative treatments and lifestyle changes that may help manage your condition. Always discuss these options with your healthcare provider before making any changes to your treatment plan. Our telemedicine providers are available to help you explore these alternatives.
Alternatives for Depression
Other antidepressants, such as sertraline (Zoloft), fluoxetine (Prozac), or bupropion (Wellbutrin), may be effective options. Additionally, cognitive-behavioral therapy (CBT), regular physical activity, and mindfulness practices can help manage symptoms of depression.
Alternatives for Generalized Anxiety Disorder
Medications like escitalopram (Lexapro) or buspirone (Buspar) may be suitable alternatives. Relaxation techniques, yoga, and therapy can also provide relief.
Alternatives for Social Anxiety Disorder
Medications such as venlafaxine (Effexor) or beta-blockers (e.g., propranolol) may be helpful. Cognitive-behavioral therapy (CBT) is also a highly effective treatment for social anxiety.
Alternatives for Panic Disorder
Other SSRIs, such as fluoxetine (Prozac), or benzodiazepines (e.g., clonazepam), may be considered. Breathing exercises and exposure therapy can also help manage panic attacks.
Alternatives for Obsessive-Compulsive Disorder (OCD)
Clomipramine (Anafranil) or fluvoxamine (Luvox) are potential alternatives. Exposure and response prevention (ERP) therapy is a key non-medication treatment for OCD.
Alternatives for Post-Traumatic Stress Disorder (PTSD)
Sertraline (Zoloft) or venlafaxine (Effexor) are commonly prescribed for PTSD. Trauma-focused therapies, such as Eye Movement Desensitization and Reprocessing (EMDR), can also be highly effective.
Alternatives for Premenstrual Dysphoric Disorder (PMDD)
Fluoxetine (Sarafem) or certain birth control pills may be considered. Lifestyle changes, including regular exercise and a balanced diet, can also help alleviate symptoms.
Alternatives for Chronic Pain
Duloxetine (Cymbalta) or gabapentin (Neurontin) may be used to manage chronic pain. Non-medication options, such as physical therapy and acupuncture, can also provide relief.
Alternatives for Eating Disorders
Fluoxetine (Prozac) or olanzapine (Zyprexa) may be prescribed for certain eating disorders. Nutritional counseling and therapy are essential components of a comprehensive treatment plan.
Alternatives for Insomnia
Medications like trazodone or non-medication approaches, such as cognitive-behavioral therapy for insomnia (CBT-I), may be helpful. Practicing good sleep hygiene, such as maintaining a consistent sleep schedule, can also improve sleep quality.
Recent Updates on Paroxetine Research
Recent studies on Paroxetine have focused on its long-term safety and effectiveness. Some research has explored its use in treating conditions beyond depression and anxiety, such as chronic pain and hot flashes in menopausal women. Additionally, ongoing studies are investigating the potential for Paroxetine to be used in combination with other medications to enhance its effectiveness while minimizing side effects. However, more research is needed to confirm these findings. If you are interested in learning more about the latest research on Paroxetine or are considering a change in your treatment, we encourage you to schedule a telemedicine visit with one of our providers to discuss your options.
