Paroxetine

Brand names of paroxetine

  • Paxil

Depression is an issue around the world that affects numerous people everywhere. An oral drug known as paroxetine can be used to treat depression. It is listed in a group of drugs that is known as SSRIs (selective serotonin reuptake inhibitors); the group also contains citalopram (Celexa), fluoxetine (Prozac), and sertraline (Zoloft). Paroxetine works on the chemicals in the nerves inside the brain used for communication, called neurotransmitters. These neurotransmitters are produced and released in the brain by nerves, and then they move to other nearby nerves and attach themselves to those nerves. Thus, neurotransmitters are considered to be the communication system in the brain. Serotonin is one of the neurotransmitter that the nerves in the brain release. It either moves between the spaces among the nerves, attaching itself to receptors of the nerves that are nearby (these receptors are on the surface of the nerves) or they either get attached to the receptors of the very nerves that it has been produced by, it is then again taken and released by the nerve (this process is called re-uptake).

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It is believed by numerous experts that the imbalance of neurotransmitters is what causes depression. Paroxetine is what prevents the reuptake of serotonin after its release. The mechanism of reuptake is important, as it removes the released neurotransmitters and its action is terminated on the nerves nearby, free serotonin is increased as uptake is reduced by paroxetine, stimulating the nerve cells. This medicine had been approved by FDA on December 1992.

Things you need to tell your physician before taking paroxetine

If you are allergic to paroxetine then before taking it you should tell your doctor, and even about other allergies if you have any. Paroxetine may have some inactive ingredients by which allergic reactions can be caused. Ask the doctor for deeper information. Your medical history should be disclosed to the doctor, yours and your family history as well, especially of manic-depression/bipolar, liver problems, being suicidal, seizures, kidney problems, intestinal bleeding/ulcers, low sodium in the blood, glaucoma (narrow-angle type). The drug can cause you to feel drowsy, dizzy or even blur your vision. Hence it is not advisable to use machinery, drive, or attempt any activity that needs a clear vision or alertness, until you are fully assured that you can perform the activity.

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All alcoholic beverages should be avoided. In case of surgery, your dentist or doctor should be aware of every product that's used by you (the prescribed drugs, herbal products, non-prescribed drugs). Older people can be more affected by the drugs' side effects, mainly bleeding. They are more likely of developing hyponatremia (a sort of salt imbalance), especially if water pills (diuretics) have also been taken. These side effects can be harsher on children as well and may result in weight loss and loss of appetite. The height and weight of children that are prescribed this drug should be monitored. Pregnant women are not to use this medication as it can put the unborn child at risk. Also, pregnant women using this drug before three months of their delivery, the baby may develop symptoms of breathing/feeding difficulties, symptoms of withdrawal, seizures, constant crying and muscle stiffness. If any such symptoms are seen in the baby, the doctor should be consulted at once. Depression that is not treated can be serious, so this medication should not be stopped unless the doctor says so. If you become pregnant, or are thinking of pregnancy, or probably already pregnant, your doctor should be consulted at once and know about the usage of the drug at the time of pregnancy. This drug mixes with breast milk, take doctors advice before you breast-feed your child.

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Usage

Paroxetine even treats obsessive-compulsive disorder, panic attacks, post-traumatic stress disorder and anxiety disorders other than depression. Paroxetine is effective as it balances the serotonin (a natural substance) that's in the brain, it is also known as SSRI (selective serotonin reuptake inhibitor). This drug is able to improve your sleep, mood, energy levels, appetite and interest in daily life. It is able to reduce anxiety, fear, panic attacks and unwanted thoughts. It can also reduce compulsive behaviour (repeated behaviour) such as checking, counting and hand-washing. This drug can also be taken for treating severe form of premenstrual syndrome.

How to use paroxetine

You get paroxetine as suspension (liquid), controlled-release (long-acting) and in tablet form, which is to be swallowed. Usually it is to be taken once a day, either in the evening or morning, without food or with food. Paroxetine can be taken with food if stomach upset is to be prevented. Paroxetine should be taken at the same time daily, the prescribed direction should be followed carefully, and any part that you don't understand should be cleared out by the pharmacist or your doctor. Never take more or less than the quantity that is prescribed to you.

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Before taking the liquid it should be shaken well so that the medication is mixed evenly.

The extended release and regular tablets need to be swallowed whole, should not be crushed or chewed.

You may be prescribed a low dosage at first and gradually your dose may increase, once a week.

You must remember that your condition is controlled by paroxetine but not cured. The effects may take many weeks or more, before its whole benefit is felt. Even after you feel better, you should still continue taking the medication. It should not be stopped before consulting your doctor, who may reduce your dosage, but if it is suddenly stopped, then you may experience symptoms like mood changes, depression, abnormal excited moods, anxiety, irritability, dizziness, confusion, tiredness, headache, numbness in your hands, legs, feet and arms, difficulty to sleep, strange dreams, sweating or nausea, if any such symptoms are experienced even after the dose has been reduced then you should consult your doctor.

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How paroxetine works

Paroxetine works on the serotonin levels, a chemical in the brain, which is believed to be linked with our mental state, emotions and mood.

Side effects

Serious:
  • agitation or irritability
  • dilated pupils
  • muscle pain
  • fainting
  • fatigue
  • light-headedness
  • rapid heartbeat
  • rash
  • severe drowsiness
  • severe dry mouth
  • severe nausea or vomiting
  • trembling
Common:
  • constipation
  • difficulty urinating
  • dizziness
  • headache
  • insomnia
  • loss of initiative
  • nausea or vomiting
  • sexual dysfunction
  • trembling
  • unusual fatigue
Less common:
  • blurred vision
  • burning feeling
  • change in sense of taste
  • decreased or increased appetite
  • decreased sexual desire
  • heartbeat irregularities
  • tingling
  • weight loss or gain

Possible interactions

Herbal medicines or minerals:
St. John's wort also acts in increasing serotonin, but St. John's wort and paroxetine are not advised to be taken in combination. Since ginseng partly works on inhibiting MAO, hence paroxetine and ginseng should not be combined. Yohimbe, kava kava, ma huang and Indian snakeroot should be avoided as well, when paroxetine is being taken.
Alcohol:
Alcohol should be avoided during medication as recommended by the manufacturer.
Marijuana smoking:
Marijuana smoking can cause additive sedation.
Exposure to heat:
Paroxetine causes excessive sweating. In case of much activity or being in hot environment, then sufficient fluids should be taken so that you can avoid getting dehydrated.
Heavy exercise or exertion:
Since excess sweating is caused by this medicine, make sure that the lost fluids are replaced.

Discontinuation

This medicine is not to be stopped without consulting your doctor. For patients that take over 40 mg a day or have been taking it for a long period, gradual dosage decrease (tapering) is recommended over many days.

Storage instructions

The medicine should be kept away from children. It should be stored in the same container that it is packed in, closed tightly, stored at room temperature and not in a moist or hot place. Outdated or medication that is not needed anymore should be thrown away. Find out the proper way of disposing the medication from your pharmacist.

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