Paroxetine

Paroxetine Brand Names

Brisdelle | Paxil | Paxil CR | Pexeva

What is Paroxetine

Paroxetine is an oral selective serotonin reuptake inhibitor (SSRI) that has no active metabolites.

FDA-approved indications in adults include the treatment of major depressive disorder, obsessive-compulsive disorder, panic disorder, social anxiety disorder, generalized anxiety disorder, and premenstrual dysphoric disorder (PMDD).

Paroxetine was the first non-hormonal agent to be approved by the FDA for moderate to severe vasomotor symptoms associated with menopause. The drug is used off-label for treating premature ejaculation in men.

Paroxetine is not FDA-approved for any indication in children or adolescents; however, the drug has been used off-label for certain childhood anxiety disorders.

Paroxetine exhibits anticholinergic activity that may be problematic for some elderly adults.

Clinically significant drug interactions may result from potent CYP2D6 inhibition by paroxetine.

Paroxetine should be avoided during pregnancy due to data suggesting an increased risk for congenital malformations, particularly cardiac malformations, during first-trimester exposure.

Product labels for all antidepressants contain a boxed warning related to an increased risk of suicidality in children, adolescents, and young adults during the initial stages of therapy when treating depression or other conditions; therefore, the necessity of pharmacologic therapy versus the potential risks should be carefully considered in these populations.

Indications

  1. depression
  2. generalized anxiety disorder (GAD)
  3. hot flashes
  4. menopause
  5. obsessive-compulsive disorder (OCD)
  6. panic disorder
  7. posttraumatic stress disorder (PTSD)
  8. premature ejaculation
  9. premenstrual dysphoric disorder (PMDD)
  10. social phobia (social anxiety disorder)

Side Effects

  1. abdominal pain
  2. abnormal dreams
  3. acne vulgaris
  4. agitation
  5. agranulocytosis
  6. akathisia
  7. akinesia
  8. alopecia
  9. amblyopia
  10. amenorrhea
  11. amnesia
  12. anaphylactoid reactions
  13. anemia
  14. angina
  15. angioedema
  16. anorexia
  17. anxiety
  18. aphasia
  19. aplastic anemia
  20. appetite stimulation
  21. arthralgia
  22. asthenia
  23. ataxia
  24. atopic dermatitis
  25. atrial fibrillation
  26. back pain
  27. bleeding
  28. blepharitis
  29. blurred vision
  30. bone fractures
  31. bradycardia
  32. breast discharge
  33. breast enlargement
  34. bronchospasm
  35. bullous rash
  36. bundle-branch block
  37. candidiasis
  38. cataracts
  39. chest pain (unspecified)
  40. chills
  41. cholelithiasis
  42. choreoathetosis
  43. colitis
  44. coma
  45. confusion
  46. conjunctivitis
  47. constipation
  48. contact dermatitis
  49. cough
  50. cystitis
  51. dehydration
  52. delirium
  53. dental caries
  54. dental pain
  55. depression
  56. diabetes mellitus
  57. diarrhea
  58. diplopia
  59. dizziness
  60. drowsiness
  61. Drug Reaction with Eosinophilia and Systemic Symptoms (DRESS)
  62. dysarthria
  63. dysgeusia
  64. dyskinesia
  65. dysmenorrhea
  66. dyspepsia
  67. dysphagia
  68. dysphonia
  69. dyspnea
  70. dystonic reaction
  71. dysuria
  72. ecchymosis
  73. edema
  74. ejaculation dysfunction
  75. elevated hepatic enzymes
  76. emotional lability
  77. eosinophilia
  78. epididymitis
  79. eructation
  80. erythema multiforme
  81. erythema nodosum
  82. esophagitis
  83. euphoria
  84. exfoliative dermatitis
  85. exophthalmos
  86. fatigue
  87. fecal incontinence
  88. fever
  89. flank pain
  90. flatulence
  91. furunculosis
  92. galactorrhea
  93. gastritis
  94. gastroesophageal reflux
  95. GI bleeding
  96. GI obstruction
  97. gingival hyperplasia
  98. gingivitis
  99. glossitis
  100. goiter
  101. gout
  102. growth inhibition
  103. Guillain-Barre syndrome
  104. gynecomastia
  105. hallucinations
  106. headache
  107. hearing loss
  108. heart failure
  109. hematemesis
  110. hematoma
  111. hematuria
  112. hemolytic anemia
  113. hemoptysis
  114. hemorrhoids
  115. hepatic necrosis
  116. hepatitis
  117. hepatomegaly
  118. hiccups
  119. hirsutism
  120. hostility
  121. hyperacusis
  122. hyperalgesia
  123. hyperbilirubinemia
  124. hypercalcemia
  125. hypercholesterolemia
  126. hyperglycemia
  127. hyperhidrosis
  128. hyperkalemia
  129. hyperkinesis
  130. hyperphosphatemia
  131. hyperprolactinemia
  132. hyperreflexia
  133. hypertension
  134. hyperthyroidism
  135. hypertonia
  136. hyperventilation
  137. hypocalcemia
  138. hypoesthesia
  139. hypoglycemia
  140. hypokalemia
  141. hyponatremia
  142. hyporeflexia
  143. hypotension
  144. hypothermia
  145. hypothyroidism
  146. ileus
  147. impotence (erectile dysfunction)
  148. increased urinary frequency
  149. infection
  150. insomnia
  151. jaundice
  152. keratoconjunctivitis
  153. laryngitis
  154. laryngospasm
  155. lethargy
  156. leukocytosis
  157. leukopenia
  158. leukorrhea
  159. libido decrease
  160. libido increase
  161. lymphadenopathy
  162. lymphocytosis
  163. lymphopenia
  164. maculopapular rash
  165. malaise
  166. mania
  167. mastalgia
  168. melena
  169. memory impairment
  170. meningitis
  171. menorrhagia
  172. migraine
  173. muscle cramps
  174. muscle paralysis
  175. myalgia
  176. myasthenia
  177. mydriasis
  178. myelitis
  179. myocardial infarction
  180. myoclonia
  181. myopathy
  182. nausea
  183. neonatal abstinence syndrome
  184. nephrolithiasis
  185. neuritis
  186. neuropathic pain
  187. nocturia
  188. nystagmus
  189. ocular hemorrhage
  190. ocular hypertension
  191. ocular pain
  192. oliguria
  193. optic neuritis
  194. oral ulceration
  195. orgasm dysfunction
  196. orthostatic hypotension
  197. osteopenia
  198. osteoporosis
  199. otalgia
  200. pallor
  201. palpitations
  202. pancreatitis
  203. pancytopenia
  204. paranoia
  205. paresthesias
  206. parosmia
  207. pelvic pain
  208. peptic ulcer
  209. peripheral edema
  210. peripheral vasodilation
  211. persistent pulmonary hypertension of the newborn
  212. petechiae
  213. pharyngitis
  214. phlebitis
  215. photophobia
  216. photosensitivity
  217. platelet dysfunction
  218. pneumonitis
  219. polydipsia
  220. polyuria
  221. porphyria
  222. priapism
  223. prolonged bleeding time
  224. prostatitis
  225. proteinuria
  226. pruritus
  227. psychosis
  228. ptosis
  229. pulmonary edema
  230. pulmonary embolism
  231. pulmonary fibrosis
  232. pulmonary hypertension
  233. purpura
  234. pyuria
  235. rash
  236. renal failure (unspecified)
  237. restless legs syndrome (RLS)
  238. retinal hemorrhage
  239. rhinitis
  240. seborrhea
  241. seizures
  242. serotonin syndrome
  243. SIADH
  244. sialadenitis
  245. sinus tachycardia
  246. sinusitis
  247. skin discoloration
  248. skin ulcer
  249. Stevens-Johnson syndrome
  250. stomatitis
  251. stroke
  252. suicidal ideation
  253. supraventricular tachycardia (SVT)
  254. syncope
  255. teeth grinding (bruxism)
  256. teratogenesis
  257. tetany
  258. thrombocytopenia
  259. thrombosis
  260. tinnitus
  261. tongue discoloration
  262. torsade de pointes
  263. torticollis
  264. toxic epidermal necrolysis
  265. tremor
  266. trismus
  267. urinary incontinence
  268. urinary retention
  269. urinary urgency
  270. urticaria
  271. vaginal bleeding
  272. vaginitis
  273. vasculitis
  274. ventricular fibrillation
  275. ventricular tachycardia
  276. vertigo
  277. vesicular rash
  278. visual impairment
  279. vomiting
  280. weight gain
  281. weight loss
  282. withdrawal
  283. xerosis
  284. xerostomia
  285. yawning

Monitoring Parameters

  • blood pressure
  • growth rate
  • heart rate
  • thyroid function tests (TFTs)
  • weight

Contraindications

  • abrupt discontinuation
  • akathisia
  • anorexia nervosa
  • anticholinergic medications
  • anticoagulant therapy
  • bipolar disorder
  • bleeding
  • bone fractures
  • breast-feeding
  • cardiac disease
  • children
  • closed-angle glaucoma
  • congenital heart disease
  • dehydration
  • driving or operating machinery
  • electroconvulsive therapy (ECT)
  • ethanol ingestion
  • geriatric
  • growth inhibition
  • hepatic disease
  • hyponatremia
  • hypovolemia
  • increased intraocular pressure
  • mania
  • MAOI therapy
  • neonates
  • osteoporosis
  • pregnancy
  • renal failure
  • renal impairment
  • seizure disorder
  • seizures
  • suicidal ideation
  • thrombolytic therapy

Interactions

  • Abciximab
  • Acetaminophen; Aspirin, ASA; Caffeine
  • Acetaminophen; Butalbital; Caffeine; Codeine
  • Acetaminophen; Caffeine; Dihydrocodeine
  • Acetaminophen; Caffeine; Magnesium Salicylate; Phenyltoloxamine
  • Acetaminophen; Caffeine; Phenyltoloxamine; Salicylamide
  • Acetaminophen; Chlorpheniramine; Dextromethorphan; Phenylephrine
  • Acetaminophen; Chlorpheniramine; Dextromethorphan; Pseudoephedrine
  • Acetaminophen; Chlorpheniramine; Phenylephrine; Phenyltoloxamine
  • Acetaminophen; Codeine
  • Acetaminophen; Dextromethorphan
  • Acetaminophen; Dextromethorphan; Doxylamine
  • Acetaminophen; Dextromethorphan; Guaifenesin; Phenylephrine
  • Acetaminophen; Dextromethorphan; Phenylephrine
  • Acetaminophen; Dextromethorphan; Pseudoephedrine
  • Acetaminophen; Diphenhydramine
  • Acetaminophen; Hydrocodone
  • Acetaminophen; Oxycodone
  • Acetaminophen; Pentazocine
  • Acetaminophen; Tramadol
  • Alfentanil
  • Almotriptan
  • Alprazolam
  • Alteplase
  • Amiodarone
  • Amitriptyline
  • Amitriptyline; Chlordiazepoxide
  • Amoxapine
  • Amphetamines
  • Anagrelide
  • Anticholinergics
  • Antithrombin III
  • Apixaban
  • Ardeparin
  • Aripiprazole
  • Asenapine
  • Aspirin, ASA
  • Aspirin, ASA; Butalbital; Caffeine
  • Aspirin, ASA; Butalbital; Caffeine; Codeine
  • Aspirin, ASA; Caffeine; Dihydrocodeine
  • Aspirin, ASA; Caffeine; Orphenadrine
  • Aspirin, ASA; Carisoprodol
  • Aspirin, ASA; Carisoprodol; Codeine
  • Aspirin, ASA; Citric Acid; Sodium Bicarbonate
  • Aspirin, ASA; Dipyridamole
  • Aspirin, ASA; Omeprazole
  • Aspirin, ASA; Oxycodone
  • Aspirin, ASA; Pravastatin
  • Atazanavir; Cobicistat
  • Atomoxetine
  • Atropine
  • Atropine; Benzoic Acid; Hyoscyamine; Methenamine; Methylene Blue; Phenyl Salicylate
  • Atropine; Difenoxin
  • Atropine; Diphenoxylate
  • Atropine; Edrophonium
  • Atropine; Hyoscyamine; Phenobarbital; Scopolamine
  • Barbiturates
  • Belladonna Alkaloids; Ergotamine; Phenobarbital
  • Belladonna; Opium
  • Benzhydrocodone; Acetaminophen
  • Benzoic Acid; Hyoscyamine; Methenamine; Methylene Blue; Phenyl Salicylate
  • Benztropine
  • Betrixaban
  • Bismuth Subsalicylate
  • Bismuth Subsalicylate; Metronidazole; Tetracycline
  • Brexpiprazole
  • Brimonidine; Timolol
  • Brompheniramine
  • Brompheniramine; Carbetapentane; Phenylephrine
  • Brompheniramine; Dextromethorphan; Guaifenesin
  • Brompheniramine; Dextromethorphan; Phenylephrine
  • Brompheniramine; Guaifenesin; Hydrocodone
  • Brompheniramine; Hydrocodone; Pseudoephedrine
  • Brompheniramine; Pseudoephedrine
  • Buprenorphine
  • Buprenorphine; Naloxone
  • Bupropion
  • Bupropion; Naltrexone
  • Buspirone
  • Caffeine; Ergotamine
  • Cangrelor
  • Carbetapentane; Chlorpheniramine
  • Carbetapentane; Chlorpheniramine; Phenylephrine
  • Carbetapentane; Diphenhydramine; Phenylephrine
  • Carbetapentane; Phenylephrine; Pyrilamine
  • Carbetapentane; Pyrilamine
  • Carbinoxamine
  • Carbinoxamine; Dextromethorphan; Pseudoephedrine
  • Carbinoxamine; Hydrocodone; Phenylephrine
  • Carbinoxamine; Hydrocodone; Pseudoephedrine
  • Carbinoxamine; Phenylephrine
  • Carbinoxamine; Pseudoephedrine
  • Carvedilol
  • Cevimeline
  • Chlophedianol; Dexbrompheniramine
  • Chlophedianol; Dexchlorpheniramine; Pseudoephedrine
  • Chlordiazepoxide; Clidinium
  • Chlorpheniramine
  • Chlorpheniramine; Codeine
  • Chlorpheniramine; Dextromethorphan
  • Chlorpheniramine; Dextromethorphan; Phenylephrine
  • Chlorpheniramine; Dihydrocodeine; Phenylephrine
  • Chlorpheniramine; Dihydrocodeine; Pseudoephedrine
  • Chlorpheniramine; Guaifenesin; Hydrocodone; Pseudoephedrine
  • Chlorpheniramine; Hydrocodone
  • Chlorpheniramine; Hydrocodone; Phenylephrine
  • Chlorpheniramine; Hydrocodone; Pseudoephedrine
  • Chlorpheniramine; Phenylephrine
  • Chlorpheniramine; Pseudoephedrine
  • Chlorpromazine
  • Choline Salicylate; Magnesium Salicylate
  • Cilostazol
  • Cimetidine
  • Cinacalcet
  • Citalopram
  • Class IC Antiarrhythmics
  • Clemastine
  • Clomipramine
  • Clopidogrel
  • Clozapine
  • Cobicistat
  • Cocaine
  • Codeine
  • Codeine; Guaifenesin
  • Codeine; Phenylephrine; Promethazine
  • Codeine; Promethazine
  • Cyclobenzaprine
  • Cyproheptadine
  • Dabigatran
  • Dacomitinib
  • Dalteparin
  • Danaparoid
  • Darifenacin
  • Darunavir
  • Darunavir; Cobicistat
  • Darunavir; Cobicistat; Emtricitabine; Tenofovir alafenamide
  • Dasabuvir; Ombitasvir; Paritaprevir; Ritonavir
  • Delavirdine
  • Desipramine
  • Desmopressin
  • Desvenlafaxine
  • Deutetrabenazine
  • Dexchlorpheniramine
  • Dexchlorpheniramine; Dextromethorphan; Pseudoephedrine
  • Dexmethylphenidate
  • Dextromethorphan
  • Dextromethorphan; Diphenhydramine; Phenylephrine
  • Dextromethorphan; Guaifenesin
  • Dextromethorphan; Guaifenesin; Phenylephrine
  • Dextromethorphan; Guaifenesin; Potassium Guaiacolsulfonate
  • Dextromethorphan; Guaifenesin; Pseudoephedrine
  • Dextromethorphan; Promethazine
  • Dextromethorphan; Quinidine
  • Dicyclomine
  • Digoxin
  • Dihydrocodeine; Guaifenesin; Pseudoephedrine
  • Dihydroergotamine
  • Dimenhydrinate
  • Diphenhydramine
  • Diphenhydramine; Hydrocodone; Phenylephrine
  • Diphenhydramine; Ibuprofen
  • Diphenhydramine; Naproxen
  • Diphenhydramine; Phenylephrine
  • Dipyridamole
  • Disopyramide
  • Diuretics
  • Dolasetron
  • Donepezil
  • Donepezil; Memantine
  • Dorzolamide; Timolol
  • Doxepin
  • Doxercalciferol
  • Doxorubicin
  • Doxylamine
  • Doxylamine; Pyridoxine
  • Duloxetine
  • Dutasteride; Tamsulosin
  • Edoxaban
  • Eletriptan
  • Eliglustat
  • Elvitegravir; Cobicistat; Emtricitabine; Tenofovir Alafenamide
  • Elvitegravir; Cobicistat; Emtricitabine; Tenofovir Disoproxil Fumarate
  • Encainide
  • Enoxaparin
  • Eptifibatide
  • Ergoloid Mesylates
  • Ergonovine
  • Ergot alkaloids
  • Ergotamine
  • Escitalopram
  • Ethanol
  • Fenfluramine
  • Fentanyl
  • Flavoxate
  • Flecainide
  • Fluoxetine
  • Fluoxetine; Olanzapine
  • Fluphenazine
  • Fluvoxamine
  • Fondaparinux
  • Fosamprenavir
  • Fosphenytoin
  • Frovatriptan
  • Gefitinib
  • Gilteritinib
  • Glycopyrrolate
  • Glycopyrrolate; Formoterol
  • Granisetron
  • Guaifenesin; Hydrocodone
  • Guaifenesin; Hydrocodone; Pseudoephedrine
  • Haloperidol
  • Heparin
  • Homatropine; Hydrocodone
  • Hydrochlorothiazide, HCTZ; Metoprolol
  • Hydrochlorothiazide, HCTZ; Propranolol
  • Hydrocodone
  • Hydrocodone; Ibuprofen
  • Hydrocodone; Phenylephrine
  • Hydrocodone; Potassium Guaiacolsulfonate
  • Hydrocodone; Potassium Guaiacolsulfonate; Pseudoephedrine
  • Hydrocodone; Pseudoephedrine
  • Hydromorphone
  • Hydroxyzine
  • Hyoscyamine
  • Hyoscyamine; Methenamine; Methylene Blue; Phenyl Salicylate; Sodium Biphosphate
  • Ibuprofen; Oxycodone
  • Iloperidone
  • Imatinib
  • Imipramine
  • Indacaterol; Glycopyrrolate
  • Isocarboxazid
  • Isoniazid, INH
  • Isoniazid, INH; Pyrazinamide, PZA; Rifampin
  • Isoniazid, INH; Rifampin
  • Lasmiditan
  • Levomilnacipran
  • Levorphanol
  • Linezolid
  • Lithium
  • Lofexidine
  • Loperamide
  • Loperamide; Simethicone
  • Lopinavir; Ritonavir
  • Lorcaserin
  • Low Molecular Weight Heparins
  • Loxapine
  • Magnesium Salicylate
  • Maprotiline
  • Meclizine
  • Mepenzolate
  • Meperidine
  • Meperidine; Promethazine
  • Mesoridazine
  • Methadone
  • Methenamine; Sodium Acid Phosphate; Methylene Blue; Hyoscyamine
  • Methscopolamine
  • Methylene Blue
  • Methylergonovine
  • Methylphenidate
  • Methysergide
  • Metoclopramide
  • Metoprolol
  • Mexiletine
  • Milnacipran
  • Mirabegron
  • Mirtazapine
  • Monoamine oxidase inhibitors
  • Moricizine
  • Morphine
  • Morphine; Naltrexone
  • Nalbuphine
  • Naproxen; Sumatriptan
  • Naratriptan
  • Nebivolol
  • Nebivolol; Valsartan
  • Nefazodone
  • Netupitant, Fosnetupitant; Palonosetron
  • Nitroglycerin
  • Nonsteroidal antiinflammatory drugs
  • Nortriptyline
  • Olanzapine
  • Ombitasvir; Paritaprevir; Ritonavir
  • Ondansetron
  • Oritavancin
  • Orphenadrine
  • Oxybutynin
  • Oxycodone
  • Oxymorphone
  • Ozanimod
  • Paliperidone
  • Palonosetron
  • Peginterferon Alfa-2b
  • Pentamidine
  • Pentazocine
  • Pentazocine; Naloxone
  • Pentosan
  • Pergolide
  • Perphenazine
  • Perphenazine; Amitriptyline
  • Phenelzine
  • Phentermine
  • Phentermine; Topiramate
  • Phenylephrine; Promethazine
  • Phenytoin
  • Pimozide
  • Pirfenidone
  • Pitolisant
  • Prasugrel
  • Procarbazine
  • Prochlorperazine
  • Promethazine
  • Propafenone
  • Propantheline
  • Propranolol
  • Protriptyline
  • Quetiapine
  • Quinidine
  • Quinine
  • Ranolazine
  • Rasagiline
  • Remifentanil
  • Reteplase, r-PA
  • Risperidone
  • Ritonavir
  • Rivaroxaban
  • Rizatriptan
  • Rolapitant
  • Safinamide
  • Salsalate
  • Scopolamine
  • Selegiline
  • Sertraline
  • Sibutramine
  • Sodium picosulfate; Magnesium oxide; Anhydrous citric acid
  • St. John’s Wort, Hypericum perforatum
  • Streptokinase
  • Sufentanil
  • Sumatriptan
  • Tamoxifen
  • Tamsulosin
  • Tapentadol
  • Tedizolid
  • Tenecteplase
  • Terbinafine
  • Tetrabenazine
  • Theophylline, Aminophylline
  • Thioridazine
  • Thrombin Inhibitors
  • Thrombolytic Agents
  • Ticagrelor
  • Ticlopidine
  • Timolol
  • Tinzaparin
  • Tipranavir
  • Tirofiban
  • Tolterodine
  • Topiramate
  • Tramadol
  • Tranylcypromine
  • Trazodone
  • Trifluoperazine
  • Trihexyphenidyl
  • Trimipramine
  • Triprolidine
  • Urokinase
  • Valbenazine
  • Valerian, Valeriana officinalis
  • Vasopressin, ADH
  • Vemurafenib
  • Venlafaxine
  • Vilazodone
  • Vorapaxar
  • Vortioxetine
  • Warfarin
  • Ziprasidone
  • Zolmitriptan
  • Zolpidem
15585

Sign up to receive the trending updates and tons of Health Tips

Join SeekhealthZ and never miss the latest health information

15856