What's on this Page
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
- depression
- generalized anxiety disorder (GAD)
- hot flashes
- menopause
- obsessive-compulsive disorder (OCD)
- panic disorder
- posttraumatic stress disorder (PTSD)
- premature ejaculation
- premenstrual dysphoric disorder (PMDD)
- social phobia (social anxiety disorder)
Side Effects
- abdominal pain
- abnormal dreams
- acne vulgaris
- agitation
- agranulocytosis
- akathisia
- akinesia
- alopecia
- amblyopia
- amenorrhea
- amnesia
- anaphylactoid reactions
- anemia
- angina
- angioedema
- anorexia
- anxiety
- aphasia
- aplastic anemia
- appetite stimulation
- arthralgia
- asthenia
- ataxia
- atopic dermatitis
- atrial fibrillation
- back pain
- bleeding
- blepharitis
- blurred vision
- bone fractures
- bradycardia
- breast discharge
- breast enlargement
- bronchospasm
- bullous rash
- bundle-branch block
- candidiasis
- cataracts
- chest pain (unspecified)
- chills
- cholelithiasis
- choreoathetosis
- colitis
- coma
- confusion
- conjunctivitis
- constipation
- contact dermatitis
- cough
- cystitis
- dehydration
- delirium
- dental caries
- dental pain
- depression
- diabetes mellitus
- diarrhea
- diplopia
- dizziness
- drowsiness
- Drug Reaction with Eosinophilia and Systemic Symptoms (DRESS)
- dysarthria
- dysgeusia
- dyskinesia
- dysmenorrhea
- dyspepsia
- dysphagia
- dysphonia
- dyspnea
- dystonic reaction
- dysuria
- ecchymosis
- edema
- ejaculation dysfunction
- elevated hepatic enzymes
- emotional lability
- eosinophilia
- epididymitis
- eructation
- erythema multiforme
- erythema nodosum
- esophagitis
- euphoria
- exfoliative dermatitis
- exophthalmos
- fatigue
- fecal incontinence
- fever
- flank pain
- flatulence
- furunculosis
- galactorrhea
- gastritis
- gastroesophageal reflux
- GI bleeding
- GI obstruction
- gingival hyperplasia
- gingivitis
- glossitis
- goiter
- gout
- growth inhibition
- Guillain-Barre syndrome
- gynecomastia
- hallucinations
- headache
- hearing loss
- heart failure
- hematemesis
- hematoma
- hematuria
- hemolytic anemia
- hemoptysis
- hemorrhoids
- hepatic necrosis
- hepatitis
- hepatomegaly
- hiccups
- hirsutism
- hostility
- hyperacusis
- hyperalgesia
- hyperbilirubinemia
- hypercalcemia
- hypercholesterolemia
- hyperglycemia
- hyperhidrosis
- hyperkalemia
- hyperkinesis
- hyperphosphatemia
- hyperprolactinemia
- hyperreflexia
- hypertension
- hyperthyroidism
- hypertonia
- hyperventilation
- hypocalcemia
- hypoesthesia
- hypoglycemia
- hypokalemia
- hyponatremia
- hyporeflexia
- hypotension
- hypothermia
- hypothyroidism
- ileus
- impotence (erectile dysfunction)
- increased urinary frequency
- infection
- insomnia
- jaundice
- keratoconjunctivitis
- laryngitis
- laryngospasm
- lethargy
- leukocytosis
- leukopenia
- leukorrhea
- libido decrease
- libido increase
- lymphadenopathy
- lymphocytosis
- lymphopenia
- maculopapular rash
- malaise
- mania
- mastalgia
- melena
- memory impairment
- meningitis
- menorrhagia
- migraine
- muscle cramps
- muscle paralysis
- myalgia
- myasthenia
- mydriasis
- myelitis
- myocardial infarction
- myoclonia
- myopathy
- nausea
- neonatal abstinence syndrome
- nephrolithiasis
- neuritis
- neuropathic pain
- nocturia
- nystagmus
- ocular hemorrhage
- ocular hypertension
- ocular pain
- oliguria
- optic neuritis
- oral ulceration
- orgasm dysfunction
- orthostatic hypotension
- osteopenia
- osteoporosis
- otalgia
- pallor
- palpitations
- pancreatitis
- pancytopenia
- paranoia
- paresthesias
- parosmia
- pelvic pain
- peptic ulcer
- peripheral edema
- peripheral vasodilation
- persistent pulmonary hypertension of the newborn
- petechiae
- pharyngitis
- phlebitis
- photophobia
- photosensitivity
- platelet dysfunction
- pneumonitis
- polydipsia
- polyuria
- porphyria
- priapism
- prolonged bleeding time
- prostatitis
- proteinuria
- pruritus
- psychosis
- ptosis
- pulmonary edema
- pulmonary embolism
- pulmonary fibrosis
- pulmonary hypertension
- purpura
- pyuria
- rash
- renal failure (unspecified)
- restless legs syndrome (RLS)
- retinal hemorrhage
- rhinitis
- seborrhea
- seizures
- serotonin syndrome
- SIADH
- sialadenitis
- sinus tachycardia
- sinusitis
- skin discoloration
- skin ulcer
- Stevens-Johnson syndrome
- stomatitis
- stroke
- suicidal ideation
- supraventricular tachycardia (SVT)
- syncope
- teeth grinding (bruxism)
- teratogenesis
- tetany
- thrombocytopenia
- thrombosis
- tinnitus
- tongue discoloration
- torsade de pointes
- torticollis
- toxic epidermal necrolysis
- tremor
- trismus
- urinary incontinence
- urinary retention
- urinary urgency
- urticaria
- vaginal bleeding
- vaginitis
- vasculitis
- ventricular fibrillation
- ventricular tachycardia
- vertigo
- vesicular rash
- visual impairment
- vomiting
- weight gain
- weight loss
- withdrawal
- xerosis
- xerostomia
- 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