Paroxetine is a selective serotonin reuptake inhibitor (SSRI) widely prescribed for the management of major depressive disorder, various anxiety disorders, and related conditions. As a potent and well-studied antidepressant, it functions by increasing serotonin levels in the brain, which helps improve mood, reduce anxiety, and restore emotional balance. Its efficacy, tolerability, and established safety profile make it a first-line treatment option in psychiatric and primary care settings worldwide.

Features

• Active ingredient: Paroxetine hydrochloride
• Available in tablet and oral suspension formulations
• Standard strengths: 10 mg, 20 mg, 30 mg, 40 mg
• Extended-release formulation available for once-daily dosing
• FDA-approved for multiple psychiatric indications
• Bioavailability: Completely absorbed after oral administration
• Half-life: Approximately 21 hours in adults

Benefits

• Effectively reduces symptoms of depression, including low mood and loss of interest
• Alleviates anxiety, panic attacks, and obsessive-compulsive behaviors
• Helps restore normal sleep patterns and improve energy levels
• Enhances overall quality of life and daily functioning
• Supported by extensive clinical research and long-term safety data
• Suitable for long-term maintenance therapy in chronic conditions

Common use

Paroxetine is indicated for the treatment of major depressive disorder (MDD), generalized anxiety disorder (GAD), social anxiety disorder (social phobia), panic disorder with or without agoraphobia, obsessive-compulsive disorder (OCD), and post-traumatic stress disorder (PTSD). It is also used off-label for premenstrual dysphoric disorder (PMDD), vasomotor symptoms of menopause, and certain chronic pain conditions. Treatment is typically initiated after a thorough psychiatric evaluation and consideration of individual patient factors.

Dosage and direction

The recommended starting dose for most adults is 20 mg once daily, preferably taken in the morning with or without food. Dosage may be adjusted based on therapeutic response and tolerability, with increases made in increments of 10 mg per day at intervals of at least one week. The maximum recommended dose is 50 mg per day for depression and 60 mg per day for OCD. For elderly patients or those with hepatic impairment, a lower starting dose of 10 mg is advised. Patients should be instructed to swallow tablets whole and not to crush or chew them. Consistent daily administration is important to maintain steady-state plasma concentrations.

Precautions

Patients should be monitored closely for clinical worsening, suicidality, or unusual changes in behavior, particularly during the initial months of therapy or after dosage changes. Paroxetine may impair judgment, thinking, or motor skills; caution is advised when driving or operating machinery. Use with caution in patients with a history of mania/hypomania, seizures, or angle-closure glaucoma. Regular monitoring of sodium levels is recommended due to risk of hyponatremia, especially in elderly patients. Abrupt discontinuation should be avoided due to risk of withdrawal symptoms.

Contraindications

Paroxetine is contraindicated in patients taking monoamine oxidase inhibitors (MAOIs) or within 14 days of discontinuing MAOI therapy due to risk of serotonin syndrome. Concomitant use with thioridazine or pimozide is contraindicated. It should not be used in patients with known hypersensitivity to paroxetine or any component of the formulation. Use is contraindicated in patients with uncontrolled narrow-angle glaucoma.

Possible side effect

Common side effects (≥1%) include nausea, somnolence, asthenia, dizziness, insomnia, sweating, sexual dysfunction, constipation, decreased appetite, and dry mouth. Less frequent adverse reactions may include tremor, nervousness, anxiety, blurred vision, yawning, and weight changes. Serious but rare side effects include serotonin syndrome, abnormal bleeding, hyponatremia, angle-closure glaucoma, and bone fractures. Most side effects are dose-dependent and often diminish with continued therapy.

Drug interaction

Paroxetine is a potent inhibitor of CYP2D6 and may increase plasma concentrations of drugs metabolized by this enzyme (e.g., tricyclic antidepressants, antipsychotics, beta-blockers, antiarrhythmics). Concomitant use with serotonergic drugs (tramadol, triptans, other SSRIs) increases risk of serotonin syndrome. NSAIDs, aspirin, or other drugs affecting coagulation may increase bleeding risk. Interactions with tamoxifen may reduce its efficacy. Plasma concentrations may be affected by CYP2D6 inhibitors or inducers.

Missed dose

If a dose is missed, it should be taken as soon as remembered unless it is close to the time for the next scheduled dose. In that case, the missed dose should be skipped and the regular dosing schedule resumed. Patients should not take a double dose to make up for a missed one. Consistency in dosing is important to maintain therapeutic effect and minimize withdrawal symptoms.

Overdose

Symptoms of overdose may include nausea, vomiting, tremor, agitation, dizziness, tachycardia, dilated pupils, and drowsiness. Severe overdose may lead to serotonin syndrome, seizures, or coma. There is no specific antidote for paroxetine overdose. Treatment is supportive and symptomatic, including gastric lavage if presented early, activated charcoal, and monitoring of vital signs. ECG monitoring is recommended due to potential QTc prolongation.

Storage

Store at room temperature (20-25°C or 68-77°F) in a dry place, protected from light and moisture. Keep in the original container with the lid tightly closed. Do not store in bathroom or other humid areas. Keep out of reach of children and pets. Properly dispose of any expired or unused medication according to local regulations.

Disclaimer

This information is for educational purposes only and does not constitute medical advice. Paroxetine is a prescription medication that should be used only under the supervision of a qualified healthcare professional. Dosage and treatment duration should be individualized based on patient characteristics and response. Patients should not initiate, adjust, or discontinue therapy without consulting their prescribing physician.

Reviews

Clinical studies demonstrate paroxetine’s efficacy across multiple indications, with response rates typically exceeding 60% in depression and anxiety disorders. Many patients report significant improvement in symptoms within 4-6 weeks of therapy. Long-term studies support its effectiveness in maintenance treatment and relapse prevention. While side effects are common initially, most are transient and manageable. Patient satisfaction surveys indicate improved quality of life and functional outcomes with continued treatment under proper medical supervision.