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Paroxetine

    Brands

    DEA Class;  Rx

    Common Brand Names; Paxil, Brisdelle, Paxil CR, Pexeva

    • Antidepressants, SSRIs

    Oral selective serotonin reuptake inhibitor (SSRI) antidepressant
    Indicated for depression, OCD, social anxiety, generalized anxiety disorder, panic disorder, PTSD, premenstrual dysphoric disorder, and menopausal hot flashed in adults
    Do not use during pregnancy; increased risk of suicidality during treatment initiation in pediatric and young adult patients

    Indicated for the treatment of major depression.

    For the treatment of generalized anxiety disorder (GAD).
    For the treatment of obsessive-compulsive disorder (OCD).
    For the treatment of panic disorder, with or without agoraphobia.
    For the treatment of social phobia (social anxiety disorder).
    For the treatment of posttraumatic stress disorder (PTSD).
    For the treatment of premenstrual dysphoric disorder (PMDD).
    For the treatment of moderate to severe hot flashes associated with menopause, including in women who have been treated for breast cancer.
    For the treatment of premature ejaculation.

    Hypersensitivity

    Concomitant administration with pimozide or thioridazine

    • Nausea (15-24%)
    • Insomnia (11-24%)
    • Dry mouth (9-18%)
    • Headache (17%)
    • Asthenia (10-15%)
    • Constipation (10-15%)
    • Diarrhea (9-12%)
    • Dizziness (6-14%)
    • Ejaculation disorder (10-15%)
    • Tremor (4-11%)
    • Anxiety (5-10%)
    • Blurred vision (5-10%)
    • Decreased appetite (5-10%)
    • Impotence (2-9%)
    • Nervousness (2-5%)
    • Paresthesia (2-5%)
    • Hypomania (0.3 to 2.2%)
    • Hypertension
    • Tachycardia
    • Emotional lability
    • Pruritus
    • Weight gain
    • Arthralgia
    • Tinnitus
    • Vertigo
    • Angle clossure glaucoma

    Clinical worsening and suicidal ideation may occur despite medication in adolescents and young adults (18-24 years)

    Use caution in patients with history of seizure or suicidal thought/behavior; discontinue therapy in patients who develop seizures

    In patients with bipolar disorder, treating a depressive episode may precipitate a mixed/manic episode; prior to initiating treatment, screen patients for any personal or family history of bipolar disorder, mania, or hypomania

    Adverse reactions after discontinuation of serotonergic antidepressants, particularly after abrupt discontinuation, include, nausea, sweating, dysphoric mood, irritability, agitation, dizziness, sensory disturbances (eg, paresthesia, such as electric shock sensations), tremor, anxiety, confusion, headache, lethargy, emotional lability, insomnia, hypomania, tinnitus, and seizures; a gradual reduction in dosage rather than abrupt cessation is recommended whenever possible

    Pregnancy category: D

    Excreted in breast milk; use caution (AAP states effect on nursing infants is unknown but may be of concern)

    Adults

    60 mg/day PO for immediate-release formulation; 75 mg/day PO for controlled-release formulation.

    Geriatric

    40 mg/day PO for immediate-release formulation; 50 mg/day PO for controlled-release formulation.

    Adolescents

    Safety and efficacy have not been established; however, doses up to 50 mg/day PO have been used off-label for anxiety disorders.

    Children

    7 to 12 years: Safety and efficacy have not been established; however, doses up to 50 mg/day PO have been used off-label for anxiety disorders.
    1 to 6 years: Safety and efficacy have not been established.

    Infants

    Safety and efficacy have not been established.

    Neonates

    Safety and efficacy have not been established.

    Paroxetine

    Paroxetine mesylate

    Paroxetine hydrochloride

    tablet

    • 10mg
    • 20mg
    • 30mg
    • 40mg

    capsule

    • 7.5mg

    tablet, extended-release

    • 12.5mg
    • 25mg
    • 37.5mg

    oral suspension

    • 10mg/5mL