Description
Simple
A medication used to treat depression, anxiety, OCD, and PTSD, as well as the symptoms of menopause such as hot flashes.
Clinical
A selective serotonin reuptake inhibitor used to treat major depressive disorder, panic disorder, OCD, social phobia, generalized anxiety disorder, the vasomotor symptoms of menopause, and premenstrual dysphoric disorder.
Overview
Paroxetine is a selective serotonin reuptake inhibitor (SSRI) drug commonly known as Paxil. It has a variety of uses, including the treatment of anxiety disorders, major depression, posttraumatic stress disorder, and symptoms of menopause, among others.[25] It was approved by the FDA in the early 1990s and marketed by SmithKline Beecham.[31,32] A unique feature of this drug is that it is highly potent and selective in its inhibition of serotonin reuptake and has little effect on other neurotransmitters.[13] Because of its potent inhibition of serotonin reuptake, paroxetine is more likely to cause withdrawal effects upon cessation. Paroxetine is well tolerated in most patients with a similar adverse effect profile to other members of its drug class.[Read more
Pharmacology
Indication
Paroxetine is indicated for the management of depression, obsessive-compulsive disorder, panic disorder, social anxiety disorder, generalized anxiety disorder, posttraumatic stress disorder.[28] One form of paroxetine,... Read more
Pharmacodynamic
Paroxetine treats the symptoms of depression, various anxiety disorders, posttraumatic stress disorder, obsessive-compulsive disorder, and the vasomotor symptoms of menopause via the inhibition of serotonin reuptake.[ Read more
Mechanism of action
Paroxetine enhances serotonergic activity via the inhibition presynaptic reuptake of serotonin by the serotonin (SERT) receptor.[ Read more
Absorption
Paroxetine is readily absorbed from the gastrointestinal tract. Due to the first-pass metabolism, the bioavailability ranges from 30-60%. Cmax is attained 2 to 8 hours after an oral dose.[ Read more
Protein binding
Paroxetine is 95% bound to plasma proteins.[7, Read more
Volume of distribution
Paroxetine has a large volume of distribution and is found throughout the body, including in the central nervous system. Only 1% of the drug is found in the plasma.[28]Paroxetine is found in the breast milk at concent... Read more
Clearance
The apparent oral clearance of paroxetine is 167 L/h.[14] The clearance... Read more
Half life
The mean elimination half-life of paroxetine is about 21 hours.[28] In healthy young subjects, mean elimination half-life was found to be 17.3 hours.[ Read more
Route of elimination
About 2/3 of a single paroxetine dose is found to be excreted in the urine and the remainder is found to be excreted in feces. Almost all of the dose is eliminated as metabolites; 3% is found to be excreted as unchanged paroxetine.[ Read more
Toxicity
The acute LD50 in mice and rats is 350 mg/kg.[34]
Overdose information
The lowest dose of paroxetine reported to lead to a fatal outcome is approximately 400 mg. The largest reported paroxetine overdose fr...
Read more
Adverse Effects
Effect | Regions | Age Groups | Incidences | Evidence Type |
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Ejaculation disorder | US |
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Clinical Trial |
Abnormal ejaculation | US |
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Clinical Trial |
Abnormal ejaculation | US |
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Clinical Trial |
Anorgasmia | US |
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Clinical Trial |
Delayed ejaculation | US |
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Clinical Trial |
Headache | US |
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Clinical Trial |
Delayed ejaculation | US |
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Clinical Trial |
Abnormal ejaculation | US |
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Clinical Trial |
Anorgasmia | US |
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Clinical Trial |
Nausea | US |
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Clinical Trial |
Nausea | US |
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Clinical Trial |
Abnormal ejaculation | US |
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Clinical Trial |
Nausea | US |
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Clinical Trial |
Somnolence | US |
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Clinical Trial |
Insomnia | US |
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Clinical Trial |
Somnolence | US |
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Clinical Trial |
Insomnia | US |
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Clinical Trial |
Nausea | US |
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Clinical Trial |
Ejaculation disorder | US |
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Clinical Trial |
Nausea | US |
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Clinical Trial |
Nausea | US |
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Clinical Trial |
Headache | US |
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Clinical Trial |
Nausea | US |
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Clinical Trial |
Abnormal ejaculation | US |
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Clinical Trial |
Nausea | US |
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Clinical Trial |
Somnolence | US |
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Clinical Trial |
Somnolence | US |
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Clinical Trial |
Asthenia | US |
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Clinical Trial |
Asthenia | US |
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Clinical Trial |
Nausea | US |
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Clinical Trial |
Nausea | US |
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Clinical Trial |
Somnolence | US |
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Clinical Trial |
Somnolence | US |
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Clinical Trial |
Asthenia | US |
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Clinical Trial |
Asthenia | US |
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Clinical Trial |
Insomnia | US |
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Clinical Trial |
Ejaculation disorder | US |
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Clinical Trial |
Somnolence | US |
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Clinical Trial |
Abnormal ejaculation | US |
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Clinical Trial |
Insomnia | US |
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Clinical Trial |
Insomnia | US |
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Clinical Trial |
Somnolence | US |
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Clinical Trial |
Nausea | US |
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Clinical Trial |
Somnolence | US |
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Clinical Trial |
Somnolence | US |
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Clinical Trial |
Insomnia | US |
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Clinical Trial |
Dry Mouth | US |
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Clinical Trial |
Dry Mouth | US |
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Clinical Trial |
Nausea | US |
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Clinical Trial |
Diarrhea | US |
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Clinical Trial |
Contraindications
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Food Interactions
Avoid alcohol.
Take with or without food. Food does not significantly affect absorption.