Paroxetine is a selective serotonin reuptake inhibitor (SSRI) primarily used to treat depression, anxiety-related disorders, and other psychiatric conditions. This medication works by increasing serotonin levels in the brain to improve mood and cognitive function, and is often prescribed for long-term symptom management.
Paroxetine’s efficacy mainly targets symptoms such as low mood, insomnia, and anxiety, with clinical evidence supporting its use in panic disorder, obsessive-compulsive disorder (OCD), and post-traumatic stress disorder (PTSD). Patients should adhere to their physician’s instructions for regular medication intake, with noticeable effects typically appearing after 2-4 weeks.
The generic name of this medication is "Paroxetine," with common commercial brands including "Seroxat" among others. Different regions may use different brand names, but the chemical composition and mechanism of action are identical.
Paroxetine is classified as a "Selective Serotonin Reuptake Inhibitor" (SSRI), belonging to the second-generation antidepressants. Compared to traditional tricyclic antidepressants, SSRIs have a lower risk of side effects and a higher safety profile.
Main indications include:
Clinicians may also extend its use to social anxiety disorder or migraine prophylaxis based on clinical judgment, with appropriate monitoring.
Common mild side effects include:
Serious side effects require immediate medical attention:
Contraindications: Use is prohibited in individuals allergic to paroxetine or its components. Patients with severe liver or kidney impairment should have dosage adjustments. Combining with monoamine oxidase inhibitors (MAOIs) may trigger "serotonin syndrome," requiring at least a 14-day interval.
Use during pregnancy may increase the risk of neonatal withdrawal syndrome; caution is advised during late pregnancy. Use during breastfeeding may affect the infant through breast milk; discuss alternative options with your healthcare provider.
Concurrent use with other serotonergic drugs (such as tramadol, triptans) may induce "serotonin syndrome," characterized by high fever, muscle rigidity, and altered mental status. Combining with warfarin or other anticoagulants may increase bleeding risk.
Using with antiepileptic drugs (such as carbamazepine) may reduce efficacy, requiring dose adjustments. Always inform your healthcare provider of all prescription medications, over-the-counter drugs, or herbal supplements you are taking.
The usual starting dose for adults with depression is 20 mg daily, which can be gradually increased to 50 mg in severe cases. For generalized anxiety disorder, a dose of 20-50 mg once daily is recommended. Dosage should be adjusted based on age, weight, and liver/kidney function.
Take at the same time each day, with or without food. Tablets should be swallowed whole; do not chew. If a dose is missed and the next dose is due within 4 hours, take it immediately; otherwise, skip the missed dose and resume the regular schedule.
If a dose is missed on the same day, take it as soon as possible. If less than 4 hours remain before the next scheduled dose, skip the missed dose. Do not double the dose to compensate for a missed one, as this may increase side effects.
Overdose may cause coma, respiratory depression, or abnormal blood pressure. Seek immediate medical attention and inform healthcare providers of the remaining medication. Severe symptoms may require gastric lavage or activated charcoal to adsorb the excess drug.
During hospital observation, medical staff will monitor heart rhythm, blood pressure, and neurological status, providing supportive care as needed to stabilize vital signs.
Generally, no special dietary restrictions are necessary when taking paroxetine. However, it is recommended to avoid taking it on an empty stomach to reduce gastrointestinal discomfort. If nausea occurs, try taking the medication with meals. Avoid excessive alcohol intake, as it may increase drowsiness or affect the medication’s efficacy.
What are the consequences of suddenly stopping paroxetine?Sudden discontinuation of paroxetine may cause withdrawal symptoms such as dizziness, headache, anxiety, or sleep disturbances. Doctors usually advise gradual dose reduction to minimize discomfort. If severe withdrawal symptoms occur, seek medical advice immediately.
Can paroxetine be used together with other antidepressants or anxiolytics?Combining paroxetine with other antidepressants (such as MAOIs or tricyclic antidepressants) may increase the risk of serotonin syndrome and should be done only under strict medical supervision. When used with anxiolytics, dosage adjustments are necessary to avoid excessive sedation or liver burden.
Is regular liver function or blood test monitoring required during treatment?Long-term users of paroxetine may need periodic liver function tests, as rare cases have shown potential liver impact. If jaundice, dark urine, or unusual fatigue occurs, discontinue medication and consult a healthcare provider immediately.
Can high-risk activities or driving be performed while on paroxetine?During initial treatment or dosage adjustments, side effects such as dizziness or impaired concentration may occur. Avoid operating machinery or driving until the medication’s effects are well tolerated. Once the body adapts and no significant side effects are present, normal activities can usually resume, but individual responses should be monitored.
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