Paroxetine

CAUTION:
Studies have shown that children and teenagers who take antidepressants ('mood elevators') such as paroxetine may be more likely to think about harming or killing themselves or to plan or try to do so than children who do not take antidepressants. Children younger than 18 years of age should not normally take paroxetine.If your child’s doctor has prescribed paroxetine for your child, you should watch his or her behavior very carefully, especially at the beginning of treatment and any time his or her dose is increased or decreased.

General Information and Indications:

Paroxetine tablets, suspension (liquid) and extended-release (long-acting) tablets are used to treat depression, panic disorder (sudden, unexpected attacks of extreme fear and worry about these attacks), and social anxiety disorder (extreme fear of interacting with others or performing in front of others that interferes with normal life). Paroxetine tablets and oral solution are also used to treat obsessive compulsive disorder (bothersome thoughts that won't go away and the need to perform certain actions over and over), generalized anxiety disorder (excessive worrying that is difficult to control), and posttraumatic stress disorder (disturbing psychological symptoms that develop after a frightening experience). Paroxetine extended-release tablets are also used to treat premenstrual dysphoric disorder (PMDD, physical and psychological symptoms that occur before the onset of the menstrual period each month). Paroxetine is in a class of medications called selective serotonin reuptake inhibitors (SSRIs). It works by increasing the amount of serotonin, a natural substance in the brain that helps maintain mental balance.

Information For Users:

Paroxetine comes as a tablet, a suspension (liquid), and a controlled-release (long-acting) tablet to take by mouth. It is usually taken once daily in the morning or evening, with or without food. You may want to take paroxetine with food to stop it from upsetting your stomach. To help you remember to take paroxetine, take it around the same time every day. Follow the directions on your prescription label, ask your doctor or pharmacist If you have any questions. Take paroxetine exactly as directed. Do not take more or less of it or take it more often than prescribed by your health care provider.

Shake the liquid well before each use to mix the medication evenly.

Swallow the extended-release tablets whole; do not split, chew, or crush them.

Your doctor might start you on a low dose of paroxetine and slowly increase your dose, not more than once a week.

Paroxetine controls your condition but does not cure it. It may take several weeks or longer before you feel the full benefit of paroxetine. Continue taking paroxetine even if you feel well. Do not discontinue taking paroxetine without informing your doctor. Your doctor will probably decrease your dose gradually. If you suddenly stop taking paroxetine, you may experience withdrawal symptoms such as depression; mood changes; frenzied or abnormally excited mood; irritability; anxiety; confusion; dizziness; headache; tiredness; numbness or tingling in the arms, legs, hands, or feet; unusual dreams; difficulty falling asleep or staying asleep; upset stomach; or sweating. Inform your doctor if you experience any of these symptoms when your dose of paroxetine is decreased.

Paroxetine is also sometimes used to treat chronic headaches, tingling in the hands and feet caused by diabetes, and certain male sexual problems. Paroxetine is also used with other medications to treat bipolar disorder (mood that changes from depressed to abnormally excited ). Talk to your doctor about the possible risks of using this medication.

special precautions:

o Inform your doctor or pharmacist if you have allergy to paroxetine or any other medications.
o do not take paroxetine if you are taking monoamine oxidase (MAO) inhibitors, including isocarboxazid (Marplan), phenelzine (Nardil), selegiline (Eldepryl), and tranylcypromine (Parnate), or have stopped taking them within the past two weeks. If you stop taking paroxetine, you should wait at least 2 weeks before you start to take an MAO inhibitor. Do not take paroxetine if you are taking thioridazine (Mellaril).
o Inform your doctor and pharmacist what other prescription and nonprescription medications, and vitamins you are taking. Be sure to mention any of the following: anticoagulants ('blood thinners') such as warfarin (Coumadin); antidepressants (mood elevators) such as amitriptyline (Elavil), amoxapine (Asendin), clomipramine (Anafranil), desipramine (Norpramin), doxepin (Adapin, Sinequan), imipramine (Tofranil), nortriptyline (Aventyl, Pamelor), protriptyline (Vivactil), and trimipramine (Surmontil); antihistamines; aspirin and other nonsteroidal anti-inflammatory medications (NSAIDs) such as ibuprofen (Advil, Motrin), and naproxen (Aleve, Naprosyn); atazanavir (Reyataz); bromocriptine (Parlodel); bupropion (Wellbutrin); buspirone (Buspar); celecoxib (Celebrex); chlorpromazine (Thorazine); cimetidine (Tagamet); clopidogrel (Plavix); codeine (found in many cough and pain medications); dexamethasone (Decadron); dextromethorphan (found in many cough medications); diazepam (Valium); dicloxacillin (Dynapen); digoxin (Lanoxin); dipyridamole (Persantine); diuretics ('water pills'); haloperidol (Haldol); isoniazid (INH, Nydrazid); lithium (Eskalith, Lithobid); medications for irregular heartbeat such as amiodarone (Cordarone, Pacerone), encainide (Enkaid), flecainide (Tambocor), mexiletine (Mexitil), moricizine (Ethmozine): propafenone (Rythmol), and quinidine (Quinidex); medications for mental illness and nausea; medications for seizures such as phenobarbital (Luminal, Solfoton) and phenytoin (Dilantin); meperidine (Demerol); methadone (Dolophine); metoclopromide (Reglan); metoprolol (Lopressor, Toprol XL); odansetron (Zofran); other selective serotonin reuptake inhibitors such as citalopram (Celexa), fluoxetine (Prozac, Sarafem); fluvoxamine (Luvox); and sertraline (Zoloft); pimozide (Orap); procyclidine (Kemadrin); propoxyphene (Darvon); propranolol (Inderal); ranitidine (Zantac); rifampin (Rifadin, Rimactane); risperidone (Risperdal); ritonavir (Norvir); sumatriptan (Imitrex); tamoxifen (Nolvadex); terbinafine (Lamisil); theopylline (Theobid, Theo-Dur); ticlopidine (Ticlid); timolol (Blocadren); tramadol (Ultram); trazodone (Desyrel); and venlafaxine (Effexor). Your doctor may need to change the doses of your medications or monitor you carefully for side effects.
o Inform your doctor what herbal products and nutritional supplements you are taking, especially St. John's wort and tryptophan.
o Inform your doctor if you or anyone in your family has or has ever had depression, bipolar disorder (mood that changes from depressed to abnormally excited), or mania (frenzied, abnormally excited mood), or if you or anyone in your family has thought about or attempted suicide. Also Inform your doctor if you use or have ever used street drugs or have overused prescription medications, if you have recently had a heart attack, and if you have or have ever had glaucoma (an eye disease); seizures; bleeding from your stomach or esphagus (tube that connects the mouth and stomach) or liver, kidney, or heart disease.
o Inform your doctor if you are pregnant, plan to become pregnant, or are breast-feeding. If you become pregnant while taking paroxetine, call your doctor.
o you should know that paroxetine may make you drowsy and affect your judgment and thinking. Do not drive a car or operate machinery until you know how this medication affects you.
o ask your doctor about the safe use of alcoholic beverages while you are taking paroxetine.
o you should know that your mental health may change in unexpected ways, especially at the beginning of your treatment and any time that your dose is increased or decreased. These changes may occur at any time if you have depression or another mental illness, whether or not you are taking paroxetine or any other medication. You, your family, or caregiver should call your doctor right away if you experience any of the following symptoms: new or worsening depression; thinking about harming or killing yourself, or planning or trying to do so; extreme worry; agitation; panic attacks; difficulty falling asleep or staying asleep; aggressive behavior; irritability; acting without thinking; severe restlessness; and frenzied abnormal excitement. Be sure that your family or caregiver knows which symptoms may be serious so they can call the doctor when you are unable to seek treatment on your own.

Possible Adverse Effects:

Paroxetine may cause adverse effects. Inform your doctor if any of the following symptoms are severe or do not go away:

o headache
o dizziness
o weakness
o difficulty concentrating
o nervousness
o forgetfulness
o confusion
o sleepiness or feeling "drugged"
o difficulty falling asleep or staying asleep
o upset stomach
o vomiting
o diarrhea
o constipation
o gas
o stomach pain
o heartburn
o changes in ability to taste food
o decreased appetite
o weight loss or gain
o changes in sex drive or ability, impotence
o dry mouth
o sweating
o yawning
o sensitivity to light
o runny nose
o cough
o lump or tightness in throat
o pain in the back, muscles, joints, or anywhere in the body
o muscle weakness or tightness
o flushing
o problems with teeth
o unusual dreams
o painful or irregular menstruation

Some adverse effects could be serious. The following symptoms are uncommon, but if you experience any of them or those listed in the CAUTION section, call your doctor without delay:

o blurred vision (Impaired vision)
o rapid, pounding, or irregular heartbeat
o chest pain
o seizure
o abnormal bleeding or bruising
o sore throat, fever, chills, and other signs of infection
o hand tremor, shaking hands
o sudden muscle twitching or jerking that you cannot control
o numbness or tingling in your hands, feet, arms, or legs
o difficult, frequent, or painful urination
o swelling, itching, burning, or infection in the vagina
o painful erection that lasts for hours
o sudden upset stomach, vomiting, weakness, cramping, bloating, swelling, tightness in hands and feet, dizziness, headache and/or confusion
o hives (Urticaria)
o skin rash
o itching
o swelling of the face, throat, tongue, lips, eyes, hands, feet, ankles, or lower legs
o hoarseness
o difficulty swallowing or breathing
o black and tarry stools (Melena)
o red blood in stools
o blood in the vomit (Hematemesis)
o vomiting that looks like coffee grounds

Possible Symptoms of Overdose:

o drowsiness
o coma
o upset stomach
o hand tremor, shaking hands
o fast, pounding, irregular, or slow heartbeat
o confusion
o vomiting
o dizziness
o seizures
o fainting
o blurred vision (Impaired vision)
o extreme tiredness
o unusual bruising or bleeding
o lack of energy
o loss of appetite (anorexia)
o pain in the upper right part of the stomach
o flu like symptoms
o yellowing of the skin and eyes
o aggressive behavior
o muscle pain, stiffness or weakness
o sudden muscle twitching or jerking that you cannot control
o dark red or brown urine
o difficulty in urination
o diarrhea
o frenzied, abnormally excited mood
o sweating
o fever
o difficulty walking

Brand Name(s):

o Paxil®
o Paxil® CR