Drug reference

Paroxetine

SSRI · Antidepressant, Anxiolytic

SSRIAntidepressant, Anxiolytic

CDSCO approvedSchedule H

EXCRETION

—

not curated

INTERACTIONS

12 major

incl. contraindicated

PREGNANCY

—

not curated

Top interactionssee all 12 →

Monoamine Oxidase Inhibitors (maois)ContraindicatedDatabase
PimozideContraindicatedDatabaseDDInter
ThioridazineContraindicatedDatabaseDDInter
Aceclofenac + ParacetamolSevereTextbookKDT 7e

Mechanism

Paroxetine is a Selective Serotonin Reuptake Inhibitor (SSRI).

Indications

AnxietyAnxiety disordersObsessive-compulsive disorderMajor depressive disorderPanic disorderGeneralized anxiety disorderFibromyalgiaNeuropathic painmajor depressiongeneralized anxietysocial anxietyPTSDpremenstrual dysphoric syndromepreventing vasovagal symptoms in postmenopausal womenDepression in terminally ill patients (with prognosis of several months or longer)Anxiety and sleeplessness (when they are major symptoms, due to sedating properties)Depression in cancer patients

Dosing

Adult: effective dose and for the shortest time possible, with a regular review at least every 6 weeks. h In patients who have dementia with Lewy bodies or Parkinson’s disease dementia, antipsychotic drugs can worsen the motor features of the condition, and in some cases cause severe antipsychotic sensitivity reactions. See also management of psychotic symptoms in Parkinson’s disease p. 429.…

Pharmacokinetics

Half-life

17 hours

Bioavailability

Dose dependent

Protein binding

95%

Metabolism

hepatic (CYP2D6)

Excretion

<2%

Contraindications

Minimize use in patients with dementia due to increased antimuscarinic burden and potential for cognitive impairment.

Side effects

Common

Sexual dysfunctioninsomniaincreased anxietyirritabilitydecreased libidoerectile dysfunction (more prominent)anorgasmia (more prominent)ejaculatory delay (more prominent)nauseadiarrheaemesisdullness of intellectual abilitiesconcentration issuescomparatively few

Serious

Serotonin syndrome
serotonin syndrome (with MAOIs)
suicidal ideation or behavior (black-box warning in children and adolescents)
discontinuation syndrome (most intense)
congenital cardiac malformations (when administered in first trimester of pregnancy)
persistent pulmonary hypertension in newborns

Drug interactions

Monoamine Oxidase Inhibitors (maois)

Contraindicated

Database

Increased risk of serotonin syndrome (hyperthermia, rigidity, myoclonus, autonomic instability, mental status changes)

Concomitant use is contraindicated. A washout period of at least 14 days is required when switching from an MAOI to paroxetine, and at least 14 days when switching from paroxetine to an MAOI.

Pimozide

Contraindicated

Database

Increased risk of QT prolongation and ventricular arrhythmias

Concomitant use is contraindicated.

Source: DDInter

Thioridazine

Contraindicated

Database

Increased risk of serious ventricular arrhythmias (e.g., Torsades de Pointes) and sudden death.

Concomitant use is contraindicated. A washout period is required when switching between these drugs.

Source: DDInter

Aceclofenac + Paracetamol

Severe

Textbook