Paroxetine: A Proficient Antidepressant

Depression is referred to as a Mood disorder that involves continual feelings of sadness and loss of interest in routine activities. As depression is an ongoing problem and it can affect adults, children and adolescents and everyone has different symptoms. Treatment for depression takes time of several weeks, months or even years.

Signs and Symptoms of Depression:

Signs and symptoms of depression are different in everyone suffering. Some common symptoms are given as follows:

  • Poor Concentration 
  • Feeling of worthlessness 
  • Thoughts of harming yourself 
  • Lost of interest in daily activities
  • Persistent sadness 
  • Feeling of emptiness, hopelessness 
  • Irritability
  • Sleep disturbances 
  • Decreased energy
  • Anxiety 
  • Appetite changes 

Causes Of Depression:

Depression, as complex disease does not have any exact causes while some main causes of depression that can be:

  • Conflict 
  • Age
  • Abuse
  • Use of certain medications
  • Genes
  • Gender 
  • Death or loss
  • Serious illness
  • Substance Misuse 
  • Personal issues

Treatment of depression:

In treatment of Depression, Antidepressants are of major importance. They are used in the treatment of major depression disorders, chronic panic attacks, OCD(Obsessive Compulsive Disorder). Among the class of antidepressants one of them is (Selective Serotonin Reuptake Inhibitors) and Paroxetine is a SSRI. Paroxetine is used in the treatment of many conditions like depression, OCD, panic disorders etc. It works by restoring the level of Serotonin in the brain. It also improves your mood, energy level, sleep,  appetite, and ameliorates your interesting daily activities. It is a prescription medicine for treatment of depression. 

Paroxetine Brand Names:

There are different brands of Paroxetine:

  • Brisdelle(Brand Name)

Paroxetine(Generic Name)

  • Paxil(Brand Name)

Paroxetine(Generic Name)

  • Paxil CR(Brand Name)

Paroxetine Hydrochloride(Generic Name)

  • Pexeva(Brand Name)

Paroxetine Mesylate(Generic Name)

Citalopram: A Proficient Antidepressant

Citalopram is a SSRI(Selective Serotonin Reuptake Inhibitors). It is a prescription medicine for treatment of depression. 

Citalopram Uses:

  • Citalopram is used to treat Depression.
  • Citalopram is also used in the treatment of Major Depressive Disorder(MDD).
  • Citalopram is also used for treatment  of anxiety.

Paroxetine Uses:

  • It is used in the treatment of Depression and other major depressive disorders.
  • It is used in the treatment of Panic Disorders and Anxiety Disorders.
  • It is used in treatment of Obsessive Compulsive Disorder(OCD).
  • It is used in the treatment of Premenstrual Dysphoric Disorder(PDD).
  • In treatment of Posttraumatic Stress Disorder(PTSD) Paxil is used.
  • There is a Brand of Paroxetine which is Brisdelle, it is used to treat hot flashes related to menopause.
  • Brisdelle is specific to be used only for this condition not for any other.

Paroxetine Dosage:

Patients should take Paroxetine as prescribed and guided by their doctor. An important thing about taking any medication is that the patient should rigorously follow the instructions which are written on the label of the medicine. This will prevent the occurrence of many serious side effects. It has different doses for different conditions.

Paroxetine Dosage for Depression:

Conventional Dose;

Initial: 20 mg PO qDay 

This disease may be increased by 10 mg/day but it should not exceed 50 mg/day.

Paxil CR;

Initial: 25 mg PO qDay 

This dose may be increased by 12.5 mg/day qWeek but it should not exceed 62.5 mg/day.

Paroxetine Dosage for OCD:

Initial: 20 PO qDay

This dose may be increased by 10 mg qWeek but it should not exceed 60 mg/day.

Paroxetine Dosage for Panic Disorders:

Initial: 10 mg PO qDay

Target Dose: 40 mg/day 

This dose may be increased by 10 mg qWeek but the dose should not be increased by 60 mg/day.

Paxil CR;

Initial:

12.5 mg PO qDay

This dose may be increased by 12.5 mg qWeek but it should not exceed by 75 mg/day.

Paroxetine Dosage for Generalized Anxiety Disorder:

Initial:

20 mg PO qDay

This dose may be increased by 10 mg qWeek.

Paroxetine Dosage for Posttraumatic Stress Disorder:

Initial: 

20 mg PO qDay

This dose may be increased by 10 mg qWeek.

Paroxetine Dosage for Social Phobia:

20 mg PO qDay

Paxil CR;

12.5 mg PO qDay 

This dose may be increased by 12.5 mg qWeek but it should not exceed 37.5 mg/day.

Paroxetine Dosage for Premenstrual Dysphoric Disorder:

Brisdelle Dosage:

7.5 mg PO qHS

Paxil CR(off label use):

12.5 mg-25 mg PO qDay

Paroxetine Contraindications:

The use of these drugs should be prohibited as they can cause serious problems:

  • Selegiline
  • Procarbazine
  • Eliglustat
  • Pimozide
  • Thioridazine
  • Tryptophan(found in dietary Supplements)
  • Linezolid / IV Methylene Blue

There is a list of medicines which interact with each other but names of some of them are given above. 

Interaction with these drugs can ameliorate the risk of adverse effects:

  • NSAIDS(e.g. Ibuprofen, Naproxen etc.)
  • Amphetamines
  • Lithium
  • Theophylline 
  • Cimetidine 
  • Phenothiazines
  • Quinidine
  • Tricyclic Antidepressants(TCAs)

Interaction with these drugs can make Paxil less effective:

  • Phenobarbital
  • Digoxin
  • Phenytoin
  • Tamoxifen 
  • Ritonavir 

Paroxetine Warnings:

A patient should not take any medicine if he/she is allergic to it. Before taking medicine one should tell his doctor about previous medical history if he/she is already taking any other medications.

  • Sexual problems 
  • Heart Diseases or high blood pressure 
  • Narrow angle glaucoma 
  • Epilepsy or seizures 
  • Low sodium levels in blood
  • Bleeding or clotting disorder 
  • Bipolar disorders 
  • Liver or kidney disease 
  • The use of Paxil with other stimulant drugs like opioids, mental illness, Parkinson’s Disease, etc. can lead to Serotonin Syndrome. 
  • It can induce Suicidal thoughts in young people.
  • Brisdelle is prohibited in case of pregnancy.
  • A patient should not breastfeed if she is taking Paroxetine.
  • It is not an approved drug for use by people younger than 18 years old.

Paroxetine Side Effects:

Consult your doctor if you experience any serious side effects because in some cases it can be life threatening. Some Paxil side effects are given as follows;

  • Sleeplessness 
  • Thoughts of Attempting suicide or dying
  • Anger, Irritability, aggressiveness 
  • Hallucinations 
  • Nausea, Vomiting, Diarrhoea 
  • Fever,  headache 
  • Sweating
  • High or low blood pressure 
  • Eye pain
  • Change n vision
  • Swelling or redness around eye
  • Allergic Reactions 
  • Hives 
  • Rash
  • Blisters 
  • Joint Pain
  • Abnormal bleeding 
  • Weakness 
  • Bruising
  • Bone pain
  • Tenderness 
  • Low sodium levels

Pros and Cons of Paroxetine:

Pros:

  • It is available in tablet and oral liquid form as well.
  • It is taken once a day.
  • It can be taken with or without food.
  • It can be used to treat different mental conditions.

Cons:

  • It can interact with several medications.
  • To achieve full benefits, it takes time of several weeks or months.
  • As compared to other SSRIs it can cause weight gain and sexual problems.

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