Paroxetine

Generic Name: Paroxetine
Common Brand Names: Paxil, Pexeva, Brisdelle

Introduction

Paroxetine is a selective serotonin reuptake inhibitor (SSRI) widely used for treating mood and anxiety disorders. It is particularly effective for major depressive disorder, generalized anxiety disorder, and post-traumatic stress disorder.

Conditions of Use (Indications)

1. Major Depressive Disorder (MDD):

• First-line therapy.

2. Anxiety Disorders:

• Generalized anxiety disorder (GAD), social anxiety disorder (SAD), panic disorder.

3. Obsessive-Compulsive Disorder (OCD):

• Long-term management.

4. Post-Traumatic Stress Disorder (PTSD):

• FDA-approved for PTSD.

5. Premenstrual Dysphoric Disorder (PMDD):

• Effective symptom relief.

Mechanism of Action

Paroxetine inhibits the reuptake of serotonin (5-HT) at the presynaptic terminal, increasing serotonin levels in the synaptic cleft. Enhanced serotonin signaling improves mood, reduces anxiety, and alleviates symptoms of depression.

Side Effects

1. Common Side Effects:

• Nausea, dry mouth, somnolence, sexual dysfunction, weight gain.

2. Serious Side Effects:

• Serotonin syndrome, increased risk of suicidality (in young adults), withdrawal syndrome upon abrupt cessation.

Harmful Interactions

1. MAO Inhibitors (e.g., phenelzine):

• Risk of hypertensive crisis and serotonin syndrome.

2.NSAIDs and Anticoagulants:

• Increased risk of gastrointestinal bleeding.

3.Other Serotonergic Drugs:

• Risk of serotonin syndrome.

Contraindications

1. Concurrent use of MAO inhibitors or linezolid.
2. Hypersensitivity to paroxetine.
3. Severe renal or hepatic impairment (dose adjustment required).

Latest References

1. APA Guidelines for Depression Treatment (2023).
2. Lancet Psychiatry (2023): Efficacy and Safety of SSRIs.
3. Cochrane Review (2023): Paroxetine for Anxiety Disorders.