What is Paroxetine? Paroxetine is a medication that is used to treat a variety of mental health conditions. It is in a class of drugs known as selective serotonin reuptake inhibitors (SSRIs). SSRIs work by increasing the levels of serotonin in the brain. Serotonin is a neurotransmitter, or chemical messenger, that is involved in a variety of functions, including mood, appetite, and sleep. Low levels of serotonin are thought to be a factor in depression. By increasing serotonin levels, SSRIs can help to improve mood and relieve symptoms of depression. Paroxetine is approved by the Food and Drug Administration (FDA) to treat major depressive disorder, panic disorder, social anxiety disorder, and obsessive-compulsive disorder (OCD). It is also approved to treat menopausal hot flashes and to be used in combination with other medications to treat bipolar disorder. Paroxetine is available in both brand-name and generic form. Brand names for paroxetine include Paxil, Paxil CR, Pexeva, and Brisdelle. Paroxetine may also be used "off-label" for other conditions, such as premenstrual dysphoric disorder (PMDD), attention deficit hyperactivity disorder (ADHD), post-traumatic stress disorder (PTSD), and general anxiety disorder. How Does Paroxetine Work? As mentioned, paroxetine is an SSRI. SSRIs work by increasing the levels of serotonin in the brain. It's thought that depression is caused, at least in part, by low levels of serotonin. By increasing serotonin levels, SSRIs can help improve mood and relieve symptoms of depression. It's not entirely clear how paroxetine works to treat other conditions, such as hot flashes, OCD, or anxiety disorders. Paroxetine Side Effects Paroxetine can cause a variety of side effects. Common side effects include: nausea vomiting diarrhea constipation upset stomach dry mouth drowsiness tiredness increased sweating shaking dizziness sleep problems (insomnia) decreased sex drive More serious side effects include: serotonin syndrome manic episodes seizures changes in blood pressure changes in heart rate kidney problems liver problems pancreatitis bleeding problems low sodium levels in the blood You should talk to your doctor about the potential side effects of paroxetine before starting treatment. Paroxetine Interactions Paroxetine can interact with other medications, herbs, or vitamins you might be taking. An interaction is when a substance changes the way a drug works. This can be harmful or prevent the drug from working well. To help avoid interactions, your doctor should manage all of your medications carefully. Be sure to tell your doctor about all medications, herbs, or vitamins you're taking. To find out how this drug might interact with something else you're taking, talk to your doctor or pharmacist. Examples of drugs that can cause interactions with paroxetine are listed below. MAO inhibitors Tricyclic antidepressants SSRIs SNRIs Lithium Tryptophan Linezolid St. John's wort This is not a complete list of paroxetine drug interactions. Ask your doctor or pharmacist for more information. Paroxetine and Alcohol You should avoid drinking alcohol while taking paroxetine. Drinking alcohol can increase certain side effects of paroxetine. Side effects that can be increased include drowsiness, dizziness, and difficulty concentrating. It can also increase the risk of bleeding when paroxetine is used with blood thinners or aspirin. Pregnancy and Paroxetine Paroxetine should be used during pregnancy only if the potential benefit justifies the potential risk to the fetus. Paroxetine is a category C pregnancy drug. That means two things: Research in animals has shown adverse effects to the fetus when the mother takes the drug. There are no adequate studies in humans, and no well-controlled studies have been done in pregnant women. Paroxetine crosses the placenta and has been found in cord blood at delivery. talk to your doctor about the risks of taking paroxetine during pregnancy. This drug should only be used during pregnancy if the potential benefit justifies the potential risk to the fetus. Paroxetine and Breastfeeding Paroxetine is excreted in human milk. You should not breastfeed while taking paroxetine. If you are taking paroxetine and plan to breastfeed, talk to your doctor about the risks and benefits of breastfeeding while taking this drug. How Should I Take Paroxetine? Paroxetine is available in tablet, extended-release tablet, suspension, and capsule form. It's usually taken once or twice a day, with or without food. The extended-release tablet is taken once a day, with or without food. The suspension should be taken with food. The capsule should be taken with a full glass of water. If you have trouble swallowing capsules, you can open the capsule and sprinkle the contents into a spoonful of applesauce. Swallow all of the mixture right away. Do not save it for later use. Paroxetine should be taken at about the same time every day. To help you remember to take paroxetine, take it at the same time each day. Do not take paroxetine if you have taken an MAO inhibitor in the past 14 days. A dangerous drug interaction could occur. MAO inhibitors include isocarboxazid, linezolid, methylene blue injection, phenelzine, rasagiline, selegiline, tranylcypromine, and others. Do not stop taking paroxetine suddenly, or you could have unpleasant withdrawal symptoms. Talk to your doctor about how to avoid withdrawal symptoms when stopping the medication. If you miss a dose of paroxetine, take it as soon as you remember. If it is almost time for your next dose, skip the missed dose and take the medicine at the next regularly scheduled time. Do not take two doses of paroxetine at the same time. Store paroxetine at room temperature away from moisture and heat. You should not take paroxetine if you are allergic to it. To make sure paroxetine is safe for you, tell your doctor if you have: liver disease kidney disease seizures bipolar disorder (manic depression) a history of drug abuse or suicidal thoughts Some young people have thoughts about suicide when first taking an antidepressant. Stay alert to changes in your mood or symptoms. Report any new or worsening

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