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Paxil 20mg Tablet
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Indications & Clinical Uses
- Paxil 20 mg tablets contain paroxetine, a selective serotonin reuptake inhibitor (SSRI) antidepressant.
- It is approved for use in adults to treat major depressive disorder, obsessive-compulsive disorder, panic disorder, social anxiety disorder, generalized anxiety disorder, and post-traumatic stress disorder.
- Paxil is not approved for children or adolescents under 18 years of age.
- The tablet is taken by mouth, usually once daily in the morning with or without food, and the dose is adjusted gradually by a healthcare provider according to response and tolerability.
- The same active ingredient, paroxetine, is also sold as Paxil CR in an extended-release form and as generic paroxetine tablets or capsules; check with the pharmacist if a different brand has been dispensed.
- Paxil should be prescribed and monitored by a healthcare provider experienced in treating psychiatric conditions.
Side Effects
- Paxil carries a boxed warning: antidepressants, including paroxetine, can increase the risk of suicidal thoughts and behaviour in children, adolescents and young adults up to age 24, especially during the first weeks of treatment or after a dose change, and close monitoring is needed.
- Very common side effects, affecting more than 1 in 10 people, include nausea, dry mouth, weakness, sweating, drowsiness, tremor and sexual problems such as reduced libido or difficulty reaching orgasm.
- Common effects include dizziness, insomnia, constipation, diarrhoea and decreased appetite.
- Serious but rare reactions include serotonin syndrome, unusual bleeding, and severe agitation, mania or worsening depression; seek urgent medical help for chest pain, seizures, high fever, confusion or thoughts of self-harm.
- Stopping abruptly can cause withdrawal symptoms, so any dose change should be made gradually under medical supervision.
Precautions & Warnings
- Paxil must not be combined with a monoamine oxidase inhibitor (MAOI) or started within 14 days of stopping one, and it is contraindicated with pimozide or thioridazine because of serious heart rhythm risks.
- It should be used with caution in people with a history of mania, seizures, bleeding disorders or angle-closure glaucoma, and liver or kidney impairment may require a lower dose.
- Paroxetine taken in early pregnancy has been linked to a small increase in heart defects in the baby, and use in late pregnancy may cause breathing or feeding problems in the newborn; discuss the risks and benefits of continuing or stopping treatment with a healthcare provider before or during pregnancy.
- Paroxetine passes into breast milk, so breastfed infants should be watched for unusual sleepiness or poor feeding.
- Paxil can impair alertness, so driving or operating machinery should be avoided until the individual effect on the person is known.
- Mood and blood pressure should be monitored periodically during treatment.
Avoid Interactions
- Combining Paxil with other serotonergic medicines, such as other antidepressants, tramadol, triptans, St John's Wort or lithium, increases the risk of serotonin syndrome, with agitation, high temperature, rapid heartbeat and muscle twitching needing urgent medical attention.
- Paxil must never be taken with an MAOI, and pimozide and thioridazine must be avoided completely because of the risk of dangerous heart rhythm changes.
- Paroxetine inhibits the CYP2D6 liver enzyme, so it can raise blood levels of other drugs broken down by this pathway, including tamoxifen (reducing its effectiveness), some antipsychotics, certain beta-blockers and antiarrhythmics such as flecainide and propafenone.
- Anticoagulants such as warfarin, and antiplatelet drugs such as aspirin or NSAIDs, carry an increased bleeding risk when taken with Paxil.
- Alcohol can worsen drowsiness and should be limited.
- Always tell the healthcare provider and pharmacist about all prescription medicines, over-the-counter products and herbal supplements being taken before starting Paxil.
References
Frequently Asked Questions
Paxil (paroxetine) 20 mg is an SSRI antidepressant used in adults for major depression, obsessive-compulsive disorder, panic disorder, social anxiety, generalized anxiety and post-traumatic stress disorder. It is taken once daily and is not approved for use in children or adolescents under 18.
Paxil is a tablet taken by mouth once daily, usually in the morning, with or without food. Your healthcare provider starts at a low dose and adjusts it gradually based on how you respond and tolerate it. Do not stop it suddenly.
Common Paxil side effects include nausea, dry mouth, drowsiness, sweating, tremor and sexual problems. Paxil carries a boxed warning for increased suicidal thoughts and behaviour in people under 24; get urgent help for agitation, self-harm thoughts or severe mood changes.
Avoid MAOIs, pimozide and thioridazine with Paxil because of serious interaction risks, and avoid alcohol, which worsens drowsiness. Tell your provider about other antidepressants, tramadol, triptans, warfarin or St John's Wort, since combining these can cause serotonin syndrome or bleeding.
If you miss a Paxil dose, take it as soon as you remember unless it is almost time for the next one; do not double up. Missing doses or stopping abruptly can trigger withdrawal symptoms such as dizziness or irritability, so any change should be gradual and supervised.
Paxil (paroxetine) in early pregnancy is linked to a small increase in heart defects, and late-pregnancy use may cause newborn breathing or feeding problems. Tell your healthcare provider if you are pregnant, planning pregnancy or breastfeeding so the risks and benefits can be weighed.
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