Paroxetine (Paxil, Pexeva) Side Effects

Paroxetine (Paxil, Pexeva) is one of a class of antidepressants called selective serotonin reuptake inhibitor (SSRI). It has been marketed since 1992 by Glaxo SmithKline (formerly SmithKline Beecham) and has been available under generic brands since 2003. It is prescribed for major depression, panic disorder, obsessive-compulsive disorder, posttraumatic stress disorder, social anxiety, generalized anxiety disorder, and menopausal hot flashes and night sweats.

Paroxetine should not be prescribed as much as possible to anyone under 18, many adult males, and pregnant women. The last warning is because clinical trials indicate that it increases the risk of birth defects. This should also apply to women who are planning to get pregnant.

The drug is also contraindicated for pediatric and adolescent patients with depression or anxiety disorders as paroxetine trials showed an increased risk of suicidality. Paroxetine is also associated with higher than usual incidence of drowsiness, nausea, and weight gain. Sexual dysfunction, which is a side effect shared by SSRI drugs, includes genital anesthesia and ejaculatory anhedonia, and can last for a long time after discontinuation of the drug. Paroxetine is also associated with the highest incidence and most severe cases of withdrawal syndrome in its class, although using a liquid formulation may help prevent this by allowing a gradual decrease of the dosages.  Other symptoms associated with paroxetine includes asthenia (lack of energy), sweating, insomnia, dry mouth, dizziness, high blood pressure, impaired memory, decreased fertility, paresthesia (tingling sensation), and tremors.

These side effects generally present within the first 4 weeks of drug intake but even when the body acquires a tolerance, the effects can re-emerge as withdrawal can have a rebound effect. Changing the dosage may also trigger a re-emergence or worsening of the side effects. There are also observed cases of akathisia (feeling of uneasiness and restlessness), mania, hypomania, alcohol abuse, long-term memory impairment, hyperacusis, and activation syndrome with paroxetine treatment.

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