Paroxetine

Paroxetine is a type of antidepressant known as an SSRI (selective serotonin reuptake inhibitor).

It’s often used to treat depression and also sometimes for obsessive compulsive disorder (OCD), panic attacks, anxiety or post-traumatic stress disorder (PTSD).

Paroxetine helps many people recover from depression, and it has fewer unwanted effects than older antidepressants.

Paroxetine is available on prescription. It comes as tablets and as a liquid that you swallow.

• It usually takes 4 to 6 weeks for paroxetine to work.
• Side effects such as feeling sick or sexual problems are common. They are usually mild and go away after a couple of weeks.
• If you and your doctor decide to take you off paroxetine, your doctor will probably recommend reducing your dose gradually to help prevent extra side effects.
• Paroxetine is also called by the brand name Seroxat.

Paroxetine can be taken by adults aged 18 and over.

Check with your doctor before starting to take paroxetine if you:

• have had an allergic reaction to paroxetine or any other medicines in the past
• have a heart problem – as paroxetine can speed up or change your heartbeat
• have ever taken any other medicines for depression – some rarely
  used antidepressants can interact with paroxetine to cause very high blood pressure, even when they have been stopped for a few weeks
• are trying to become pregnant, are already pregnant or you are
  breastfeeding
• have an eye condition called glaucoma because paroxetine can increase the pressure in your eye
• have epilepsy or are having electroconvulsive treatment – as paroxetine may increase your seizures

If you have diabetes, paroxetine can make it more difficult to keep your blood sugar stable.
Monitor your blood sugar more often for the first few weeks of treatment with paroxetine and adjust your diabetes treatment if necessary.

Take paroxetine once a day, in the morning. It’s best to take it with food so it doesn’t upset your stomach.

Paroxetine tablets come in different strengths ranging from 10mg to 30mg.

How much will I take?

The dose of paroxetine that you’re prescribed depends on why you are
taking it. Most people will start with 10mg or 20mg. This might be
gradually increased until you and your doctor agree that you have found a dose that suits you.

The maximum recommended dose of paroxetine is 50mg or 60mg, depending on why you are taking it. If you are 65 or older the maximum recommended dose is 40mg a day. If you have problems with your liver or kidneys, you may be asked to take a lower dose than usual.

With paroxetine liquid, 10ml is equivalent to a 20mg tablet.

What if I forget to take it?

If you occasionally forget to take a dose of paroxetine, don’t worry. If you remember before bed, take your paroxetine straight away. If you remember during the night, or the next day, leave out the dose
completely. Never take 2 doses at the same time to make up for a
forgotten one.

If you forget doses often, it may help to set an alarm to remind you. You could also ask your pharmacist for advice on other ways
to help you remember to take your medicine.

What if I take too much?

The amount of paroxetine that can lead to an overdose varies from person to person.

Call your doctor straight away if:

Like all medicines, paroxetine can cause side effects in some people, but many people have no side effects or only minor ones. Some of the common side effects of paroxetine will gradually improve as your body gets used to it.

Common side effects

Common side effects happen in more than 1 in 100 people. Keep taking the medicine but tell your doctor or pharmacist if these side effects bother you or don’t go away:

• feeling sick (nausea)
• headaches
• being unable to sleep
• diarrhoea
• feeling tired or weak

Serious side effects

Serious side effects are rare and happen in less than 1 in 1,000 people.

Go to A&E immediately if you get:

• chest pain or pressure or shortness of breath
• painful erections that last longer than 4 hours – this may happen even when you’re not having sex
• any bleeding that is very bad or that you can’t stop such as cuts or nosebleeds that don’t stop within 10 minutes

Tell a doctor straight away if you get:

• constant headaches, long lasting confusion or weakness, frequent muscle cramps – these can all be signs of low sodium levels in your blood. In severe cases low sodium levels can lead to seizures.
• thoughts about harming yourself or ending your life
• vomiting blood or dark vomit, coughing up blood, blood in your
  pee, black or red poo – these can be signs of bleeding from the gut
• bleeding from the gums or bruises that appear without a reason or that get bigger

Book an appointment with your doctor if you experience:

• restlessness or can’t sit still
• blurred vision
• weight gain or loss without trying
• changes in your periods such as heavy bleeding, spotting or bleeding between periods

Serious allergic reaction

In rare cases, it’s possible to have a serious allergic reaction (anaphylaxis) to paroxetine.

Call 999 or go to A&E if:

These are not all the side effects of paroxetine. For a full list see the leaflet inside your medicines packet.

You can report any suspected side effect to the UK safety scheme.

What to do about:

• feeling sick (nausea) – try taking paroxetine with or after food. It may also help to stick to simple meals and avoid rich or spicy food.
• headaches – make sure you rest and drink plenty of fluids. Do not drink too much alcohol. Ask your pharmacist to recommend a painkiller. Headaches should usually go away after the first week of taking paroxetine. Talk to your doctor if they last longer than a week or are severe.
• being unable to sleep – take paroxetine first thing in the morning
• diarrhoea – drink plenty of water or other fluids to avoid dehydration. Signs of dehydration include peeing less than usual or having dark strong-smelling pee. Do not take any other medicines to treat diarrhoea without speaking to a pharmacist or doctor.
• feeling tired or weak – if paroxetine makes you feel tired or weak, stop what you’re doing and sit or lie down until you feel better. Do not drive or use tools or machinery if you’re feeling tired. Do not drink alcohol as it will make you feel worse. If these symptoms don’t go away after a week or two, ask your doctor for advice.

It’s important for you and your baby that you stay well during your pregnancy. If you become pregnant while taking paroxetine speak to your doctor. Do not stop taking your medicine unless your doctor tells you to.

Paroxetine has been linked to a very small increased risk of problems for your unborn baby. However, if your depression is not treated during pregnancy this can also increase the chance of problems.

You may need to take paroxetine during pregnancy if you need it to remain well. Your doctor can explain the risks and the benefits, and will help you decide which treatment is best for you and your baby.

For more information about how paroxetine can affect you and your baby during pregnancy, read the leaflet about the best use of medicines in pregnancy (BUMPS).

Paroxetine and breastfeeding

If your doctor or health visitor says your baby is healthy, paroxetine can be used during breastfeeding. It has been used by many breastfeeding mothers without any problems.

Paroxetine passes into breast milk in very small amounts, and has been linked with side effects in very few breastfed babies.

It is important to continue taking paroxetine to keep you well. Breastfeeding will also benefit both you and your baby.

If you notice that your baby isn’t feeding as well as usual, or seems unusually sleepy, or if you have any other concerns about your baby, then talk to your health visitor or doctor as soon as possible.

Tell your doctor if you’re:

Some medicines and paroxetine can interfere with each other and increase the chances of you having side effects.

Tell your doctor if you’re taking these medicines before you start paroxetine:

• any medicines that affect your heartbeat – as paroxetine can speed up or change your heartbeat
• any other medicines for depression – some rarely used
  antidepressants can interact with paroxetine to cause very high blood
  pressure even when they have been stopped for a few weeks
• any medicines for schizophrenia – some rarely used medicines for schizophrenia can interact with paroxetine to cause heart problems

Mixing paroxetine with herbal remedies and supplements

Do not take St John’s wort, the herbal remedy for depression, while
you are being treated with paroxetine as this will increase your risk of
side effects.

Important

Tell your doctor or pharmacist if you’re taking any other medicines, including herbal remedies, vitamins or supplements.