Paroxetine Hydrochloride

Generic Details

Generic Name

Paroxetine Hydrochloride

Other Names

  • Paxil
  • Pexeva
  • Brisdelle

Drug Class

  • Selective Serotonin Reuptake Inhibitor (SSRI)

Chemical Formula

C19H20F1NO3.HCl

Molecular Weight

374.8 g/mol

Mechanism of Action

  • Inhibits the reuptake of serotonin in the brain, leading to increased serotonin levels in the synaptic cleft

Indications

  • Major Depressive Disorder
  • Generalized Anxiety Disorder
  • Obsessive-Compulsive Disorder
  • Panic Disorder
  • Post-Traumatic Stress Disorder

Common Dosage Forms

  • Tablet
  • Oral Suspension

Typical Dosage

  • 20-50 mg once daily

Pediatric Dosage

  • Not established for most indications

Geriatric Dosage

  • Start with lower doses due to increased risk of side effects

Side Effects

  • Nausea
  • Drowsiness
  • Headache
  • Insomnia
  • Sexual dysfunction

Contraindications

  • Hypersensitivity to paroxetine
  • Concomitant use with MAO inhibitors

Pregnancy Category

  • Category D - Risk of fetal harm, but potential benefits may outweigh risks in certain situations

Lactation Safety

  • Limited data available, caution advised

Drug Interactions

  • MAO Inhibitors
  • Thioridazine
  • Tamoxifen
  • Tricyclic Antidepressants

Overdose Symptoms

  • Sweating
  • Tremor
  • Seizures

Antidote for Overdose

  • There is no specific antidote, treatment is supportive and symptomatic

Storage Conditions

  • Store at room temperature away from moisture and heat

Pharmacokinetics

  • Absorption: Well absorbed orally, peak plasma concentrations in 6-10 hours
  • Distribution: Crosses the blood-brain barrier and placenta, excreted in breast milk
  • Metabolism: Primarily hepatic through the CYP2D6 pathway
  • Excretion: Mainly through urine, with minimal excretion in feces

Precautions

  • Monitor for worsening of symptoms, especially in the initial weeks of therapy
  • Consider dose reduction in hepatic impairment

Warnings

  • Increased risk of suicidal thinking and behavior in children, adolescents, and young adults

Others

  • May cause withdrawal symptoms if stopped abruptly, taper dosage gradually