Class: SSRI Antidepressant
Dosage Forms. Tablet: 10 mg, 20 mg, 30 mg, 40 mg; Tablet (Controlled Release): 12.5 mg, 25 mg, 37.5 mg; Solution, Syrup: 10 mg/5 mL; Suspension: 10 mg/5mL
Common FDA Label Indication, Dosing, and Titration.
1. Depression: Adults, immediate release, 20 mg po daily, titrate to 50 mg po daily; Adults, controlled release, 12.5 mg po daily, titrate to 62.5 mg po daily; Children 8 y and older, 10-20 mg po daily
2. OCD: Adults, 20 mg po daily, titrate to 60 mg po daily; Children, 8 y of age and older, 10 mg po daily, titrate to 30 mg daily
3. Panic disorder: Immediate release, 10 mg po daily, titrate to 60 mg po daily; Controlled release, 12.5 mg po daily, titrate to 75 mg po daily
4. Premenstrual dysphoric disorder: 12.5 mg po daily or for 14 d prior to expected start of menses, titrate to 25 mg po daily
Off-Label Uses. None
MOA. Paroxetine is a highly selective and potent inhibitor of serotonin reuptake (an SSRI) similar to fluoxetine.
Drug Characteristics: Paroxetine
Medication Safety Issues: Paroxetine
Drug Interactions: Paroxetine
Adverse Reactions: Paroxetine
Efficacy Monitoring Parameters. Improvement in symptoms of depression, panic disorder, OCD, premenstrual syndrome.
Toxicity Monitoring Parameters. Worsening of depression, suicidality, or unusual changes in behavior, especially at the initiation of therapy or with dosage increases or decreases; signs/symptoms of abnormal bleeding.
Key Patient Counseling Points. Do not chew or crush controlled-release tablet. Shake suspension well before using. Avoid activities requiring mental alertness or coordination until drug effects are realized. Symptomatic improvement may not be seen for several weeks. Avoid abrupt discontinuation. Do not drink alcohol or use NSAIDs or aspirin while taking this drug.
Clinical Pearls. If intolerable withdrawal symptoms occur following a decrease in dose or therapy discontinuation, may need to resume the previous dose and taper at a more gradual rate.