Paroxetine

  1. About 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.

  2. Key facts

    • 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.
    • Paroxetine can affect an unborn baby. Tell your doctor straight away if you’re trying to get pregnant or become pregnant while taking it.
    • Paroxetine can cause withdrawal symptoms, so don't stop taking it without talking to your doctor.
    • Paroxetine is called by the brand name Seroxat.
  3. Who can and can't take paroxetine

    Paroxetine can be taken by adults aged 18 and over.

    Paroxetine isn't suitable for some people. 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 having electroconvulsive treatment
    • are trying to become pregnant, are already pregnant or you are breastfeeding - paroxetine is not recommended in pregnancy or while breastfeeding
    • have an eye condition called glaucoma because paroxetine can increase the pressure in your eye
    • have epilepsy, as paroxetine can affect your risk of having a seizure

    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.

  4. How and when to take it

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

    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?

    Ask your doctor for advice straight away. An overdose can lead to potentially serious symptoms such as:

    • vomiting
    • shaking
    • feeling sleepy
    • fast heart rate
    • seizures
    • fever
  5. Side effects

    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:

    • less appetite than usual
    • sweating a lot
    • feeling sleepy or being unable to sleep
    • unusual dreams
    • feeling dizzy
    • headache
    • feeling like you can’t concentrate
    • shaking
    • yawning
    • dry mouth
    • constipation or diarrhoea
    • feeling weak or tired
    • feeling sick or vomiting
    • feeling more or less interested in sex, or having problems reaching orgasm

    Serious side effects

    Serious side effects are rare and happen in less than 1 in 1,000 people. Tell a doctor straight away if you get:

    • headache, trouble focusing, memory problems, not thinking clearly, weakness, seizures or losing your balance - these can be signs of low sodium levels
    • thoughts about harming yourself or ending your life
    • restlessness or can't sit still
    • chest pain or pressure or shortness of breath
    • blurred vision
    • weight gain or loss without trying to
    • changes in your periods such as heavy bleeding, spotting or bleeding between periods
    • painful erections that last longer than 4 hours - this may happen even when you're not having sex

    Or, if you develop any signs of abnormal bleeding including:

    • 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
    • any bleeding that is very bad or that you can't stop

    Serious allergic reaction

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

    A serious allergic reaction is an emergency. Contact a doctor straight away if you think you or someone around you is having a serious allergic reaction.

    The warning signs of a serious allergic reaction are:

    • getting a skin rash that may include itchy, red, swollen, blistered or peeling skin
    • wheezing
    • tightness in the chest or throat
    • having trouble breathing or talking
    • swelling of the mouth, face, lips, tongue, or throat

    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.

  6. How to cope with side effects

    What to do about:

    • feeling sleepy - cut down the amount of alcohol you drink
    • dry mouth - chew sugar-free gum or sugar-free sweets
    • being unable to sleep - take paroxetine first thing in the morning
    • feeling sick - make sure you take paroxetine in the morning with some food
    • constipation - eat more high-fibre foods such as fresh fruit and vegetables and cereals, and drink plenty of water. Try to exercise more regularly, for example, by going for a daily walk or run. If this doesn't help, talk to your pharmacist or doctor.
    • diarrhoea - drink plenty of water in small, frequent sips. Do not take any other medicines to treat diarrhoea without speaking to a pharmacist or doctor. 

    Except for problems getting to sleep, you can reduce the chance of having a side effect that bothers you if you take paroxetine in the evening. That way you're asleep when the level of medicine in your body is highest.

  7. Pregnancy and breastfeeding

    No medicines for depression are considered completely safe to take in pregnancy or while breastfeeding. Your doctor will want to prescribe paroxetine only when the benefits of you taking the medicine outweigh the risks.

    Paroxetine and similar antidepressants have been linked with a small risk of problems for the unborn baby when they're taken in early or late pregnancy.

    Paroxetine and breastfeeding

    Paroxetine passes into breast milk and has been linked with side effects, including withdrawal symptoms, in breastfed babies.

    Tell your doctor if you're trying to get pregnant, are already pregnant or if you're breastfeeding.

  8. Cautions with other medicines

    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

    Don't 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.​

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

  9. Common questions

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