Paroxetine is used to treat depression and anxiety.
It may also be used to treat other mood related disorders such as general feeling of anxiousness, social anxiety disorder (fear of social situations), panic disorder (with or without a fear of places and situations that might cause panic, helplessness, or embarrassment), obsessive-compulsive disorder or OCD (a disorder characterised by uncontrollable urge to do repetitive and ritualised behaviours), and posttraumatic stress disorder (a condition that occurs after a very emotional traumatic experience).
This medicine may also be used to treat premenstrual dysphoric disorder (a condition in women characterised by severe depression, irritability and tension before menstruation). It may also be used to help reduce moderate to severe hot flashes associated in menopausal women.
This medicine may be used to treat other conditions as decided by your doctor.
Your doctor will discuss the use of this medicine as different brands and preparations of Paroxetine may only be used for a specific condition.
Do not use this medicine for any conditions other than what is prescribed by your doctor.
Take Paroxetine exactly as directed by your doctor or according to the instructions on the label. Do not take more or less than instructed by your doctor.
You may take this medicine with or without food. Try to take it at the same time every day.
Paroxetine is available as a tablet (in conventional or modified-release form), capsule or as an oral suspension.
If you are taking an oral suspension, shake the bottle well before you take it to ensure that the liquid is evenly mixed. Use the measuring spoon or cup provided to measure your dose.
If you are taking the modified-release/controlled-release/extended-release type of tablet (usually labeled as “CR”, “ER”), swallow it whole. Do not divide, chew or crush the tablet.
It is best to take the tablet or oral suspension in the morning with food.
If you are taking the capsule, it is best to be taken at bedtime with or without food.
The dose of this medicine will be decided by your doctor. Different brands of Paroxetine are indicated for a specific condition. Your doctor will advise you on the treatment timeframe depending on your condition and response to the medication.
Paroxetine must be taken regularly for it to be effective. Continue taking this medicine even when you feel better. Do not stop taking it suddenly as it may worsen your condition.
Take the missed dose as soon as you remember. If it is almost time for your next dose, skip the missed dose and return to your normal dosing schedule.
DO NOT double a dose under any circumstances.
If you often forget to take your medicine, let your doctor and pharmacist know.
Alert your doctor if you have uncontrolled epilepsy (fits or seizures) as this medicine may not be suitable for you.
Do not take Paroxetine if you are pregnant. If you become pregnant while being treated with this medicine, alert your doctor immediately. Paroxetine may cause harm to your unborn child. You must use proven birth control methods while taking this medicine.
Do not take Paroxetine with medicines used to treat depression known as monoamine oxidase inhibitors (MAOIs), medicines for mood disorder, blood disorder, and certain antibiotic. Please see section “Can I take it with other medicines?” below for more information.
Inform your doctor if you have the following conditions:
- bipolar disorder (mood changes between feeling very high and very low)
- history of mania (feeling highly excited, being over-active and easily irritated or distracted)
- with or a history of epilepsy (fits or seizures) or predisposing conditions to fits or seizures e.g. brain damage, alcoholism
- narrow-angle glaucoma (increased pressure in the eye)
- heart disease e.g. recent heart attack
- history of bleeding problems
- diabetes
- low blood volume circulating in the body
- stomach problems
- liver disease
- kidney disease
Let your doctor know if you are breastfeeding.
Be sure to check with your doctor or pharmacist before giving Paroxetine to an elderly or those who are debilitated (a person who is physically or mentally weak usually due to illness or old age). Elderly and debilitated people may be more sensitive to the side effects.
Do not switch dosage forms and brands unless instructed by your doctor. Different preparation and brands of this medicine may vary on how it works in your body.
Notify your doctor if you have recently undergone electroshock therapy (also known as electroconvulsive therapy or ECT).
A certain enzyme called CYP2D6 is involved in the breakdown of this medicine in the body. Individuals who are known as poor metabolisers of CYP2D6 may experience enhanced side effects of Paroxetine (e.g. difficulty sleeping, headache) that may require dose adjustments. Although not routinely done, your doctor may advise you to undergo genetic testing to check if this medicine is best suited for you. If you know you have this gene type, inform your doctor.
Keep your appointments with your doctor. Your doctor needs to monitor your condition and check your response to the medication regularly.
- Pregnancy tests must be done before your treatment to know if this medicine is suited for you to take.
- Your doctor may need to perform blood tests to make sure that your liver and kidney functions are normal. Your doctor will advise you about how often you will need to have these tests.
- It is important for you to monitor your condition especially at the start of treatment and if your dosage is still being adjusted. Monitor for signs of suicidal thoughts and unusual changes in behaviour or mood while you are being treated with this medicine.
What lifestyle changes should I make to cope with depression?
Regular exercise and eating a healthy diet will help increase energy and hormones in the body such as serotonin, endorphins and other feel-good chemicals that minimise mood swings. Get enough sleep, as lack of sleep may cause irritability, moodiness, sadness, and tiredness.
Paroxetine may affect your ability to make decisions, think clearly, or react quickly. If affected, do not drive or take part in any activity in which you need to be alert.
Other side effects include any of the following: headache, dizziness, difficulty in concentrating, nausea, vomiting, constipation, dry mouth, diarrhoea, yawning, loss of appetite, weight gain, and difficulty sleeping.
Some side effects may need immediate medical help. Alert your doctor quickly if you experience any of the following:
- having thoughts of self-harm
- unusual changes in mood or behaviour (being too depressed, irritable, aggressive, or having compulsive and impulsive behaviour)
- confusion or hallucination (seeing, hearing or feeling things that are not existent)
- fast heartbeat, increased sweating, stiffness, sudden jerking or shaking of muscles
- restlessness, unable to sit or stand still, or need to move often
- painful eyes, blurring of your vision, swelling or redness around the eyes
- fits or seizures
- changes in sex drive
- unusual bleeding or bruising, coughing up of blood, passing bloody stools
- rashes, breathlessness, swollen face, eyes, tongue or throat
Inform your doctor if any of these side effects do not go away or are severe, or if you experience other side effects.
Do not take Paroxetine if you are currently taking or have taken a medicine to treat depression known as monoamine oxidase inhibitor (MAOI) such as isocarboxazid, phenelzine and tranylcypromine within 14 days of stopping MAOI.
Do not take this medicine if you are taking or using any of the following medicines:
- medicines for mood disorders e.g. pimozide, thioridazine
- linezolid (antibiotic)
- injectable methylene blue (medicine for certain blood disorder)
Inform your doctor and pharmacist if you are taking or using any of these medicines:
- other medicines for depression or mood disorder
- medicines for epilepsy (fits or seizures) e.g. phenytoin, phenobarbital, carbamazepine
- medicines for migraine e.g. sumatriptan, oxitriptan
- strong painkillers e.g. fentanyl, tramadol, pethidine
- medicines for pain and inflammation e.g. aspirin, ibuprofen, celecoxib, meloxicam, diclofenac
- medicines for irregular heartbeat e.g. propafenone, flecainide, encainide, digoxin
- blood-thinning medicines e.g. warfarin, clopidogrel
- muscle relaxants used during surgery e.g. suxamethonium, mivacurium
- tamoxifen (medicine for breast cancer)
- fosamprenavir/ritonavir (medicine for HIV infection)
- pravastatin (cholesterol-lowering medicine)
- metoprolol (medicine for high blood pressure)
- procyclidine (medicine for Parkinson’s disease)
- atomoxetine (medicine to treat hyperactivity disorders)
- buspirone (medicine for anxiety)
- theophylline (asthma medicine)
- St. John’s wort (herbal supplement)
This list does not include all medicines that may interact with Paroxetine.
Always notify your doctor and pharmacist if you are taking any other medicines, including herbal tonics such as traditional Chinese medicines, supplements and medicines that you buy without a prescription.
Avoid alcohol.
Store in a cool, dry place away from the reach of children.
Keep the tablets and capsules in their original package to protect from light and humidity.
Medicines must not be used past the expiry date.
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