Suffering from depression can feel frustrating, even overwhelming, especially if you have limited access to personalized care. Although common, depression often goes untreated. For many people, taking medication is a significant step in allowing them to improve their mental health.

Paroxetine (often known by the brand names Paxil, Pexeva, or Brisdelle) is one common medication often used to treat major depressive disorder (MDD), post-traumatic stress disorder (PTSD), and generalized anxiety disorder (GAD). On this page, we’ve outlined some important information about the drug.

What is paroxetine (Paxil)?

What is paroxetine? How does it work?

Paroxetine is an antidepressant approved to treat conditions such as major depressive disorder (MDD), generalized anxiety disorder (GAD), post-traumatic stress disorder, social anxiety disorder, and panic disorder. It may sometimes be used off-label to treat chronic headaches or tingling in the hands and feet caused by diabetes. 

Paroxetine belongs to a class of medications called Selective Serotonin Reuptake Inhibitors (SSRIs). This class of medications produce an effect by regulating the level of a neurotransmitter called serotonin in the brain. SSRIs do this by preventing the reabsorption of serotonin. This, in turn, increases the level of serotonin circulating in the brain, which can help improve mood and mental balance.  

How is paroxetine typically used?

A typical adult dosage of paroxetine in treatment of major depressive disorder or general anxiety disorder is 20mg orally, once daily (generally in the morning). Those with panic or social anxiety disorders are often prescribed a lower amount—around 10 mg once daily. The optimal dosage for you may differ from average depending on your body and your mental health needs, and thus you should only take medication as prescribed by your doctor.

If you have been prescribed paroxetine, don’t worry if you do not see full effects right away. Many medications take some time to begin showing effects. Moreover, doctors will sometimes start their patients over lose and ramp it up over time to help prevent any negative reactions.

If your doctor believes that you are ready to come off of the medication, they will gradually reduce your dose over time until it is safe to stop taking the medication completely. This process is often referred to as “tapering”, and it helps prevent negative reactions associated with stopping a medication too quickly. 

What are some possible side effects?

Some common side effects of paroxetine include:

• Dizziness
• Difficulty concentrating
• Dry mouth
• Heartburn
• Diarrhea
• Headaches

Some serious (but uncommon side effects) include:

• Hallucinations
• Difficulty breathing or swallowing
• Seizures
• Uncontrollable shaking of some parts of the body
• Bloody vomit
• Bloody stools
• Chest pain

Call 911 or seek emergency care if you notice any severe side effects. You can click here to see a more comprehensive list of paroxetine side effects. 

Why do these side effects occur? 

Any medication can potentially lead to side effects, and a person’s likelihood of having side effects depends on many factors, including age, lifestyle, and the type of medication itself. Side effects may occur because drugs often have broad or poorly targeted effects, or the drug target itself may have many downstream effects on the body. 

Serotonin is a chemical in the brain responsible for several activities and functions of the body such as mood, sleep, digestion etc. paroxetine increases the level of serotonin in the brain, which can affect some of these other body functions and cause unintended side effects. 

Many non-serious side effects of mental health medications like paroxetine go away after a few weeks as your body gets used to the medication. However, if a side effect persists, is intolerable, or severely hinders your ability to go about your daily life, talk to your doctor, because this might be a sign that the medication is not a good fit. 

How do your genes relate to paroxetine? 

Genetics can affect your body’s response to medication. Some people with a certain variation of CYP2D6 might be slow metabolizers for paroxetine. Being a slow metabolizer means your body will break down the medication more slowly than others, which means the drug sticks around in your body for longer than average and may lead to side effects. For slow metabolizers, a doctor might opt to prescribe a different medication or prescribe a lower dosage. 

Paroxetine may also inhibit the activity of CYP2D6, leading to slower medication breakdown. Doctors must be careful when prescribing paroxetine alongside other medications, because some medications may stay in the body unmetabolized longer than the optimal time frame.  

One way to predict whether you’ll have a positive outcome while taking paroxetine is by taking a genetic test to determine what genetic variations you have and how they affect medication metabolization. Your DNA can help your doctor rule out less suitable medications and make more informed decisions so that you can get better, faster.

Special Precautions

• Inform your doctor of any other medication or supplements you are taking to prevent any unwanted drug interactions. 
• Paroxetine should not be used during pregnancy. Inform your doctor if you are pregnant or are planning to get pregnant soon if you have already started taking paroxetine. 
• Paroxetine may cause some feelings of irritation or agitation in teenagers and young adults. Notify your doctor immediately if you notice any behavioral changes when taking paroxetine. 
• Paroxetine may affect your vision or cause you to be drowsy, you should avoid driving or handling heavy machinery after using paroxetine. 

If you show signs of an allergic reaction to paroxetine (hives, difficulty breathing, rash, swelling), call 911 or go to the nearest emergency department.

Some medications, vitamins, and herbs may interfere with how paroxetine works. Make sure to tell your doctor about all other medications you are taking before starting paroxetine to avoid negative interactions. For full details, see the FDA’s full list of precautions. 

Looking to find the right medication for your mental health? Join Prairie today to connect to expert providers and affordable medication options.