Paroxetine – Potent SSRI antidepressant for depression and anxiety disorders.
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What is Paroxetine?
Paroxetine is a potent SSRI antidepressant that’s particularly effective for severe anxiety disorders and depression, though it requires careful management due to its challenging withdrawal profile and side effect considerations. It remains valuable for specific clinical situations where its unique properties are beneficial.
Book an online consultation if you’re experiencing severe depression or anxiety disorders that may benefit from SSRI treatment, or if you need expert guidance on antidepressant management. Our GPs can assess your mental health needs and determine if Paroxetine is appropriate while providing proper monitoring and support.
What is Paroxetine used for?
- Major depressive disorder
- Generalised anxiety disorder
- Panic disorder
- Social anxiety disorder (social phobia)
- Post-traumatic stress disorder (PTSD)
- Obsessive-compulsive disorder (OCD)
- Premenstrual dysphoric disorder
How does Paroxetine work?
A selective serotonin reuptake inhibitor (SSRI) that blocks serotonin reuptake more potently than other SSRIs, increasing serotonin levels in the brain to improve mood and reduce anxiety symptoms.
Dosage and Administration
Adults
Starting dose 20mg daily, may be increased to 40-50mg daily. Maximum 60mg daily for severe conditions.
Children
Not recommended for children and adolescents under 18 years.
Important Notes
- Take in the morning with or without food.
- Start with lowest effective dose and increase gradually if needed.
- May take 4-6 weeks to feel full benefits.
- NEVER stop suddenly—very gradual dose reduction essential.
Side Effects
Common Side Effects
- Nausea and stomach upset
- Drowsiness or insomnia
- Dry mouth
- Dizziness
- Tremor
- Sexual side effects
- Weight gain
- Increased sweating
Serious Side Effects
Seek immediate medical attention if you experience:
- Thoughts of self-harm or suicide (especially when starting)
- Serotonin syndrome (confusion, rapid heart rate, fever)
- Severe withdrawal symptoms if stopped suddenly
- Abnormal bleeding
- Low sodium levels (hyponatraemia)
- Severe allergic reactions
Important Warnings
- May increase thoughts of self-harm, especially in young adults—close monitoring required.
- NEVER stop suddenly—paroxetine has the most severe withdrawal syndrome of all SSRIs.
- Tell your GP if you have bleeding disorders, epilepsy, or kidney problems.
- May increase bleeding risk, especially with blood thinners.
- Withdrawal must be extremely gradual due to short half-life.
Drug Interactions
Tell your GP if you're taking any of the following medications:
- MAOIs—dangerous interaction, must avoid completely.
- Warfarin and blood thinners—significantly increased bleeding risk.
- Tramadol—increased risk of serotonin syndrome.
- Tamoxifen—may reduce tamoxifen effectiveness.
- Other antidepressants—risk of serotonin syndrome.
- St John's Wort—avoid this herbal supplement.
Frequently Asked Questions
Why is Paroxetine withdrawal considered particularly difficult?
Paroxetine has the shortest half-life of all SSRIs and is the most potent, making withdrawal symptoms more severe and frequent. Extremely gradual tapering over months is often necessary.
How is Paroxetine different from other SSRIs like Sertraline?
Paroxetine is more potent and sedating than other SSRIs, with more anticholinergic effects (dry mouth, constipation) and more weight gain, but may be more effective for severe anxiety.
Can Paroxetine be used during pregnancy?
Paroxetine may increase risk of heart defects in early pregnancy and should generally be avoided. Your GP will help you weigh risks and benefits or switch to safer alternatives.
Why might my GP choose Paroxetine over other antidepressants?
Paroxetine may be chosen for severe anxiety disorders, when sedation is beneficial, or when other SSRIs haven't been effective, despite its more challenging side effect profile.
Medically Reviewed by: Mohammed Hassan - Independent Prescriber
Last Updated: 2025-01-14