Paroxetine (generic for Paxil®)

Paroxetine is the generic equivalent of Paxil®.

By law, a generic drug must be the same as its brand name counterpart in terms of active ingredient, dosage, safety, effectiveness, strength, stability, and quality. A generic may, however, differ in its inactive ingredients (i.e. flavoring, fillers, and preservatives).

Paroxetine (Paxil®) does come with serious warnings. These include:

• Increased risk of suicidal thoughts or actions*

• Serotonin syndrome—a rare, but potentially life-threatening condition that occurs when there’s too much serotonin in the brain

• Withdrawal symptoms—abrupt discontinuation of treatment can cause nausea, anxiety, confusion, and dizziness

• Abnormal bleeding

• Seizures or convulsions

• Manic episodes or hypomania in patients with bipolar disorder

• Severe allergic reactions

• Changes in appetite or weight

• Low sodium levels in the blood

• Visual problems or glaucoma

• Difficulty sitting still or restlessness (akathisia)

• Increased risk of bone fractures

• May cause harm to the fetus if taken during pregnancy

If any of the above concern you, speak with your doctor or pharmacist about your perceived risk and other treatment options that exist.

*This warning is a boxed warning. A boxed warning is the most serious type of medication warning assigned by the FDA.

Paroxetine is FDA approved for the treatment of:

• Major depressive disorder (MDD) or depression

• Obsessive compulsive disorder (OCD)

• Panic disorder (PD)

• Generalized anxiety disorder (GAD)

• Social anxiety disorder (SAD)

• Post-traumatic stress disorder (PTSD)

Paroxetine is a selective serotonin reuptake inhibitor, or SSRI. It works by blocking the brain’s quick absorption of serotonin, a “feed good” chemical in your brain. The end result? An increased level of serotonin in your brain, which is thought to improve mood.

The most common side effects of paroxetine include:

• Constipation

• Sleepiness, drowsiness

• Sexual dysfunction, including altered sex drive and abnormal ejaculation

• Abnormal physical weakness or lack of energy (asthenia)

• Loss of appetite

• Nausea or vomiting

• Diarrhea

• Dry mouth

• Infection

• Flu symptoms

• Change in sleep habits, insomnia

• Tremor or shaking

• Sweating

• Feeling anxious or nervous

Side effects may improve over time as your body adjusts to the medicine.

This list doesn’t represent all possible side effects (or serious side effects) of paroxetine. If you’re experiencing any ongoing, bothersome side effect(s), tell your healthcare provider right away.

If you’d like to learn more, speak with your doctor or pharmacist. The Food and Drug Administration (FDA) also has a helpful medication guide for paroxetine here.

Paroxetine can interact with some medicines and supplements. It’s always recommended to give both your doctor and pharmacy an updated list of everything you’re taking, so drug interactions can be identified.

Some medicines and supplements paroxetine can interact with include:

• Monoamine oxidase inhibitors (MAOIs): selegiline, phenelzine, linezolid, methylene blue, tranylcypromine, isocarboxazid

• Thioridazine

• Pimozide

• Other SSRIs: sertraline (Zoloft®), citalopram, escitalopram, fluoxetine

• SNRIs (serotonin and norepinephrine reuptake inhibitors): desvenlafaxine, venlafaxine, duloxetine, milnacipran

• Tricyclic antidepressants: amitriptyline, doxepin, imipramine, nortriptyline

• Triptans: sumatriptan, naratriptan

• Alcohol

• Amphetamines

• Benzodiazepines: diazepam, alprazolam

• Antipsychotics: haloperidol, clozapine, pimozide, and thioridazine

• Seizure medicines: carbamazepine, phenytoin

• St. John’s Wort

• Lithium

• Tamoxifen

• Blood thinners or drugs that affect blood clotting: aspirin, ibuprofen, clopidogrel, heparin, warfarin

• Opioids: tramadol, hydromorphone, codeine

This list doesn’t represent all the drugs that may not be safe to take with paroxetine. If you’re unsure whether a certain drug or supplement can be taken with paroxetine, speak with your doctor or pharmacist. The FDA also has a helpful medication guide for paroxetine here.

If you accidentally miss your dose of paroxetine, take the dose as soon as you remember. If it’s almost time for your next dose (within 2 hours), skip the missed dose and take your next dose at the usual time. Don't take 2 doses at the same time or extra doses.

Paroxetine may be taken with or without food.

During pregnancy: Paroxetine may cause harm to the fetus. Other medications may be preferred.

While breastfeeding: Paroxetine may be detected in breastmilk, but there haven’t been any reports of adverse effects in nursing infants.

It’s important to treat mental health-related conditions when pregnant or nursing, as untreated depression, anxiety, or other mental illnesses can harm both you and baby. Always let your provider know if you’re pregnant or breastfeeding, so you can discuss the risks and benefits of starting or continuing paroxetine.

It may be okay to have an occasional drink (light to moderate drinking) while taking paroxetine. Drinking alcohol while taking paroxetine may make you feel sleepy.