SSRI·Psychiatry - Antidepressants

PARoxetine

Major Depressive Disorder, OCD, Panic Disorder, Social Anxiety, PTSD

PBSSSRIAropax, Paxtine20 mg tabletS4+1

No source link confirmed for this record yet. Its own source notes are under Additional.

At a glance

Max Dose

60 mg/day

Half-life

21 h

High risk: Withdrawal

SEVERE

Caution: Weight Gain

HIGH RISK

Cautions

Avoid / Cautions

Concurrent MAOI use. Pregnancy Category D. Uniquely teratogenic among SSRIs (causes atrial/ventricular septal heart defects in the fetus).

Where it stands

Rapid Summary

Overview

The most sedating, weight-gaining, and anticholinergic of all the SSRIs. Highly effective for severe anxiety, but plagued by a horrific withdrawal syndrome and terrible side effects.

Clinical Focus

Has the shortest half-life and no active metabolites. Missing a single pill causes severe 'brain zaps' and withdrawal.

Bottom Line

Paroxetine is an SSRI effective for depression and anxiety disorders, but has the worst discontinuation syndrome of all SSRIs and significant anticholinergic effects.

Formulation & Access

Brand Names

Aropax, Paxtine

Oral Routes

Tablets (20 mg). Controlled Release (12.5 mg, 25 mg).

Prescribing & PBS

Unrestricted General Benefit (S4).

Indications & Use

Primary

PBSTGA

Major Depressive Disorder, OCD, Panic Disorder, Social Anxiety, PTSD.

Clinical Place

Largely relegated to 3rd-line SSRI therapy due to weight gain and withdrawal risks. Still used for very severe, refractory anxiety.

Quick reference

Class & Role

SSRI — The most sedating, weight-gaining, and anticholinergic of all the SSRIs.

Route / Formulation

Tablets (20 mg). Controlled Release (12.5 mg, 25 mg). (Aropax, Paxtine)

Usual Dose & Max

Start PO 20 mg OD (morning). Titrate to Max 50-60 mg/day.

Key Indication Doses

Depression / Severe Anxiety: Start PO 20 mg OD (morning). Titrate to Max 50-60 mg/day. Panic Disorder: Start PO 10 mg OD (to avoid initial panic exacerbation). Max 50 mg/day. Elderly: Max 40 mg/day. High risk of anticholinergic confusion.

Best Uses

Paroxetine is an SSRI effective for depression and anxiety disorders, but has the worst discontinuation syndrome of all SSRIs and significant anticholinergic effects.

Key Risks

Neurological: Discontinuation syndrome ('brain zaps', severe vertigo, flu-like symptoms). HIGH — Sedation, fatigue. Gastrointestinal: Dry mouth, severe constipation (due to anticholinergic effect). Metabolic: Significant weight gain (worst of all SSRIs). Endocrine/GU: Severe sexual dysfunction (highest rate among SSRIs).

Key Interactions

Potent irreversible inhibitor of CYP2D6. Will completely block the liver from converting Codeine or Tramadol into their active pain-killing forms. Will massively spike levels of Risperidone and Metoprolol.

Monitoring

Counsel strictly on daily adherence. Advise a prolonged, glacial taper (over months) if stopping the drug. Routine U&E (sodium) and Weight.

Clinical Pearl

If a young woman on Paroxetine wishes to become pregnant, you MUST cross-taper her to Sertraline or Escitalopram months in advance. Paroxetine is strictly contraindicated in pregnancy.

Access

Aropax, Paxtine20 mg tablet

Brand: Aropax, Paxtine
Formulation: Tablets (20 mg). Controlled Release (12.5 mg, 25 mg).

From this page

No calculator, monitoring schedule or factsheet is linked to this medicine page yet.

SSRI·Psychiatry - Antidepressants

PARoxetine

Major Depressive Disorder, OCD, Panic Disorder, Social Anxiety, PTSD

PBSSSRIAropax, Paxtine20 mg tabletS4+1

No source link confirmed for this record yet. Its own source notes are under Additional.

At a glance

Max Dose

60 mg/day

Half-life

21 h

High risk: Withdrawal

SEVERE

Caution: Weight Gain

HIGH RISK

Cautions

Avoid / Cautions

Concurrent MAOI use. Pregnancy Category D. Uniquely teratogenic among SSRIs (causes atrial/ventricular septal heart defects in the fetus).

Where it stands

Rapid Summary

Overview

The most sedating, weight-gaining, and anticholinergic of all the SSRIs. Highly effective for severe anxiety, but plagued by a horrific withdrawal syndrome and terrible side effects.

Clinical Focus

Has the shortest half-life and no active metabolites. Missing a single pill causes severe 'brain zaps' and withdrawal.

Bottom Line

Paroxetine is an SSRI effective for depression and anxiety disorders, but has the worst discontinuation syndrome of all SSRIs and significant anticholinergic effects.

Formulation & Access

Brand Names

Aropax, Paxtine

Oral Routes

Tablets (20 mg). Controlled Release (12.5 mg, 25 mg).

Prescribing & PBS

Unrestricted General Benefit (S4).

Indications & Use

Primary

PBSTGA

Major Depressive Disorder, OCD, Panic Disorder, Social Anxiety, PTSD.

Clinical Place

Largely relegated to 3rd-line SSRI therapy due to weight gain and withdrawal risks. Still used for very severe, refractory anxiety.

Quick reference

Class & Role

SSRI — The most sedating, weight-gaining, and anticholinergic of all the SSRIs.

Route / Formulation

Tablets (20 mg). Controlled Release (12.5 mg, 25 mg). (Aropax, Paxtine)

Usual Dose & Max

Start PO 20 mg OD (morning). Titrate to Max 50-60 mg/day.

Key Indication Doses

Best Uses

Paroxetine is an SSRI effective for depression and anxiety disorders, but has the worst discontinuation syndrome of all SSRIs and significant anticholinergic effects.

Key Risks

Key Interactions

Monitoring

Counsel strictly on daily adherence. Advise a prolonged, glacial taper (over months) if stopping the drug. Routine U&E (sodium) and Weight.

Clinical Pearl

If a young woman on Paroxetine wishes to become pregnant, you MUST cross-taper her to Sertraline or Escitalopram months in advance. Paroxetine is strictly contraindicated in pregnancy.

Access

Aropax, Paxtine20 mg tablet

Brand: Aropax, Paxtine
Formulation: Tablets (20 mg). Controlled Release (12.5 mg, 25 mg).

From this page

No calculator, monitoring schedule or factsheet is linked to this medicine page yet.