About Paxil
Paxil is an antidepressant and anxiety medication used for treating
several mood disorders. Paxil belongs to a group of antidepressant
drugs called SSRIs (selective serotonin reuptake inhibitor), which
are thought to work by increasing the amount of serotonin (a chemical
involved in communication between nerve cells) available to the
brain, so that it comes back to a normal level. Low levels of serotonin
are believed to be associated with mood disorders, and high levels
of serotonin seem to have an antidepressant effect.
Paxil has been shown to be effective in relieving several kinds
of emotional disturbance that decrease the ability to function normally.
This includes: panic attacks, depression, posttraumatic stress syndrome,
obsessive-compulsive disorder, and persistent anxiety. In low doses,
Paxil may be used to treat fibromyalgia. Paxil may
take several weeks to improve your condition.
Paxil is normally taken once a day, and can be taken with or without food. If you miss a dose, do not take a double dose the following day.
Paxil should be stopped slowly, by gradually decreasing dosage as directed by your doctor. Suddenly stopping Paxil treatment can cause increased side effects. Paxil is only available by prescription, and is used to treat several mood and anxiety disorders.
Paxil should be stored away from heat and light.
Paxil Side Effects
Paxil side effects are usually temporary and can include the following, based on a Paxil dosage of 20-50 mg/day.
Paxil side effects that may occur in 5% or more of patients: asthenia (lack or loss of strength), sweating, nausea (can be helped by taking with food), dry mouth, decreased appetite, somnolence (drowsiness), dizziness, insomnia, tremor, constipation, diarrhea, decreased libido, yawn, nervousness, sexual side effects.
Take care to avoid operating a vehicle or other heavy machinery
until you know how you react to Paxil. Paxil side effects may include
impaired thinking and motor skills, or cause blurred vision.
Cautions: Paxil should be used cautiously in patients with:
manic disorders, blood circulation and metabolism difficulties,
or a history of seizures. Paxil may not be an appropriate medication
for patients with brain damage or disease, or congenital brain defects.
Paxil dosages should be lower for patients with kidney or liver
trouble. Tell your doctor if you have ever had an allergic reaction
to Paxil, to an antidepressant or anxiety medication of any type,
or any other medication.
Paxil Interactions
Paxil and alcohol have not been shown to interfere with each other,
but taking them together is not recommended.
Certain medications and supplements may increase the risk of serotonin
syndrome in combination with Paxil. Serotonin syndrome may cause
confusion, restlessness, lowered coordination, shivering or trembling,
diarrhea, fever, sweating, twitching, or behaving with an excitement
you can't control. If you experience a cluster of these symptoms,
and you suspect that it may be due to a drug interaction or overdose,
seek medical attention immediately. (This condition is very rare.)
Paxil interactions with the following drugs may be limited by following your doctor's advice. Always tell your doctor if you are taking any of the following:
- Appetite suppressants like Phentermine/Adipex
(fastin) or Meridia (sibutramine).
- Benzodiazepines (a class of antidepressants, anti-panic agents,
and muscle relaxants) such as Ativan
(lorazepam), Valium (diazepam),
Halcion (triazolam), Restoril (temazepam), Librium (chlordiazepoxide),
Xanax (alprazolam),
Tranxene-SD (clorazepate), Paxipam (halazepam), ProSom (estazolam),
Klonopin (clonazepam)
should probably not be mixed with Paxil.
- Beta Blockers - Drugs like Inderal
(propranolol), Lopressor (metoprolol), Tenormin (atenolol),
and others may build up in the body to toxic levels when combined
with SSRIs.
- BuSpar (buspirone)
- Cough medicine (dextromethorphan)
- Coumadin (warfarin) - may cause bleeding problems when used
with Paxil. Your doctor may prevent this by adjusting the dosage
of one of these medications.
- Desyrel (trazodone)
- Dilantin (phenytoin)
- Effexor (venlafaxine)
- When used with Paxil, increases the chance of developing serotonin
syndrome.
- Hismanal (astemizole) - May alter your heartbeat if used with
Paxil.
- Inderal, Inderide (propranolol)
- Kemadrin (procyclidine)
- Lanoxin (digoxin)
- Lithium (Eskalith)
- Manarex (moclobemide) - This medication should not be mixed
with Paxil, and you should allow a week following the use of
Manarex before starting Paxil. Allow 2 full weeks after stopping
Paxil before beginning use of Manarex. Serious side effects,
including serotonin syndrome can develop.
- MAO inhibitors - Paxil must never be mixed with MAO (monoamine
oxidase) inhibitors, a class of antidepressants and antisenility
drugs, such as Eldepryl (selegiline), Furoxone (furazolidone),
Nardil (phenelzine), Marplan (isocarboxazid), or Parnate (tranylcypromine).
Never use Paxil within 2 weeks of starting or stopping an MAO
inhibitor. This drug interaction could cause severe heart
problems or death. Patients over 65 should allow a longer wait
period between using Paxil and an MAO, as Paxil may stay in their
system longer than in other patients.
- Migraine medications of the triptan class such as Amerge
(naratriptan), Imitrex
(sumatriptan), Maxalt (rizatriptan), or Zomig (zolmitriptan)
can cause coordination difficulties when mixed with SSRIs.
- Narcotic pain medication like Codeine, Demerol
(meperidine), Buprenex (buprenorphine), Darvon (propoxyphene),
Dilaudid (hydromorphone), MS Contin or Kadian (morphine), nalbuphine,
OxyContin (oxycodone),
Percocet (oxycodone and
acetaminophen), Stadol (butorphanol), Talwin compound (pentazocine),
Vicodin (hydrocodone and acetaminophen),
or Vicoprofen (hydrocodone and
ibuprofen) should be used cautiously with Paxil.
- Parlodel (bromocriptine)
- Quinaglute (quinidine)
- Rhythmol (propafenone)
- Sedatives like Fioricet
(butalbital, acetaminophen, and caffeine), Fiorinal,
Phenobarbitol, Seconal, or other barbiturates.
- Selective serotonin reuptake inhibitors (SSRIs) of any other
type, like Celexa (citalopram),
Prozac (fluoxetine), Luvox (fluvoxamine), or Zoloft (sertraline).
- Serzone (nefazodone)
- Sinemet (carbidopa, levodopa)
- Sleep medication like Ambien
(zolpidem), Sonata (zaleplon),
or over the counter sleeping pills should be used with Paxil only
as, and if, advised by your doctor.
- Street drugs such as LSD, Ecstasy (MDMA), or marijuana. These
drugs also affect serotonin levels in the brain and may react
strongly with an SSRI like Paxil. These interactions have not
been studied in clinical tests and the side effects may prove
very dangerous.
- Tagamet (cimetidine)
- Tambocor (flecainide)
- Thioridazine - Severe Paxil interactions can occur with this
medication. Paxil should not be taken within two weeks of thioridazine.
This drug interaction could cause severe heart problems or death.
Patients over 65 should allow a longer wait period between using
Paxil and thioridazine, as Paxil may stay in their system longer
than in other patients.
- Tranquilizers such as Haldol (haloperidol) or Thorazine (chlorpromazine)
may cause oversedation.
- Tricyclic antidepressants such as Elavil
(amitriptyline), Asendin (amoxapine), Anafranil (clomipramine),
Pertofrane or Norpramin (desipramine), Sinequan
(doxepin), Tofranil (imipramine), Aventyl or Pamelor (nortriptyline),
Vivactil (protriptyline), and Surmontil (trimipramine), may increase
the risk of side effects from Paxil. The use of Paxil with Elavil,
Anafranil, or Tofranil can increase the chance of developing serotonin
syndrome.
- Tryptophan or 5-HTP (Contained in certain amino acid supplements
or by itself) - This supplement may increase the risk of serotonin
syndrome when mixed with Paxil.
- Ultram (Tramadol)
- Wellbutrin/Zyban (bupropion)
Talk with your doctor if you are considering mixing an antidepressant
and anxiety medication like Paxil with any other antidepressant,
or any medication that may cause drowsiness. Anxiety medication
can have increased, unexpected, or severe side effects when mixed
with other medications that affect the central nervous system.
Paxil Dosages
Paxil is available as a tablet, or liquid. Your Paxil dosage should
be the least amount required to treat your symptoms.
- Paxil 10 mg, yellow tablet
- Paxil 20 mg, pink tablet
- Paxil 30 mg, blue tablet
- Paxil 40 mg, green tablet
- Paxil liquid, orange color and flavor, 5mL equals 10 mg. Shake well, store below 77°F (25°C), but do not freeze.
Paxil dosages usually begin at 20 mg/day, except for panic disorders,
where the beginning dose is usually 10 mg/day. The dosage may be
stepped up at a rate of 10 mg/week according to your doctor's advice.
If you are planning to stop taking Paxil, ask your doctor about
reducing your dose gradually. It is not usually recommended for
patients to stop Paxil all at once.
People with kidney or liver trouble, the elderly, or those with weak constitutions should take no more than 40 mg/day.
Maximum Paxil dosage should not exceed 60 mg/day. Paxil
overdose may cause coma, irritability, dizziness, drowsiness, racing
heartbeat, facial flushing, nausea, sweating, tremor, or vomiting,
and should be treated by a healthcare professional immediately.
Paxil and Pregnancy
Paxil has not been shown to cause damage to the fetus during pregnancy,
but it has not been fully studied in humans and proven safe. Animal
studies did not indicate an increase of defects in offspring, but
did show a slight increase in the death rate of newborn animals
when Paxil was taken in the last trimester of pregnancy. Animal
studies are not always predictive of results in humans.
Advise your doctor if you are pregnant, or are planning a pregnancy
if you are considering taking Paxil. The manufacturer recommends
that Paxil be taken during pregnancy only if the benefit justifies
the possible risk to the fetus.
Similar precautions apply for breastfeeding, where some amount
of Paxil may pass to the child. Discuss the risks and benefits of
treatment with your doctor.
Paxil and Children
Paxil has not been studied for use in children.
Paxil and Seniors
Paxil has not been shown to have different side effects in the
elderly than in the general population, but it appears to stay in
the system longer. Patients 65 years or older should try a lower
starting dose of Paxil.
What Paxil Treats
Paxil is currently prescribed as a medication for:
- Major Depressive Disorder (Paxil dosage 20-50 mg/day)
- Obsessive Compulsive Disorder (Paxil dosage 20-60 mg/day)
- Panic Disorder (Paxil dosage 10-40 mg/day)
- Social Anxiety Disorder (Paxil dosage 20 mg/day)
- Generalized Anxiety Disorder (Paxil dosage 20 mg/day)
- Posttraumatic Stress Disorder (Paxil dosage 20-50 mg/day)
Paxil is a trademark of GlaxoSmithKline
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The information contained in this document is provided for educational purposes
and information only. It is not a
substitute for consultation with a physician or Health professional, either to diagnose
symptoms or prescribe treatment. Any dosages mentioned are general
guidelines only, please follow the directions of your doctor or
pharmacist exactly when taking medication. We have made every effort to
ensure that this information is accurate, but only your doctor,
physician or Health professional can say
if a medication, a drug alternative or drug combination, is safe for you. Information
intended for US residents only.
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