Paroxetine

You can drink some alcohol while taking paroxetine

• If you drink alcohol, you can continue to drink some alcohol while taking paroxetine.
• Drinking alcohol every day, however, can make the symptoms of depression worse and you will not feel the benefit of your medicine.
• Side-effects might make you sleepy or you might lose your focus when you first start taking paroxetine.
• This could be dangerous if you drive or use machines or do anything that needs a lot of focus.
• So, during the first few days, it might be best to stop drinking alcohol until you see how the medicine affects you, or until the effects pass.

Do not drive or ride a bike just after you start taking paroxetine

• Taking paroxetine may affect your ability to do things like driving a car, riding a bike, using machines, or anything else that needs a lot of focus.
• You might find it difficult to concentrate, you might feel sleepy and your eyesight may be blurred.
• It might be best to stop doing these things for the first few days, until you know how it affects you or until the effects pass.
• You have to make sure that you are safe to drive.
• You could go and practise emergency stops in a safe place, or get a friend or family member to go with you and see if they notice a difference in your driving.
• Do not worry - most people drive as normal while taking paroxetine.

Try not to take paroxetine for the first time just before your exams

• Taking paroxetine may affect your ability to do exams.
• You might find it difficult to concentrate, you might have sleep problems and your eyesight may be blurred. You also might find it difficult to sit still.
• You should talk to your doctor about any future exams if you are starting paroxetine.
• You might decide together to delay starting it until you have done them. If they are more than a month away, however, you might find that it is better to start paroxetine to lift your mood and improve your motivation to study.
• Do not worry - most people do exams as normal while taking paroxetine.

Paroxetine can make it hard to concentrate

• Taking paroxetine may affect your concentration, and your ability to do anything that needs a lot of focus.
• After the first few days you will know how it affects you, or the side-effect might get better.

Paroxetine is not a banned substance in sport

• Paroxetine is not a banned substance in sport.
• Taking paroxetine may affect your concentration to do things like riding a bike, competitive gymnastics, or anything else that needs a lot of focus.
• You might find it difficult to concentrate, you might have sleep problems and your eyesight may be blurred. You also might find it difficult to sit still.
• It might be best to stop such sports for the first few days, until you know how it affects you or the effects get better.
• Do not worry - most people do sports as normal while taking paroxetine.

Your weight can be affected by paroxetine

• A side-effect of paroxetine can be not feeling as hungry as normal, which might lead to weight loss.
• It is also possible to have a side-effect of weight gain.
• It is very difficult to know how it will affect each person who takes it.
• Talk to your doctor about this if it worries you.

Paroxetine can affect your sleep

• You can feel sleepy in the first few days of taking paroxetine.
• You can also have sleep problems (insomnia, vivid dreams).
• It should, however, get better after the first week or two.
• If you feel very sleepy, and you’ve been taking it for more than a month, you should go back to the doctor and see what else you could do.

Let your family and friends know you are taking paroxetine so they can support you and help you look out for side effects

• The side-effects of paroxetine might put a strain on your friendships and relationships, especially in the first few days of taking it.
• You may become more anxious, for example, or it may make you irritable or confused.
• These side-effects should get better after a few days.
• After a month you should be getting the good effects of paroxetine, and that should improve your relationships in itself.
• It might actually be a great idea to choose a good friend to tell about your medicine when you start taking it. (Or - even better - to take one with you to the doctor before you start taking it!)
• They could look at the medicine leaflet, or at this website.
• They could then help you to understand whether the medicine changes your behaviour, or gives you side-effects (sometimes it is hard for us to see it ourselves).

Paroxetine can have side-effects that might affect your sex life

The good effects of paroxetine may, after a while, have a good effect on your sex life as your mood lifts and you become interested in life and relationships again.

Some of the possible negative side effects include:

• Men might get problems with getting hard (getting an erection) and coming (ejaculating).
• Men might get a painful erection that lasts for a long time (priapism), and would need to go to hospital straight away for treatment.
• Women might have some bleeding from their vagina, or their periods may become irregular.
• Women might not come (reach orgasm) the same way as before.
• Both men and women might see some growth in their breasts, and some milk flow.        
• You may have a lower sex drive.
• If you lose or gain weight, or get other physical side-effects, you may just not feel as sexy as before.

These effects should pass after the first couple of weeks. If they do not, and this is a problem for you, go back to the doctor and see what else you could try.

Paroxetine does not seem to affect human fertility. You need good contraception when you are taking paroxetine. Talk to your doctor about your paroxetine if you are trying to get pregnant.

• In animal tests, paroxetine had an effect on sperm quality that made males less likely to make their partner pregnant (less fertile).
• The SSRI group of medicines have shown some effects on sperm quality in humans, which seems to be reversible if you stop taking the medicine.
• There has not, however, been any report of actual human fertility problems with these medicines.
• You should use good contraception when you are taking paroxetine. This is because there is a slightly higher risk of problems in the developing baby if you take paroxetine in the early stages of pregnancy (see next section).
• If you do become pregnant while you are on paroxetine, you should carry on taking the medicine and go back to your doctor as soon as possible, to see if you should change or stop your medicine.
• Remember that you need to stay well through your pregnancy, and you may need a medicine to help you to do that.

Paroxetine can cause heart problems in the developing baby, and other symptoms in newborn babies. Paroxetine is passed to the baby in breastmilk.

• There is a slightly higher risk of heart problems in the baby if you take paroxetine in the early stages of pregnancy.
• Studies have shown that the risk of having a baby with a heart problem when taking paroxetine is 2 out of 100 babies, where the risk in the general population is 1 out of 100 babies.
• If you agree - with your doctor - to carry on taking paroxetine, you should tell your midwife that you are taking it before you give birth. 
• If paroxetine is taken in the last 3 months of a pregnancy, it can cause a serious condition called persistent pulmonary hypertension of the newborn (PPHN).
• The risk of PPHN was shown in studies to be 5 out of 1,000 babies, compared with 1-2 out of 1,000 babies in the general population.
• This can make the baby breathe faster and look a bit blue in colour.
• This happens in the first 24 hours after birth: you will need help from the midwife and doctors, so it is better if they are looking out for symptoms.
• The newborn baby may also develop other side effects:
  • Shaking, jittery or having fits
  • Being stiff or floppy
  • Being sick and not feeding properly
  • Being very tired, not able to sleep or crying a lot
  • Being too hot or too cold
  • Having extreme muscle reactions (reflexes)

• These might not happen straight away, so you should look out for them over the first few days after the baby is born.

• Paroxetine can be passed to the baby in breastmilk, but no side-effects have been seen in breastfed babies.
• Talk to your doctor or midwife about your feeding options.

High doses of caffeine taken with paroxetine may bring on serotonin syndrome

• If you drink a lot of coffee, cola drinks or caffeine drinks when taking paroxetine, it can put you at a higher risk of getting serotonin syndrome.
• The symptoms are any combination of the following symptoms - high fever, agitation, confusion, trembling, sweating, diarrhoea (loose poo), fast heartbeat or weird movements of your muscles.
• You need to go to a hospital straight away if you get these symptoms.

Reference sources

Seroxat SPC 4.5 Updated 03/11/2015
https://www.medicines.org.uk/emc/medicine/2057
Accessed 23/02/2017

Seroxat SPC 4.6 Updated 03/11/2015
https://www.medicines.org.uk/emc/medicine/2057
Accessed 23/02/2017

Seroxat SPC 4.7 Updated 03/11/2015
https://www.medicines.org.uk/emc/medicine/2057
Accessed 23/02/2017

Seroxat SPC 4.8 Updated 03/11/2015
https://www.medicines.org.uk/emc/medicine/2057
Accessed 23/02/2017

WADA 2016 list

Maudsley 12^th ed p692