Paroxetine

Headmeds fills the medicines information gaps for young people - things you might want to know about meds like will it affect my sex life? Can I still study? Can I drink?
Headmeds does not give medical advice so this is just general information.
Each medicine has a balance of good and bad effects, and each person gets their own individual effects.
You might want to know just one thing about your medicine, but on each page we have given you the ‘safety headlines’. Please read them as they are important.
We have included lots of information about each medicine - but if you want all the details, please look at the patient information leaflet - which is inside every pack. These leaflets are also at www.medicines.org.uk - where there will be the most up-to-date information.

SAFETY HEADLINES

• If you have taken more paroxetine than it said on the label, you must see a doctor quickly - even if you do not feel any different.
• Paroxetine can make some people think about hurting themselves or committing suicide. You must go straight to hospital with your medicine if you have any of these thoughts.
• Paroxetine can also cause other serious side-effects: allergic reactions (difficulty breathing, swelling of your face or throat, itching skin lumps), and other serious symptoms that you can find here. Go to a hospital if you get any of these symptoms, with your medicine.
• Do not take paroxetine if you have taken a monoamine oxidase inhibitor antidepressant (MAOI) like moclobemide, phenelzine, isocarboxazid or tranylcypromine in the last 14 days, or if you take thioridazine or pimozide.
• Stopping paroxetine suddenly can cause serious side-effects - go to your doctor if you want to stop, or if you are having these effects.
• You might not be able to concentrate very well, and may feel sleepy, in the first few days after taking paroxetine - do not drive a car, ride a bike or operate machines until you see how this affects you.
• If you take paroxetine while you are pregnant, it may affect the developing baby. Use good contraception while you are taking paroxetine. It can also cause symptoms in newborn babies if you take it at the end of pregnancy. Talk to your doctor or midwife about this and get their help.

The oral suspension liquid medicine contains sorbitol and some additives that can cause allergic reactions

• The oral suspension liquid medicine contains sorbitol (E420). If you have been told by your doctor that you have an intolerance to some sugars, contact your doctor before taking Seroxat.
• The oral suspension also contains methyl parahydroxybenzoate (E218), propyl parahydroxybenzoate (E216) and sunset yellow FCF (E110), which may all cause allergic reactions.

Paroxetine can be used for a number of conditions

• Low mood (depression)
• Anxiety
• Eating disorders such as bulimia nervosa and binge eating disorder
• Panic Disorder (with or without agoraphobia)
• Generalised Anxiety Disorder
• Obsessive Compulsive Disorder OCD
• Body Dysmorphic Disorder
• Post-Traumatic Stress Disorder PTSD
• Social anxiety disorder
• Social phobia

Paroxetine can help to adjust the chemicals your brain needs

For depression:

• Experiments suggest that depression is more likely to happen when the brain does not have enough of a chemical called serotonin (also called ‘5HT’).
• Medicines like paroxetine are called selective serotonin reuptake inhibitors (SSRIs) because they stop serotonin being taken back up into nerve cells.
• At first, the brain senses that there is more, and stops producing serotonin to keep the levels the same in the brain.
• Over time, however, it starts to produce more serotonin and the level rises.
• This means that the amount of serotonin becomes more normal and the depression lifts.

You can take paroxetine once a day, in the morning after food

• You will get the best effect from paroxetine if you take it regularly every day.
• Make sure that you know your dose. If it is not written on the label, check it with your pharmacist or doctor.
• Choose a time each morning that you can always remember. This could be with breakfast, or when you brush your teeth.
• Take it after food. This helps to prevent feelings of sickness.
• Swallow the tablet with a drink of water - if you chew it, it tastes bitter.

If you forget to take a dose then just take it as soon as possible, but do not double dose

What to do if you miss a dose:

• If you remember later during the day, take it as soon as possible.
• You may find it difficult to sleep if you take it towards bedtime.
• If you forget to take it by the time of your next dose, just take the next dose.
• Do not take a double dose. 

What might happen?

• If you forget to take it for a few days, you may start getting withdrawal symptoms and should talk to your doctor about it.

You must go to A&E if you take too much

What to do if you take too much:

• If you have taken more paroxetine than it said on the label, you must get help quickly – even if you do not feel any different.
• Go to A&E. Take your medicine with you, to show to the doctors. Tell them how much you have taken.
• Get a friend or family member to go with you, if you can, just in case you feel ill on the way.

• You might get any of the side-effects listed here.
• You are also at risk of getting ‘Serotonin syndrome’. This is when you can get a high fever, agitation, confusion, trembling, or weird movements of your muscles. This is rare, but you should watch out for it.

It can take 1-2 weeks for paroxetine to start helping  

• It takes 1-2 weeks for paroxetine to start helping, and it could take some weeks or months to get its full effect. We do not know why.
• To get the best effect, you need to take your paroxetine every day and give it a chance to work for you.
• Scientists believe that at first the higher level of serotonin feeds back to the brain that it should make less of it (this means you do not feel any better).
• But after some days of regular treatment, the feedback receptors send fewer messages and the brain gradually releases more serotonin.

Your doctor might start you on a low dose and then increase it slowly over 2-4 weeks to your full dose.

Most people take paroxetine for at least 6 months

• You and your doctor should talk about how long you need to take paroxetine.
• Take paroxetine until you feel better, which probably takes at least 6 months.
• This will help keep you well.
• If you get side-effects that you cannot live with, then talk to your doctor about other options.

Reference sources

Seroxat PIL 2 Updated August 2015
https://www.medicines.org.uk/emc/PIL.3185.latest.pdf
Accessed 23/02/2017

Seroxat PIL 3 Updated August 2015
https://www.medicines.org.uk/emc/PIL.3185.latest.pdf
Accessed 23/02/2017

Seroxat SPC 4.1  Updated 03/11/2015
https://www.medicines.org.uk/emc/medicine/2057
Accessed 23/02/2017

Seroxat SPC 4.2 Updated 03/11/2015
https://www.medicines.org.uk/emc/medicine/2057
Accessed 23/02/2017

YM Clinician Survey 2013

Neal MC. Medical Pharmacology at a Glance (7^th Edition). Oxford: John Wiley & Sons, 2012. P63

Maudsley 12^th edition p473

BNF 70 p287