What is “Paroxetine” intended for? Instructions for use of this medication will be presented in this article. Also from it you will become aware of what contraindications and indications this medication has, whether it has side effects, in what form it is released and how the medicine interacts with other drugs.
Composition, packaging and release form of the medicinal product
The drug "Paroxetine" goes on sale in the form of tablets, film-coated. They have a round and biconvex shape, white color, at risk and a rough surface.
The active substance of the agent we are considering is paroxetine hydrochloride hemihydrate. The preparation also has auxiliary elements in the form of colloidal silicon dioxide, microcrystalline cellulose, crospovidone, calcium hydrogen phosphate, copovidone, magnesium stearate and talc.
Paroxetine tablets are sold in blisters of 10 pieces, which are placed in a cardboard box.
Pharmacological action of the drug
What is the drug "Paroxetine", analogues of which will be named a little further? It is an antidepressant. It is an inhibitor of (selective) serotonin reuptake by brain neurons. This is what determines its antidepressant effect, as well as its effectiveness in the treatment of panic and obsessive-compulsive disorders.
The medication under consideration has a very low affinity for α2-, α1- and β-adrenergic receptors, as well as for m-cholinergic receptors, dopamine, 51-like, 52-like and histamine H1-receptors.
Does the drug “Paroxetine” disrupt psychomotor functions? Reviews of doctors say that this medicine does not affect the human psyche in a negative way. Moreover, it does not potentiate the inhibitory effect of ethanol on psychomotor functions.
According to the researchers, such an antidepressant has weak activating properties only if it is prescribed in dosages in excess of those required to inhibit serotonin uptake. It can not be said that this drug does not cause a significant change in the level of blood pressure, EEG and heart rate.
Pharmacokinetics of a medical product
How is Paroxetine absorbed? Instructions for use, reviews of doctors say that after ingestion, the active substance is absorbed from the digestive tract, and is also metabolized through the liver.
The stationary concentration of the drug in the blood is achieved 1-1.7 weeks after the start of drug treatment. The active substance of the drug is distributed extensively in the tissues. However, only one percent of it is found in plasma. Communication with proteins is about 95%.
The antidepressant in the liver is metabolized. As a result of this, inactive metabolites are formed. They are quite quickly eliminated from the body, and also have a small pharmacological activity and do not affect the therapeutic effect of the drug in any way.
How is the drug "Paroxetine"? Instructions, reviews of pharmacists say that approximately 64% of the active substance comes out with urine, and the remaining 36% through the intestines (with bile).
Pharmacokinetics of the drug in special clinical cases
The concentration of the active substance in blood plasma increases with impaired functioning of the kidneys and liver, as well as in the elderly.
Indications for the use of a medical device
In what cases is the antidepressant “Paroxetine” prescribed to patients? Instructions for use of this tool contain the following list of indications:
- depression of any type, including severe endogenous, reactive and accompanied by anxiety;
- panic disorders, including agoraphobia;
- obsessive-compulsive disorder (or OCD for short);
- generalized anxiety disorders;
- social anxiety disorders, or so-called social phobia.
Contraindications to the use of a medical device
In what cases in no case should the patients be prescribed the antidepressant Paroxetine? Instructions for use of this tool include the following list of contraindications:
- epilepsy is unstable;
- simultaneous use of MAO inhibitors, as well as a two-week period after their withdrawal;
- childhood;
- the period of gestation;
- hypersensitivity to the elements of the drug;
- period of breastfeeding.
Use with extreme caution
In what cases should you control the use of the antidepressant Paroxetine? Instructions for use state that this drug is prescribed with caution to patients with liver failure, angle-closure glaucoma, renal failure, mania, prostatic hyperplasia, convulsive conditions, heart pathology, epilepsy. In addition, the simultaneous use of the medication and the conduct of electro-pulse therapy, as well as taking medications that increase the risk of bleeding, are unacceptable. Particular attention should be paid to the presence of risk factors for increased bleeding and diseases contributing to this condition.
Antidepressant Paroxetine: how to take medicine?
The medication considered by us should be taken orally once a day (in the morning) during breakfast. The tablets must be swallowed whole with normal water.
During the first three weeks after the start of treatment, the dosage of the drug is selected individually. Subsequently, it is adjusted (if necessary).
During prolonged depression, the recommended medication volume is 20 mg once a day. If required, the dose is gradually increased by another 10 mg. The maximum amount of the drug should not exceed 50 mg.
In obsessive-compulsive disorder, the initial dosage of an antidepressant is 20 mg per day. Subsequently, it increases by 10 mg. The recommended average daily dose of the drug with this deviation is 40 mg. In urgent need, it can be increased to 60 mg.
If the patient has panic disorders, then initially you can take up to 10 mg of the drug per day. To reduce the possible risk of developing panic symptoms, the next dose of the drug is increased by another 10 mg. On average, with such a deviation, it is permissible to consume 40 mg of Paroxetine per day, the maximum amount is 50 mg.
With social phobias or social anxiety disorders, the initial amount of medication should be no more than 20 mg per day. If after such treatment the desired effect was not achieved, then over the course of 2 weeks the dose is gradually increased to the maximum, that is, up to 50 mg per day.
With generalized anxiety disorders, the therapeutic and initial volume of the drug is 20 mg per day
If the patient is diagnosed with liver or kidney failure, then the recommended dose should be 20 mg per day.
Seniors per day can consume no more than 40 mg of the specified medication.
In order to prevent withdrawal syndrome , it is recommended to stop taking the drug gradually.
Overdose cases
Have there been cases of overdose with antidepressants such as Paroxetine, Fluoxetine? Experts note that when you use a large number of tablets, they really adversely affect the human body. The patient has nausea, dry mouth, sinus tachycardia, vomiting, convulsions, tremors, bradycardia, mydriasis, agitation, irritability, sweating, nystagmus, increased blood pressure, drowsiness, and nodal rhythm.
In quite rare cases, with the simultaneous use of the drug with other psychotropic medicines, as well as alcoholic beverages, the patient may experience a coma and a change in ECG readings. With a pronounced overdose, the patient has serotonin syndrome and rhabdomyolysis.
What to do in such situations? In case of overdose with Paroxetine, you should rinse your stomach and take activated charcoal. If necessary, symptomatic treatment is performed.
Side effects
What side effects can the Paroxetine medication cause? Reviews of doctors say that this tool really contributes to the development of negative reactions. The following conditions and pathologies can be attributed to them:
- From the side of the central nervous system and peripheral nervous system: mania, drowsiness, confusion, tremor, serotonin syndrome, asthenia, hallucinations, insomnia, nervousness, dizziness, depersonalization, fatigue, panic attacks, convulsions, agitation, amnesia, extrapyramidal disorders, anxiety, mylon.
- Musculoskeletal system: muscle weakness, arthralgia, myopathy and myalgia.
- Sense organs: fuzziness and visual impairment in general.
- Urinary system: rapid urination or urinary retention.
- Alimentary tract: increased or decreased appetite, hepatitis, taste change, dry mouth, nausea, diarrhea, vomiting, constipation.
- Reproductive system: anorgasmia, sexual dysfunction, hyperprolactinemia or galactorrhea, ejaculation disorders and impotence.
- Cardiovascular system: orthostatic hypotension.
- Allergy: pruritus, rash, angioedema, ecchymosis and urticaria.
- Other deviations: rhinitis, increased sweating, impaired secretion of antidiuretic hormone, hyponatremia.
Interaction with other medical devices
The simultaneous use of antacids does not affect the pharmacokinetic parameters and absorption of the drug "Paroxetine."
The one-time use of the agent we are considering is contraindicated with MAO inhibitors.
The concomitant use of the Paroxetine medication with drugs that inhibit liver enzymes requires a lower dose of the first.
Antidepressant increases the duration of bleeding against the background of a single use of "Warfarin."
The simultaneous use of the Paroxetine medication with tricyclic antidepressants, acetylsalicylic acid, atypical antipsychotics, NSAIDs and phenothiazine-type drugs contributes to the disruption of the blood coagulation process.
Simultaneous administration with serotonergic drugs (such as Tramadol and Sumatriptan) can easily lead to an enhanced serotonergic effect.
Important to remember!
To avoid the development of antipsychotic syndrome (malignant), with special care, the drug "Paroxetine" is prescribed to patients who take antipsychotics.
In elderly people, while taking the medication, hyponatremia may develop.
When seizures and the first signs of mania appear, antidepressant therapy is discontinued.
During the first weeks of treatment with Paroxetine, careful monitoring of the patient's condition is necessary in connection with a possible suicide.
During therapy, one should refrain from taking alcoholic beverages in connection with their enhanced toxic effect.
Pediatric Use
The drug "Paroxetine" is not prescribed for children, since its effectiveness and safety in the treatment of patients of this group have not been established.
Antidepressant "Paroxetine": analogues
What can replace the drug "Paroxetine"? It should be noted that this medicine has quite a few analogues. Among them, I would like to highlight the following drugs: Rexetin, Adepress, Plizil, Apo-Paroxetine, Actaparoxetine, Paxil, Sertraline, Paroxetine hydrochloride hemihydrate, Sirestill, etc.
You can buy all of the above medicines in a pharmacy only by prescription.
Reviews about the drug
The drug "Paroxetine" has many conflicting reviews, both from specialists and from patients. On the one hand, he is praised for contributing to the rapid elimination of depression of any type (including severe endogenous, reactive and accompanied by anxiety), as well as panic, obsessive-compulsive, generalized and socially-anxious disorders. On the other hand, many patients claim that immediately after using the drug they develop a fairly large number of adverse reactions. As a result, people were even forced to stop treatment.
In general, experts note that "Paroxetine" is a very effective and effective drug that copes with the task assigned to it. However, it can only be used as directed by a specialist.