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What
is Paxil?
Paxil (paroxetine hydrochloride) and Paxil CR are antidepressant
medications also used to treat anxiety disorders. Paxil was
introduced into the United States in early 1993. They are
members of the SSRI (selective serotonin reuptake inhibitor)
family (along with Zoloft and Prozac). These medications are
effective in alleviating the symptoms of major depression
without causing some of the harmful side effects caused by
the older tricyclic antidepressants (TCAs). Paxil is also
approved for the treatment of anxiety disorders, including
generalized anxiety disorder (GAD), panic disorder, post-traumatic
stress disorder (PTSD), social anxiety disorder, and obsessive-compulsive
disorder (OCD).
What
does Paxil treat?
Depression and anxiety disorders are biologically based disorders,
although social factors may contribute to these illnesses.
Depression is associated with decreased activity of neurotransmitters
in the brain (particularly serotonin and norepinephrine).
These chemical messengers help regulate several functions
and thoughts, including mood. Paxil blocks the reabsorption
of serotonin and normalizes the brain's chemical supply.
What
are the advantages of Paxil over other antidepressants?
Paxil is as effective in relieving depression as TCAs such
as imipramine. However, Paxil causes fewer adverse cardiovascular
and anticholinergic effects (dry mouth, constipation, blurred
vision, urinary retention) than the older TCAs. It does not
usually cause drowsiness or low blood pressure. Paxil has
no active metabolites and leaves one's system 24 hours after
it enters.
Who
can benefit from taking Paxil?
Paxil is equally effective in elderly depressed patients as
it is in younger patients. Paxil is effective in the treatment
of anxiety which accompanies depression in some people. Those
experiencing lethargy at the beginning of treatment can also
take Paxil with positive results because Paxil does not impair
psychomotor function.
What
is the standard dose of Paxil?
The usual dose of Paxil is 20 mg taken once daily, usually
in the morning. Paxil comes in either 10 mg tablets and 40
mg tablets. For the depressed elderly, the recommended starting
dose is 10 mg once daily. Physicians may change the dose by
10 mg at a time and the dose should not exceed 50 mg per day
(40 mg in geriatric patients). There should be a one-week
interval between dose adjustments. The dose of Paxil for the
anxiety disorders is generally the same as for depression,
except that for patients with panic disorder it is recommended
to start at 10 mg. Consumers with panic disorder often need
to take 40 mg a day to feel better.
Can
I take Paxil with other medications?
Paxil should not be used while taking any MAOI (monoamine
oxidase inhibitor) medication. The interaction between the
two could produce fatal results. Therefore, there should be
a fourteen-day interval between stopping the MAOI and starting
Paxil, or vice versa.
Patients with kidney
or liver dysfunction should take Paxil with caution. Other
combinations of medications require consultation with your
doctor. Alcohol consumption is best avoided while one is taking
Paxil. There are some potentially problematic interactions
between Paxil and other drugs such as tricyclic antidepressants
and beta-blockers.
What
are the most common side effects of Paxil?
For the most part, the side effects of Paxil are mild and
brief. The major side effect of Paxil is nausea, which can
be reduced by taking Paxil with food. Paxil CR has a lower
risk of nausea than Paxil. Side effects may include drowsiness,
asthenia (lack of physical strength) tremors, nervousness,
dizziness, insomnia, weight gain, sweating, ejaculatory delay,
and other male genital dysfunction. Only a small percentage
of people have had to discontinue their use of Paxil because
of side effects. Both men and women commonly experience difficulty
having an orgasm while on Paxil. Also, patients who stop taking
Paxil abruptly often experience dizziness, nausea, vertigo
and shock-like sensations. Therefore, slow tapering is recommended.
Women
who become pregnant or who are nursing an infant should discuss
with their doctors the effects of Paxil. People with kidney
or liver dysfunction should use Paxil with caution.
How
soon will I feel better?
Some people will notice improvements within a week or two,
but it may take up to six weeks for the full therapeutic effect
to be realized. Depressed mood, concentration problems, and
slowed activity may improve in the first week, sleep disturbances
within the second week.
How
long should I stay on Paxil?
Paxil should be continued as directed by the prescribing physician.
Paxil is effective in the treatment of both short-term and
long-term depression, and it can be beneficial in preventing
relapse into depression. Studies have shown that Paxil is
easily tolerated for up to four years. It is important to
be in close communication with the prescribing physician,
and to promptly report any unusual or distressing symptoms
or side effects.
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and supports, and medications;
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