Trade Names: Paroxetine Aurovitas, Paroxetine Teva, Parogen, Paroxinor, Paxtin, Rexetin, Seroxat, Arketis, Dropax, Serestill
Paroxetine: an antidepressant that can restore calm
Paroxetine is one of the most powerful antidepressants among SSRIs, and if you are familiar with constant anxiety, panic attacks, or obsessive thoughts, then this drug might be what you need. Its main weapon is its strong effect on the serotonin system, and in this, it truly stands out among its “colleagues.” But like any strong remedy, paroxetine requires caution, as its side effects can be an unexpected challenge.
This drug works like this: it increases the concentration of serotonin in the brain. Serotonin is the “happiness hormone” that helps us feel calm and satisfied with life. When serotonin is lacking, depression, anxiety, sleep problems, and a general loss of motivation appear. Paroxetine blocks the reuptake of serotonin, allowing it to stay in the brain longer. This is why it is so effective for anxiety disorders. But this is not its only strength — it has other interesting properties as well.
What does paroxetine treat?
Let’s start with the obvious — anxiety and depression. It copes perfectly with panic attacks, when suddenly it becomes difficult to breathe, the heart races, and the thought spins in your head: “This is the end.” It helps with phobias and obsessive-compulsive disorders (OCD), when a person checks a hundred times if the lights are off or suffers from obsessive thoughts that they cannot stop.
When it comes to depression, paroxetine is especially effective when depression is accompanied by anxiety. But if a person simply lies on the couch and does not want to do anything, feeling apathy and fatigue, this drug may not work as well. In such cases, venlafaxine or bupropion are better suited.
Paroxetine even helps with irritable bowel syndrome, when stress triggers abdominal pain and cramps. It reduces bowel activity, which alleviates the condition of patients with this diagnosis.
Side effects
It all starts with serotonin and cholinergic receptors. Paroxetine blocks M1-cholinergic receptors, which causes problems such as dry mouth, constipation, and urinary disorders. Many complain of nausea during the first days of use, but over time, this passes.
There is also a more unpleasant effect that patients call “emotional anesthesia.” A person feels as if life has stopped bringing joy, even if everything is fine. They simply feel nothing. This is associated with an excess of serotonin. In such cases, doctors adjust the treatment by adding drugs like bupropion or mirtazapine, which stimulate the noradrenaline and dopamine systems.
Paroxetine can also lead to weight gain. In this regard, it is one of the leaders among antidepressants. People begin to eat more, appetite increases, and metabolism slows down.
Another issue is its effect on sexual function. Paroxetine can delay ejaculation, which is sometimes used to treat premature ejaculation. However, some patients experience difficulty achieving orgasm and a decrease in libido. Here, everything depends on the individual response of the body.
Dosage and how to take it
Most often, the treatment starts with 20 mg per day. If the drug is poorly tolerated, you can start with 10 mg and gradually increase it. For depression, 20-40 mg is sufficient, and for OCD, up to 60 mg per day may be needed. The dose can be increased by 10 mg each week, but it depends on the patient’s response.
Paroxetine is a strong inhibitor of the cytochrome P450 enzyme, which means it can affect the action of other medications. For example, it can enhance the effect of anticoagulants or antihypertensive drugs, so their dosage should be adjusted. Be sure to inform your doctor about any medications you are taking to avoid unpleasant consequences.
If you suddenly decide to stop taking it, unpleasant sensations may occur. Paroxetine has a pronounced withdrawal syndrome, which includes dizziness, headache, nausea, and even so-called “brain zaps” — a sensation as if you are being shocked by electricity. This is due to the short half-life of paroxetine, and its concentration in the blood quickly drops if the intake is stopped.
To avoid withdrawal syndrome, doctors recommend gradually reducing the dose — by 10 mg per week or even slower if symptoms begin to appear. In difficult cases, anti-anxiety medications may be added to ease the transition.
Conclusion
Paroxetine is a powerful and effective drug, but it requires patience and a cautious approach. If the correct dose is chosen and treatment is not stopped too early, it can significantly improve the quality of life, helping to cope with anxiety, panic attacks, and obsessive thoughts. The key is to be aware of the possible side effects and not to abruptly stop taking the medication.
If you’re feeling overwhelmed by anxious thoughts or your well-being has worsened, don’t postpone taking care of yourself. At the Plexus center in Warsaw, you’ll find a psychiatrist who speaks Polish and Russian, who will help you find a solution tailored to your needs.