List of adverse effects of paroxetine

[[Paroxetine, a widely used antidepressant in the class of Selective Serotonin Reuptake Inhibitors (SSRIs), is prescribed to treat a variety of mental health conditions, including depression, anxiety disorders, obsessive-compulsive disorder (OCD), post-traumatic stress disorder (PTSD), and premenstrual dysphoric disorder (PMDD). Despite its therapeutic benefits, paroxetine is associated with a range of adverse effects, which can vary in severity and occurrence among individuals. This article provides a detailed list of the known adverse effects of paroxetine, categorized by their frequency and system affected.

Common Adverse Effects

Common adverse effects are those that occur in more than 1% of patients taking paroxetine. These include, but are not limited to:

• Nausea
• Dry mouth
• Constipation
• Dizziness
• Sedation or Fatigue
• Insomnia
• Sweating
• Weakness

Uncommon Adverse Effects

Uncommon adverse effects occur in 0.1% to 1% of patients. These effects include:

• Blurred vision
• Yawning
• Tremor
• Sexual dysfunction, including decreased libido, erectile dysfunction, and anorgasmia
• Weight gain

Rare Adverse Effects

Rare adverse effects are those that occur in less than 0.1% of patients. These can include:

• Serotonin Syndrome - a potentially life-threatening condition characterized by high body temperature, agitation, increased reflexes, tremor, sweating, dilated pupils, and diarrhea.
• Hyponatremia - low sodium levels in the blood, particularly in elderly patients.
• Rash or Pruritus (itching)
• Hepatotoxicity - liver damage
• Suicidal ideation and behavior in adolescents and young adults

Withdrawal Symptoms

Discontinuation of paroxetine, especially abruptly, can lead to withdrawal symptoms, also known as discontinuation syndrome. Symptoms can include:

• Dizziness
• Sensory disturbances
• Anxiety
• Confusion
• Irritability

Black Box Warning

Paroxetine carries a black box warning, the FDA's most stringent warning, due to the increased risk of suicidal thoughts and behaviors in children, adolescents, and young adults.

Pregnancy and Lactation

Paroxetine is classified as Pregnancy Category D by the FDA, indicating evidence of human fetal risk, but the potential benefits from use in pregnant women may be acceptable despite these risks. It has been associated with congenital malformations and persistent pulmonary hypertension of the newborn (PPHN) when taken during pregnancy. Paroxetine is also excreted in breast milk and can affect a nursing infant.

Interactions

Paroxetine can interact with a wide range of medications, leading to increased risk of adverse effects or decreased effectiveness of treatments. Notable interactions include:

• Monoamine Oxidase Inhibitors (MAOIs)
• Other SSRIs and Serotonin and Norepinephrine Reuptake Inhibitors (SNRIs)
• Warfarin
• Triptans
• CYP2D6 substrates

Conclusion

While paroxetine is an effective treatment for various mental health conditions, it is associated with a wide range of adverse effects. Patients should be closely monitored by their healthcare provider for any adverse effects, especially during the initial stages of treatment or when changing doses.

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