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Indication & Dosage |
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| Oral |
| TREATMENT OF DEPRESSION |
| Adult:
20 mg daily, increase gradually, if necessary, by 10-mg increments wkly; max dose: 50 mg/day.
Elderly: Initially, 10 mg daily, increase if needed by 10mg/day at 1 wk intervals; max: 40 mg daily. |
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| Oral |
| MANAGEMENT OF OBSESSIVE-COMPULSIVE DISORDERS |
| Adult:
Initially, 20 mg daily, increase wkly in 10-mg increments. Maintenance: 40-60 mg daily.
Elderly: Initially, 10 mg daily, increase if needed by 10 mg/day at 1 wk intervals; max: 40 mg daily. |
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| Oral |
| TREATMENT OF PANIC DISORDER WITH OR WITHOUT AGORAPHOBIA |
| Adult:
Initially, 10 mg daily, increase wkly in 10-mg increments according to clinical response. Maintenance: 40-60 mg daily.
Elderly: Initially, 10 mg daily, increase if needed by 10 mg/day at 1 wk intervals; max: 40 mg daily. |
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| Oral |
| SOCIAL ANXIETY DISORDER |
| Adult:
Initially, 20 mg daily, increase after several wk by 10-mg increments; max dose: 50-60 mg/day.
Elderly: Initially, 10 mg daily, increase if needed by 10 mg/day at 1 wk intervals; max: 40 mg daily. |
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| Oral |
| GENERALISED ANXIETY DISORDER |
| Adult:
Initially, 20 mg daily, increase in wkly increments of 10 mg; max dose: 50 mg/day.
Elderly: Elderly: Initially, 10 mg daily, increase if needed by 10 mg/day at 1 wk intervals; max: 40 mg daily. |
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| Oral |
| POSTTRAUMATIC STRESS DISORDER |
| Adult:
20 mg daily, may be increased in 10-mg increments if necessary; max dose: 50 mg/day.
Elderly: Initially, 10 mg daily, increase if needed by 10 mg/day at 1 wk intervals; max: 40 mg daily. |
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| Oral |
| PREMENSTRUAL DYSMORPHIC DISORDER |
| Adult:
As hydrochloride, modified-release preparation: Initially, 12.5 mg once daily, usually in the morning; may increase up to 25 mg once daily after at least 1 wk, if necessary; given throughout the menstrual cycle or limited to the luteal phase.
Elderly: Initially, 10 mg daily, increase if needed by 10 mg/day at 1 wk intervals; max: 40 mg daily. |
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| Administration |
May be taken with or without food. (May be taken w/ meals to minimise GI upset.) |
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| Precautions |
Epilepsy, glaucoma, history of mania, cardiac disease, DM, history of bleeding disorders and on drugs with increased risk of bleeding; renal and hepatic impairment; patients receiving electroconvulsive therapy; achlorhydria or high gastric pH (reduced absorption of oral suspension). Pregnancy and lactation. The risk of suicidal behaviour is may be higher in young adults, closely monitor. May impair ability to drive or perform tasks. Paroxetine should not be withdrawn abruptly. |
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| Adverse Drug Reactions |
Somnolence, insomnia, headache, dizziness; decreased libido; nausea, xerostomia, constipation, diarrhea; ejaculatory disturbances; weakness, tremor, diaphoresis; vasodilation, chest pain, palpitation, hypertension, Tachycardia, nervousness, anxiety , agitation, abnormal dreams, impaired concentration, yawning, depersonalization, amnesia, emotional lability, vertigo, confusion, chills; rash, pruritus; orgasmic disturbance, dysmenorrhea; anorexia, decreased appetite, dyspepsia, flatulence, abdominal pain, appetite increased, vomiting, taste perversion, weight gain; impotence, genital disorder, urinary frequency, UTI; paresthesia, myalgia, back pain, myoclonus, myopathy, myasthenia, arthralgia; blurred vision, abnormal vision; tinnitus; respiratory disorder, pharyngitis, sinusitis, rhinitis; infection. |
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| Interactions |
Levels/effects inhibited by cyproheptadine, phenytoin. Levels/effects increased by carbamazepine, cimetidine, CYP2D6 inhibitors (e.g. chlorpromazine, delavirdine, fluoxetine, miconazole, pergolide, quinidine, quinine, ritonavir, ropinirole). Increases levels/effects of atomoxetine, carvedilol, clozapine, CYP2B6 substrates (e.g. bupropion, promethazine, propofol, selegiline, sertraline), CYP2D6 substrates (e.g. amphetamines, selected beta-blockers, dextromethorphan, fluoxetine, lidocaine, mirtazapine, nefazodone, risperidone, ritonavir, thioridazine, TCAs, venlafaxine), duloxetine, galantamine, mexilitine, pimozide, procyclidine, propafenone. Decreases levels/effects of CYP2D6 prodrug substrates (e.g. codeine, hydrocodone, oxycodone, tramadol). Inhibits the metabolism dextromethorphan, haloperidol, thioridazine. Enhances bradycardic effect of beta-blockers. Enhances toxic effects of other CNS depressants. Increased risk of serotonin syndrome with amphetamines, SSRIs, meperidine, nefazodone, trazodone, serotonin agonists, sibutramine, sympathomimetics, tramadol, venlafaxine. Increases risk of bleeding with NSAIDs, aspirin, warfarin, or other drugs affecting coagulation. Increases sensitivity to amphetamines. Neurotoxicity with lithium. Additive hyponatremia with loop diuretics. Mania or hypertension with selegiline. |
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