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Paroxetine is a selective serotonin reuptake inhibitor (SSRI) drug that is used to treat a variety of psychiatric disorders, as well as a few menopausal symptoms.

7 Minute Read | Published Oct 04 2023 | Updated Feb 28 2024 Expert Verified
Emma Collins
Written by
Jennifer Williams
Reviewed by
Emma Collins
Written by
Jennifer Williams
Reviewed by

Common Brand Names: Brisdelle, Paxil, Paxil CR, Pexeva

As an SSRI antidepressant, paroxetine works by preventing the body from reabsorbing serotonin. This results in increased serotonin levels in the brain, which can help enhance mood and maintain mental balance.

While Paroxetine is not a scheduled substance in the United States, it is a prescription-only drug.

Medical Uses of Paroxetine

Paroxetine is approved by the U.S. Food and Drug Administration for:

  • Depression
  • Panic disorder
  • Social anxiety disorder (SAD)
  • Major depressive disorder (MDD)
  • Obsessive-compulsive disorder (OCD)
  • Posttraumatic stress disorder (PTSD)
  • Generalized anxiety disorder (GAD)

Doctors may also recommend paroxetine to patients experiencing premenstrual dysphoric disorder (PMDD), as well as vasomotor symptoms associated with menopause like hot flashes and night sweats.

Off-label, paroxetine is used to treat the following:

  • Separation anxiety
  • Dysthymia, also known as persistent depressive disorder
  • Body dysmorphic disorder
  • Postpartum depression
  • Premature ejaculation
  • Malignancy-related pruritus (skin itching) that is unresponsive to standard treatment

Paroxetine is not approved for those under 18 years of age. However, some medical professionals may recommend paroxetine for the above-mentioned off-label uses to this group.

In addition, paroxetine is not recommended for pregnant women, particularly those in the third trimester. Meanwhile, elderly patients may still be prescribed paroxetine but at a lower dose.

Paroxetine Abuse and Misuse

While many antidepressants like paroxetine are associated with withdrawal or discontinuation symptoms, there are very few links between the drug and features of addiction. The most common issues related to the use of antidepressants is prematurely stopping the therapy or taking lower than the recommended dosage. What’s more, the level of mood elevation provided by paroxetine is not a “desirable” enough effect to induce addiction.

Nevertheless, there are still reports of co-occurring antidepressant abuse in individuals who are experiencing substance use or mood disorders. These individuals abuse antidepressants by taking higher doses than recommended, usually through intranasal or intravenous routes. Often, the ultimate goal is to mimic the effect of psychostimulants.

Paroxetine Drug Interactions

Using paroxetine with other drugs or substances may produce undesirable reactions. Thus, it’s important that those who may try to use or abuse paroxetine to treat their medical conditions be aware which drugs or substances can result in such effects. Those with significant effects are the following:

  • Tryptophan: It’s not advisable to coadminister paroxetine (or other SSRIs) with tryptophan, as it may result in adverse experiences such as nausea, sweating, and dizziness.
  • Warfarin: Further research is needed to establish the interactions between paroxetine and warfarin. Nevertheless, preliminary data show the possibility of increased bleeding diathesis (a tendency to bruise or bleed easily) when paroxetine and warfarin are used concomitantly.
  • Tricyclic Antidepressants (TCAs): Paroxetine may slow down the metabolism of TCAs.
  • Triptans: There are some reports of serotonin syndrome that supposedly arose with the use of an SSRI with a triptan (a type of medication used to counteract symptoms of migraines).

Some studies have also shown that SSRIs may affect fertility in some men, particularly with regard to the decline of sperm quality.

Adverse Effects of Paroxetine

In general, the side effects associated with paroxetine use are dose-dependent. Some of the most common side effects one may experience after taking paroxetine include:

  • Dry mouth
  • Loss of appetite
  • Constipation
  • Diarrhea
  • Nausea
  • Increased sweating
  • Drowsiness
  • Dizziness
  • Headache
  • Tremors
  • Sleep disturbances
  • Problems related with sexual function
  • Apathy
  • Mania or hypomania
  • Weight gain
  • Edema (swelling due to retained fluid in the body)
  • Palpitations
  • Increased heart rate

Symptoms that may point to a serious adverse drug event include:

  • Hallucinations
  • Fainting
  • Irregular heartbeat
  • Chest pain
  • Difficulty breathing
  • Seizures
  • Severe muscle stiffness or twitching
  • Abnormal bleeding or bruising
  • Uncontrollable shaking of a part of the body
  • Uncontrollable and sudden muscle twitching or jerking
  • Numbness or tingling in the extremities
  • Painful and prolonged erection that lasts for hours
  • Frequent or painful urination
  • Infection in the vagina
  • Black and tarry stools
  • Red blood in stools
  • Presence of blood in the vomit
  • Bone pain

If you or someone you know who is taking paroxetine experiences any of these adverse effects, contact emergency services or go to the nearest hospital immediately.

Moreover, paroxetine has been associated with an increased risk of suicidality, particularly among adolescents and young adults. Some studies also show that this may also extend to adults. Patients must be closely observed for signs pointing to this adverse effect.

Signs of Paroxetine Overdose

While paroxetine is not a controlled substance, patients can still overdose on it. Do note that while paroxetine overdose is rarely a lethal event, you should still seek immediate medical assistance for relief and to prevent the symptoms from getting worse.

That being said, here are some key signs of paroxetine overdose to watch out for:

  • Feeling sleepy
  • Drowsiness
  • Extreme tiredness
  • Lack of energy
  • Fast heart rate
  • Seizures
  • Fever
  • Coma
  • Confusion
  • Nausea and vomiting
  • Loss of consciousness
  • Blurred vision
  • Loss of appetite
  • Yellowing of the skin and eyes
  • Aggressive behavior
  • Frenzied or abnormally excited mood

Paroxetine: Dependence, Withdrawal, and Addiction

As mentioned, paroxetine and many other antidepressants are not known to be addictive substances.

However, evidence has shown that withdrawal, also called discontinuation syndrome, is more common in individuals that use paroxetine than in those that use other SSRIs. Some symptoms linked to paroxetine withdrawal include:

  • Nausea and vomiting
  • Headache
  • Dizziness
  • Low energy
  • Fever
  • Chills
  • Anxiety
  • Irritability

Withdrawal is usually a sign that the body has become dependent on a certain substance—in this case, on paroxetine. Do note, however, that being dependent on a drug doesn’t immediately constitute being addicted to it, although dependence usually accompanies addiction. While dependence simply means that an individual may experience withdrawal symptoms when they suddenly stop taking the drug, substance use disorder or addiction is an illness that is characterized by a continuing pattern of compulsive drug use despite the negative consequences.

Patients that develop drug dependence and withdrawal symptoms are typically advised to undergo medical detoxification, which is a set of interventions that are aimed at managing acute intoxication and symptoms of withdrawal.

Rehabilitation from Paroxetine Misuse and Abuse

Paroxetine is not considered an addictive antidepressant. As mentioned above, clinical studies have not shown any significant association between paroxetine use and drug-seeking behavior. However, long- term abuse and misuse of paroxetine can still negatively affect your health and everyday life.

The best thing to do to prevent further misuse or abuse of paroxetine is to seek professional rehabilitation services. There are two options available to you or a loved one:

  • Inpatient treatment: This type of drug rehabilitation program is an intensive one in which you will be required to stay at an assigned facility. You will be given a combination of treatments, which can include multiple medications for health conditions that may have been caused by drug use, as well as behavioral therapies that teach positive coping mechanisms and impulse control techniques, especially if you have co-occurring substance use disorders or mental health concerns.
  • Outpatient treatment. Outpatient treatment is a less intensive option but no less effective. In this type of rehab program, you can continue living at home and conducting your usual activities like going to school or work. However, you’re obligated to attend therapy and counseling at the treatment center recommended by your doctors. Outpatient rehab is typically recommended for individuals with mild symptoms or those who have demonstrated compliance to treatment protocols in the past.

Achieving a drug-free life is possible with the right support system. Get the best rehab care with the help of Better Addiction Care’s comprehensive rehab referral services. Contact us at (800) 429-7690 to speak to a recovery support advisor and take the first step towards your recovery.

We can help you find a treatment center that’s suitable for your unique needs. Our support advisors can also assist you with verifying your insurance to check your coverage. If you don’t have insurance, there are other available options that you can discuss with us.

A Brief History of Paroxetine

Paroxetine was approved by the U.S. Food and Drug Administration for medical use in 1992, when it was also first introduced to the American market. Because of its significant benefits against depression and other psychiatric disorders, it quickly gained popularity and soon became one of the most prescribed antidepressants in the country. It was first sold by GlaxoSmithKline under the brand name Paxil, but generic formulations have also become widely available.


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bullet U.S. Food and Drug Administration (2012)
"Paxil: Prescribing Information"
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bullet Haddad, P. (1999)
"Do Antidepressants Have Any Potential to Cause Addiction?. Journal of Psychopharmacology (Oxford, England)"
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"Is There a Difference Between Physical Dependence and Addiction? Principles of Drug Addiction Treatment: A Research-Based Guide (Third Edition)"
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