Brand name : Paxil
Pronounced : PACKS-ill
Generic name : Paroxetine hydrochloride

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Why is this drug prescribed?

Paxil relieves a variety of emotional problems. It can be prescribed for serious, continuing depression that interferes with your ability to function. Symptoms of this type of depression often include changes in appetite and sleep patterns, a persistent low mood, loss of interest in people and activities, decreased sex drive, feelings of guilt or worthlessness, suicidal thoughts, difficulty concentrating, and slowed thinking.

Paxil is also used to treat obsessive-compulsive disorder (OCD), a disease marked by unwanted, but stubbornly persistent thoughts, or unreasonable rituals you feel compelled to repeat.

In addition, Paxil is prescribed for panic disorder, a crippling emotional problem characterized by sudden attacks of at least four of the following symptoms: palpitations, sweating, shaking, numbness, chills or hot flashes, shortness of breath, a feeling of choking, chest pain, nausea or abdominal distress, dizziness or faintness, feelings of unreality or detachment, fear of losing control, or fear of dying.

Paxil can be prescribed for generalized anxiety disorder, a disease marked by excessive anxiety and worry that persists for at least 6 months and can't be easily controlled. True cases of generalized anxiety disorder are accompanied by at least three of the following symptoms: restlessness or a keyed-up or on-edge feeling, a tendency to tire easily, difficulty concentrating or spells when the mind goes blank, irritability, muscle tension, or sleep disturbance.

Paxil can also be used in the treatment of social anxiety disorder (also known as social phobia), a condition marked by shyness or stage fright so intense that it interferes with an individual's work and social life.

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Most important fact about this drug

Your depression may seem to improve within 1 to 4 weeks after beginning treatment with Paxil. Even if you feel better, continue to take the medication as long as your doctor tells you to do so.

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How should you take this medication?

Paxil is taken once a day, with or without food, usually in the morning. Inform your doctor if you are taking or plan to take any prescription or over-the-counter drugs, since they may interact unfavorably with Paxil.

Shake the oral suspension well before using.

—If you miss a dose�E/i>

Skip the forgotten dose and go back to your regular schedule with the next dose. Do not take a double dose to make up for the one you missed.

—Storage instructions�E/i>

Paxil tablets and suspension can be stored at room temperature.

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What side effects may occur?

Side effects cannot be anticipated. If any develop or change in intensity, inform your doctor as soon as possible. Only your doctor can determine whether it is safe for you to continue taking this medication.

Over a 4 to 6 week period, you may find some side effects less troublesome (nausea and dizziness, for example) than others (dry mouth, drowsiness, and weakness).

More common side effects may include:
Constipation, decreased appetite, diarrhea, dizziness, drowsiness, dry mouth, gas, male genital disorders, nausea, nervousness, sleeplessness, sweating, tremor, weakness, vertigo

Less common side effects may include:
Abnormal vision, agitation, altered taste sensation, blurred vision, burning or tingling sensation, decreased sex drive, drugged feeling, emotional instability, headache, increased appetite, infection, muscle tenderness or weakness, pounding heartbeat, rash, ringing in ears, sinus inflammation, tightness in throat, twitching, upset stomach, urinary disorders, vomiting, yawning

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Why should this drug not be prescribed?

Dangerous and even fatal reactions are possible when Paxil is combined with thioridazine (Mellaril) or drugs classified as monoamine oxidase (MAO) inhibitors, such as the antidepressants Nardil and Parnate. Never take Paxil with any of these medications, or within 2 weeks of starting or stopping use of an MAO inhibitor. You'll also need to avoid Paxil if it gives you an allergic reaction.

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Special warnings about this medication

Paxil should be used cautiously by people with a history of manic disorders.

If you have a history of seizures, make sure your doctor knows about it. Paxil should be used with caution in this situation. If you develop seizures once therapy has begun, the drug should be discontinued.

If you have a disease or condition that affects your metabolism or blood circulation, make sure your doctor is aware of it. Paxil should be used cautiously in this situation.

Paxil may impair your judgment, thinking, or motor skills. Do not drive, operate dangerous machinery, or participate in any hazardous activity that requires full mental alertness until you are sure the medication is not affecting you in this way.

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Possible food and drug interactions when taking this medication

Remember that Paxil must never be combined with Mellaril or MAO inhibitors such as Nardil and Parnate.

If Paxil is taken with certain other drugs, the effects of either could be increased, decreased, or altered. It is especially important to check with your doctor before combining Paxil with any of the following:

- Alcohol
- Antidepressants such as Elavil, Tofranil, Norpramin, Pamelor, Prozac
- Cimetidine (Tagamet)
- Diazepam (Valium)
- Digoxin (Lanoxin)
- Flecainide (Tambocor)
- Lithium (Eskalith)
- Phenobarbital
- Phenytoin (Dilantin)
- Procyclidine (Kemadrin)
- Propafenone (Rythmol)
- Propranolol (Inderal, Inderide)
- Quinidine (Quinaglute)
- Sumatriptan (Imitrex)
- Tryptophan
- Warfarin (Coumadin)

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Special information if you are pregnant or breastfeeding

The effects of Paxil during pregnancy have not been adequately studied. If you are pregnant or plan to become pregnant, inform your doctor immediately. Paxil appears in breast milk and could affect a nursing infant. If this medication is essential to your health, your doctor may advise you to discontinue breastfeeding until your treatment with Paxil is finished.

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Recommended dosage

DEPRESSION

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The usual starting dose is 20 milligrams a day, taken as a single dose, usually in the morning. At intervals of at least 1 week, your physician may increase your dosage by 10 milligrams a day, up to a maximum of 50 milligrams a day.

OBSESSIVE-COMPULSIVE DISORDER

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The usual starting dose is 20 milligrams a day, typically taken in the morning. At intervals of at least 1 week, your doctor may increase the dosage by 10 milligrams a day. The recommended long-term dosage is 40 milligrams daily. The maximum is 60 milligrams a day.

PANIC DISORDER

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The usual starting dose is 10 milligrams a day, taken in the morning. At intervals of 1 week or more, the doctor may increase the dose by 10 milligrams a day. The target dose is 40 milligrams daily; dosage should never exceed 60 milligrams.

GENERALIZED ANXIETY DISORDER

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The recommended dose is 20 milligrams taken once a day, usually in the morning.

SOCIAL ANXIETY DISORDER

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The recommended dose is 20 milligrams taken once a day, usually in the morning.
For older adults, the weak, and those with severe kidney or liver disease, starting doses are reduced to 10 milligrams daily, and later doses are limited to no more than 40 milligrams a day. Safety and effectiveness in children have not been established.

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Overdosage

Any medication taken in excess can have serious consequences. If you suspect an overdose, seek medical attention immediately.

The symptoms of Paxil overdose may include:
Coma, dizziness, drowsiness, facial flushing, nausea, sweating, tremor, vomiting