"Paroxetine": instructions for use, reviews. Drug analogues

What is the purpose of the drug "Paroxetine"? Instructions for using this medication will be provided in this article. Also from it you will become aware of what contraindications and indications there are for this medication, whether it has side effects, in what form is produced and how the medication interacts with other drugs.

Composition, packaging and form of the drug

The drug "Paroxetine" goes on sale in the form of tablets, covered with a film membrane. They have a round and biconvex shape, white color, risk and rough surface.

The active substance of the agent under consideration is paroxetine hydrochloride hemihydrate. Also, the preparation in its composition has auxiliary elements in the form of colloidal silicon dioxide, microcrystalline cellulose, crospovidone, calcium hydrophosphate, copovidone, magnesium stearate and talc.

Tablets "Paroxetine" are sold in blisters for 10 pieces, which are placed in a cardboard box.

Pharmacological action of the drug

What is the drug "Paroxetine", analogues of which will be named a little further? It's an antidepressant. It is an inhibitor of (selective) reuptake of serotonin by brain neurons. This is what determines its antidepressant effect, as well as its effectiveness in the treatment of panic and obsessive-compulsive disorders.

The drug we are considering has very low affinity for α2, α1 and β-adrenoreceptors, as well as for m-cholinergic receptors, dopamine, 5HT1-like, 5HT2-like and histamine H1 receptors.

Does psychomotor function disturb the drug "Paroxetine"? The doctors say that this medicine does not affect the human psyche in a negative way. Moreover, it does not potentiate the inhibitory effect of ethanol on psychomotor functions.

According to the researchers, such an antidepressant reveals weak activating properties only if it is administered at dosages higher than those required to inhibit the capture of serotonin. It should also be said that this drug does not cause a significant change in the level of blood pressure, EEG and heart rate.

Pharmacokinetics of the medicine

How is the drug "Paroxetine" absorbed? Instructions for use, reviews of doctors say that after ingestion, the active substance is absorbed from the digestive tract, and is also metabolized through the liver.

The steady-state concentration of the drug in the blood is reached in 1-1.7 weeks after the start of drug treatment. The active substance of the drug is distributed in the tissues extensively. However, only one percent of it is found in the plasma. The connection with proteins is about 95%.

The antidepressant in the liver is metabolized. As a result, inactive metabolites are formed. They are quickly removed from the body, and also have little pharmacological activity and do not affect the therapeutic effect of the drug.

How is the drug "Paroxetine"? Instructions, reviews of pharmacists say that approximately 64% of the active substance goes along with the urine, and the remaining 36% - through the intestines (with bile).

Pharmacokinetics of medicament in special clinical cases

The concentration of the active substance in the blood plasma increases when the kidneys and liver, as well as in the elderly, are disrupted.

Indications for use of a medical device

In what cases are patients prescribed antidepressant "Paroxetine"? Instructions for use of this tool include the following list of indications:

• Depression of all types, including severe endogenous, reactive and accompanied by anxiety;
• Panic disorders, including agoraphobia;
• Obsessive-compulsive disorder (or abbreviated OCD);
• Generalized anxiety disorders;
• Social anxiety disorders, or the so-called social phobia.

Contraindications to the use of a medical device

In what cases, in any case, can not prescribe to patients an antidepressant "Paroxetine"? Instructions for use of this tool include the following list of contraindications:

• Epilepsy is unstable;
• Simultaneous use of MAO inhibitors, as well as a two-week period after their cancellation;
• childhood;
• Period of gestation;
• Increased sensitivity to the elements of the drug;
• The period of breastfeeding.

Use with extreme caution

In what cases should you monitor the use of the antidepressant "Paroxetine"? Instructions for use say that this drug is prescribed with caution to patients with hepatic insufficiency, closed-angle glaucoma, renal insufficiency, mania, prostatic hyperplasia, convulsive conditions, cardiac pathology, epilepsy. In addition, simultaneous use of the medication and conducting electropulse therapy, as well as taking medications that increase the risk of bleeding, is unacceptable. It should pay special attention to the presence of risk factors for increased bleeding and contributing to this condition.

Antidepressant "Paroxetine": how to take medicine?

The medicament considered by us should be taken orally once a day (in the morning) during breakfast. Tablets should be swallowed whole, washed down with plain water.

During the first three weeks after the start of treatment, the dosage of the drug is selected individually. Subsequently, it is adjusted (if necessary).

During prolonged depression, the recommended amount of medication is 20 mg once a day. If required, the dose is gradually increased by another 10 mg. The maximum amount of medication taken should not exceed 50 mg.

With obsessive-compulsive disorder, the initial dosage of the antidepressant is 20 mg per day. In the future, it increases by 10 mg. The recommended average daily dose of the drug with this deviation is 40 mg. If urgently needed, it can be increased to 60 mg.

If a patient has panic disorder, then initially up to 10 mg of the drug per day can be taken. To reduce the possible risk of developing panic symptoms, in the subsequent dose of the drug is increased by another 10 mg. On average, with such a deviation, it is permissible to use 40 mg of "Paroxetine" per day, the maximum amount is 50 mg.

With social phobias or social anxiety disorders, the initial volume of the drug should not exceed 20 mg per day. If after such treatment the desired effect was not achieved, then within 2 weeks the dose is gradually increased to a maximum, that is, up to 50 mg per day.

In generalized anxiety disorders, the therapeutic and initial volume of the drug is 20 mg per day

If the patient is diagnosed with hepatic or renal failure, the recommended dose should be 20 mg per day.

Elderly people per day can use no more than 40 mg of this medication.

In order to prevent withdrawal syndrome , it is recommended to stop taking the drug gradually.

Cases of overdose

Have there been cases of overdose with such antidepressants as "Paroxetine", "Fluoxetine"? Experts note that when using a large number of tablets, they really detrimental to the human body. The patient has nausea, dry mouth, sinus tachycardia, vomiting, convulsions, tremor, bradycardia, mydriasis, agitation, irritability, sweating, nystagmus, increased blood pressure, drowsiness and nodal rhythm.

In very rare cases with simultaneous use of the drug with other psychotropic medications, as well as alcoholic beverages, the comatose state of the patient and the change in ECG readings are possible. With severe overdose, the patient has serotonin syndrome and rhabdomyolysis.

What to do in such situations? In case of an overdose with the drug "Paroxetine" you should wash the stomach, and also take activated charcoal. If necessary, then perform symptomatic treatment.

Adverse events

What side effects can the drug "Paroxetine" cause? Reviews of doctors say that this tool really contributes to the development of negative reactions. These include the following conditions and pathologies:

• From the side of the central nervous system and peripheral nervous system: mania, drowsiness, confusion, tremor, serotonin syndrome, asthenia, hallucinations, insomnia, nervousness, dizziness, depersonalization, fatigue, panic attacks, seizures, agitation, amnesia, extrapyramidal disorders, myoclonia, anxiety.
• Musculoskeletal system: muscle weakness, arthralgia, myopathy and myalgia.
• Sense organs: blurred vision and blurred vision in general.
• Urinary system: frequent urination or urinary retention.
• Digestive tract: increase or decrease in appetite, hepatitis, change in taste, dry mouth, nausea, diarrhea, vomiting, constipation.
• Sexual system: anorgasmia, sexual function disorders, hyperprolactinaemia or galactorrhea, ejaculatory disorders and impotence.
• Cardiovascular system: hypotension orthostatic.
• Allergy: itching, rash, angioedema, ecchymosis and urticaria.
• Other abnormalities: rhinitis, increased sweating, impaired secretion of antidiuretic hormone, hyponatremia.

Interaction with other medical devices

The simultaneous use of antacids does not affect the pharmacokinetic parameters and absorption of the drug "Paroxetine".

Contraindicated one-time use of the agent we are considering with MAO inhibitors.

Simultaneous reception of the drug "Paroxetine" with drugs that inhibit liver enzymes, requires a lower dose of the former.

Antidepressant increases the duration of bleeding against the background of a one-time application of "Warfarin".

The simultaneous use of the drug "Paroxetine" with tricyclic antidepressants, acetylsalicylic acid, atypical antipsychotics, NSAIDs and phenothiazine series helps disrupt the blood clotting process.

Simultaneous administration with serotonergic drugs (such as Tramadol and Sumatriptan) can easily lead to an increased serotonergic effect.

Important to remember!

To avoid the development of neuroleptic syndrome (malignant), with particular caution the drug "Paroxetine" is prescribed for patients who take antipsychotics.

In elderly people against the background of taking medication, it is possible to develop hyponatremia.

When there are seizures and the first signs of mania, antidepressant therapy is discontinued.

During the first weeks of treatment with the drug "Paroxetine" careful monitoring of the patient's condition in connection with possible suicide is necessary.

During therapy should refrain from taking alcoholic beverages due to their increased toxic effect.

Pediatric Use

The drug "Paroxetine" is not prescribed for children, since its effectiveness and safety in the treatment of patients in this group have not been established.

Antidepressant "Paroxetine": analogues

What can I replace the drug "Paroxetine"? It should be noted that this medicine has quite a lot of analogues. Among them, I would like to highlight the following medicines: Rexetin, Adapepress, Plizil, Apo-Paroxetine, Aktaparoxetin, Paksil, Sertralin, Paroxetine Hydrochloride Hemihydrate, Sierestill and so on.

Acquire all of the above medicines in the pharmacy can only be prescribed by a doctor.

Reviews about the drug

The drug "Paroxetine" has a lot of conflicting reviews, both from specialists and patients. On the one hand, it is praised for the fact that it contributes to the rapid elimination of depression of all types (including severe endogenous, reactive and accompanied by anxiety), as well as panic, obsessive-compulsive, generalized and socially-anxious disorders. On the other hand, many patients claim that immediately after using the drug they develop a fairly large number of adverse reactions. As a result, people even had to stop treatment.

In general, experts note that "Paroxetine" is a very effective and effective drug that perfectly copes with the task assigned to it. However, it can only be used for the purpose of a specialist.