Experiences with
Paroxetine

Paroxetine is a type of antidepressant known as a selective serotonin reuptake inhibitor (SSRI).

It's often used to treat depression, and sometimes obsessive compulsive disorder (OCD), panic attacks, anxiety or post-traumatic stress disorder (PTSD).

Paroxetine helps many people recover from depression, and it has fewer unwanted effects than older antidepressants.

Paroxetine is available on prescription. It comes as tablets and as a liquid that you swallow.

Who can take paroxetine

Most adults aged 18 and over can take paroxetine.

If you have diabetes, paroxetine can make it more difficult to keep your blood sugar stable. Your doctor may recommend you monitor your blood sugar more often for the first few weeks and adjust your diabetes treatment if necessary.

Who may not be able to take paroxetine

Paroxetine is not suitable for everyone. To make sure it's safe for you, check with your doctor before starting to take paroxetine if you:

have ever had an allergic reaction to paroxetine or any other medicine
have a heart problem – paroxetine can make your heart beat faster or cause an irregular heartbeat (arrhythmia)
have ever taken any other medicines for depression – some rarely used antidepressants can affect the way paroxetine works. They can cause very high blood pressure, even when they have been stopped for a few weeks
are trying to become pregnant, are already pregnant or you are breastfeeding
have glaucoma – paroxetine can increase the pressure in your eye
have epilepsy or are having electroconvulsive treatment – paroxetine may increase your seizures (fits)

Dosage and strength

Paroxetine is available as 10mg, 20mg and 40mg tablets

It is also available as a liquid. 10ml of paroxetine liquid is the same as a 20mg tablet.

Most people will start with a dose of 10mg or 20mg. This might be gradually increased until you and your doctor agree that you have found a dose that suits you.

The maximum recommended dose of paroxetine is 50mg or 60mg a day, depending on why you are taking it.

If you are 65 or older, the maximum recommended dose is 40mg a day. If you have problems with your liver or kidneys, you may be asked to take a lower dose than usual.

The dose of paroxetine that you're prescribed depends on why you are taking it.

How to take paroxetine

Take paroxetine once a day, in the morning. It's best to take it with food so it does not upset your stomach.

How long to take it for

Once you're feeling better it's likely that you'll carry on taking paroxetine for several more months. This is to stop the symptoms returning.

You'll need to discuss the benefits and risks of taking paroxetine for longer than a few months with your doctor. The decision will depend on what symptoms you have and how bad they are. It will also depend on whether it's a one-off problem or one that keeps coming back, how well paroxetine works for you and whether you've had any bad side effects.

If you forget to take it

If you forget to take a dose of paroxetine, but remember it before you go to bed, take it straight away. If you do not remember until the next day, skip the missed dose and take your next dose at the usual time.

Never take 2 doses at the same time to make up for a forgotten one.

If you forget doses often, it may help to set an alarm to remind you. You could also ask your pharmacist for advice on other ways to help you remember to take your medicine.

The amount of paroxetine that can lead to an overdose varies from person to person.

you've taken more than your prescribed dose of paroxetine and get symptoms such as :

being sick (vomiting)
shaking
feeling sleepy
fast heart rate
a high temperature

Go to 111.nhs.uk or call 111

If you need to go to A&E do not drive yourself. Get someone else to drive you or call for an ambulance.

Take the paroxetine packet, or the leaflet inside it, plus any remaining medicine with you.

you take more than your prescribed dose of paroxetine and have a seizure

If you've been feeling better for 6 months or more, your doctor may suggest coming off paroxetine.

Before you stop taking paroxetine, your doctor will recommend reducing your dose gradually over several weeks, or longer if you have been taking it for a long time.

This is to help prevent any withdrawal side effects caused by coming come off the medicine too quickly. These can include:

feeling dizzy
feeling sick
numbness or tingling in the hands or feet
trouble sleeping (insomnia)
feeling agitated or anxious
headaches
shaking

Do not stop taking paroxetine suddenly, or without talking to your doctor first.

Common side effects

These common side effects of paroxetine happen in more than 1 in 100 people. There are things you can do to help cope with them:

Try taking paroxetine with or after food. It may also help to stick to simple meals and avoid rich or spicy food.

Make sure you rest and drink plenty of fluids. Try not to drink too much alcohol. Ask your pharmacist to recommend a painkiller.

Headaches should usually go away after the first week of taking paroxetine. Talk to your doctor if they last longer than a week or are severe.

Try taking paroxetine first thing in the morning.

Drink plenty of water or other fluids to avoid dehydration. Signs of dehydration include peeing less than usual or having dark, strong-smelling pee. Do not take any other medicines to treat diarrhoea without speaking to a pharmacist or doctor.

If you're taking the combined contraceptive pill or progestogen-only pill and you have severe diarrhoea for more than 24 hours, your contraception may not protect you from pregnancy. Check the pill packet for advice.

If paroxetine makes you feel tired or weak, stop what you're doing and sit or lie down until you feel better. Do not drive or use tools or machinery if you're feeling tired. It's best not drink alcohol as it will make you feel worse.

If these symptoms do not go away after a week or two, ask your doctor for advice.

Serious side effects are rare and happen in less than 1 in 1,000 people.

Book an appointment with your doctor if you:

lose or gain weight without trying
have changes in your periods such as heavy bleeding, spotting or bleeding between periods

Call your doctor or call 111 straight away if you:

get constant headaches, long lasting confusion or weakness, or frequent muscle cramps – these can all be signs of low sodium levels in your blood
cough up blood or have blood in your pee
have black or red poo or blood in your vomit – these can be signs of bleeding from the gut
are bleeding from the gums or have bruises that appear without a reason or that get bigger
are feeling restless or cannot sit or stand still
get blurred vision

you have chest pain or pressure or shortness of breath – chest pain is a possible symptom of a heart attack and needs to be checked out as soon as possible
you get painful erections that last longer than 2 hours – this may happen even when you're not having sex
you have thoughts about harming yourself or ending your life
you have any heavy bleeding or bleeding that you cannot stop such as cuts or nosebleeds that do not stop within 10 minutes

Meds - serious side effects A&E safety messaging

In rare cases, it's possible to have a serious allergic reaction (anaphylaxis) to paroxetine.

Meds New IA (H4) - serious allergic reaction

For most people, paroxetine is safe to take for a long time.

A few people may get sexual side effects, such as problems getting an erection or a lower sex drive. In some cases these can continue even after stopping the medicine. Speak to your doctor if you are worried.

Taking paroxetine for more than a year has also been linked to a small, increased risk of getting diabetes. But you will be regularly checked for this.

Other side effects

These are not all the side effects of paroxetine. For a full list, see the leaflet inside your medicine packet.

Paroxetine and pregnancy

Paroxetine can be taken in pregnancy. Some studies have suggested that paroxetine might occasionally affect the development of a baby's heart. However, if there is any risk, it is small, and the majority of babies born to women taking paroxetine have a normal heart.

When paroxetine is taken in the weeks before delivery it can sometimes cause short-term withdrawal symptoms and, very rarely, breathing problems in the baby. Your baby will be checked after birth and given extra care if needed.

Taking paroxetine in the last month of pregnancy may slightly increase your risk of bleeding after delivery. However, because this side effect is rare and can be treated, it's not a reason to stop taking paroxetine for most pregnant women.

It is important that your mental health is well treated as this can affect both you and your baby's wellbeing. Depression and anxiety can sometimes get worse during pregnancy, and after your baby's born.

Speak to your doctor if you become pregnant. They will help you weigh up the risks and benefits so you can decide on the best treatment for you and your baby.

Paroxetine and breastfeeding

If your doctor or health visitor says your baby is healthy, it's OK to take paroxetine while breastfeeding. It is one of the preferred antidepressants to take when breastfeeding and has been used by many breastfeeding mothers without any problems.

Paroxetine passes into breast milk in very small amounts, and has been linked with side effects in very few breastfed babies.

It is important to continue taking paroxetine to keep you well. Breastfeeding will also benefit both you and your baby.

If you notice that your baby is not feeding as well as usual, seems unusually sleepy or irritable, has colic or if you have any other concerns about your baby, then talk to your health visitor or doctor as soon as possible.

Paroxetine and fertility

Paroxetine may possibly reduce sperm quality, but it's not known whether this reduces fertility or not. Speak to your doctor if you're having difficulty trying for a baby.

For women, there's no evidence to suggest that taking paroxetine will reduce your fertility. Speak to a pharmacist or your doctor if you're trying to get pregnant as they may want to review your treatment.

Meds New IA (H2) - Pregnancy non-urgent care card

Cautions with other medicines

Paroxetine can be affected by other medicines you're taking, and it can affect the way that other medicines work. Either way, it can increase the chances of you having side effects.

Tell your doctor if you're taking any of these medicines before you start paroxetine:

any medicines that affect your heartbeat – paroxetine can make your heart beat faster or cause an irregular heartbeat (arrhythmia)
any other medicines for depression – some rarely used antidepressants can interact with paroxetine and cause very high blood pressure even a few weeks after you've stopped taking them
any medicines for schizophrenia – some rarely used medicines for schizophrenia can affect how paroxetine works and cause heart problems

Mixing paroxetine with herbal remedies and supplements

Do not take St John's wort, the herbal remedy for depression, if you're taking paroxetine because it increases your risk of side effects.

There's not enough information to say that other herbal remedies and supplements are safe to take with paroxetine. They're not tested in the same way as pharmacy and prescription medicines. They're generally not tested for the effect they have on other medicines.

Meds New IA (H2) - Cautions with other medicines alert