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Reviewed by Dr Roy Kedem, MD
Information last reviewed 09/10/20
Paroxetine is an SSRI (selective serotonin reuptake inhibitor). SSRIs are a class of medications commonly prescribed as antidepressants, but were also found to be effective in reducing hot flashes in menopausal women.
Paroxetine is a selective serotonin reuptake inhibitor (SSRI). Serotonin is a chemical in your brain that is involved in nerve signaling and is often considered to be the ‘happiness hormone’. Serotonin also plays a role in helping you maintain a stable body temperature. Paroxetine works by reducing the amount of serotonin that can be reabsorbed by your cells, meaning there is more serotonin available. If more serotonin is available, you should be able to better regulate your body temperature.
Paroxetine can be used to treat hot flashes, but it is also used to treat several mental health conditions, including:
It can take a few weeks for Paroxetine to work. You should see a 33-67% reduction in the frequency of your hot flashes within 6-12 weeks. Some effects, including side effects, may occur shortly after you start taking Paroxetine.
Paroxetine usually takes about 4-6 weeks before having the intended effect. During this period, you may experience some side effects including anxiety or depression, but this varies from person to person. It is common to feel anxious or depressed initially when taking any SSRI medication but this should go away after the body becomes accustomed to the medication. After 4-6 weeks, you should feel more like your usual self, and you should notice a reduction in your hot flashes. If you do not experience an improvement of symptoms at this time, or if you continue to experience significant side effects, you may want to speak to your doctor about alternatives.
The active ingredient in Paroxetine depends upon which type you take. Paroxetine is available with paroxetine mesylate or paroxetine hydrochloride as the active ingredient.
Inactive ingredients can vary across different manufacturers. Paxil is a branded version of Paroxetine manufactured by GlaxoSmithKline (GSK). It contains the following inactive ingredients: dibasic calcium phosphate dihydrate, hypromellose, magnesium stearate, polyethylene glycols, polysorbate 80, sodium starch glycolate, titanium dioxide and colorings.
Unless you are specifically allergic to one of the active or inactive ingredients, there is no ingredient normally associated with allergies. If you start taking Paroxetine and notice difficulty breathing, a rash or swelling of the tongue, face, eyes, or mouth, stop taking it immediately and proceed to the nearest emergency department.
The Paroxetine dosage for hot flash treatment depends upon which type of Paroxetine you are taking:
Paroxetine should be taken once daily in the morning. Paroxetine should be taken with food to avoid side effects such as nausea. It is recommended that you take Paroxetine in the morning because it can cause difficulty sleeping. If you find it difficult to tolerate the side effects of Paroxetine during the day, you could try taking it at night instead.
Paroxetine is available in different forms. Regular Paroxetine and sustained release (or controlled release) tablets should not be crushed or cut in half, as this would cause the medication to be released too quickly, exacerbating potential side effects.
Common side effects of Paroxetine include:
Please see the patient information leaflet for a full list of side effects.
Paroxetine should not be taken by individuals with a seizure disorder. Individuals with bipolar disorder, clinical depression or a significant anxiety disorder should be evaluated in person before starting paroxetine.
Over 450 drugs are known to interact with Paroxetine. This includes common drugs such as Zoloft and Aspirin, as well as some more unusual medications. Therefore, it is vital that you tell your doctor about any medications or recreational drugs that you are taking, to avoid any negative interactions.
Alcohol can exacerbate the side effects of Paroxetine, such as dizziness, nausea, and confusion. Therefore, it is recommended that you avoid drinking alcohol while taking Paroxetine.
Paroxetine is not recommended during pregnancy, as it can increase the risk of birth defects if taken during the first trimester. The risk of birth defects has been found to increase by 23%, meaning that the overall risk of birth defects is 3.69% for women taking Paroxetine in their first trimester. Paroxetine would not be prescribed for hot flashes in pregnant women; as a hot flash treatment, Paroxetine would only be prescribed to menopausal women.
A small amount of Paroxetine can be passed into breast milk, and a small number of babies have experienced side effects from Paroxetine. However, this is not considered to be a significant risk, so breastfeeding mothers of healthy children may be able to take Paroxetine. The prescribing doctor will help you weigh up the risks and benefits of treatment before prescribing Paroxetine. Paroxetine would not be prescribed for hot flashes in breastfeeding women; as a hot flash treatment, Paroxetine is only given to menopausal women, however Paroxetine does have other uses such as the treatment of depression.
Paroxetine can cause drowsiness and difficulty concentrating. Some people however, experience insomnia and difficulty sleeping when taking Paroxetine.
Headaches are a common side effect of Paroxetine. If you do experience headaches, you should avoid taking Aspirin as this can interact with Paroxetine.
When combined with some specific antidepressants, Paroxetine can cause very high blood pressure which can persist for a few weeks, even if you stop taking it. Paroxetine will not lower blood pressure. Other antidepressants that can increase blood pressure are: Venlafaxine (Effexor XR), Monoamine oxidase inhibitors, Tricyclic antidepressants and Fluoxetine (Prozac, Sarafem, others)
Hormone replacement therapy is usually suggested for menopausal women experiencing hot flashes. Some women prefer to avoid hormone-based treatment, and in this case, antidepressants such as Paroxetine or Venlafaxine may be prescribed. Additionally, paroxetine may be better suited for women who have been diagnosed with breast cancer, specifically those who are not taking Tamoxifen.
Antidepressants such as Paroxetine and Venlafaxine are effective medications for hot flashes in menopausal women. However, not all antidepressants are considered to be effective in treating hot flashes. For example, Sertraline and Fluoxetine do not have any proven effect in this regard.
Paroxetine and Venlafaxine are equally effective in the treatment of hot flashes, however, only Paroxetine has FDA approval for this indication. Paroxetine is therefore, often the first-choice for treatment when HRT is considered unsuitable. When Venlafaxine is prescribed for hot flashes, it is considered off-label use.
Paroxetine is not addictive, but it can produce withdrawal symptoms such as:
Some people do experience fatigue and drowsiness in response to Paroxetine. Some people however, experience insomnia and difficulty sleeping when taking Paroxetine.
Paroxetine is usually taken in the morning because it can cause insomnia and difficulty sleeping. If you experience significant side effects during the day, you could try moving your dose to the evening to see which time works better for you.
Paroxetine can cause changes in appetite that can lead to weight gain. Some people find that they eat more high-calorie foods when taking Paroxetine. It is important to try to maintain a balanced diet to avoid excess weight gain when taking Paroxetine.
Paroxetine is a generic drug and can be produced by a number of different manufacturers. Paxil and Seroxat are branded versions of Paroxetine manufactured by GlaxoSmithKline (GSK).
Disclaimer: This is not medical advice. You and your physician will determine if and how you should take any medication prescribed to you following a medical consultation.
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