Paroxetine
From Ganfyd
BNF-registration required
BNF for children-registration required
Indication
- Major Depressive Episode
- Obsessive Compulsive Disorder
- Panic Disorder with and without agoraphobia
- Social Anxiety Disorders/Social phobia
- Generalised Anxiety Disorder
- Post-traumatic Stress Disorder
Dose
- Major Depressive Episode
The recommended dose is 20 mg daily. In general, improvement in patients starts after one week but may only become evident from the second week of therapy.
As with all antidepressant medicinal products, dosage should be reviewed and adjusted if necessary within 3 to 4 weeks of initiation of therapy and thereafter as judged clinically appropriate. In some patients, with insufficient response to 20 mg, the dose may be increased gradually up to a maximum of 50 mg a day in 10 mg steps according to the patient's response.
Patients with depression should be treated for a sufficient period of at least 6 months to ensure that they are free from symptoms.
- Obsessive Compulsive Disorder
The recommended dose is 40 mg daily. Patients should start on 20 mg/day and the dose may be increased gradually in 10 mg increments to the recommended dose. If after some weeks on the recommended dose insufficient response is seen some patients may benefit from having their dose increased gradually up to a maximum of 60 mg/day.
Patients with OCD should be treated for a sufficient period to ensure that they are free from symptoms. This period may be several months or even longer.
- Panic Disorder with and without agoraphobia
The recommended dose is 40 mg daily. Patients should be started on 10 mg/day and the dose gradually increased in 10 mg steps according to the patient's response up to the recommended dose. A low initial starting dose is recommended to minimise the potential worsening of panic symptomatology, which is generally recognised to occur early in the treatment of this disorder. If after some weeks on the recommended dose insufficient response is seen some patients may benefit from having their dose increased gradually up to a maximum of 60 mg/day.
Patients with panic disorder should be treated for a sufficient period to ensure that they are free from symptoms. This period may be several months or even longer
- Social Anxiety Disorders/Social phobia
The recommended dose is 20 mg daily.If after some weeks on the recommended dose insufficient response is seen some patients may benefit from having their dose increased gradually in 10 mg steps up to a maximum of 50 mg/day.Long-term use should be regularly evaluated (see section 5.1 Pharmacodynamic properties).
- Generalised Anxiety Disorder
The recommended dose is 20 mg daily.If after some weeks on the recommended dose insufficient response is seen some patients may benefit from having their dose increased gradually in 10 mg steps up to a maximum of 50 mg/day.Long-term use should be regularly evaluated
- Post-traumatic Stress Disorder
The recommended dose is 20 mg daily.If after some weeks on the recommended dose insufficient response is seen some patients may benefit from having their dose increased gradually in 10 mg steps up to a maximum of 50 mg/day.Long-term use should be regularly evaluated
Side Effects
- Serotonin syndrome
- Bleeding (this risk is much enhanced in those on NSAIDs and aspirin)[1]
