
{| border="1" cellpadding="3" cellspacing="0" width="250px" align="right" style="border-collapse: collapse; margin: 0 0 0 0.5em" |- | bgcolor="#ffffff" align="center" colspan="2" |
''Paroxetine'' |- | align="center" colspan="2" | ''(3S-trans)-3-((1,3-Benzodioxol-5-yloxy)methyl)
-4-(4-fluorophenyl)-piperidine hydrochloride'' |- align="center" style="border-bottom: 3px solid gray" | CAS number
? | ATC code
? |- | bgcolor="#eeeeee" | Chemical formula | bgcolor="#ddeeff" | CHFNO, Cl, 0.5 HO |- | bgcolor="#eeeeee" | Molecular weight | bgcolor="#ddeeff" | 374.8 |- | bgcolor="#eeeeee" | Bioavailability | bgcolor="#ddeeff" | ? |- | bgcolor="#eeeeee" | Max concentration | bgcolor="#ddeeff" | ? hours |- | bgcolor="#eeeeee" | Metabolism | bgcolor="#ddeeff" | ? |- | bgcolor="#eeeeee" | Elimination half-life | bgcolor="#ddeeff" | 16-24 days |- | bgcolor="#eeeeee" | Excretion | bgcolor="#ddeeff" | 66% urina
37% bile |- | bgcolor="#eeeeee" | Pregnancy category (pharmaceutical) | bgcolor="#ddeeff" | ? |- | bgcolor="#eeeeee" | Regulation of therapeutic goods | bgcolor="#ddeeff" | ? |- | bgcolor="#eeeeee" | Routes of administration | bgcolor="#ddeeff" | Oral |- |} Paroxetine (paroxetine hydrochloride; trade names Paxil® (United States), Seroxat® (United Kingdom), Aropax® (Australia)) is an antidepressant of the selective serotonin reuptake inhibitor (SSRI) type. It was released onto the market in 1992 by the pharmaceutical company GlaxoSmithKline and has since become one of the most prescribed antidepressants on the market. It is the second most prescribed anti-depressant in the UK. It is now the subject of a fraud case in the United States due to allegations that GlaxoSmithKline suppressed research indicating that the drug caused young people to become suicidal. Like some other antidepressants, it is also prescribed in the treatment of anxiety disorders and OCD. It was the first (and as of 2002, the only) antidepressant formally approved in the United States for the treatment of social anxiety disorder, causing it to be sometimes referred to (although inaccurately) as an anti-shyness drug. ==Addiction Potential== The manufacturers claim it is impossible to become addiction to paroxetine. Other campaigners disagree. The medical community generally considers that withdrawal symptoms are not enough to regard a drug as addictive; it has to leave the user needing more and more in order to gain the same desired effect. Despite the frequency of 'Prozac poop-out', where an antidepressant becomes less effective over time, and that tolerance to side-effects over the first few weeks of treatment is acknowledged, it is still often claimed that tolerance does not occur. Note, however, that addiction is generally also an extremely debated issue, although no drug is generally considered to be addictive that does not have both withdrawal symptoms and tolerance. ==Suicide and Children== Recent studies have found that the drug is relatively ineffective in children, and that they are prone to becoming suicidal in the early stages of treatment. Some psychologists believe that this is due to the way the drug begins to work in many patients. The first effect most people notice is a decrease in the lethargy and amotivation they experienced during their depression. This effect happens ''before'' the depression itself improves, so many children end up with enough "energy" and motivation to act on suicidal tendencies they may have already had. It is also important to note many people who are prescribed Paxil are suicidal to begin with, however most studies have compared suicide rates in patients using Paroxetine vs. a control group of depressed individuals not being treated with paroxetine. == Side Effects == A growing body of anecdotal evidence has raised concerns about some of its side effects. Although the manufacturers say there is no reliable clinical evidence that the drug can cause violence or aggression, the company was sued in the US after Donald Schell killed his wife, daughter and grandchild after two days on the drug. During the investigation of the clinical records, it was reported that although paroxetine is safe and effective most of the time, in a minority of cases the drug can cause unpredictable side effects, such as wild mood swings or suicide thoughts. However, in June 2004 GlaxoSmithKline were again fighting a lawsuit over the drug due to allegations of fraud. The lawsuit alleges that five studies conducted by GSK between 1998 and 2002 suggested that the drug had little more effect than a placebo and increased suicidal tendencies. Common side effects include: * drowsiness * sleepiness * nausea * upset stomach * dry mouth * constipation * diarrhea * decrease of sexual desire * delayed orgasm or anorgasmia * rash * itch * changes in urination Individuals experiencing any of the following symptoms should contact their doctor immediately: * jaw, neck, and back muscle spasms * fever, chills, sore throat, or flu-like symptoms * yellowing of the skin or eyes ==Withdrawal Symptoms== There is a growing amount of personal and anecdotal accounts of withdrawal symptoms from paroxetine. See, for example, [http://www.join-the-fun.com/paxil-withdrawal-symptoms.html] or [http://www.socialaudit.org.uk/_disc//messages/23/23.html?FridayApril2920051117pm]. Initially, the response of drug regulators (based eg on a report by Price et al, 1995) were that withdrawal symptoms (or 'discontinuation reactions' as SKB/GSK insisted) were generally mild and short-lived, an opinion that has been replaced by mounting concern. Now, it seems about a third of users have problems stopping paroxetine, and the symptoms are strikingly similar ('electric shock' paraesthesia, dizziness, flu-like symptoms, etc) so that it is clear that what is under discussion is not psychological dependence. Anyway a person taking paroxetine must not stop to take it at once. The best way to avoid any withdrawal symptoms is observing the simple strategy of gradually lowering the dose during several days. ==Chemistry== Paroxetine is chemically identified as (''Immediate-Release Tablets / Oral Suspension'':) (-)-''trans''-4''R''-(4-fluorophenyl)-3''S''-[(3,4-methylenedioxyphenoxy) methyl]piperidine hydrochloride hemihydrate, or (''Controlled-Release Tablets'':) (-)-(3''S'',4''R'')-4-[(''p''-fluorophenyl)-3-[(3,4-methylenedioxy)phenoxy]methyl] piperidine hydrochloride hemihydrate. Its empirical formula is carbon19hydrogen20fluorinenitrogenoxygen3, with a molecular weight of 374.8 (329.3703 as free base (chemistry)). Paroxetine hydrochloride is an odorless, off-white powder, having a melting point range of 120° to 138°C and a solubility of 5.4 mg/mL in water. ==Pharmacology== Paroxetine is a potent and selective serotonin (5-hydroxytryptamine, 5-HT) reuptake inhibitor (SSRI). This activity of the drug on brain neurons is thought to be responsible for its antidepressant effects. Paroxetine is a phenylpiperidine derivative which is chemically unrelated to the tricyclic antidepressant or tetracyclic antidepressant antidepressants. In receptor binding studies, paroxetine did not exhibit significant affinity for the adrenergic (alpha(1), alpha(2), beta), dopaminergic, serotonergic (5HT(1), 5HT(2)), or histaminergic receptors of rat brain membrane. A weak affinity for the muscarinic acetylcholine receptor was evident. The predominant metabolites of paroxetine are essentially inactive as 5-HT reuptake inhibitors. ==External links== * [http://www.rcpsych.ac.uk/press/preleases/pr/seroDoH.htm Press Release - Seroxat must not be used for treatment of children] * [http://www.mhra.gov.uk/news/2003/seroxat10603.pdf Press Release - Seroxat must not be used for treatment of children .pdf version] * [http://news.bbc.co.uk/1/hi/programmes/panorama/2310197.stm BBC Panorama investigation, The Secrets of Seroxat] * [http://www.paroxetine.com/ Paroxetine.com - The official paroxetine site] * [http://www.quitpaxil.info/ paxil withdrawal information] * [http://www.depressionblog.com/archives/cat_paxil.shtml Paxil feedback] * [http://www.washingtonpost.com/wp-dyn/articles/A20624-2004Apr17.html Antidepressant Use in Children Soars Despite Efficacy Doubts] * [http://www.seroxatusergroup.org.uk/ Seroxat User Group] - A support group for those suffering adverse effects of the drug * [http://www.paxilprogress.org/ paxilprogress] : Paxil and Paxil Withdrawal Information * [http://www.guardian.co.uk/uk_news/story/0,3604,1230156,00.html Glaxo faces drug fraud lawsuit] - [http://www.guardian.co.uk The Guardian] - June 2004 ** [http://www.guardian.co.uk/medicine/story/0,11381,1242678,00.html Follow-up story: Glaxo changes tack after Spitzer assault] - The Guardian - June 2004 * [http://www.guardian.co.uk/uk_news/story/0,,1309077,00.html Seroxat and Prozac 'can make people homicidal'] - [http://www.guardian.co.uk The Guardian] - * [http://www.benzo.org.uk/healy.htm Dependence on Antidepressants & Halting SSRIs - protocol for withdrawal] Selective serotonin reuptake inhibitors
---- I know someone who was on Paxil. His doctor switched him over to Effexor, and didn't have him taper off use of Paxil. He didn't notice any withdrawal after he stopped using Paxil. :User:Jesster79 03:32, 2 Jun 2004 (UTC) ---- Whever one says "recent studies have shown," it would be best to give citations, especially when the results are controversial, as any new results concerning a widely-used drug like Paroxetine would be. ---- I was under the impression that the reason the medicine appeared to make people prone to suicide was that the ideation was already there, but they didn't have the energy before to carry out their plans. The medicine gave them that energy to attempt or complete suicide. User:Jesster79 02:59, Nov 20, 2004 (UTC) ---- I removed the link to serotonergic from the pharmacology section which is currently (probably inappropriately) a redirect to Noradrenergic and specific serotonergic antidepressant. --User:Overand 00:01, 26 Apr 2005 (UTC)
See other meanings of words starting from letter:
Words begining with Paroxetine:
Paroxetine
Paroxetine
Paroxetine_hydrochloride
Paroxetine
{| border="1" cellpadding="3" cellspacing="0" width="250px" align="right" style="border-collapse: collapse; margin: 0 0 0 0.5em" |- | bgcolor="#ffffff" align="center" colspan="2" |
''Paroxetine'' |- | align="center" colspan="2" | ''(3S-trans)-3-((1,3-Benzodioxol-5-yloxy)methyl)
-4-(4-fluorophenyl)-piperidine hydrochloride'' |- align="center" style="border-bottom: 3px solid gray" | CAS number
? | ATC code
? |- | bgcolor="#eeeeee" | Chemical formula | bgcolor="#ddeeff" | CHFNO, Cl, 0.5 HO |- | bgcolor="#eeeeee" | Molecular weight | bgcolor="#ddeeff" | 374.8 |- | bgcolor="#eeeeee" | Bioavailability | bgcolor="#ddeeff" | ? |- | bgcolor="#eeeeee" | Max concentration | bgcolor="#ddeeff" | ? hours |- | bgcolor="#eeeeee" | Metabolism | bgcolor="#ddeeff" | ? |- | bgcolor="#eeeeee" | Elimination half-life | bgcolor="#ddeeff" | 16-24 days |- | bgcolor="#eeeeee" | Excretion | bgcolor="#ddeeff" | 66% urina
37% bile |- | bgcolor="#eeeeee" | Pregnancy category (pharmaceutical) | bgcolor="#ddeeff" | ? |- | bgcolor="#eeeeee" | Regulation of therapeutic goods | bgcolor="#ddeeff" | ? |- | bgcolor="#eeeeee" | Routes of administration | bgcolor="#ddeeff" | Oral |- |} Paroxetine (paroxetine hydrochloride; trade names Paxil® (United States), Seroxat® (United Kingdom), Aropax® (Australia)) is an antidepressant of the selective serotonin reuptake inhibitor (SSRI) type. It was released onto the market in 1992 by the pharmaceutical company GlaxoSmithKline and has since become one of the most prescribed antidepressants on the market. It is the second most prescribed anti-depressant in the UK. It is now the subject of a fraud case in the United States due to allegations that GlaxoSmithKline suppressed research indicating that the drug caused young people to become suicidal. Like some other antidepressants, it is also prescribed in the treatment of anxiety disorders and OCD. It was the first (and as of 2002, the only) antidepressant formally approved in the United States for the treatment of social anxiety disorder, causing it to be sometimes referred to (although inaccurately) as an anti-shyness drug. ==Addiction Potential== The manufacturers claim it is impossible to become addiction to paroxetine. Other campaigners disagree. The medical community generally considers that withdrawal symptoms are not enough to regard a drug as addictive; it has to leave the user needing more and more in order to gain the same desired effect. Despite the frequency of 'Prozac poop-out', where an antidepressant becomes less effective over time, and that tolerance to side-effects over the first few weeks of treatment is acknowledged, it is still often claimed that tolerance does not occur. Note, however, that addiction is generally also an extremely debated issue, although no drug is generally considered to be addictive that does not have both withdrawal symptoms and tolerance. ==Suicide and Children== Recent studies have found that the drug is relatively ineffective in children, and that they are prone to becoming suicidal in the early stages of treatment. Some psychologists believe that this is due to the way the drug begins to work in many patients. The first effect most people notice is a decrease in the lethargy and amotivation they experienced during their depression. This effect happens ''before'' the depression itself improves, so many children end up with enough "energy" and motivation to act on suicidal tendencies they may have already had. It is also important to note many people who are prescribed Paxil are suicidal to begin with, however most studies have compared suicide rates in patients using Paroxetine vs. a control group of depressed individuals not being treated with paroxetine. == Side Effects == A growing body of anecdotal evidence has raised concerns about some of its side effects. Although the manufacturers say there is no reliable clinical evidence that the drug can cause violence or aggression, the company was sued in the US after Donald Schell killed his wife, daughter and grandchild after two days on the drug. During the investigation of the clinical records, it was reported that although paroxetine is safe and effective most of the time, in a minority of cases the drug can cause unpredictable side effects, such as wild mood swings or suicide thoughts. However, in June 2004 GlaxoSmithKline were again fighting a lawsuit over the drug due to allegations of fraud. The lawsuit alleges that five studies conducted by GSK between 1998 and 2002 suggested that the drug had little more effect than a placebo and increased suicidal tendencies. Common side effects include: * drowsiness * sleepiness * nausea * upset stomach * dry mouth * constipation * diarrhea * decrease of sexual desire * delayed orgasm or anorgasmia * rash * itch * changes in urination Individuals experiencing any of the following symptoms should contact their doctor immediately: * jaw, neck, and back muscle spasms * fever, chills, sore throat, or flu-like symptoms * yellowing of the skin or eyes ==Withdrawal Symptoms== There is a growing amount of personal and anecdotal accounts of withdrawal symptoms from paroxetine. See, for example, [http://www.join-the-fun.com/paxil-withdrawal-symptoms.html] or [http://www.socialaudit.org.uk/_disc//messages/23/23.html?FridayApril2920051117pm]. Initially, the response of drug regulators (based eg on a report by Price et al, 1995) were that withdrawal symptoms (or 'discontinuation reactions' as SKB/GSK insisted) were generally mild and short-lived, an opinion that has been replaced by mounting concern. Now, it seems about a third of users have problems stopping paroxetine, and the symptoms are strikingly similar ('electric shock' paraesthesia, dizziness, flu-like symptoms, etc) so that it is clear that what is under discussion is not psychological dependence. Anyway a person taking paroxetine must not stop to take it at once. The best way to avoid any withdrawal symptoms is observing the simple strategy of gradually lowering the dose during several days. ==Chemistry== Paroxetine is chemically identified as (''Immediate-Release Tablets / Oral Suspension'':) (-)-''trans''-4''R''-(4-fluorophenyl)-3''S''-[(3,4-methylenedioxyphenoxy) methyl]piperidine hydrochloride hemihydrate, or (''Controlled-Release Tablets'':) (-)-(3''S'',4''R'')-4-[(''p''-fluorophenyl)-3-[(3,4-methylenedioxy)phenoxy]methyl] piperidine hydrochloride hemihydrate. Its empirical formula is carbon19hydrogen20fluorinenitrogenoxygen3, with a molecular weight of 374.8 (329.3703 as free base (chemistry)). Paroxetine hydrochloride is an odorless, off-white powder, having a melting point range of 120° to 138°C and a solubility of 5.4 mg/mL in water. ==Pharmacology== Paroxetine is a potent and selective serotonin (5-hydroxytryptamine, 5-HT) reuptake inhibitor (SSRI). This activity of the drug on brain neurons is thought to be responsible for its antidepressant effects. Paroxetine is a phenylpiperidine derivative which is chemically unrelated to the tricyclic antidepressant or tetracyclic antidepressant antidepressants. In receptor binding studies, paroxetine did not exhibit significant affinity for the adrenergic (alpha(1), alpha(2), beta), dopaminergic, serotonergic (5HT(1), 5HT(2)), or histaminergic receptors of rat brain membrane. A weak affinity for the muscarinic acetylcholine receptor was evident. The predominant metabolites of paroxetine are essentially inactive as 5-HT reuptake inhibitors. ==External links== * [http://www.rcpsych.ac.uk/press/preleases/pr/seroDoH.htm Press Release - Seroxat must not be used for treatment of children] * [http://www.mhra.gov.uk/news/2003/seroxat10603.pdf Press Release - Seroxat must not be used for treatment of children .pdf version] * [http://news.bbc.co.uk/1/hi/programmes/panorama/2310197.stm BBC Panorama investigation, The Secrets of Seroxat] * [http://www.paroxetine.com/ Paroxetine.com - The official paroxetine site] * [http://www.quitpaxil.info/ paxil withdrawal information] * [http://www.depressionblog.com/archives/cat_paxil.shtml Paxil feedback] * [http://www.washingtonpost.com/wp-dyn/articles/A20624-2004Apr17.html Antidepressant Use in Children Soars Despite Efficacy Doubts] * [http://www.seroxatusergroup.org.uk/ Seroxat User Group] - A support group for those suffering adverse effects of the drug * [http://www.paxilprogress.org/ paxilprogress] : Paxil and Paxil Withdrawal Information * [http://www.guardian.co.uk/uk_news/story/0,3604,1230156,00.html Glaxo faces drug fraud lawsuit] - [http://www.guardian.co.uk The Guardian] - June 2004 ** [http://www.guardian.co.uk/medicine/story/0,11381,1242678,00.html Follow-up story: Glaxo changes tack after Spitzer assault] - The Guardian - June 2004 * [http://www.guardian.co.uk/uk_news/story/0,,1309077,00.html Seroxat and Prozac 'can make people homicidal'] - [http://www.guardian.co.uk The Guardian] - * [http://www.benzo.org.uk/healy.htm Dependence on Antidepressants & Halting SSRIs - protocol for withdrawal] Selective serotonin reuptake inhibitors
Paroxetine
---- I know someone who was on Paxil. His doctor switched him over to Effexor, and didn't have him taper off use of Paxil. He didn't notice any withdrawal after he stopped using Paxil. :User:Jesster79 03:32, 2 Jun 2004 (UTC) ---- Whever one says "recent studies have shown," it would be best to give citations, especially when the results are controversial, as any new results concerning a widely-used drug like Paroxetine would be. ---- I was under the impression that the reason the medicine appeared to make people prone to suicide was that the ideation was already there, but they didn't have the energy before to carry out their plans. The medicine gave them that energy to attempt or complete suicide. User:Jesster79 02:59, Nov 20, 2004 (UTC) ---- I removed the link to serotonergic from the pharmacology section which is currently (probably inappropriately) a redirect to Noradrenergic and specific serotonergic antidepressant. --User:Overand 00:01, 26 Apr 2005 (UTC)
See other meanings of words starting from letter:
P
PA | PB | PC | PD | PE | PF | PG | PH | PI | PJ | PK | PL | PM | PN | PO | PR | PS | PT | PU | PW | PX | PY | PZ |Words begining with Paroxetine:
Paroxetine
Paroxetine
Paroxetine_hydrochloride
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