Paroxetine (Paxil)

  • Dose range: 20-60mg daily
  • Paroxetine-related discontinuation syndrome is bad!
    • If a patient has difficulty tapering off paroxetine due to discontinuation symptoms, fluoxetine can be added as a 2 week course of therapy to help with taper (e.g. 10mg fluoxetine)
  • Anticholinergic activity can cause more sedation compared to other SSRIs
  • Nitric oxide synthetase inhibition may increase sexual dysfunction
  • Half-life varies significantly, complicating withdrawal
  • Rarely used as a first line medication
  • Paxil is POTENT, that’s why you get withdrawal symptoms