Paroxetine

Paroxetine should start helping with depression within one to two weeks. It may take four weeks or longer for you to get the full effect.

How people respond to treatment can vary. Sometimes improvement is slow, and you may not feel any different to start with. This can be hard when your mood is low, and if you experience any side effects from your medication you may think you feel worse and not better. If you can, give your medication a chance to work and continue to take it for at least three to four weeks to see if it makes a difference.

Your parents, friends and doctor may notice an improvement in you before you feel it yourself, so it’s a good idea to talk to them.

If you think your medicine has not made any difference to how you feel after three to four weeks, you should go back to your doctor. They might recommend a change in dose or a different medication. However, it can take longer to work for some people than for others, so they may suggest you wait six to eight weeks before deciding.

For anxiety and obsessive-compulsive disorder, it may take longer for the benefits to be noticed. It could take up to three months before you feel the full benefit.

For some people, anxiety symptoms briefly increase at the start of treatment, but this should decrease over time. To avoid or minimise this, your doctor will usually start treatment with a low dose and increase this after one to two weeks.

Paroxetine can make you feel less hungry than normal, which might lead to weight loss.

Some people find that they gain a little weight in the long term. This might be due in part to a return of appetite as your mood improves.

It is not possible to predict how paroxetine will affect each person before they start taking it. Talk to your doctor or pharmacist if you are concerned about your weight, or changes to your weight, while taking paroxetine.

A common side effect of paroxetine is a dry mouth. Over a long time, this can increase your risk of developing tooth decay or gum disease. Make sure you brush your teeth well and have regular dental check-ups. Speak to your dentist, doctor or pharmacist about things you can do to help.

You may want to let your family and friends know you are taking paroxetine so they can support you and help you look out for side effects.

You can feel sleepy in the first few days of taking paroxetine. This should improve within a few weeks. If it makes you feel drowsy, try taking it just before you go to bed.

Some people find that paroxetine causes insomnia (difficulty getting to sleep), and vivid dreams or nightmares. If this happens, try taking the paroxetine first thing in the morning.

If you have been taking paroxetine for more than a month and you continue to feel very tired, sleepy or struggle to function during the day, you should go back to your doctor and discuss what changes could be made to help. This may include switching to a different medicine.

Alcohol

It may be possible to drink some alcohol while taking paroxetine but the two together might make you feel very sleepy and unsteady on your feet, especially when you first start taking the medication.

During the first few weeks of treatment, it is recommended that you don’t drink alcohol until you know how the medicine affects you.

Drinking alcohol every day, or in large amounts, can make your symptoms worse and may mean you won’t get the maximum benefit from your medication.

Street drugs

There is limited information about how paroxetine mixes with street drugs, but it is likely to be similar to other SSRIs.

Cannabis can make drowsiness worse with paroxetine and give you a fast heartbeat.

Cannabis and other drugs may have their own side effects on your mental health, like anxiety or psychosis.

Paroxetine could raise the level of cocaine in your body, giving you a bigger reaction. There may be an increased chance of having a seizure.

Taking paroxetine with cocaine, ecstasy or amfetamines could bring on serotonin syndrome. You could get a high temperature/fever, agitation, confusion, trembling or weird muscle movements. You need to go to hospital urgently if this happens. Tell the doctor everything that you have taken.

Methadone can make drowsiness worse with paroxetine. The paroxetine is likely to increase the concentration of methadone in your body. There is also an increased risk of serotonin syndrome.

There are many other street drugs, but we don’t know what effect taking them with paroxetine will have, so it’s best to be cautious. There is no regulation of street drugs or ‘legal highs’, so even if there are no known issues with the medication you take, the supply you receive might be mixed with other substances that could be dangerous.

Get more advice on our drugs and alcohol guide.

Paroxetine does not mix well with some other medicines, including herbal remedies. It may affect how they work or could cause more side effects.

Do not take paroxetine if you take an antidepressant medicine called a monoamine oxidase inhibitor (MAOI), or if you have taken one in the last two weeks. MAOIs include moclobemide, isocarboxazid, phenelzine and tranylcypromine.

Before you start taking paroxetine, tell your doctor if you are taking any other medications including things you have bought from a pharmacy or other shop for common illnesses like colds and flu or medications that you put on your skin.

Always tell the pharmacist that you are taking paroxetine if you buy any medicines from a pharmacy.

Look at the leaflet inside your medicine box for more information about other medicines that can interact with paroxetine. With some medicines your doctor may need to adjust the dose of your medicines if you take them together. Ask a doctor or pharmacist for more information if you have any questions.

There are several companies that manufacture this medicine and the non-active ingredients are likely to vary between products and different strengths of tablets available.

Always let your pharmacist know if you have any food allergies or intolerances, and always check with them if you’re concerned about any of the ingredients in your medication.

If you need to avoid animal products, please note that non-active ingredients used in the production of medicines may sometimes be of animal origin. Ask your pharmacist if you have any questions about the ingredients.

Further information about practical considerations for medicines if you need to avoid animal products can be found on the Vegan Society website.

Taking paroxetine may affect your ability to do things like driving a car, riding a bike, using machines, or anything else that needs a lot of focus.

You might find it difficult to concentrate, you might feel sleepy and your eyesight may be blurred.

It is recommended that you stop driving or riding a bike for the first few days or weeks until you know how it affects you.

Most people drive as normal while taking paroxetine. If you are worried about this or have any concerns you would like to discuss, speak to your doctor or pharmacist.

If you become pregnant while you are on paroxetine, you should carry on taking it and make an appointment to see your doctor as soon as possible They can discuss the benefits and risks of continuing paroxetine and help you to make a decision that is best for you and your baby. There may be a slightly higher risk of heart problems for your baby if you take paroxetine during the beginning of your pregnancy. Your doctor will explain the known risks to help you take the best treatment choice for you.

They may refer you to a specialist perinatal mental health team to support you with this decision.

You can find out more information about taking paroxetine during pregnancy at Bumps (Best Use of Medicines in Pregnancy).

Untreated depression or anxiety can also be harmful to you and your developing baby, so decisions about stopping or avoiding medication when you are pregnant need to be discussed carefully with your doctor. If you and your doctor agree that it is best for you to continue taking paroxetine while pregnant, you should tell your midwife. If you are planning to get pregnant, it is recommended that you take folic acid while you are trying for a baby and during pregnancy. It is safe to take this together with paroxetine.

If you are planning to get pregnant, it is recommended that you take folic acid while you are trying for a baby and during pregnancy. It is safe to take this together with paroxetine.

Post-natal

Some research shows that taking SSRI antidepressants, like paroxetine, in the month before you give birth can mean there is a small increased risk of bleeding after birth. Make sure to let your doctor and midwife know so they can monitor you.

Studies have shown that if paroxetine is taken in the last five months of pregnancy, there is an increased risk of persistent pulmonary hypertension of the newborn (PPHN). This occurs in the first 24 hours after birth and can make the baby breathe faster or look blue. If you’re concerned about this, speak with your doctor or midwife.

Some newborn babies whose mothers take paroxetine during pregnancy can get symptoms at birth or soon after, like feeding difficulties, restlessness or problems sleeping. Tell your midwife if you are taking paroxetine, so that they can help if the baby has any symptoms after birth.

Breastfeeding

Paroxetine is passed to the baby in breastmilk in small amounts.
If your baby was born early, then breastfeeding while you are taking paroxetine may not be recommended. Talk to your midwife and doctor about feeding options.

If you breastfeed while taking paroxetine, seek urgent medical advice if your baby becomes restless, very sleepy, or develops feeding problems.

Sex

Paroxetine can have side effects that affect your sex life. These include:

• painful erections or difficulty getting an erection
• bleeding from the vagina
• difficulty reaching an orgasm
• reduced genital sensation
• lower sex drive

Some other rare side effects include breast growth or milk flow from the breasts (regardless of gender). These may affect your confidence and therefore your desire to have sex. Talk to your doctor if you get these symptoms.

There is some evidence that says that some of these side effects can continue for months after you’ve stopped taking your medicine. Talk to your doctor or pharmacist if you’re concerned about this.

Untreated depression or anxiety can have a negative effect on your sex life, so if paroxetine helps you to recover, positive effects can include improving your desire, experience and enjoyment of sex as your mood lifts and you become interested in life and relationships again.

Fertility

There is no evidence to show that paroxetine affects human fertility. Talk to your doctor about your paroxetine if you are trying to get pregnant or planning a family.

Paroxetine is not a banned substance in sport.

Most people play sports as normal while taking paroxetine, but if paroxetine affects your concentration, eyesight or co-ordination, then you may want to wait to see if those effects go away before playing sports that need a lot of focus. If you have any concerns, discuss this with your doctor. Taking paroxetine may affect your ability to do things like riding a bike, competitive gymnastics, or anything else that needs a lot of focus.

Paroxetine may affect your concentration, give you blurred eyesight and make you feel dizzy and tired.

Ideally it is best not to take paroxetine for the first time just before your exams.

It is not possible to predict how the medication will make you feel, and if you do get any side effects, these are more likely to occur when you first start taking paroxetine.

You should talk to your doctor about any future exams if you are starting paroxetine. You might decide together to delay starting it until you have done them.

If they are more than a month away, however, you might find that it is better to start paroxetine to lift your mood and improve your motivation and ability to study.

Most people take exams as normal while taking paroxetine, but if you have any concerns, discuss this with your doctor.