Paroxetine - instructions for use, analogs, reviews and release forms (20 mg and 30 mg tablets) of the antidepressant drug for the treatment of depression in adults, children and pregnancy. Composition and alcohol

In this article, you can read the instructions for using the drug Paroxetine. There are reviews of visitors to the site - consumers of this medication, as well as opinions of doctors specialists on the use of Paroxetine in their practice. A big request is to actively add their feedback on the drug: the medicine helped or did not help get rid of the disease, which were observed complications and side effects, possibly not declared by the manufacturer in the annotation. Analogues of Paroxetine in the presence of existing structural analogs. Use for the treatment of depression in adults, children, as well as in pregnancy and lactation. Composition and interaction of the drug with alcohol.

Paroxetine - an antidepressant, a selective serotonin reuptake inhibitor. Has a bicyclic structure, different from the structure of other known antidepressants.

Has antidepressant and anxiolytic effects with a sufficiently pronounced stimulating (activating) effect.

Antidepressant (thymoanaleptic) action is associated with the ability of paroxetine to selectively block the reuptake of serotonin by the presynaptic membrane, which is responsible for an increase in the free content of this neurotransmitter in the synaptic cleft and the increase in its activity in the CNS.

The effect on m-holinoretseptory, alpha and beta-adrenergic receptors is negligible, which determines the extremely low severity of the corresponding side effects.

Composition

Paroxetine + excipients.

Pharmacokinetics

After ingestion paroxetine is well absorbed from the digestive tract. Eating does not affect absorption. The main metabolites of paroxetine are polar and conjugated oxidation and methylation products. In view of the low pharmacological activity of metabolites, their effect on therapeutic efficacy is unlikely.Less than 2% is excreted unchanged in the urine, the rest - in the form of metabolites, either with urine (64%) or with bile. The excretion of paroxetine is biphasic. With prolonged continuous administration, the pharmacokinetic parameters do not change.

Indications

• depression of all types, including reactive, severe endogenous depression and depression, accompanied by anxiety;
• obsessive-compulsive disorder (OCD);
• panic disorder, incl. with agoraphobia;
• social anxiety disorder / social phobia;
• generalized anxiety disorder.

Forms of release

Tablets coated with 20 mg and 30 mg.

Instructions for use and dosing regimen

Tablets should be taken orally, once a day, in the morning, while eating, swallowing whole, with water.

The dose is selected individually during the first 2-3 weeks after the start of therapy and is subsequently adjusted if necessary.

With depression, the recommended dose is 20 mg once a day. If necessary, the dose is gradually increased by 10 mg per day, the maximum daily dose should not exceed 50 mg.

In obsessive-compulsive disorders, the initial therapeutic dose is 20 mg per day, followed by a weekly increase of 10 mg.The recommended average therapeutic dose is 40 mg per day, if necessary, the dose can be increased to 60 mg per day.

In panic disorders, the initial dose is 10 mg per day (to reduce the possible risk of developing panic symptoms) followed by a weekly increase of 10 mg. The average therapeutic dose is 40 mg per day. The maximum dose is 50 mg per day.

With socially-anxiety disorders / social phobias, the initial dose is 20 mg per day, in the absence of effect for at least 2 weeks, an increase in the dose to a maximum of 50 mg per day is possible. The dose should be increased by 10 mg at intervals of at least a week in accordance with the clinical effect.

In generalized anxiety disorders, the initial and therapeutic doses are 20 mg per day.

In renal and / or liver failure, the recommended dose is 20 mg per day.

For elderly patients, the daily dose should not exceed 40 mg.

In order to prevent the development of withdrawal syndrome, the discontinuation of taking the drug should be gradual.

Side effect

• drowsiness;
• tremor;
• asthenia;
• insomnia;
• dizziness;
• fatigue;
• convulsions;
• extrapyramidal disorders;
• serotonin syndrome;
• hallucinations;
• mania;
• confusion of consciousness;
• agitation;
• anxiety;
• depersonalization;
• panic attacks;
• nervousness;
• amnesia;
• myoclonia;
• impaired vision;
• arthralgia;
• myalgia;
• muscle weakness;
• myopathy;
• retention of urine;
• frequent urination;
• violations of sexual function, including impotence and ejaculatory disorders;
• hyperprolactinaemia / galactorrhea;
• anorgasmia;
• decreased or increased appetite;
• change in taste;
• nausea, vomiting;
• dry mouth;
• constipation or diarrhea;
• hepatitis;
• orthostatic hypotension;
• rash;
• hives;
• ecchymosis;
• itching;
• angioedema;
• increased sweating;
• rhinitis (runny nose);
• hyponatremia;
• violation of the secretion of antidiuretic hormone.

Contraindications

• simultaneous administration of MAO inhibitors and a period of 14 days after their cancellation;
• unstable epilepsy;
• pregnancy;
• lactation period (breastfeeding);
• childhood;
• hypersensitivity to the components of the drug.

Application in pregnancy and lactation

The drug Paroxetine is contraindicated in pregnancy and lactation.

Use in children

The drug is contraindicated in childhood. The use of Paroxetine in children is not recommended, since its safety and effectiveness in this group of patients are not established.

Application in elderly patients

For elderly patients, the daily dose should not exceed 40 mg.

special instructions

To avoid the development of malignant neuroleptic syndrome with caution should be prescribed Paroxetine to patients taking antipsychotics.

Treatment with Paroxetine is prescribed 2 weeks after the abolition of MAO inhibitors.

In elderly patients with the administration of Paroxetine, hyponatremia is possible.

In some cases, a dose adjustment of simultaneously used insulin and / or oral hypoglycemic drugs is required.

With the development of seizures, treatment with Paroxetine is stopped.

With caution should prescribe the drug for liver failure, kidney failure, zakratougolnoy glaucoma, prostatic hyperplasia, mania, heart disease, epilepsy, convulsions, the simultaneous appointment of electropulse therapy, the simultaneous use of drugs that increase the risk of bleeding,presence of risk factors for increased bleeding and diseases that increase the risk of bleeding.

At the first sign of mania, it is necessary to cancel therapy with Paroxetine.

During the first few weeks of therapy, Paroxetine should carefully monitor the patient's condition in connection with possible suicidal attempts.

During therapy, Paroxetine should refrain from taking alcohol because of the increased toxic effect.

Impact on the ability to drive vehicles and manage mechanisms

Although paroxetine does not impair cognitive and psychomotor functions, patients should abstain or observe extreme caution when driving and engaging in other potentially dangerous activities requiring increased attention and speed of psychomotor reactions.

Drug Interactions

Simultaneous administration of antacid agents does not affect the absorption and pharmacokinetic parameters of Paroxetine.

Contraindicated concurrent use of Paroxetine with MAO inhibitors.

With concomitant administration with Paroxetine, the concentration of procyclidine increases.

In connection with paroxetine inhibition of cytochrome P450, the effect of barbiturates, phenytoin, indirect anticoagulants, tricyclic antidepressants, phenothiazine antipsychotics and antiarrhythmics of class 1C, metoprolol, and an increased risk of side effects with the simultaneous administration of these medicines is possible.

At simultaneous appointment with the preparations, inhibiting enzymes of a liver, the dose of Paroxetine can be required.

Paroxetine increases the time of bleeding against the background of simultaneous administration of Warfarin (with unchanged prothrombin time).

With the simultaneous administration of paroxetine with atypical antipsychotics, tricyclic antidepressants, preparations of the phenothiazine series, nonsteroidal anti-inflammatory drugs (NSAIDs) (including acetylsalicylic acid), a disruption of the blood coagulation process is possible.

Simultaneous administration of Paroxetine with serotonergic drugs (tramadol, sumatriptan) may lead to an increase in the serotonergic effect.

Mutual enhancement of the action of tryptophan, lithium and paroxetine preparations was noted.

With the simultaneous administration of paroxetine with phenytoin and other anticonvulsant drugs, an increase in the incidence of side effects is possible.

Paroxetine much less suppresses the antihypertensive effects of guanethidine compared with antidepressants that inhibit the seizure of norepinephrine.

Analogues of the drug Paroxetine

Structural analogs for the active substance:

• Adress;
• Aktaparoxetine;
• Apo-Paroxetine;
• Paxil;
• Paroxetine hydrochloride hemihydrate;
• Plizil;
• Plizil H;
• Rexetin;
• Sirestill.

Analogues for the pharmacological group (antidepressants):

• Agomelatine;
• Ademethionine;
• Adress;
• Azafen;
• Alventa;
• Aleval;
• Amizole;
• Amide;
• Amitriptyline;
• Anaphranil;
• Valdoxane;
• Velaxin;
• Velafax;
• Venlaksor;
• Venlafaxine;
• Vokssel;
• Gelarium Hypericum;
• Heparett;
• Heptor;
• Heptrazan;
• Heptral;
• Daplex;
• Depres;
• Depenone;
• Deprefalt;
• Deprim;
• Deprim forte;
• Doxepine;
• Duloxent;
• Duloxetine;
• Zoloft;
• Ixelles;
• Imipramine;
• Kaliksta;
• Clominal;
• Clomipramine;
• Clofranil;
• Coaxyl;
• Lenuksin;
• Lerivon;
• Maprotibene;
• Maprotiline;
• Miracitol;
• Mirzaten;
• Mirtazapine (hemihydrate);
• Mirtazonal;
• Mirtalan;
• Nerustin;
• Neuroplant;
• Noxibel;
• Newvelong;
• Oprah;
• Pipofezin;
• Pirazidol;
• Portal;
• Prozac;
• Profluzak;
• Remeron;
• Saroten retard;
• Selektra;
• Sirleft;
• Sertraline hydrochloride;
• Sinekwan;
• The Siozam;
• Stimuloton;
• Tianeptine sodium;
• Thorin;
• Triptysole;
• Trittico;
• Févarine;
• Fluval;
• Fluxonil;
• Flunisan;
• Fluoxetine;
• Framex;
• Cipralex;
• Citalopram;
• Citol;
• Elivel;
• Elicia;
• Esprital;
• Escitalopram;
• Ephevelone;
• Epevelon retard.

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