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How is Paxil CR Used in the Treatment of Social Anxiety Disorder?

Paxil for Anxiety

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Description:

Paxil is the brand name of the generic medication paroxetine hydrochloride. Paxil is a prescription medication used to treat depression, anxiety disorders, and other serious mental health problems. Manufactured by GlaxoSmithKline, Paxil was the first medication approved for the treatment of Social Anxiety Disorder (SAD). Paxil CR is the longer-acting, controlled-release version of Paxil. A selective serotonin reuptake inhibitor (SSRI), Paxil slows reabsorption of the chemical serotonin in the brain. Serotonin is believed to play a role in the regulation of mood and anxiety.

How to Take Paxil:

Paxil comes in tablet form and must be swallowed whole -- not chewed or crushed. It is generally taken once per day in the morning, with or without food. If you forget to take a daily dose, take it when you remember. However if it is close to the time of your next dose, it is better to skip the missed dose altogether.

It is important to continue taking Paxil as long as your doctor instructs, even if you begin to feel better. If you abruptly stop taking Paxil, you may experience withdrawal symptoms such as dizziness, abnormal dreams, and tingly sensations. To avoid these symptoms, your doctor will slowly taper your dosage when you stop taking Paxil.

Dosage Guidelines:

For people with SAD, typical dosage of Paxil CR starts at 12.5 mg, with increases of 12.5 mg weekly, to a maximum of 37.5 mg. In general, elderly people will be given a lower dose.

Who Shouldn't Take Paxil:

Paxil should be used with caution if you:

  • have impaired liver or kidney function
  • have a history of seizures
  • have a history of mania
  • are pregnant or planning to become pregnant
  • are breastfeeding

The effectiveness of Paxil in children and adolescents has not been studied and the medication has not been approved for people under 18 years of age. There is some evidence to suggest an increased risk of suicidal thoughts and behaviors in children taking Paxil.

Medication Interactions:

Paxil should not be taken in combination with, or within weeks of taking Monoamine Oxidase Inhibitors (MAOIs), thioridazine, or pimozide. The result of such combinations can be fatal.

Caution should be used when taking a number of other medications in combination with Paxil, such as anticoagulants and anti-inflammatories. Consumption of alcohol is also not advised while taking Paxil. In general, you should inform your doctor of any prescription or over-the-counter medications, or any other substances that you are taking or plan to take.

Side Effects:

Side effects of Paxil generally appear in the first four to six weeks and may include nausea, drowsiness, insomnia, sweating, tremors, weakness/loss of strength, dizziness, dry mouth, sexual dysfunction, constipation, diarrhea, gas, nervousness, and decreased appetite. Long-term use may lead to weight gain.

When first starting Paxil or when changing dosage, watch for more serious side effects such as agitation, hostility, panic, extreme hyperactivity, and suicidal thoughts and behaviors. If you experience any of these symptoms, it is important to report these to your doctor immediately.

For some people, Paxil may interfere with judgment, thinking, and motor skills. It is important not to operate dangerous machinery or participate in hazardous activities unless you are sure that Paxil is not affecting you in this way.

Associated Risks:

The risk of a fatal overdose of Paxil is very low. Symptoms of an overdose include dizziness, drowsiness, facial flushing, nausea, sweating, vomiting, and coma. When combined with some medications, there is risk of Serotonin Syndrome, a potentially fatal condition. Symptoms of Serotonin Syndrome include agitation, confusion, sweating, hallucinations, abnormal reflexes, muscle spasms and rapid heartbeat.

Other Anxiety Medications

Sources:

Bezchlibnyk-Butler KZ, Jeffries, JJ, eds. Clinical Handbook of Psychotropic Drugs. Toronto, Canada: Hogrefe & Huber; 2003.

GlaxoSmithKline. Paxil CR: Prescribing Information. 1 October 2007.

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