Peroxetine; Uses, Dosage, Side Effects, Interactions

Last updated: February 7, 2026Reviewed date: February 7, 2026Reading time: 8 min read

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Paroxetine is a selective serotonin reuptake inhibitor (SSRI) used in the therapy of depression, anxiety disorders and obsessive-compulsive disorder. Paroxetine therapy can be associated with transient asymptomatic elevations in serum aminotransferase levels and has been linked to rare instances of clinically apparent acute liver injury. Paroxetine hydrochloride and paroxetine mesylate...

For severe symptoms, danger signs, pregnancy, child illness, or sudden worsening, seek urgent medical care.

বাংলা রোগী নোট এখনো যোগ করা হয়নি। পোস্ট এডিটরে “RX Bangla Patient Mode” বক্স থেকে সহজ বাংলা সারাংশ যোগ করুন।

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Article Summary

Key Takeaways

This article explains Mechanism of Action of Paroxetine in simple medical language.
This article explains Indications of Paroxetine in simple medical language.
This article explains Contra-Indications of Paroxetine in simple medical language.
This article explains Dosage of Paroxetine in simple medical language.

Educational health guideWritten for patient understanding and clinical awareness.

Reviewed content workflowUse writer and reviewer profiles for stronger trust.

Emergency safety firstUrgent warning signs are highlighted below.

Seek urgent medical care if you notice

These warning signs are general safety guidance. Local emergency numbers and clinical judgment should always come first.

Severe symptoms, breathing difficulty, fainting, confusion, or rapidly worsening illness.
New weakness, severe pain, high fever, or symptoms after a serious injury.
Any symptom that feels urgent, unusual, or unsafe for the patient.

Emergency now

Use emergency care for severe, sudden, rapidly worsening, or life-threatening symptoms.

See a doctor

Book a professional medical evaluation if symptoms persist, worsen, recur often, affect daily activities, or occur in a high-risk patient.

Learn safely

Use this article to understand possible causes, tests, treatment options, prevention, and questions to ask your clinician.

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Definition

Paroxetine is a selective serotonin reuptake inhibitor (SSRI) used in the therapy of depression, anxiety disorders and obsessive-compulsive disorder. Paroxetine therapy can be associated with transient asymptomatic elevations in serum aminotransferase levels and has been linked to rare instances of clinically apparent acute liver injury.

Paroxetine hydrochloride and paroxetine mesylate belong to a class of antidepressant agents known as selective serotonin-reuptake inhibitors (SSRIs). Despite distinct structural differences between compounds in this class, SSRIs possess similar pharmacological activity. As with other antidepressant agents, several weeks of therapy may be required before a clinical effect is seen. SSRIs are potent inhibitors of neuronal serotonin reuptake. They have little to no effect on norepinephrine or dopamine reuptake and do not antagonize ⍺- or β-adrenergic, dopamine D₂ or histamine H₁ receptors.

Mechanism of Action of Paroxetine

Paroxetine is a potent and highly selective inhibitor of neuronal serotonin reuptake. Paroxetine likely inhibits the reuptake of serotonin at the neuronal membrane, enhances serotonergic neurotransmission by reducing turnover of the neurotransmitter, therefore it prolongs its activity at synaptic receptor sites and potentiates 5-HT in the CNS; paroxetine is more potent than both sertraline and fluoxetine in its ability to inhibit 5-HT reuptake. Compared to the tricyclic antidepressants, SSRIs have dramatically decreased binding to histamine, acetylcholine, and norepinephrine receptors. The mechanism of action for the treatment of vasomotor symptoms is unknown. In human platelets, paroxetine blocks the uptake of serotonin. It has weak effects on norepinephrine and dopamine neuronal reuptake. In vitro radioligand binding studies indicate that paroxetine has little affinity for muscarinic alpha1-, alpha2-, beta-adrenergic-, dopamine (D2)-, 5-HT1-, 5-HT2-, and histamine (H1)-receptors.

Indications of Paroxetine

Contra-Indications of Paroxetine

Syndrome of Inappropriate Antidiuretic Hormone Secretion
low amount of sodium in the blood
increased risk of bleeding
Behaving with Excessive Cheerfulness and Activity
Manic-Depression
Having Thoughts of Suicide
serotonin syndrome – adverse drug interaction
closed angle glaucoma
liver problems
Bleeding from Stomach
Esophagus or Duodenum
severe renal impairment
seizures
A Feeling of Restlessness with Inability to Sit Still
pregnancy
Broken Bone due to Disease or Illness
risk of angle-closure glaucoma due to narrow angle of anterior chamber of eye

Dosage of Paroxetine

Strengths: 12.5 mg; 25 mg; 37.5 mg; 10 mg; 20 mg; 30 mg; 40 mg; 10 mg/5 mL; 7.5 mg; mesylate 10 mg; mesylate 20 mg; mesylate 30 mg; mesylate 40 mg

Depression

Immediate-release tablets and suspension

Initial dose: 20 mg orally once a day
Maintenance dose: 20 to 50 mg orally once a day
Maximum dose: 50 mg orally once a day

Controlled-release tablets

Initial dose: 25 mg orally once a day
Maintenance dose: 25 to 62.5 mg orally once a day
Maximum dose: 62.5 mg orally once a day.

Immediate-release tablets and suspension

Initial dose: 20 mg orally once a day
Maintenance dose: 20 to 60 mg orally once a day
Maximum dose: 60 mg orally once a day

Controlled-release tablets

Initial dose: 12.5 mg orally once a day
Maintenance dose: 12.5 to 37.5 mg orally once a day

Panic Disorder

Immediate-release tablets and suspension

Initial dose: 10 mg orally once a day
Maintenance dose: 10 to 40 mg orally once a day
Maximum dose: 60 mg orally once a day

Controlled-release oral tablets

Initial dose: 12.5 mg orally once a day
Maintenance dose: 12.5 to 75 mg orally once a day
Maximum dose: 75 mg orally once a day

Premenstrual Dysphoric Disorder

Controlled-release tablets
Continuous regimen

Initial dose: 12.5 mg orally once a day during the menstrual cycle
Maintenance dose: 25 mg orally once a day during the menstrual cycle

Cyclic regimen

Initial dose: 12.5 mg orally once a day, starting 14 days prior to the anticipated start of menstruation through to the first full day of menses, and repeated with each new cycle
Maintenance dose: 12.5 to 25 mg orally once a day

Obsessive Compulsive Disorder

Immediate-release tablets and suspension

Initial dose: 20 mg orally once a day
Maintenance dose: 20 to 60 mg orally once a day
Maximum dose: 60 mg orally once a day

Duration: Efficacy has been demonstrated for up to 6 months

Generalized Anxiety Disorder

Immediate-release tablets and suspension

Initial dose: 20 mg orally once a day
Maintenance dose: 20 to 50 mg orally once a day
Maximum dose: 50 mg orally once a day

Geriatric Dose for Depression

Immediate-release tablets and suspension

Initial dose: 10 mg orally once a day
Maintenance dose: 10 to 40 mg orally once a day
Maximum dose: 40 mg orally once a day

Controlled-release tablets

Initial dose: 12.5 mg orally once a day
Maintenance dose: 12.5 to 50 mg orally once a day
Maximum dose: 50 mg orally once a day

Side Effects of Paroxetine

The most common

clumsiness or unsteadiness
dizziness
drowsiness
dry mouth
false sense of well-being
increased watering of mouth
lightheadedness
constipation;
vision changes;
breast swelling (in men or women); or
decreased sex drive, impotence, or difficulty having an orgasm.
blurred vision, tunnel vision, eye pain or swelling, or seeing halos around lights;
restless muscle movements in your eyes, tongue, jaw, or neck;
a light-headed feeling, like you might pass out;

Common

Drowsiness and lightheadedness the day after taking the medicine.
Confusion.
Numbed emotions.
Visual disturbances such as blurred vision or double vision.
Shaky movements and unsteady walk (ataxia).
Loss of memory (amnesia).
Muscle weakness.
Dizziness.
Headache.
Skin rashes.
Disturbances of the gut such as diarrhoea, c onstipation, nausea, vomiting or abdominal pain.
Difficulty in passing urine (urinary retention).
Changes in sex drive.
Low blood pressure (hypotension).
Blood disorders.
Jaundice.
Unexpected aggression, restlessness or irritability (tell your doctor if you experience this).
Nightmares or hallucinations (tell your doctor if you experience this).

Serious

agitation
anxiety
behavioural changes, including aggressiveness, angry outbursts, bizarre behaviour, or decreased inhibitions
confusion
increased trouble sleeping
memory problems
muscle spasms
shortness of breath
signs of depression (e.g., poor concentration, changes in weight, changes in sleep, decreased interest in activities, thoughts of suicide)
sleepwalking

Drug Interactions of Paroxetine

Paroxetine may interact with following drugs, supplements & may change the efficacy of drugs

amlodipine
general anesthetics
antihistamines (e.g., cetirizine, doxylamine, diphenhydramine, hydroxyzine, loratadine)
antipsychotics (e.g., chlorpromazine, clozapine, haloperidol, olanzapine, quetiapine, risperidone)
aripiprazole
baclofen
barbiturates (e.g., butalbital, pentobarbital, phenobarbital)
benzodiazepines (e.g., alprazolam, diazepam, lorazepam)
bupropion
celecoxib
cilostazol
clopidogrel
cyclosporine
diabetes medications (e.g., chlorpropamide, metformin, nateglinide, rosiglitazone)
diltiazem
estrogens (e.g., conjugated estrogen, )
glucosamine
heparin
low molecular weight heparins
mirtazapine
monoamine oxidase inhibitors (MAOIs; e.g. rasagiline, selegiline, )
multivitamins
muscle relaxants
nifedipine
non-steroidal anti-inflammatory medications (NSAIDs; e.g., diclofenac, ibuprofen, naproxen)
omega-3 fatty acids
pentoxifylline
propranolol
quinolone antibiotics (e.g., ciprofloxacin, norfloxacin, ofloxacin)
rasagiline
seizure medications ( phenobarbital, phenytoin, valproic acid, )
selective serotonin reuptake inhibitors (SSRIs; e.g., citalopram, duloxetine, fluoxetine, paroxetine, sertraline)
serotonin antagonists (anti-emetic medications; e.g., granisetron, ondansetron)
tapentadol
theophyllines (e.g., aminophylline, oxtriphylline, theophylline)
thiazide diuretics (water pills; e.g., hydrochlorothiazide, )
thyroid replacements (e.g., dessicated thyroid, levothyroxine)
tizanidine
tramadol
tricyclic antidepressants (e.g., desipramine, nortriptyline)
triptans (e.g., sumatriptan, rizatriptan)

Pregnancy & Lactation of Paroxetine

Pregnancy

Pregnant women should not take paroxetine, particularly in early pregnancy and during the last few months of pregnancy. The drug may cause heart defects in unborn babies and has been linked to other health problems in newborns.

Lactation

If you’re breastfeeding a baby, talk with your doctor before taking paroxetine because the drug may affect the quality of your breast milk.

References

Peroxetine; Uses, Dosage, Side Effects, Interactions

Safety note: This is not a prescription or diagnosis. For severe symptoms, pregnancy danger signs, children with serious illness, chest pain, breathing difficulty, stroke-like weakness, or major injury, seek urgent care.

Which doctor may help?

Start with a registered doctor or the nearest qualified health center.

What to tell the doctor

Write when the problem started and how it changed.
Bring old prescriptions, investigation reports, and current medicines.
Write allergies, pregnancy status, diabetes, kidney/liver disease, and major past illnesses.
Bring one family member if the patient is weak, elderly, confused, or a child.

Questions to ask

What is the most likely cause of my symptoms?
Which danger signs mean I should go to hospital quickly?
Which tests are necessary now, and which can wait?
How should I take medicines safely and what side effects should I watch for?
When should I come for follow-up?

Tests to discuss

Vital signs: temperature, pulse, blood pressure, oxygen saturation
Basic physical examination by a clinician
CBC, urine test, blood sugar, or imaging only when clinically needed

Avoid these mistakes

Do not use antibiotics, steroid tablets/injections, or strong painkillers without proper medical advice.
Do not hide pregnancy, kidney disease, ulcer, allergy, or blood thinner use.
Do not delay emergency care when danger signs are present.

Medicine safety and first-aid guide

This section is for patient education only. It does not replace a doctor, pharmacist, or emergency care.

Safe first steps

Avoid heavy lifting, sudden bending, and prolonged bed rest.
Use comfortable posture and gentle movement as tolerated.
Discuss physiotherapy, X-ray, or MRI only when clinically needed.

OTC medicine safety

For mild back pain, pain-relief medicine may be discussed with a doctor or pharmacist.
Avoid repeated painkiller use if you have kidney disease, stomach ulcer, uncontrolled blood pressure, or are taking blood thinners.

Avoid these mistakes

Do not start antibiotics without a proper medical decision.
Do not use steroid tablets or injections casually for quick relief.
Do not delay emergency care because of home remedies.

Get urgent help if

Back pain with leg weakness, numbness around private area, loss of urine/stool control, fever, cancer history, or major injury needs urgent care.

Medicine names, dose, and timing must be decided by a qualified clinician or pharmacist after checking age, pregnancy, allergy, other diseases, and current medicines.

For rural patients and family caregivers

Patient health record and symptom diary

Write your symptoms, medicines already taken, test results, and questions before visiting a doctor. This note stays on your device unless you print or copy it.

Doctor to discuss: Doctor / qualified healthcare provider

Tests to discuss with doctor

Basic vital signs: temperature, pulse, blood pressure, oxygen level if needed
Relevant blood, urine, imaging, or specialist tests only after clinical assessment

Questions to ask

What is the most likely cause of my symptoms?
Which warning signs mean I should go to emergency care?
Which tests are really needed now?
Which medicines are safe for my age, pregnancy status, allergy, kidney/liver/stomach condition, and current medicines?

Emergency warning signs such as chest pain, severe breathing difficulty, sudden weakness, confusion, severe dehydration, major injury, or loss of bladder/bowel control need urgent medical care. Do not wait for online information.

Go to emergency care if you notice:

Severe or rapidly worsening symptoms
Breathing difficulty, chest pain, fainting, confusion, severe weakness, major injury, or severe dehydration

Doctor / service to discuss: Qualified healthcare provider; specialist depends on symptoms and examination.

Step 1
Check danger signs first

If danger signs are present, seek emergency care and do not wait for online information.
Step 2
Record the symptom story

Write when symptoms started, severity, medicines already taken, allergies, pregnancy status, and test results.
Step 3
Visit a qualified clinician

A doctor, nurse, or qualified healthcare provider can examine you and decide which tests or treatment are needed.
Step 4
Do only useful tests

Do tests after clinical assessment. Avoid unnecessary tests, random antibiotics, or repeated medicines without diagnosis.
Step 5
Follow up and return early if worse

If symptoms worsen, new warning signs appear, or treatment is not helping, return for review quickly.

Rural patient practical tips

Take a written symptom diary and all previous prescriptions/test reports.
Do not hide medicines already taken, even herbal or over-the-counter medicines.
Ask which warning signs mean urgent referral to hospital.

This roadmap is for education. A real diagnosis and treatment plan requires history, examination, and clinical judgment.

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Emergency first: Severe chest pain, breathing trouble, unconsciousness, stroke signs, severe injury, heavy bleeding, or rapidly worsening symptoms need urgent local medical care now.

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Frequently Asked Questions

Is this article a replacement for a doctor?

No. It is educational content only. Patients should consult a qualified clinician for diagnosis and treatment.

When should I seek urgent care?

Seek urgent care for severe symptoms, rapidly worsening condition, breathing difficulty, severe pain, neurological changes, or any emergency warning sign.

References

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