Paroxetine

Antidepressant — SSRI

Indications

DepressionGADOCDPanicPTSDSocial anxiety

Adult dose

Start 20 mg OD; max 50 mg (60 mg in OCD).

Common side effects

NauseaSexual dysfunction (notably high)SedationWeight gainAnticholinergic

Serious side effects

Discontinuation syndrome (most marked of SSRIs)HyponatraemiaSerotonin syndrome

Contraindications

MAOI within 14 daysPregnancy (cardiac malformations — relative)

Monitoring

  • Sodium in elderly
  • Discuss discontinuation syndrome before stopping

Notable interactions

  • Strong CYP2D6 inhibitor — tamoxifen (avoid), TCAs, opioids
  • MAOIs

Curated reference based on BNF, Maudsley Prescribing Guidelines and NICE. Verify against current BNF and local guidelines before prescribing.