Paxil medicine instructions for use. Paxil - instructions for the use of tablets, composition, indications, side effects, analogues and price

Paroxetine hydrochloride hemihydrate 22.8 milligrams (Equivalent to 20.0 milligrams paroxetine ), as auxiliary substances: calcium dihydrogen phosphate dihydrate , sodium carboxymethyl starch type A, magnesium stearin shell tablets - Opadry white YS - 1R - 7003 (macrogol 400, titanium dioxide, hypromellose, polysorbate 80).

Release form

The drug is produced in biconvex tablets, packed in blisters of 10 pcs., In one package there can be one, three or ten blisters.

pharmachologic effect

Renders antidepressant action by the mechanism of specific oppression by reuptake in functional cells of the brain - neurons .

Pharmacodynamics and pharmacokinetics

Has a low affinity for muscarinic cholinergic receptors ... As a result of the research, we obtained data that:

• On animals anticholinergic properties appear weak.
• In vitro studies of paroxetine - low affinity for α1-, α2- and β-adrenergic receptors including to dopamine (D2), serotonin subtype 5-HT1- and 5-HT2- , including histamine receptors (H1) .
• In vivo studies have confirmed in vitro results - does not interact with postsynaptic receptors and does not depress the central nervous system and does not cause arterial hypotension .
• Without breaking psychomotor functions , paroxetine does not increase the inhibitory effect ethanol on central nervous system .
• The study of behavioral changes showed that paroxetine is able to cause a weak activating effect in a dose exceeding the slowdown of serotonin reuptake, while the mechanism is not amphetamine-like .
• Paroxetine has no significant changes in blood pressure on a healthy body (), Heart rate and ECG.

With regard to pharmacokinetics, after oral administration, the drug absorbed and metabolized during the "first pass" of the liver, as a result of which less paroxetine is supplied to it than absorbed from the gastrointestinal tract. By increasing the amount of paroxetine in the body (single intake of large doses or repeated administration of regular doses), partial saturation is achieved metabolic pathway and a decrease in the clearance of paroxetine, leading to a disproportionate increase in the plasma concentration of paroxetine. This means that the pharmacokinetic parameters are unstable and the kinetics are non-linear. However, non-linearity is usually mild and is seen in patients taking low doses of the drug that cause low plasma paroxetine levels. An equilibrium plasma concentration can be achieved in 1-2 weeks.

Paroxetine is distributed in tissues, and according to pharmacokinetic calculations, 1% of the total amount of paroxetine that is present in the body remains in plasma. At therapeutic concentrations, approximately 95% of paroxetine in plasma is associated with proteins ... There was no relationship between the concentration of paroxetine in plasma and clinical effects, adverse reactions. He is able to penetrate breast milk and in embryos .

Biotransformation occurs in 2 phases: including primary and systemic elimination before inactive polar and conjugated products as a result of the process oxidation and. Half-life varies within 16-24 hours. Approximately 64% are excreted in the urine as metabolites, 2% - unchanged; the rest - with feces as metabolites and 1% - unchanged.

Indications for use

The drug is used in all types of adults, including reactive and severe, accompanied by anxiety, for supportive and preventive therapy. Children and adolescents 7–17 years old with panic disorders with and without agoraphobia, social phobias, generalized anxiety disorders, post-traumatic stress disorders.

Contraindications

Hypersensitivity to paroxetine or other constituent components.

Side effects

A decrease in the frequency and intensity of certain side effects of paroxetine occurs as the course of treatment progresses, and therefore does not require discontinuation of the appointment. The frequency gradation is as follows:

• very often (≥1 / 10);
• often (≥1 / 100,<1/10);
• sometimes it happens (≥1 / 1000,<1/100);
• rarely (≥1 / 10,000,<1/1000);
• rarely (<1/10 000), учитывая отдельные случаи.

Frequent and very frequent occurrence is determined on the basis of generalized data on the safety of the drug in more than 8 thousand patients. Clinical trials were carried out to calculate the difference in the incidence of side effects in the Paxil group and the second placebo group. The incidence of rare or very rare side effects of Paxil has been determined based on post-marketing information on the frequency of reports, and not on the true frequency of these effects.

Side-effect rates are stratified by organ and frequency:

• Blood and lymphatic system: rarely happen abnormal (hemorrhage in the skin and mucous membranes). Very rarely possible thrombocytopenia .
• Endocrine system: very rare - impaired secretion.
• The immune system: very rare allergic reactions type and.
• Metabolism: "Often" cases of decrease, sometimes in elderly patients with impaired secretion of ADH - hyponatremia .
• CNS: often occurs or, seizures ; seldom - clouding of consciousness , manic reactions as possible symptoms of the disease itself.
• Vision: very rarely occurs aggravation , however "often" - blurred vision.
• The cardiovascular system: "Rarely" was noted sinus as well as a transient decrease or increase in blood pressure.
• Respiratory system, chest and mediastinum: "Often" noted yawn .
• Gastrointestinal tract : "Very often" is fixed nausea ; often - or when dry mouth ; very rarely register gastrointestinal bleeding.
• Hepatobiliary system: rather "rarely" there was an increase in the level of production hepatic ; very rare cases of accompanied jaundice and / or liver failure .
• Epidermis: often recorded; rare case skin rashes and very rare - reactions photosensitivity .
• urinary system: rarely recorded.
• Reproductive system: very often - cases sexual dysfunction ; rarely - and galactorrhea .
• Common violations: often fixed asthenia , and very rarely - peripheral edema.

An approximate list of symptoms that may occur after completing the course has been established paroxetine : "Often" noted by others sensory impairment , sleep disturbances, the presence of anxiety,; sometimes - strong emotional arousal , nausea , sweating , and diarrhea ... Most often, these symptoms in patients are mild and mild, pass without intervention. There are no registered groups of patients at increased risk of side effects, but if there is no greater need for treatment with paroxetine, the dose is gradually reduced until completely canceled.

Paxil tablets, application instruction (Way and dosage)

The tablets are taken orally, swallowed whole and not chewed. It is taken once a day in the morning with meals.

Interaction

Paroxetine is not recommended for use with mAO inhibitors , as well as within 2 weeks after the completion of the course; in combination with, because, like other drugs that inhibit activity enzyme CYP2 D6 cytochrome P450 , increases the concentration of thioridazine in plasma. Paxil is able to enhance the effect of alcohol-containing drugs and reduce the effectiveness and Tamoxifen . Microsomal oxidation inhibitors and Cimetidine increase the activity of paroxetine. When used with indirect coagulants or antithrombotic agents, an increase in bleeding is observed.

Terms of sale

On prescription.

Storage conditions

In a dry place, out of the reach of children, protected from light. The admissible temperature is not more than 30 ° Celsius.

Shelf life

Stored for up to three years.

Paxil and alcohol

As a result of clinical studies, data were obtained that the absorption and pharmacokinetics of the active substance, paroxetine, does not depend or almost does not depend (that is, dependence does not require changing doses) from alcohol. It has not been established that paroxetine increases the negative effect of ethanol on psychomotor skills however, it is not recommended to take it together with alcohol, since alcohol generally suppresses the effect of the drug - reducing the effectiveness of treatment.

Paxil is a drug with antidepressant action.

Release form and composition

Paxil is available in the form of film-coated tablets: white, oval, biconvex, engraved with “20” on one side, and with a break line on the other (10 pcs. In a blister made of PVC / aluminum foil or PVC / PVDC / aluminum foil; in a cardboard box 1, 3 or 10 blisters).

Composition of 1 tablet:

• Active ingredient: paroxetine hydrochloride hemihydrate - 22.8 mg (which corresponds to 20 mg of paroxetine base);
• Additional components: magnesium stearate, sodium carboxymethyl starch type A, calcium hydrogen phosphate dihydrate;
• Shell composition: polysorbate 80, macrogol 400, titanium dioxide, hypromellose.

Indications for use

Paxil is recommended for the treatment of depression of all types, including severe and reactive, as well as depression accompanied by anxiety. There is information confirming the good effectiveness of the drug in cases of ineffectiveness of standard antidepressant therapy. The use of the product in the morning hours does not adversely affect the duration and quality of sleep. Over the course of several weeks of drug therapy, the symptoms of depression decrease, and the appearance of suicidal thoughts decreases. According to research results, the drug is also effective in preventing relapse of depression.

Paxil is also indicated for the treatment of the following diseases (including as a means of preventive and maintenance therapy):

• Obsessive-compulsive disorder (including relapse prevention);
• Panic disorder with and without agoraphobia and relapse prevention (the combination of cognitive-behavioral therapy and paroxetine has been found to be significantly more effective than the isolated use of cognitive-behavioral therapy);
• Social phobia;
• Generalized anxiety disorder (including prevention of relapse).

It is also used to treat post-traumatic stress disorder.

Contraindications

• Simultaneous reception with monoamine oxidase inhibitors (MAO), as well as a period of 2 weeks after their cancellation (MAO inhibitors should not be taken for 2 weeks after the end of therapy with paroxetine);
• Concomitant use with thioridazine (since paroxetine increases plasma thioridazine levels, which can lead to prolongation of the QT interval and the appearance of associated arrhythmias such as "pirouette" and sudden death);
• Simultaneous reception with pimozide (due to possible prolongation of the QT interval);
• Age up to 18 years (the effectiveness and safety of using the drug in children under 7 years old have not been studied; in children and adolescents 7-18 years old, according to research results, the effectiveness of paroxetine has not been proven);
• Hypersensitivity to drug components.

In experimental studies on animals, the embryotoxic and teratogenic effects of Paxil have not been identified. At the same time, in the course of the latest epidemiological studies of pregnancy outcomes with the use of antidepressants in the first trimester, an increased threat of congenital anomalies, in particular, of the cardiovascular system, was established. As a result, before prescribing the drug, it is required to consider the possibility of alternative therapy during pregnancy, and in women planning a pregnancy. Paroxetine should only be taken if the expected benefit of the treatment outweighs the potential for complications.

Particular attention should be paid to the health of those newborns whose mothers used paroxetine in late pregnancy, since there are reports of the development of complications in newborns. These effects include seizures, apnea, cyanosis, respiratory distress, temperature instability, vomiting, feeding difficulties, hypotension, hypertension, hypoglycemia, lethargy, irritability, nervous excitability, tremors, tremors, hyperreflexia, drowsiness, and constant crying ... In most cases, these reactions were observed almost immediately after childbirth or shortly after.

Paxil passes into breast milk in small amounts, but, nevertheless, it is not recommended to use it during lactation.

Method of administration and dosage

The drug should be taken 1 time per day during breakfast, without breaking or chewing, the tablet is swallowed whole.

• Depression. The daily dose is 20 mg, in the absence of the desired effect, a weekly dose increase of 10 mg per day is possible. The maximum allowable daily dose should not exceed 50 mg. It is required to adjust the dose and evaluate the effectiveness of treatment 2-3 weeks after the start of the course, and further, depending on clinical indications. To prevent relapses and to relieve symptoms of depression, it is necessary to observe an adequate duration of maintenance and relief therapy. The recommended course duration is up to several months;
• Obsessive-compulsive disorder. The daily dose is 40 mg, at the beginning of therapy, 20 mg is taken per day. If necessary, the daily dose can be increased every week by 10 mg, but not more than 60 mg per day. The course can take several months or longer;
• Panic disorder. The recommended dose is 40 mg per day. The initial dose is 10 mg per day, in the absence of a therapeutic effect, the dose can be increased weekly by 10 mg to a maximum daily dose of 60 mg. A low starting dose is necessary to minimize the possible aggravation of the symptoms of panic disorder that occurs early in therapy. The duration of treatment is from several months or more;
• Social phobia, generalized anxiety disorder, post-traumatic stress disorder. The agent is taken at 20 mg per day. If necessary, taking into account the clinical effect, the daily dose is increased every week by 10 mg to the maximum allowable 50 mg per day.

It is necessary to stop taking Paxil gradually, avoiding abrupt withdrawal, it is recommended to reduce the daily dose every week by 10 mg. After reaching a dose of 20 mg per day, it should be taken within 7 days, and only then completely cancel the reception.

In the event of withdrawal symptoms during the period of dose reduction or after discontinuation of therapy, it is advisable to resume using the drug at the previously prescribed dose and consult a specialist.

For patients with severe functional disorders of the kidneys and / or liver, the drug is prescribed in doses that are in the lower part of the therapeutic range.

Side effects

• Hematopoietic system: infrequent - abnormal bleeding, mainly hemorrhage in the mucous membranes and skin (most often - bruising); very rare - thrombocytopenia;
• Immune system: very rare - allergic reactions (angioedema, urticaria);
• Endocrine system: extremely rare - syndrome of impaired secretion of antidiuretic hormone;
• Metabolic and nutritional disorders: frequent - increased cholesterol levels, decreased appetite; rare - hyponatremia (mainly in elderly patients, possibly caused by a syndrome of impaired secretion of antidiuretic hormone);
• Mental disorders: frequent - agitation, insomnia, drowsiness, unusual dreams (including nightmares); infrequent - hallucinations, confusion; rare - manic disorders (may be caused by the disease itself);
• Nervous system: frequent - headache, tremors, dizziness; infrequent - extrapyramidal disorders; rare - restless legs syndrome, akathisia, convulsions; very rare - serotonin syndrome, especially when combined with neuroleptics and / or other serotonergic drugs (may include tremor, tachycardia with tremors, myoclonus, hyperreflexia, hallucinations, increased sweating, confusion, agitation); the development of extrapyramidal symptoms (including orofacial dystonia) - in patients with impaired motor functions or taking antipsychotics;
• Organ of vision: frequent - blurred vision; infrequent - mydriasis; very rare - acute glaucoma;
• Respiratory system: frequent - yawning;
• Cardiovascular system: infrequent - postural hypotension, sinus tachycardia;
• Digestive system: very frequent - nausea; frequent - dry mouth, vomiting, diarrhea, constipation; very rare - gastrointestinal bleeding;
• Hepatobiliary disorders: rare - increased levels of liver enzymes; very rare - hepatitis, accompanied by liver failure and / or jaundice;
• Skin and subcutaneous tissues: frequent - sweating; infrequent - skin rash; extremely rare - photosensitivity, erythema multiforme, toxic epidermal necrolysis, Stevens-Johnson syndrome;
• Urinary system: rare - urinary incontinence, urinary retention;
• Reproductive system and mammary glands: very common - sexual dysfunction; rare - galactorrhea / hyperprolactinemia;
• Others: frequent - weight gain, asthenia; extremely rare - peripheral edema;
• Symptoms observed upon discontinuation of the drug (especially with abrupt withdrawal): frequent - headache, anxiety, sleep disturbances, sensory disturbances, dizziness; infrequent - diarrhea, sweating, confusion, tremors, nausea, agitation (in most patients, these effects are mild or moderate and disappear spontaneously).

During clinical studies in children, the following adverse reactions were noted: agitation, hyperkinesia, sweating, tremors, loss of appetite, hostility, mood swings, tearfulness, suicidal thoughts and attempts, as well as self-harm.

special instructions

During the period of Paxil therapy in patients aged 18-24 years (especially in those suffering from major depressive disorder), the risk of suicidal behavior may increase. The presence of this risk can be noted until a pronounced remission is achieved. As a result, in the first weeks of therapy, until an improvement in the condition is achieved, it is required to closely monitor young patients for the timely detection of suicidality and clinical exacerbation.

Particular attention should also be paid to persons of any age with a history of suicidal attempts or suicidal thoughts. In the event of signs of clinical deterioration and / or suicidal thoughts / behavior (especially when they suddenly appear or the severity of manifestations), it is recommended to reconsider the treatment regimen until the drug is discontinued.

In the first weeks of therapy, there is a likelihood of developing akathisia, manifested by psychomotor agitation and a feeling of internal anxiety.

In the presence of epilepsy, Paxil must be used with extreme caution; if a seizure develops, it must be discontinued.

At the beginning of the course of treatment, the possible risk of bone fractures should be considered.

The drug can lead to the appearance of mydriasis, as a result of which it must be taken with caution in angle-closure glaucoma.

The drug is not intended for the treatment of a depressive episode in the context of bipolar disorder. Before starting the course, to assess the risk of its occurrence in the patient, it is necessary to carry out thorough screening (which includes data on the presence of bipolar disorder, depression and cases of suicide in the family).

Paxil should be used with extreme caution if there is a history of mania, in combination with electro-pulse therapy, and also in combination with drugs that increase the risk of bleeding, especially in patients with a bleeding tendency.

Paroxetine may affect the quality of semen, an effect that is reversible after drug withdrawal.

During the period of therapy, caution is required when driving vehicles and other complex mechanisms.

Drug interactions

Possible interaction reactions when combining paroxetine with other drugs:

• Lithium, fentanyl, drugs of the group of selective serotonin reuptake inhibitors (SSRIs), tramadol, triptans, L-tryptophan - serotonin syndrome may appear;
• Inhibitors of enzymes involved in the metabolism of drugs - it is possible to change the metabolism and pharmacokinetics of paroxetine;
• Fosamprenavir and ritonavir - the level of paroxetine in the blood plasma is significantly reduced;
• Procyclidine - its concentration in blood plasma increases;
• Metoprolol, some class 1 C antiarrhythmics (for example, flecainide and propafenone), atomoxetine, risperidone, phenothiazine antipsychotics (thioridazine and perphenazine), tricyclic antidepressants (desipramine, imipramine, nortriptyline, possibly an increase in plasmidinephrine) paroxetine of the hepatic enzyme CYP2D6);
• Sodium valproate, phenytoin, carbamazepine (anticonvulsants) - there is no change in their pharmacokinetics and pharmacodynamics in patients with epilepsy;
• Tamoxifen - its effectiveness may be reduced.

According to clinical studies, the pharmacokinetics and absorption of paroxetine is practically independent (i.e., no change in its dose is required) from propranolol, digoxin, antacids, ethanol and food. Although paroxetine does not enhance the negative effects of alcohol on psychomotor functions, it is not recommended to take them simultaneously.

Terms and conditions of storage

Store at a temperature not exceeding 30 ° C, out of the reach of children.

The shelf life is 3 years.

Paxil is one of the most common antidepressants. Reviews of the drug among patients and doctors are very different. This remedy has earned its popularity for its ability to cope with various anxiety, stressful conditions, phobias and panic attacks. The drug does not cause drowsiness, pressure drops, sleep disturbances, depression of brain activity, which is especially important for working and active patients.

Consider the reviews of patients and doctors about the use of this drug in the treatment of various anxiety-depressive disorders.

Patient reviews

“I was prescribed a course of treatment with Paxil. The doctor immediately warned of possible side effects. She started treatment with 10 mg per day.

The first day of therapy was harmless. However, for the next 5-6 days I felt a strange feeling of detachment at home, on the street and even at work. This, of course, alarmed me, but the doctor said that this is such a period of adaptation and must be endured. From the second week of treatment, the dose of the drug was prescribed 20 mg. To my surprise, increasing the dose of the drug not only did not cause discomfort, but even eliminated the mild nausea that was observed after taking 10 mg in the previous days. With an increase in the dose, the feeling of detachment disappeared, for a while there was even a slight euphoria. I have been drinking the drug for the third month already. I feel great. "

Alyona

“I was treated with Paxil for depression for about 3 years. Several times I tried to quit taking the pills, but each time the symptoms returned on the 3rd day. I feel like a drug addict. However, it’s better than that from which the treatment began. ”

Irina

“I was prescribed Paxil two weeks ago. The drug seems to be tolerated well, but I'm very afraid that it will be addictive. However, the doctor says that the withdrawal of the drug will not cause me any inconvenience if all his recommendations are followed. "

Oksana

“Treatment with Paxil was effective for me, but the withdrawal syndrome negates all the advantages of this drug. It was very hard and for a long time to cancel it. I think it's better to get by with other drugs that are not so addictive. "

Helena

Of course, after reading various reviews about Paxil (often quite unflattering), I got terribly nervous. I was even ready to attack the doctor with claims about the appointment of this drug to me. However, in the morning she pulled herself together. The doctor explained that this remedy is very effective, but it requires caution in following the rules of appointment and cancellation. Indeed, in spite of my fears, I did not feel any unpleasant symptoms. But the improvement in general condition was noticeable already in the third week of treatment.

Lily

“I was prescribed to take Paxil 20 mg per day. The first two days I tried to endure somehow, but on the third day I decided that I would not take it anymore. There was severe weakness, nausea, several times even vomiting, dizziness. For me, it is better to be in a state of depression than to be treated with such drugs. "

Natalia

“Several years ago I was also credited with Paxil. The dose was increased gradually from 10 mg to 20 mg one week later. They were also canceled gradually. The course of treatment lasted 9 months. The first two weeks there was a feeling of slight malaise, but soon everything went away. I did not observe any withdrawal syndrome at the end of the course. I can only say positive things about efficiency. Again I wanted to live and enjoy life. There are situations when you should seek help from specialists, and not try to cope with the problem yourself. "

Yulia

« I've known Paxil for several years. This drug was once taken by my mother. After a series of troubles and stress, I also had a chance to start taking this remedy. At first I tried to do only with the consultations of a psychotherapist, but I still could not do without medications. Of course, I was somewhat worried that certain side effects and even dependence could develop from taking Paxil. However, I did not notice any unpleasant symptoms from the treatment. 7 months of treatment brought me back to life. Now she practically forgot about her former depression. The drug is effective and well tolerated. "

Alina

“I associate taking Paxil with the most unpleasant memories. I took him for five days. It seems to me that if before the treatment I had any mental disorders, then while taking these pills the symptoms only worsened. For myself I decided once and for all that I will not take antidepressants, no matter how bad I feel. "

Hope

“I was prescribed Paxil to treat postpartum depression. The course of treatment was about 10 months. The dose was gradually increased to 30 mg, then reduced. I am satisfied with the effect, this drug is tolerated normally. I did not observe any serious side effects. "

Taisiya

“Paxil was prescribed to me after a car accident. It is worth noting that after this event a lot has changed in my life. And the restoration of the body turned out to be more difficult mentally than physically. Antidepressants were not prescribed to me immediately. At first, I thought I could handle the stress myself.

However, time passed, and the situation only worsened. I was tormented by insomnia, when I fell asleep, nightmares arose. I was terribly afraid to walk down the street, nothing made me happy. After prescribing Paxil for about two weeks, she experienced some discomfort associated with mild nausea, weakness, and dizziness. However, with the beginning of the third week of treatment, everything went away. It should be noted that besides Paxil, I was prescribed other drugs. The treatment lasted 12 months. Now I feel great, I don't even remember my past problems. "

Marina

Reviews of doctors

“Antidepressants should only be prescribed as a last resort. I believe that treatment of anxiety-depressive disorders should be started with regular consultations with a psychotherapist. Only when they are ineffective can the use of antidepressants be considered. "

Anna

“Paxil is a real relief for depressed patients. I would like to note the special effectiveness of the drug in the presence of suicidal tendencies in patients. The drug copes well with various types of mental disorders, even with the ineffectiveness of other medications. Quite often, when it is necessary to prescribe an antidepressant to patients, I opt for Paxil. "

Inna

« The drug Paxil has earned the trust of many doctors due to its availability and high efficiency. If the correct dosage regimen of the drug is observed at the beginning and end of treatment, the drug's tolerance is quite good. Side effects or overdose are extremely rare. If the patient has panic attacks, I prefer to combine Paxil with nootropic drugs. "

Lydia

“Paxil is one of the few antidepressants that does not have a hypnotic effect on the patient. Also, the agent does not suppress brain activity. Thus, Paxil is suitable for the treatment of a patient who has to continue working despite the initiation of treatment. Another positive property of the drug is the lack of its effect on heart rate and blood pressure indicators. "

Vitaly

“Paxil is an excellent drug for the treatment of anxiety and depression. However, the problem with the use of Paxil in the treatment of such patients is its incorrect prescription. Many doctors, due to the lack of regular use of Paxil in their practice, do not know how to titrate the drug correctly at the beginning and at the end of the course of treatment (treatment begins with a quarter of a tablet with a gradual transition to a whole one). Also, to reduce the likelihood of developing side effects from Paxil, tranquilizers (benzodiazepine series) are prescribed. From the second week of such treatment, Paxil can be used independently. "

Dmitry

“The drug is good, if it is necessary to prescribe an antidepressant, I choose it. Many patients fear drug addiction and withdrawal. However, I would like to clarify the situation.

There is no addiction to this drug. All the unpleasant symptoms that arise when Paxil is canceled are associated with the fact that the disorders in the body have not been completely eliminated, but only temporarily the effect of the drug has been eliminated. Paxil only temporarily removes signs of mental disorder. However, in the case of serious violations, in addition to it, other medications are required, for example, homeopathic medicines. "

Valentine

“I rarely prescribe Paxil to my patients. I prefer to get by with the advice of a psychologist and the appointment of herbal remedies. If these measures are ineffective, I refer the patient to a psychotherapist. "

Evgeniya

“Paxil is an excellent drug for eliminating the manifestations of anxiety and depression. However, it should be borne in mind that in the presence of serious mental disorders, an integrated approach to the patient's treatment is required. Subject to the recommendations for the selection of an individual effective dose of the drug, Paxil provides an excellent anti-anxiety agent. "

Paxil is a potent selective serotonin reuptake inhibitor with pronounced antidepressant activity.

The drug is available in the form of tablets for oral administration. The active substance of the drug Paxil is paroxetine hydrochloride in an amount of 20 mg.

Magnesium stearate, calcium hydrogen phosphate, titanium dioxide are used as auxiliary elements.

The chemical structure of Paxil and other drugs from the group of tetracyclic and tricyclic antidepressants is different.

Pharmacological effect

The action of the drug Paxil is associated with its ability to promote selective blocking of the reuptake of serotonin and enhance the serotonergic effect in the central nervous system, which has an antidepressant effect. The psychotropic activity of a drug is associated with its ability to:

• eliminate depressive conditions;
• relieve the patient from anxiety.

There was no evidence of a carcinogenic or mutagenic effect of the drug.

According to research results, the drug can show a moderate activating effect when used in a dosage higher than that required to inhibit serotonin uptake. Paxil does not contribute to the effect on the cardiovascular system, impaired psychomotor functions, as well as depression of the central nervous system.

In the treatment of depressive conditions, Paxil demonstrates an efficacy that can be compared with the effect of drugs from the tricyclic antidepressants group. The active component of the drug demonstrates the proper therapeutic effect even during the therapy of those patients who did not respond positively to previous treatment with drugs from the antidepressant group.

An improvement in the patient's well-being is observed after 1 week of using the tablets.

If you use Paxil in the morning, the active component of the drug does not have a negative effect on the duration of sleep. In addition, effective therapy can improve sleep quality.

According to the research results, in patients who have been taking Paxil for 12 months, the risk of relapse of depressive conditions is significantly reduced.

If the drug is used during the treatment of panic disorder in combination with medications that improve behavior and cognitive functions, the administration of Paxil has a more pronounced therapeutic effect than mono treatment with other groups of drugs.

Absorption of the active substance occurs in the liver, the achievement of a stable concentration in the blood plasma is observed after 1-2 weeks of regular tablet intake. The active ingredient is excreted together with excrement.

The half-life of each patient may differ, on average it takes from 15-16 hours to a day.

Indications for admission

Paxil is indicated for use in the treatment of various types of depressive conditions:

• reactive depression;
• severe depression;
• depression accompanied by anxiety.

In addition, pills can be used when the following conditions are detected:

During the first few weeks of using the pills, there is a decrease in the symptoms of depressive conditions, suicidal thoughts pass.

Mode of application

Paxil tablets should be used once a day, with meals. The drug should not be chewed. The exact dose and course of treatment are selected taking into account the indications for admission and the patient's complaints.

In the treatment of depression, the effectiveness of the prescribed treatment should be assessed (several weeks after the start of admission) and, if necessary, the dose of the drug should be adjusted. The duration of supportive and supportive treatment can take up to several months.

Patients with severe liver and kidney dysfunction should take the tablets in the minimum effective dose.

It is worth refraining from abruptly canceling the use of Paxil tablets . If, during the period of gradual reduction of the dosage, the patient is worried about the withdrawal syndrome, it is recommended to resume taking the previously used dosage. In the future, the dose should be reduced more slowly.

Paxil is not intended for self-medication, you should definitely consult your doctor before taking the pills.

Overdose development

In case of an overdose of Paxil, an increase in undesirable side reactions is possible, as well as the development of fever, arterial pressure disorders, tachycardia, anxiety, involuntary muscle contraction. In most cases, the patient's well-being returns to normal without serious complications.

Information about cases of coma development and ECG changes was rarely received, and occasionally about deaths. In most cases, such conditions were provoked by combining Paxil with alcohol or other psychotropic substances.

Overdose therapy can be carried out in accordance with its manifestations, as well as the instructions of the national poison control center. There is no specific antidote. Therapy includes general measures, the observance of which is required in case of an overdose of an antidepressant. In addition, the basic physiological parameters of the body should be monitored and supportive treatment should be carried out.

Contraindications

Paxil is contraindicated for use:

• with intolerance to active or auxiliary elements;
• simultaneously with MAO inhibitors, substances thioridazine and pimozide;
• Paxil is also not used in the treatment of persons under the age of 18.

Application during pregnancy

Before prescribing Paxil in the course of therapy for women who are expecting a baby, the possibility of using alternative therapies should be considered. There is information about cases of premature birth of children whose mothers use Paxil in late pregnancy. The tablets should not be taken unless the potential risk outweighs the potential benefit.

A certain amount of the active substance of the drug has the ability to penetrate into breast milk. For this reason, the drug is not prescribed if the potential benefit does not exceed the likely harm to the child.

Despite the fact that the teratogenic effect of Paxil has not been identified, the tablets are used in the course of therapy for pregnant women only in exceptional cases.

The active ingredient in the drug can affect the quality of the semen.

Adverse reactions

Paxil can cause disorders of the immune, endocrine, cardiovascular, digestive, reproductive, respiratory systems, as well as mental disorders, metabolic disorders.

The most frequently reported were blurred vision, headache, yawning, tremors, dizziness, drowsiness, agitation, sleep disturbances, decreased appetite, nausea, stool disturbances, dry mouth, sweating, sexual dysfunction, asthenia, weight gain.

When the treatment with Paxil was discontinued, the most frequent complaints were the development of dizziness, sensory disturbances, anxiety, headache, and sleep disturbances.

Drug interactions

When the drug Paxil is combined with hypnotics of a short period of action, the development of additional adverse reactions is not observed.

Paxil dosage adjustment may be required when combined with drugs from the group of tricyclic antidepressants, as well as drugs based on metoprolol, procyclidine, flecainide, encaidine, propafenone, thioridazine.

The active substance of the tablets can increase the effect of drugs that contain alcohol, as well as reduce the effectiveness of drugs, the active substance of which is tamoxifen and digoxin.

Simultaneous use with drugs from the group of indirect anticoagulants and antithrombotic agents can lead to the risk of bleeding.

Paxil should not be used concurrently with drugs based on methylene blue and drugs from the group of MAO inhibitors, as well as within 14 days after stopping them. MAO inhibitor drugs should not be taken for 14 days after completing Paxil therapy.

In the course of controlled clinical trials, Paxil has not demonstrated adequate efficacy in the treatment of depressive conditions in patients of young and adolescent age (from 7 to 17 years). For this reason, the drug is not used in the treatment of this age group of patients.

Since the active substance of the drug can contribute to the development of mydriasis, the drug is used with extreme caution during the therapy of patients with angle-closure glaucoma.

Experience with drug use concurrently with electroconvulsive therapy is limited.

Paxil is used with extreme caution in the treatment of people with a history of epilepsy.

When prescribing the drug, the risk of bone fracture should be taken into account.

Be especially careful when driving and performing potentially hazardous work.

The drug is used with extreme caution in the treatment of patients with a history of mania.

The combination of the active substance of the drug with alcoholic beverages is not recommended.

Storage of the drug should be carried out in a place inaccessible to children and sunlight. The tablets are stored in compliance with the temperature regime - no more than 30 degrees.

This medication is available in pharmacies as a prescription drug.

Analogues, cost

The cost of Paxil for the period of June 2016 is formed as follows:

1. Tablets 30 pcs., 20 mg - 700-730 rubles.
2. Tablets 100 pcs., 20 mg - 2130-2190 rubles.

Paxil analogues are: Reksetin, Plizil N, Paroxetine, Adepress, Aktaparoxetine.

The drug "Paxil" is currently one of the most popular drugs in the group of antidepressants. Our life, filled with all kinds of stressful situations, needs such medications, which are sometimes the only means that can relieve stress and put aside our fears, experiences and various phobias. Therefore, now we will analyze such basic aspects regarding Paxil tablets: people's reviews, method of application, restrictions, side effects and much more.

Composition

The antidepressant described in this article contains the following elements:

• Main substance: paroxetine hydrochloride hemihydrate in the amount of 22.8 mg.
• Auxiliary components: calcium dihydrogen phosphate dihydrate, magnesium stearate, sodium carboxymethyl starch type A.

The tablet shell itself consists of hypromellose, titanium dioxide, macrogol 400 and polysorbate 80.

Implementation form

The product is available in the form of coated tablets (it can be of various colors). The pills are oval, biconvex, engraved on one side and a fracture line on the other.

Dragee are produced in blisters, 10 pieces in each. Sold in a cardboard box of 10, 30 and 100 tablets.

When is it worth using?

The drug "Paxil" can be prescribed by a doctor for the following problems:

1. Blues, prostration, depression.
2. Extreme mental disorder.
3. Social phobia.
4. Post-traumatic disorder.
5. The patient's anxiety.
6. Panic attacks.

Method of administration and dosage

How much and how to drink Paxil correctly? Instructions for use of the medication says that it is advisable to take it 1 time a day in the morning, at the time of eating. The pill should be swallowed whole, and there is no need to chew it.

Now we will consider the dosage regimen of the drug, depending on the mental state of the patient:

Stopping the drug

As with therapy with any other psychotropic drugs, the abolition of "Paxil" - pills that are good antidepressants - should be gradual. The scheme for stopping the drug can be as follows:

Dose reduction by 10 mg every 7 days.

After reaching the mark of taking the drug 20 mg per day, the patient must continue to take it in the same volume for 1 week. And only after that the pills are completely canceled.

However, if symptoms develop at the time of dose reduction or after a complete cessation of the medication, the doctor may resume taking this medication. In the future, the specialist can continue to reduce the number of pills taken, but more slowly.

To date, there are many similar medicines like Paxil pills. Analogs of this drug are called like this: tablets "Adepress", "Plezil", "Reksetin", "Sirestill". These drugs have the same composition as the antidepressant described in this article. Currently, there are drugs that are similar in their action to the medicine "Paxil". Analogues can be purchased without any problems at any pharmacy, and their composition will be similar. For example, similar drugs by pharmacological group: tablets "Amitriptyline", "Oprah", "Miracitol", "Depreneone", "Amixid", "Negrustin", "Fluoxetine", "Zoloft", "Prozac", "Tsipramil", " Stimuloton "," Framex "," Sedopram "," Noxibel "," Epivel ".

Contraindications

Patients taking MAO inhibitors such as lamizide, thioridazine, tryptophan.

Children under 18.

Women who are breastfeeding their baby.

With increased individual sensitivity to paroxetine and other auxiliary components of the drug.

It is necessary to carefully apply the medication to people who have renal and hepatic insufficiency.

Taking the drug during pregnancy

The medicine "Paxil" is prescribed to women in position only if the intended benefit to the mother is higher than the risk to the fetus. In any case, the doctor should consider alternative treatment for pregnant women.

Taking the drug by adolescents

The antidepressant "Paxil" is not prescribed for children, even in the smallest doses. Young people over the age of 18 are prescribed this medication, but it should be noted that at the beginning of such treatment, boys or girls may have an increased risk of suicidal tendencies (for example, suicide attempts, thoughts about it). The characteristic hostility of the patient (aggression, anger, irritability, impulsivity) may also be observed. There are currently no data on the safety of this antidepressant for adolescents, or on its effect on the growth, maturation and behavioral development of boys and girls.

Side effects

None of the similar drugs can not have adverse reactions, so the drug Paxil is no exception. Side effects when taking this remedy can be as follows:

1. Disorders of the lymphatic system and blood flow:

Hemorrhages in the skin and mucous membranes are rare;

Thrombocytopenia is a pathology associated with a sharp decline in the number of red blood cells (observed sporadically).

2. Problems with metabolism and nutrition:

Increased cholesterol concentration;

Decreased appetite.

3. Mental disorders:

Drowsiness or, on the contrary, insomnia, nightmares;

Agitation - emotional excitement, accompanied by anxiety, fear, anxiety (a person in this state becomes too fussy, he has a feeling of emptiness, thoughts are confused, the ability to reason is disturbed);

Hallucinations;

Suicidal thoughts (such ideas and behavior may occur early in treatment or after stopping therapy).

4. Disturbances from the nervous system:

Dizziness, headache, trouble concentrating;

Seizures, restless legs syndrome;

Very rarely - serotonin syndrome, which is characterized by confusion, increased sweating, hallucinations, chills and tremors in the body, tachycardia and tremors.

5. Problems with the organs of vision:

Acute glaucoma;

Mydriasis - dilation of the pupil;

Blurred vision.

6. Violations of the organ of hearing and heart:

The appearance of tinnitus;

Aggression.

Liver failure (signs of hepatitis and cirrhosis).

Delayed urination.

In case of an overdose, a specialist prescribes the following treatment:

1. Gastric lavage.
2. Reception of activated carbon.
3. Artificial induction of vomiting.

If the case is serious, then the patient can be admitted to the hospital and be treated further within the walls of the hospital. In a medical institution, they carry out various detoxification measures, control the work of the heart, perhaps even connect to a ventilator (at critical moments).

Medicine Paxil: price in Russia

This drug is manufactured in France, therefore, it is brought to the post-Soviet countries from there, and here its cost depends on the exchange rate, various duties at customs points, delivery and storage costs and, of course, the markup of a particular pharmacy. To date, the average cost of such an antidepressant ranges from 700-730 rubles per pack containing 30 tablets, and 2000-2300 rubles per 100 pills.

Can I drink alcohol during therapy?

From the point of view of the therapeutic interaction, Paxil tablets and alcohol are compatible concepts, therefore, purely theoretically, it can be assumed that during treatment, you can drink wine, whiskey, etc. However, in practice, doctors do not recommend doing this, since this may entail are such adverse effects:

A one-time use of a strong drink on the eve of taking the medicine significantly reduces the effect of the drug.

The systematic intake of alcohol causes an increase in both the positive results of the tablets and their side effects.

Influence on the ability to drive a car and other mechanisms

The action of "Paxil", a new generation antidepressant drug, in no way has a negative effect on the patient's psychomotor functions. At the same time, when treating with any other psychotropic drugs, patients should be extremely prudent when driving a car and working with mechanisms.

Assessment of people

Unfortunately, there is no unequivocal opinion of patients about the drug "Paxil". Reviews are both positive and negative. Good responses came from those patients who took the pills strictly as prescribed by their doctor for the treatment of severe mental disorders. People noted that they gradually managed to achieve results: the state of asthenia disappeared, panic attacks passed, anxiety, fears - all this was eliminated. The patients developed faith in the future, as well as a desire to do some important work. The only thing was that the effect did not appear immediately, we had to wait, and this is normal.

But, of course, there are also negative responses about the drug "Paxil". Reviews of a disapproving nature relate to the allegedly false therapy with this remedy. A lot of people on the forums write that at the very beginning of taking these pills they really had an excellent effect: the mood appeared, strength, energy increased, depression subsided, the person felt much better. However, as soon as you stopped taking the drug, it became even worse, and in addition, various side moments appeared: headaches, nausea, insomnia, etc. It turns out that people developed addiction, a kind of withdrawal, like drug addicts.

Also, to the disadvantages of this medication, many people attribute its high cost, because it really is an expensive drug.

Therefore, before thinking about whether it is worth taking these pills at all, maybe it is better to seek help from qualified specialists - psychiatrists who will help to cope with the problem itself, and will not dull its consequences?

Opinions of doctors

Doctors respond positively to the antidepressant Paxil. Reviews of this nature are not accidental: with proper use, this medication is able to cope with its task. Also, unlike many other similar drugs, the drug "Paxil" is a patented drug, so doctors most often prescribe it.

However, experts unanimously warn that this antidepressant must be taken correctly. It is imperative to follow all the prescriptions and prescriptions of the doctor, who sets the individual dosage of the medicine for each individual person. And if the patient turned to a specialist for help and decided to treat his nervous disorder with this particular medication, then it is necessary to finish the therapy according to the rules. What is meant? It is necessary to cancel the drug gradually, and not abruptly. And, of course, patients should not forget about interactions with other medications and alcohol. And if the patient observes all the doctor's prescriptions, then the positive effect of the drug will definitely be.

Storage conditions and periods

The medicine should be kept out of the reach of children. The storage temperature should be no higher than 30 degrees.

The shelf life of the medication is 3 years from the date of manufacture.

Today you have learned quite interesting and necessary information about such a drug as Paxil (price, application, analogues, reviews about it - all this is in the article). We found out that this medicine is a strong antidepressant, so it should be taken only if there is a doctor's prescription. By the way, only according to its purpose, a person will be sold this remedy in a pharmacy, since such a serious medication is dispensed strictly by prescription.