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Paroxetine (Paxil)
2
04/22/2023
Paroxetine (Paxil)
NURU 641
Dr. Willis
University of Massachusetts Global
Joseph Isibor
04/22/2023
Introduction
General Information on Paroxetine (Paxil)
General Information
Paroxetine (Paxil) is a U.S. Food and Drug Administration (FDA) approved treatment option for
ADULTS
Major Depressive Depression
Obsessive Compulsive Disoder
Panic Disorder
Panic Disorder
Social Anxiety
Generalized Anxiety Disorder
Post Traumatic Stress Syndrome
Prementraula Dysphoric Disoder
Menopausal Hot Flashes
KIDS
No Approval
Common off-label Use
Seperation Anxiety Disorder
Premature Ejaculation
How Does Lamotrigine (Lamictal) Works
How Does It Work
Paroxetine (Paxil) are thought to work by increasing levels of serotonin in the brain. They do this by blocking the recycling of released serotonin back into the nerve endings. Paroxetine is often prescribed alongside a talking therapy. Usually serves as the harmonizer of the chemicals in the brain, especially the neurotransmitters that affect the mood and emotions of an individual
(Carvalho et al., 2020).
Administration/Side Effects
Administration/Side Effects
Adminitration of Paroxetine (Paxil)
May be administered at any time of the day, depending on toleration.
Adults: start with 20 mg by mouth daily and increase by 10 mg weekly with a max of 50 mg per day.
Geriatric adults: start with 10 mg by mouth daily and then increase by 10 mg weekly with a max dose of 40 mg per day orally.
Side Effects that are common with Paroxetine (Paxil) are
- Agitation
- chest pain or tightness
- chills
- cold sweats
- confusion
- difficulty with breathing
- dizziness, faintness, or lightheadedness when getting up from a lying or sitting position.
- fast, pounding, or irregular heartbeat or pulse.
- muscle pain or weakness.
- skin rash
Scenerio 1
Patient 1
Matthew is a 31 year old English speaking caucasian male recently diagnozed with major depressive disorder with increase depressive symptoms over several months. Past medical history of Herpes Simplex Virus 1 and Vitamin D deficiency. Matthew is an insurance broker, married with five children of ages, 10months, 2yrs, 5yrs, 7yrs, and 8 years old.
Will Paroxetine (Paxil) recommend?
Yes.
Scenerio 2
Administration/Side Effects
Adminitration of Lamotrigine (Lamictal) comes as a tablet, an extended-release tablet, an orally disintegrating tablet (dissolves in the mouth and can be swallowed without water), and a chewable dispersible (can be chewed or dissolved in liquid) tablet to take by mouth with or without food. The extended-release tablets are taken once a day.
Side Effects that are common with Lamotrigine (Lamictal) are mild skin rash, shaking or tremor, aggression, or feeling irritable or agitated, difficulty sleeping, diarrhea, nausea, sweating, dizziness, headaches, suicidal ideation, and Steven-Johnson syndrome.
Special Instructions
Special Instructions
- Talk to your doctor if experencing worsening of mood or suicidal thoughts.
- Do not stop abruptly, it may leads to symptoms of nausea, vomiting, diarrhea, headache, sweating, tremor, vivid dreams, and insomnia.
- Avoid use with other medications that may increase risk of bleeding like other SSRI or St John's work
Black Box Warning
Black Box Warning
The FDA issued a black box warning for Paroxetine (Paxil) concerning suicidal thoughts and behavior in children, adolescents, and young adults, particularly those with major depressive disorder. The drug's label warns anyone age 24 or younger to carefully weigh these risks with the clinical need.
References
References
Afonso, H., Gomes, J., Durães, D., & de Carvalho, V. F. (2020). DRESS syndrome after lamotrigine and valproic acid use in a bipolar patient: a case report. The European Journal of Psychiatry, 34(3), 160-163.
Betchel, N. T., Fariba, K. A., & Saadabadi, A. (2022). Lamotrigine. In StatPearls [Internet]. StatPearls Publishing.
Edinoff, A. N., Nguyen, L. H., Fitz-Gerald, M. J., Crane, E., Lewis, K., St Pierre, S., ... & Urits, I. (2021). Lamotrigine and stevens-Johnson syndrome prevention. Psychopharmacology bulletin, 51(2), 96.
Naguy, A., & Al-Enezi, N. (2019). Lamotrigine uses in psychiatric practice. American journal of therapeutics, 26(1), e96-e102.
Sharma, V., & Doobay, M. (2019). Lamotrigine-induced obsessive-compulsive disorder in patients with bipolar disorder. CNS spectrums, 24(4), 390-394.
Questions
Email: jisibor@mail.umass.edu