PAXIL

	PAXIL Description / Definitions Abuse Addiction / Dependence Side Effects Withdrawal Symptoms Treatment

DESCRIPTION / DEFINITIONS: Paxil® (fluvoxamine maleate) is a selective serotonin reuptake inhibitor.

ABUSE: Paxil is a drug prescribed for the treatment of depression.

ADDICTION / DEPENDENCE: Half life and metabolism, Black Box Warning.

SIDE EFFECTS: High blood pressure, suicide, dizziness (see list below).

WITHDRAWAL SYMPTOMS: Nausea, insomnia, electric shock like sensations (see list below).

TREATMENT: Medical detoxification.

DESCRIPTION / DEFINITIONS

Paxil® (fluvoxamine maleate) is a selective serotonin reuptake inhibitor ("SSRI"). Although there are no medical tests to determine if a person has insufficient serotonin, SSRI drugs like Paxil increase the amount of serotonin in the brain. According to its label, "The efficacy of paroxetine in the treatment of major depressive disorder, social anxiety disorder, obsessive compulsive disorder (OCD), panic disorder (PD), generalized anxiety disorder (GAD), and posttraumatic stress disorder (PTSD) is presumed to be linked to potentiation of serotonergic activity in the central nervous system resulting from inhibition of neuronal reuptake of serotonin (5-hydroxy-tryptamine, 5-HT)."

ABUSE

Paxil is a drug prescribed for the treatment of depression.

ADDICTION / DEPENDENCE

HALF LIFE AND METABOLISM

The biological half life of a substance is the time it takes for a drug to lose half of its pharmacologic activity. This is significant because it affects how soon withdrawal symptoms may appear.

The half life of Paxil is 21 hours.

Paxil is mainly metabolized through the P450 pathway in the liver and the enzymes primarily handling the metabolism is CYP2D6.

The CYP enzymes are the major enzymes involved in drug metabolism, and since many drugs may increase or decrease the activity of various CYP isozymes, this is a major source of adverse drug interactions, since changes in CYP enzyme activity may affect the metabolism and clearance of various drugs. For example, if one drug inhibits the CYP-mediated metabolism of another drug, the second drug may accumulate within the body to toxic levels, possibly causing an overdose.

BLACK BOX WARNING

The Food and Drug Administration (FDA) has decided that some drugs pose very serious risks and have required that these drugs have what is called a black box warning. Paxil has a black box warning. Here is the warning.

SIDE EFFECTS

The following information is taken from the Paxil label:

abnormal dreams abnormal ejaculation abnormal electroencephalogram abnormal gait abortion acne acute abdominal syndrome acute brain syndrome agitation akathisia albuminuria alcohol intolerance alkaline phosphatase increased alopecia amenorrhea amnesia anemia angina pectoris anorexia anorgasmia antisocial reaction anxiety apathy aphthous stomatitis aplastic anemia apnea arrhythmia arthritis arthrosis asthma ataxia atelectasis atrial fibrillation biliary pain blepharitis blood dyscrasia bloody diarrhea bone pain bradycardia breast engorgement breast enlargement breast pain buccoglossal syndrome BUN increased bursitis cataract cerebral embolism cerebral ischemia cerebrovascular accident chills cholecystitis cholelithiasis cholestatic jaundice chondrodystrophy circumoral paresthesia CNS depression CNS stimulation colitis coma confusion congestive heart failure conjunctivitis constipation contact dermatitis cough decreased creatine phosphokinase increased cystitis deafness dehydration delusions depersonalization diabetes mellitus diabetic acidosis diarrhea diplopia dizziness dry eyes dry mouth duodenal ulcer dysarthria dyskinesia dyspepsia dysphagia dystonia dysuria ear pain ecchymosis eczema emotional lability emphysema enteritis eosinophilic pneumonia epidermal necrolysis epistaxis eructation erythema multiforme erythema nodosum esophageal ulcer esophagitis euphoria exfoliative dermatitis exophthalmos extrapyramidal syndrome

extrasystoles eye hemorrhage face edema fecal incontinence female lactation fever fibrocystic breast flatulence flu syndrome foot drop furunculosis gastritis gastroenteritis gastrointestinal hemorrhage generalized edema glaucoma glossitis glycosuria gout gum hemorrhage gynecomastia hallucinations headache heart arrest heart block hematemesis hematuria hemoptysis hemorrhage hemorrhage of colon hepatic failure/necrosis hepatitis herpes zoster hiccup hirsutism hostility hyperacusis hyperchlorhydria hypercholesteremia hyperesthesia hyperkalemia hyperkinesia hyperlipemia hyperprolactinemia hypertension hypertonia hyperuricemia hyperventilation hypesthesia hypocalcemia hypochromic anemia hypoglycemia hypokalemia hypomenorrhea hypotension hypothermia hypothyroidism hypoventilation hypoxia immune–related hemolytic anemia impotence incoordination increased appetite increased salivation insomnia intentional injury intentional overdose intestinal obstruction iritis iron deficiency anemia kidney failure kidney pain larynx edema leg cramps leukopenia leukorrhea libido decreased libido increased liver fatty deposit liver function tests abnormal lung edema lymphedema lymphocytosis maculopapular rash malaise melena menorrhagia metrorrhagia migraine misuse/abuse mouth ulceration movement disorders myasthenia mydriasis myocardial infarction myoclonus myopathy myositis nausea nervousness neuralgia neuritis

neuroleptic malignant syndrome neuropathy neurosis nocturia oliguria optic neuritis osteomyelitis osteoporosis pallor palpitation pancreatitis pancytopenia paralysis paranoid reaction parosmia pelvic pain peptic ulcer peripheral edema peripheral vascular disorder personality disorder petechia petechial rash pharyngitis phlebitis photophobia photosensitivity reaction pneumothorax polyuria postural hypotension priapism psoriasis psychosis pulmonary embolism pulmonary hypertension purpura purpuric rash pustular rash QT prolongation rectal hemorrhage reflexes decreased reflexes increased rheumatoid arthritis salivary gland enlargement scleritis seborrhea serotonin syndrome SGPT increased shock sinusitis skin discoloration skin ulcer sleep disorder somnolence Stevens–Johnson syndrome stomach ulcer stomach ulcer hemorrhage stomatitis strabismus stridor stupor sudden unexpected death suicidal ideation suicide attempt sweating syncope tachycardia taste loss taste perversion tenosynovitis thinking abnormal thirst thrombocythemia thrombocytopenia thrombocytopenic purpura thrombophlebitis thrombosis tinnitus tongue edema tremor urinary frequency urinary incontinence urinary retention urinary urgency uterine fibroids enlarged uterine hemorrhage vaginal bleeding after drug withdrawal vaginal hemorrhage vascular headache vasodilatation vasospasm ventricular arrhythmia ventricular extrasystoles ventricular fibrillation ventricular tachycardia (including torsades de pointes–type arrhythmias) vertigo vesiculobullous rash violent behaviors visual field defect vomiting weight gain weight loss yawn

WITHDRAWAL SYMPTOMS

Paxil can be a very difficult drug to stop taking .Here are some of the Paxil withdrawal symptoms:

agitation confusion depression diarrhea dizziness dreams, including vivid dreams drowsiness electric shock-like sensations

fatigue/malaise feelings of being hot or cold feelings of unreality flatulence flu-like feelings headache insomnia

irritability mood swings muscle spasms nausea other strange tingling or painful sensations sweating tremor

TREATMENT

Withdrawal from Paxil should only be done under the care of a health practitioner. The safest way is to withdraw at an inpatient medical detox facility. At an inpatient medical detox facility with a protocol that includes hydration, vitamins and supplements, most patients can safely stop taking Paxil in about seven days. Patients can withdraw from Paxil on an outpatient basis but it will normally take at least four weeks.