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Paxil: Serious side effects and interactions possible

Anyone already taking blood thinners, painkillers, anti-rheumatics, or St. John’s wort should avoid Paxil, as there can be considerable interactions between the medications. The same applies to lithium and many antidepressants. You can find out precisely what these are and what symptoms you should look for in this blog article from the Institute for Modern Psychotherapy in Berlin.

What is Paxil (Paroxetine), and when is it used?

Paxil (Paroxetine) is an antidepressant of the SSRI class that is used to treat mental illnesses such as depression or anxiety disorders. SSRI class means that the drug increases the serotonin level. In addition to Paxil®, paroxetine is marketed under the following brand names: Brisdelle®, Paxil® CR, and Pexeva®.

Paxil has been on the market for a long time. It is still prescribed by many doctors, even though there are now other treatment methods that often achieve significantly better results. You should always bear this in mind, as Paxil can cause numerous side effects, and the interactions with other medications are not insignificant. Here are a few examples:

Paxil: Strong interaction with Nefazodone and lithium

The simultaneous intake of Paxil and Nefazodone or lithium can lead to severe reactions, such as the development of serotonin syndrome. This is characterized by sweating, high blood pressure, nausea, diarrhea, headaches, delusions, tremors, and muscle cramps.

Caution with Paxil and blood-thinning medication

Combining Paxil with blood-thinning medications, such as Coumadin or Aspirin, can increase the risk of bleeding. It is essential that doctors carefully monitor and, if necessary, adjust the dosage of these medications to avoid adverse bleeding events.

Paxil and Advil or Aleve

Taking Paxil together with non-steroidal anti-inflammatory drugs (NSAIDs), such as Advil or Aleve, may increase the risk of gastrointestinal bleeding. Patients should avoid such combinations or use them under medical supervision, especially if they already have stomach problems.

Paxil and other antidepressants or migraine medications

Interactions can also occur when Paxil is combined with other serotonergic drugs, such as certain painkillers, triptans (for migraines), or other antidepressants. These combinations can also lead to serotonin syndrome. This potentially life-threatening reaction is accompanied by symptoms such as restlessness, confusion, rapid heartbeat, or a significantly increased body temperature.

Paxil and antipsychotics or medication for epilepsy

Paxil can affect the blood levels of certain anticonvulsants (anti-epileptic drugs) and antipsychotics. This requires closely monitoring drug levels and possible adjustments to ensure therapeutic efficacy.

Paxil and Nolvadex

Breast cancer patients are often treated with Nolvadex. If the patients also take the antidepressant Paxil, the conversion of Nolvadex into its active metabolites is restricted. According to a study published in the British Medical Journal, this leads to increased breast cancer mortality in the patients concerned.

Antidepressants and pills. Close-up of a woman holding antidepressants and other pills.

Paxil: Interaction with the cough suppressant Delsym (DXM)

Serotonin syndrome can also occur when these two drugs are taken. In addition to the symptoms already mentioned, restlessness, increased heart rate, faster breathing, and dilated pupils are also expected.

Paxil (Paroxetine) with alcohol or other psychoactive substances

Alcohol and other psychoactive substances can increase the effect of Paxil (Paroxetine), which can lead to increased drowsiness and reduced responsiveness. These combinations should also be avoided to ensure patient safety.

Paxil: Caution with these pre-existing conditions

If you have one of the following conditions, Paxil may only be administered under strict medical supervision:

  • Epilepsy
  • diabetes
  • Liver damage
  • Kidney damage
  • glaucoma or narrow-angle glaucoma
  • heart disease
  • bleeding tendency

Paxil: Not for pregnant women and breastfeeding mothers

Paxil can lead to cardiac malformations in the unborn child, especially if the drug is taken in the first three months of pregnancy. Paxil can also trigger pulmonary hypertension in newborns. This means that the vascular resistance and, thus, the blood pressure in the child’s pulmonary circulation increases. The consequences can be dramatic, as the infant can absorb less oxygen through the lungs. To compensate for this deficit, the heart has to work much harder, which in turn can lead to damage to the heart in the long term.

Paxil: All side effects listed by frequency

Paxil is a selective serotonin reuptake inhibitor (SSRI). By increasing the serotonin level, mental illnesses such as depression or anxiety disorders are supposed to be alleviated. This is a cause for concern, as, to date, not a single study has been able to prove that happy or anxiety-free people have higher serotonin levels than depressive or anxiety patients. What has been verified by a large number of studies, however, are the side effects that can occur when taking Paxil.

Side effects of Paxil

Paxil can cause various side effects, ranging from mild to severe. You should pay particular attention to side effects that are widespread or occur frequently.

Widespread side effects of Paxil:

(Occurs in at least 1 in 10 people)

  • Difficulty concentrating
  • Nausea
  • Sexual dysfunction

Frequently side effects of Paxil:

(Occurring in 1 to 10 people out of 100)

  • Loss of appetite
  • Elevated cholesterol levels
  • Tiredness
  • Insomnia
  • Inner tension and restlessness
  • Nightmares
  • dizziness
  • trembling
  • Headaches
  • Blurred vision
  • Increased yawning
  • Constipation or diarrhea
  • vomiting
  • Dry mouth
  • sweating
  • Weakness
  • weight gain

Occasional side effects of Paxil:

(Occurs in 1 to 10 people in 1,000)

  • Altered blood sugar levels in diabetics
  • Abnormal bleeding of the skin or mucous membranes
  • Confusion
  • hallucinations
  • Disturbances in movement
  • Dilated pupils
  • palpitations
  • skin rashes
  • itching
  • incontinence
  • fluctuations in blood pressure

Rare side effects

(1 to 10 users in 10,000)

  • Manic reactions
  • Anxiety
  • Experience of alienation
  • Panic attacks
  • restlessness
  • Seizures
  • Restless legs syndrome (RLS)
  • Slowed heartbeat
  • Increased liver enzyme levels
  • Reduced sodium levels in the blood

Important note:

The information on interactions and possible side effects generally relates to the active substance of the medication. It may, therefore, differ from the manufacturer’s instructions for your medication. If in doubt, please obtain further information from your doctor or pharmacist.

Suicidal thoughts under Paxil

Of concern are recurring reports of the occurrence of suicidal thoughts and behaviors in some individuals taking Paxil, particularly in young people. The US Food and Drug Administration (FDA) has issued warnings about an increased risk of suicide in children, adolescents, and young adults taking SSRI medications.

Withdrawal symptoms after stopping Paxil

Paxil is often taken for an extended period, and the decision process to stop the medication can be influenced by several factors. Some patients feel better and want to see if they can manage without medication. The justified fear of possible long-term damage, which we will discuss later, often plays a role here. Others no longer want to endure the abovementioned side effects and consider alternative treatment approaches.

Unfortunately, however, the sudden discontinuation of Paxil, in particular, often leads to severe withdrawal symptoms, which can have a considerable impact on patients’ lives. The range of possible symptoms is very diverse:

Symptoms of Paxil withdrawal are:

  • Irritability
  • The feeling of “electric shocks” in the head
  • restlessness
  • dizziness
  • Insomnia
  • Severe mood swings
  • The feeling of being emotionally overwhelmed
  • Digestive problems
  • Abdominal pain
  • Nausea

Duration and intensity of Paxil withdrawal

Withdrawal symptoms can vary from person to person, and the duration of the withdrawal process can last from weeks to months. Some people only experience mild symptoms, while others struggle with more intense and long-lasting effects. Some of our patients who had been taking Paxil for several years before coming to us even reported symptoms that were still noticeable years later.

Hands holding antidepressant pill and a glass of water

Medical supervision is essential during Paxil withdrawal.

The withdrawal symptoms of Paxil can often be significantly alleviated if the medication is slowly phased out under medical supervision. However, caution is advised if the suggestion is made to switch to another antidepressant during withdrawal. This is because there is always a risk that you will cast out the devil with the devil. It is better to stick to the following self-help measures:

  • Make sure you get enough sleep
  • Exercise in the fresh air for at least 30 minutes a day
  • Activate the self-healing power of your neuroplasticity, e.g. using the 10-Sentence Method or the 5-Channel Technique

Long-term damage and cognitive impairment from Paxil

There are growing concerns about possible long-term damage caused by the long-term use of Paxil. In addition to cognitive impairment, there is also increasing talk of memory problems and concentration disorders.

Furthermore, studies* indicate that not only Paxil but also other SSRI drugs can increase the risk of bone fractures.

*Archives of Internal Medicine (2007; 167: 188-94)
*Canadian MultiCentre Osteoporosis Study (CaMOS)

Alternatives to treatment with Paxil (Paroxetine)

The desire to overcome depression or anxiety disorders with drugs such as Paxil is quite understandable. But for this to happen, these psychological problems would have to be caused by a serotonin deficiency. The general public is just beginning to realize this is misinformation, unfortunately, disseminated by doctors for decades. In fact, we still don’t know how and why antidepressants work. Efficacy itself has long been greatly overestimated.

Thanks to a large number of studies, we now know that antidepressants are no more effective for mild and moderate depression (and probably also for anxiety disorders) than harmless sugar pills without active ingredients, also known as placebos. So why should we continue to run the risk of numerous side effects when there have long been better methods that do not require any medication at all?

Overcoming anxiety and depression without drugs

At the Institute for Modern Psychotherapy in Berlin, we have been working for over ten years on ways to overcome anxiety, depression, and even obsessive-compulsive disorder without medication. One proven successful approach is the targeted stimulation of the brain’s neuroplasticity to overcome psychological problems. With the help of special mental exercises that can even be carried out alone at home, we have achieved a real breakthrough in this field. Now known as the Bernhardt method, this method is so successful that we have already trained over 300 doctors and psychotherapists all over Europe.

For anxiety patients who want to learn the Bernhardt method themselves, there is also a detailed online video course with step-by-step instructions. If you would like to learn more about the Bernhardt Method, you can watch the first video of this online course immediately, free of charge, via this link.

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