Anyone already taking blood thinners, painkillers, anti-rheumatics, or St. John’s wort should avoid Paroxetine, as significant interactions can occur between these medications. The same applies to Lithium and many antidepressants. You can find out exactly which ones and what symptoms to watch out for in this blog article from the Institute for Modern Psychotherapy in Berlin.
Overview of All Topics
What is Paxil (Paroxetine), and when is it used?
Paroxetine is an antidepressant of the SSRI class, used to treat mental health conditions such as depression and anxiety disorders. SSRI class means that the medication increases serotonin levels. Paroxetine has been on the market for a long time and is still prescribed by many doctors, even though there are now other treatment methods that often achieve significantly better results. You should always keep this in mind, as Paroxetine 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 use of Paroxetine and St. John’s Wort or Lithium can lead to serious reactions, such as the development of serotonin syndrome. This syndrome is characterized by sweating, high blood pressure, nausea, diarrhea, headaches, hallucinations, tremors, and muscle cramps.
Caution with Paxil and blood-thinning medication
Combining Paroxetine with blood-thinning medications, such as Warfarin or Aspirin, can increase the risk of bleeding. It is important for doctors to carefully monitor and adjust the dosages of these medications as needed to avoid unwanted bleeding events.
Paxil and Advil or Aleve
Taking Paroxetine together with non-steroidal anti-inflammatory drugs (NSAIDs), such as Ibuprofen or Naproxen, can increase the risk of gastrointestinal bleeding. Patients should avoid such combinations or use them under medical supervision, especially if they already have stomach issues.
Paxil and other antidepressants or migraine medications
Interactions can also occur when Paroxetine is combined with other serotonergic medications, 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 agitation, confusion, rapid heartbeat, or significantly elevated body temperature.
Paxil and antipsychotics or medication for epilepsy
Paroxetine can affect blood levels of certain anticonvulsants (medications for epilepsy) and antipsychotics. This requires close monitoring of medication levels and possible adjustments to ensure therapeutic effectiveness.
Paxil and Nolvadex
Breast cancer patients are often treated with Tamoxifen. When these patients also take the antidepressant Paroxetine, the conversion of Tamoxifen into ist active metabolites is inhibited. According to a study published in the British Medical Journal, this leads to an increased breast cancer mortality rate among affected patients.
Paxil: Interaction with the cough suppressant Delsym (DXM)
When these two medications are taken together, serotonin syndrome can occur. In addition to the previously mentioned symptoms, one can also expect restlessness, increased heart rate, rapid breathing, and dilated pupils.
Paxil (Paroxetine) with alcohol or other psychoactive substances
Alcohol and other psychoactive substances can enhance the effects of Paroxetine, leading to increased drowsiness and reduced reaction time. These combinations should also be avoided to ensure patient safety.
Paxil: Caution with these pre-existing conditions
If any of the following conditions are present, Paroxetine should only be administered under strict medical supervision:
- Epilepsy
- Diabetes
- Liver damage
- Kidney damage
- Glaucoma or narrow-angle glaucoma
- Heart diseases
- Bleeding disorders
Paxil: Not for pregnant women and breastfeeding mothers
Paroxetine can cause heart defects in the unborn child, especially if the medication is taken during the first three months of pregnancy. In newborns, Paroxetine can also trigger pulmonary hypertension. This means that the vascular resistance and thus the blood pressure in the lung circulation of the child increases. The consequences can be dramatic, as the infant may be less able to absorb oxygen through the lungs. To compensate for this deficit, the heart has to work significantly harder, which can in turn lead to long-term heart damage.
Paxil: All side effects listed by frequency
Paroxetine is a selective serotonin reuptake inhibitor (SSRI). By increasing serotonin levels, it is intended to alleviate mental health conditions such as depression and anxiety disorders. This is concerning because, to date, there is not a single study proving that happy or anxiety-free people have higher serotonin levels than those with depression or anxiety. However, numerous studies have documented the side effects that can occur when taking Paroxetine.
Side effects of Paxil
Paroxetine can cause a range of side effects, from mild to severe. Special attention should be paid to side effects that are very common or common. Very common means that the problems occur in at least 1 in 10 users. Common means that 1 to 10 out of 100 users are affected.
Widespread side effects of Paxil: (Occur in at least 1 in 10 people)
- Difficulty concentrating
- Nausea
- Sexual dysfunction
Frequently side effects of Paxil: (Occur in 1 to 10 out of 100 people)
- Loss of appetite
- Increased cholesterol levels
- Fatigue
- Insomnia
- Inner tension and restlessness
- Nightmares
- Dizziness
- Tremors
- Headaches
- Blurred vision
- Excessive yawning
- Constipation or diarrhea
- Vomiting
- Dry mouth
- Sweating
- Weakness
- Weight gain
Occasional side effects of Paxil: (Occur in 1 to 10 out of 1,000 people)
- Altered blood sugar levels in diabetics
- Abnormal bleeding of the skin or mucous membranes
- Confusion
- Hallucinations
- Movement disorders
- Dilated pupils
- Rapid heartbeat
- Skin rashes
- Itching
- Incontinence
- Blood pressure fluctuations
Rare side effects: (Occur in 1 to 10 out of 10,000 people)
- Manic reactions
- Anxiety
- Feelings of alienation
- Panic attacks
- Akathisia (restlessness)
- Seizures
- Restless Legs Syndrome (RLS)
- Slow heartbeat
- Elevated liver enzyme levels
- Reduced sodium levels in the blood
Important Note:
The information regarding interactions and possible side effects generally pertains to the active ingredient of the medication and may therefore differ from the manufacturer’s information for your specific medication. If in doubt, please seek further information from your doctor or pharmacist.
Suicidal thoughts under Paxil
There are alarming reports of recurring suicidal thoughts and behaviors in some individuals taking Paroxetine, especially among young people. The U.S. Food and Drug Administration (FDA) has issued warnings about an increased risk of suicide in children, adolescents, and young adults who take SSRI medications.
Withdrawal symptoms after stopping Paxil
Paroxetine is often taken for extended periods, and the decision to discontinue the medication can be influenced by various factors. Some patients feel better and want to see if they can manage without medication, often driven by the legitimate fear of potential long-term effects, which will be discussed later. Others no longer wish to endure the side effects described earlier and consider alternative treatment approaches.
However, suddenly stopping Paroxetine can frequently lead to severe withdrawal symptoms that significantly impact patients’ lives. The range of possible symptoms is very diverse:
Symptoms of Paxil withdrawal are:
- Irritability
- Sensation of “electric shocks” in the head
- Restlessness
- Dizziness
- Insomnia
- Severe mood swings
- Feeling emotionally overwhelmed
- Digestive issues
- 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 range from weeks to months. Some people experience only mild symptoms, while others struggle with more intense and prolonged effects. Some of our patients who had taken Paroxetine for several years before coming to us even reported symptoms that were still noticeable years later.
Medical supervision is essential during Paxil withdrawal.
Withdrawal symptoms from Paroxetine can often be significantly reduced when the medication is tapered off slowly and under medical supervision. However, caution is advised if there is a suggestion to switch to another antidepressant during withdrawal. This carries the risk of trading one problem for another. It is better to follow these self-help measures:
- Ensure you get enough sleep.
- Exercise outdoors for at least 30 minutes daily.
- Activate the self-healing power of your neuroplasticity, e.g., through the 10-Sentence Method or the 5-Channel Technique.
Long-term damage and cognitive impairment from Paxil
concerns about potential long-term damage from the prolonged use of Paroxetine. In addition to cognitive impairments, memory problems and concentration issues are increasingly being reported.
Moreover, studies* indicate that not only Paroxetine but other SSRI medications as well 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 medications like Paroxetine is entirely understandable. However, for this to be effective, these psychological problems would have to be caused by a serotonin deficiency. That this is a misconception, unfortunately propagated by doctors for decades, is only gradually becoming widely recognized.
Overcoming anxiety and depression without drugs
At the Institute for Modern Psychotherapy in Berlin, we have been exploring how to overcome anxiety, depression, and even obsessive-compulsive disorders without medication for over 10 years. One particularly successful approach has been the targeted stimulation of one’s neuroplasticity to overcome psychological problems. Using specific mental exercises, which can even be done alone at home, we have achieved a real breakthrough. This method, now known as the Bernhardt Method, has been so successful that we have already trained over 300 doctors, psychotherapists, and alternative practitioners in psychotherapy.
Troy A.
Tampa, Florida