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General side effects are mostly present during the
first 1-4 weeks while the body adapts to the drug.
Almost all SSRIs are known to cause either one or
more of these symptoms. A person receiving paroxetine
treatment may experience a few, all, or none of the
following side-effects, and most side-effects will
disappear or lessen with continued treatment, though
some may last throughout the duration. Side effects
are also often dose-dependent, with fewer and/or less
severe symptoms being reported at lower dosages, and
more and/or more severe symptoms being reported at
higher dosages. Increases or changes in dosage may
also cause symptoms to reappear or worsen.
9 December 2004 European Medicines Agency (EMEA),
i.e. the Committee for Medicinal Products for Human
Use (CHMP), informed patients, prescribers and parents
that paroxetine should not be prescribed to children.
CHMP gave a warning to prescribers recommending close
monitoring of adult patients at high risk of suicidal
behaviour and/or suicidal thoughts. In other words,
CHMP does not prohibit use of paroxetine with adults
but stresses extreme caution in actual usage. Also
withdrawal reactions upon stopping treatment is mentioned
and therefore it is recommended to gradually reduce
the dose over several weeks or months if decision
of withdrawal is made.
Most common
- Weight loss or gain (most often gain rather than
loss)
- Headache
- Nausea
- Dry mouth
- Increased sweating
- Drowsiness/Somnolence or Insomnia
- Increased or decreased appetite
- Constipation or diarrhea
- Inability to achieve orgasm
- Partial or complete loss of libido (sexual desire)
- Erectile dysfunction
- Tremor
- Vertigo/Dizziness/Motion sickness
Less common
Check with your doctor if these continue or are bothersome.
- Increased feelings of depression and anxiety (initially)
- Apathy
- Loss of empathy
- Flattening of emotional response
- Nocturnal salivation
- Nocturnal bruxism (teeth grinding)
- Pupil dilation
- Asthenia or muscle weakness
- Muscle ache
- Pruritis
- Rash
- Nightmares or change in dreams
- Change in sense of taste
Rare
See your doctor if you have any of these symptoms.
- Myoclonus (involuntary muscle twitching)
- Sodium depletion
- Severe restlessness or akathisia
- Uncharacteristic levels of aggression (especially
in children and teens)
- Uncharacteristic risk taking
Very rare but serious
- Suicidal ideation and Suicide
- Serotonin syndrome
- Bipolar mania or hypomania
- Schizophrenia (unverified)
- Jaw, neck, and back muscle spasms
- Fever, chills, sore throat, or flu-like symptoms
- Yellowing of the skin or eyes (Jaundice)
- Black, tarry stools (this can indicate upper GI
bleeding)
Other
- Teratogenicity: Pregnant women are advised not
to take the drug due to possible fetal heart defects.
Paroxetine and other SSRIs have been shown to cause
sexual side effects in most patients, both males and
females. Although usually reversible, these sexual
side effects can sometimes last for months, years
or possibly indefinitely even after the drug has been
completely withdrawn. This disorder is known as Post
SSRI Sexual Dysfunction.
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