From the Guidelines
Paxil (paroxetine) should be initiated at a dose of 10 mg per day, with a maximum dosage of 40 mg per day, either in the morning or evening. This recommendation is based on the guidelines for managing various conditions, including depression and anxiety disorders, as outlined in the study published in the American Family Physician in 2002 1. The study provides a comprehensive overview of the recommended uses, typical side effects, and general cautions associated with selective serotonin reuptake inhibitors (SSRIs), including paroxetine.
Some key points to consider when prescribing Paxil include:
- The initial dosage of 10 mg per day can be adjusted based on the patient's response and tolerance to the medication
- The maximum dosage of 40 mg per day should not be exceeded, as this can increase the risk of adverse effects
- Paxil can be taken in the morning or evening, depending on the patient's preference and schedule
- Patients should be monitored for common side effects, such as sweating, tremors, nervousness, insomnia, and gastrointestinal disturbances, as well as sexual dysfunction and dizziness
It is essential to note that Paxil has a shorter half-life compared to other SSRIs, such as fluoxetine, and may have more anticholinergic effects 1. Therefore, patients should be closely monitored for any adverse effects, and the dosage should be adjusted accordingly. Additionally, patients should be informed about the potential for drug interactions and the importance of reporting any changes in their medication regimen to their healthcare provider.
From the FDA Drug Label
The recommended initial dose is 20 mg/day. Patients were dosed in a range of 20 to 50 mg/day in the clinical trials demonstrating the effectiveness of PAXIL in the treatment of major depressive disorder The recommended dose of PAXIL in the treatment of OCD is 40 mg daily. Patients should be started on 20 mg/day and the dose can be increased in 10-mg/day increments. The target dose of PAXIL in the treatment of panic disorder is 40 mg/day Patients should be started on 10 mg/day. The recommended and initial dosage is 20 mg/day In clinical trials the effectiveness of PAXIL was demonstrated in patients dosed in a range of 20 to 60 mg/day. The recommended starting dosage and the established effective dosage is 20 mg/day. The recommended starting dosage and the established effective dosage is 20 mg/day
The dosing of Paxil varies by condition:
- Major Depressive Disorder: 20 mg/day, with increases up to 50 mg/day
- Obsessive Compulsive Disorder (OCD): 40 mg/day, starting at 20 mg/day
- Panic Disorder: 40 mg/day, starting at 10 mg/day
- Social Anxiety Disorder: 20 mg/day
- Generalized Anxiety Disorder: 20 mg/day
- Posttraumatic Stress Disorder: 20 mg/day 2, 2, 2
From the Research
Paxil Dosing
- The recommended dosing for Paxil (paroxetine) varies depending on the condition being treated 3, 4, 5.
- For major depressive disorder, the effective dose range is 10 to 50 mg/day 3.
- For obsessive-compulsive disorder (OCD), panic disorder, social anxiety disorder, generalized anxiety disorder (GAD), and post-traumatic stress disorder (PTSD), the effective dose range is 20 to 60 mg/day 3, 4, 6.
- In elderly patients, the effective dose range for major depression is 10 to 40 mg/day 3, 4.
- The controlled-release formulation of paroxetine (paroxetine CR) is approved for the treatment of major depression, social anxiety disorder, panic disorder, and premenstrual dysphoric disorder in adults, with a recommended dose range of 25 to 62.5 mg/day 5.
Efficacy and Tolerability
- Paroxetine has been shown to be effective in preventing relapse or recurrence of depression for up to 1 year 3, 4, 5.
- The side-effect profile of paroxetine is largely similar to that of other SSRIs, although it tends to be more sedating and constipating in some patients 5.
- Paroxetine has been found to be effective in individuals with comorbid physical conditions and depressive disorders, with a benefit-risk profile similar to that of other SSRIs 7.