From the Research
Paroxetine (Paxil) should be started at a dose of 10-20 mg daily when prescribed for problematic sexual behaviors or paraphilias, with the goal of minimizing gastrointestinal side effects and maximizing efficacy, as supported by studies such as 1 and 2. The medication should be taken at the same time each day, preferably in the morning with food, to maintain a consistent serum level and reduce the risk of adverse effects.
- Key considerations for paroxetine dosing include:
- Initial dose: 10-20 mg daily
- Dose titration: gradual increase by 10 mg increments every 1-2 weeks
- Maximum dose: 60 mg daily
- Therapeutic range: most patients respond to doses between 20-40 mg daily After 4-6 weeks at the initial dose, if the response is inadequate and side effects are tolerable, the dose can be gradually increased to achieve optimal efficacy, as indicated by studies such as 3 and 4. Paroxetine works by increasing serotonin levels in the brain, which can reduce sexual urges and compulsive sexual behaviors by modulating impulse control and sexual drive, as described in 5. Common side effects include nausea, drowsiness, dry mouth, insomnia, and sexual dysfunction, which should be closely monitored and managed by a healthcare provider, as noted in 1 and 2. Importantly, the medication should not be stopped abruptly as this can cause withdrawal symptoms; any discontinuation should be gradual under medical supervision, as advised in 3 and 4. Full therapeutic effects may take 4-8 weeks to develop, so patience is necessary when beginning treatment, and regular follow-up with a healthcare provider is essential to monitor effectiveness and manage any side effects, as recommended in 5 and 2.