Paroxetine

Brand Veropharm

In stock 853 Items

Available since: 2019-09-19

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Clinical Pharmacology

Adepress - antidepressant. It is a selective serotonin reuptake inhibitor (5-hydroxytryptamine, 5-HT) by brain neurons, which determines its antidepressant effect and effectiveness in the treatment of obsessive-compulsive (OCD) and panic disorder.

Paroxetine has a low affinity for m-cholinergic receptors (has a weak anticholinergic effect), α1, α2 and β-adrenergic receptors, as well as to dopamine (D2), 5HT1-like, 5HT2-like and histamine H1 receptors. Paroxetine does not violate the psychomotor functions and does not potentiate the inhibitory effect on them of ethanol.

According to the study of behavior and EEG in paroxetine, weak activating properties are detected when it is prescribed in doses higher than those necessary for inhibiting serotonin uptake. In healthy volunteers, it does not cause a significant change in the level of blood pressure, heart rate and EEG.

Indications

Depression of all types, including reactive, severe endogenous depression and depression, accompanied by anxiety;
Obsessive Compulsive Disorder (OCD);
Panic disorder, incl. with fear of being in a crowd (agoraphobia);
Social anxiety disorder / social phobia;
Generalized anxiety disorder;
Posttraumatic stress disorder.

Composition

1 tab. contains paroxetine (in the form of hemihydrate hydrochloride) 20 mg;
excipients: calcium hydrophosphate (calcium phosphate disubstituted), corn starch, sodium carboxymethyl starch (primogel), magnesium stearate

Paroxetine is marketed under different brands and generic names, and comes in different dosage forms:

Brand name	Manufacturer	Country	Dosage form
Adepress	Veropharm	Russia	pills
Plizil	Teva	Israel	pills
Rexetin®	Gedeon Richter	Hungary	pills
Paxil	GlaxoSmithKline	UK	pills

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Dosage and Administration

Adepress should be administered 1 time / day, in the morning, during meals, without chewing, drinking water.

The dose is selected individually during the first 2-3 weeks after the start of therapy and is adjusted if necessary. The effect in most cases develops gradually. The dose should be increased by 10 mg every week to achieve a therapeutic effect. The maximum daily dose should not exceed 60 mg / day.

For renal and / or liver failure, the recommended dose is 20 mg / day.

For elderly patients, the daily dose should not exceed 40 mg.

To prevent relapse, maintenance therapy is necessary. After the disappearance of the symptoms of depression, this course may be 4-6 months, and for obsessive and panic disorders - more than 4-6 months.

Avoid abrupt withdrawal of the drug. In order to prevent the development of withdrawal syndrome, discontinuation of the drug Adepress should be carried out gradually.

Adverse reactions

From the side of the central nervous system and peripheral nervous system:often - drowsiness or insomnia, tremor, asthenia, dizziness, anxiety; sometimes - confusion, hallucinations, extrapyramidal disorders, paresthesias, reduced ability to concentrate; rarely - cramps, mania; very rarely - serotonin syndrome (agitation, hyperreflexia, diarrhea), panic disorders.
From the senses: in some cases - visual impairment, mydriasis.
From the musculoskeletal system: rarely - myasthenia, myoclonia, arthralgia, myalgia.
From the urinary system: frequent urination; rarely - urinary retention.
From the reproductive system:ejaculatory disorders, libido disorders; rarely - hyperprolactinemia / galactorrhea, anorgasmia.
From the digestive system:loss of appetite, nausea, vomiting, dry mouth; sometimes constipation or diarrhea; in some cases - hepatitis.
Since the cardiovascular system: orthostatic hypotension.
Allergic reactions:rarely - rash, urticaria, ecchimatosis, pruritus, angioedema.
Other:increased sweating; in isolated cases - hyponatremia, impaired secretion of antidiuretic hormone.

Contraindications

Simultaneous administration of MAO inhibitors and a period of 14 days after their withdrawal;
Unstable epilepsy;
Pregnancy and lactation (breastfeeding);
Childhood;
Hypersensitivity to the drug.

Carefully: in liver failure, renal failure, angle-closure glaucoma, prostatic hyperplasia, mania, cardiac pathology, epilepsy, convulsive states, simultaneous administration of electropulse therapy, simultaneous administration of drugs that increase the risk of bleeding, the risk factors for increased bleeding and diseases that increase the risk of bleeding, as well as elderly patients.

Special instructions

In order to avoid the development of neuroleptic malignant syndrome, Adepress should be prescribed with caution to patients taking neuroleptics.

In elderly patients, while receiving Adepress, hyponatremia is possible.

In some cases, it is necessary to adjust the dose of simultaneously used insulin and / or oral hypoglycemic drugs.

With the development of seizures, treatment with Adepress is stopped.

At the first signs of mania, the drug should be withdrawn.

During the first few weeks of treatment with Adepress, the patient’s condition should be carefully monitored for possible suicidal attempts.

During therapy Adepressom should refrain from taking alcohol in connection with the strengthening of its toxic effect.

Influence on ability to drive motor transport and control mechanisms
Despite the fact that paroxetine does not impair cognitive and psychomotor functions, patients should refrain or exercise extreme caution when driving and while engaging in other potentially dangerous activities that require increased concentration and psychomotor speed.