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Paxil CR is a prescription antidepressant medication used to treat certain mental health conditions, including major depressive disorder, panic disorder, and social anxiety disorder. It is also approved for premenstrual dysphoric disorder (PMDD), a severe form of mood disturbance associated with the menstrual cycle.
It contains paroxetine hydrochloride, an active ingredient belonging to a class of medications called selective serotonin reuptake inhibitors (SSRIs).
SSRIs work by blocking the reuptake of serotonin, a chemical messenger involved in regulating mood, anxiety, sleep, and emotional responses. This increases the availability of serotonin for communication between nerve cells in the brain.
Paxil CR is formulated as a controlled-release tablet, meaning the medication is released gradually rather than all at once. This helps provide a more controlled delivery of paroxetine throughout the day.
Unlike medications that provide immediate relief, Paxil CR generally requires several weeks of regular treatment before its full therapeutic benefits become noticeable.
Paxil CR is approved for major depressive disorder, panic disorder, social anxiety disorder, and premenstrual dysphoric disorder in adults. It helps manage symptoms but should only be taken under medical supervision.Â
Paxil CR is used to treat major depressive disorder, a mental health condition that causes persistent feelings of sadness, hopelessness, or a loss of interest in everyday activities.
Depression can affect how a person thinks, feels, behaves, and responds to daily situations.
Symptoms may include persistent sadness, low energy, difficulty concentrating, loss of motivation, and reduced interest in activities that were previously enjoyable.
Some patients may also experience changes in appetite, sleep disturbances, feelings of worthlessness, or difficulty making decisions.
Major depressive disorder can interfere with work, relationships, and daily responsibilities.
Paxil CR works by increasing serotonin availability in the brain, which may help improve mood and reduce certain emotional and physical symptoms associated with depression.
Some patients may notice improvements in sleep, appetite, or energy before experiencing significant changes in mood.
However, the medication does not provide immediate relief, and several weeks of treatment may be necessary before its full benefits develop.
Your healthcare provider will monitor your response and determine whether dosage adjustments are needed.
Paxil CR may help reduce persistent sadness, loss of interest, low energy, and other symptoms of major depressive disorder. Consistent treatment and follow-up appointments are important for evaluating its effectiveness.
Paxil CR is also prescribed to treat panic disorder, a condition characterized by recurrent, unexpected panic attacks.
A panic attack is a sudden episode of intense fear or discomfort that may occur even when there is no immediate danger.
Symptoms can include a racing heartbeat, sweating, trembling, chest discomfort, dizziness, shortness of breath, and a feeling of losing control.
Some individuals may also experience a fear of dying or a sensation of being detached from their surroundings.
Panic disorder can cause ongoing anxiety about having another panic attack.
This fear may lead patients to avoid certain places, activities, or situations associated with previous attacks.
Paxil CR helps regulate serotonin activity in the brain, which may reduce the frequency and severity of panic attacks over time.
It may also help decrease anticipatory anxiety, meaning the persistent worry about experiencing another episode.
However, Paxil CR is not intended to stop a panic attack immediately after it begins.
During the early stages of treatment, some patients may experience temporary increases in anxiety or restlessness.
Your healthcare provider may begin treatment at a lower dosage and adjust it gradually to improve tolerance.
Paxil CR may help reduce panic attacks and ongoing anxiety associated with panic disorder. It is intended for regular treatment rather than immediate relief during an acute panic attack.
Paxil CR is used to manage social anxiety disorder, also called social phobia.
Social anxiety disorder involves persistent and excessive fear of social situations in which a person may feel observed, judged, criticized, or embarrassed.
Common situations that trigger symptoms include speaking in public, meeting unfamiliar people, participating in group discussions, or attending social gatherings.
Individuals with social anxiety disorder may experience intense nervousness, rapid heartbeat, sweating, trembling, blushing, or difficulty speaking.
Some people may avoid social situations entirely because of fear or discomfort.
Over time, this avoidance can interfere with work, education, relationships, and everyday activities.
Paxil CR helps reduce symptoms of social anxiety by affecting serotonin signaling in the brain.
With consistent treatment, patients may experience less anxiety in social situations and feel more comfortable participating in daily activities.
However, improvement develops gradually, and several weeks of treatment may be necessary.
Psychotherapy, particularly cognitive behavioral therapy (CBT), may also be recommended alongside medication.
Paxil CR may help reduce excessive fear, nervousness, and avoidance associated with social anxiety disorder, allowing patients to participate more comfortably in social activities.
Paxil CR is also approved for the treatment of premenstrual dysphoric disorder.
PMDD is a severe form of premenstrual mood disturbance that causes significant emotional and physical symptoms before menstruation.
Symptoms typically develop during the luteal phase of the menstrual cycle, which occurs after ovulation and before menstruation.
They usually improve shortly after menstrual bleeding begins.
Patients with PMDD may experience severe irritability, mood swings, anxiety, sadness, difficulty concentrating, fatigue, and feelings of being overwhelmed.
Some individuals may also experience changes in appetite, sleep disturbances, breast tenderness, or bloating.
Unlike ordinary premenstrual symptoms, PMDD can significantly interfere with relationships, work, and daily activities.
Paxil CR helps regulate serotonin activity, which may improve mood-related symptoms associated with PMDD.
Depending on the patient’s needs, treatment may be prescribed continuously throughout the menstrual cycle or intermittently during the luteal phase.
Your healthcare provider will determine the most appropriate dosing schedule.
Paxil CR may help reduce severe mood changes, irritability, anxiety, and other symptoms associated with PMDD. Treatment should follow the specific schedule prescribed by your healthcare provider.Â
Obsessive-compulsive disorder is a mental health condition characterized by recurring unwanted thoughts, images, or urges called obsessions, along with repetitive behaviors or mental rituals called compulsions.
Obsessions may involve fears of contamination, concerns about safety, or persistent doubts.
Compulsions may include repeated checking, cleaning, counting, or arranging objects in a particular way.
These symptoms can consume significant amounts of time and interfere with daily activities.
Paroxetine, the active ingredient in Paxil CR, is approved for OCD treatment in its conventional immediate-release formulation.
However, Paxil CR is not specifically approved for OCD under its current Canadian or U.S. prescribing information.
In selected circumstances, a healthcare provider may consider an extended-release formulation based on individual treatment needs, but this would be considered an off-label use.
Cognitive behavioral therapy involving exposure and response prevention (ERP) is another established treatment for OCD.
Your healthcare provider will determine which medication formulation and treatment approach are most appropriate.
Paroxetine may be used to treat OCD, but the approved indication applies to conventional Paxil rather than Paxil CR. Do not assume that the two formulations have identical approved uses.Â
Post-traumatic stress disorder is a mental health condition that may develop after experiencing or witnessing a traumatic event.
Symptoms may include distressing memories, nightmares, flashbacks, heightened alertness, sleep disturbances, and avoidance of reminders associated with the trauma.
Some individuals may also experience persistent anxiety, emotional numbness, irritability, or difficulty concentrating.
PTSD can affect emotional well-being, relationships, sleep, and daily functioning.
Paroxetine may help reduce certain PTSD symptoms by influencing serotonin activity in the brain.
However, Paxil CR is not specifically approved for PTSD under current Canadian or U.S. prescribing information.
The immediate-release formulation of Paxil is approved for PTSD treatment in adults.
In addition to medication, trauma-focused psychotherapy is an important treatment option for many patients with PTSD.
Your healthcare provider will assess your symptoms, medical history, and previous treatments before recommending an appropriate approach.
Paroxetine is an established medication option for PTSD, but the approved indication applies to immediate-release Paxil rather than Paxil CR.
Paxil CR contains paroxetine, a selective serotonin reuptake inhibitor that affects communication between nerve cells in the brain.
Serotonin is a neurotransmitter involved in regulating mood, emotional responses, anxiety, and several other bodily functions.
Normally, after serotonin is released between nerve cells, much of it is taken back up into the releasing cell through a process called reuptake.
Paroxetine blocks the serotonin transporter responsible for this process.
As a result, serotonin remains available for longer in the space between nerve cells.
Over time, this contributes to changes in brain signalling that may help reduce symptoms of depression and certain anxiety disorders.
Increases Serotonin Availability
Paxil CR blocks serotonin reuptake, increasing the amount of serotonin available for nerve cell communication.
Helps Regulate Mood
Changes in serotonin signalling may help improve mood and reduce symptoms such as persistent sadness, hopelessness, and loss of interest.
Reduces Anxiety Symptoms
Paxil CR may help reduce excessive worry, panic symptoms, and anxiety associated with certain mental health conditions.
Provides Controlled Medication Release
The controlled-release formulation gradually releases paroxetine after administration.
This differs from immediate-release paroxetine, although both formulations contain the same active ingredient.
Paxil CR works by inhibiting serotonin reuptake, helping regulate mood and anxiety-related brain signaling over time.
The time needed for Paxil CR to produce noticeable benefits depends on the condition being treated, prescribed dosage, and individual response.
Some patients may notice early improvements in sleep, appetite, or anxiety symptoms within the first one to two weeks.
However, significant improvement in depression or anxiety often requires approximately four to six weeks of consistent treatment.
Some patients, particularly those being treated for panic disorder or social anxiety disorder, may require additional time before the full therapeutic response can be assessed.
During the early stages of treatment, your healthcare provider may monitor symptoms and side effects closely.
Do not increase your dosage if you do not notice immediate improvement.
Your healthcare provider will determine whether the dosage should be adjusted or another treatment considered.
Paxil CR may begin improving certain symptoms within the first few weeks, but its full benefits often take four to six weeks or longer to develop. Continue treatment as prescribed and attend recommended follow-up appointments.
Paxil CR is available as controlled-release tablets in strengths of 12.5 mg, 25 mg, and 37.5 mg, depending on availability.
It is generally taken once daily in the morning, with or without food.
The tablets must be swallowed whole and should not be crushed, chewed, or split because doing so may interfere with the controlled-release formulation.
Common side effects include nausea, dizziness, sleep disturbances, sweating, dry mouth, constipation, and sexual dysfunction.
More serious risks include serotonin syndrome, abnormal bleeding, low sodium levels, and worsening suicidal thoughts or behavior, particularly in younger patients during the early stages of antidepressant treatment.
Paxil CR should not be stopped abruptly because discontinuation may cause symptoms such as dizziness, nausea, anxiety, irritability, and electric-shock-like sensations.
It is not approved for use in children or adolescents younger than 18 years.
Seek urgent medical attention for new or worsening suicidal thoughts, severe agitation, confusion with fever and muscle rigidity, or other serious symptoms. Do not stop Paxil CR suddenly or change your dosage without medical guidance.
Paxil CR is a prescription antidepressant used to treat certain mental health conditions, including major depressive disorder, panic disorder, social anxiety disorder, and premenstrual dysphoric disorder (PMDD).
It contains paroxetine, a medication belonging to a class of drugs called selective serotonin reuptake inhibitors (SSRIs). These medications work by increasing the availability of serotonin, a chemical messenger involved in regulating mood, anxiety, and emotional responses.
Paxil CR is available as a controlled-release tablet, which gradually releases the medication after it is swallowed.
It is generally taken once daily, preferably in the morning, with or without food. The appropriate dosage depends on the condition being treated, the patient’s age, medical history, and response to treatment.
Because Paxil CR is a controlled-release formulation, it is important to distinguish it from immediate-release paroxetine tablets. These formulations have different dosing recommendations and should not be substituted without medical guidance.
Take Paxil CR exactly as prescribed. Swallow the tablets whole, use the medication consistently, and do not increase, decrease, or stop your dosage without consulting your healthcare provider.
Paxil CR tablets should be taken by mouth according to the instructions provided by your healthcare provider.
Swallow the tablet whole with a glass of water. Do not crush, chew, split, or dissolve the tablet because doing so may interfere with its controlled-release properties.
Paxil CR is designed to release paroxetine gradually rather than all at once. Altering the tablet may change how the medication is delivered and increase the risk of unwanted effects.
The medication can be taken with or without food. However, taking Paxil CR with a meal may help reduce nausea or stomach discomfort in some patients.
Paxil CR is usually taken once daily in the morning. Try to take it at approximately the same time each day to help maintain consistent medication levels and reduce the likelihood of missed doses.
If the medication causes sleep disturbances, drowsiness, or other side effects, contact your healthcare provider. Do not change your dosing schedule independently.
Swallow Paxil CR tablets whole and take them at approximately the same time each day. Never crush, chew, or split the controlled-release tablets.
The recommended dosage of Paxil CR varies depending on the condition being treated, the patient’s age, other medications, and individual response.
Healthcare providers generally begin treatment with a lower dose to help reduce the likelihood of side effects.
For adults with major depressive disorder, the usual starting dose is 25 mg once daily.
For panic disorder, treatment generally begins with 12.5 mg once daily because some patients may experience increased anxiety or restlessness during the early stages of treatment.
For social anxiety disorder, the usual starting dose is 12.5 mg once daily.
For premenstrual dysphoric disorder, treatment may begin with 12.5 mg once daily, depending on the prescribed schedule.
The dosage may be increased gradually if symptoms remain uncontrolled and the medication is well tolerated.
Importantly, the maximum recommended dosage is not the same for every condition. The commonly stated maximum of 50–60 mg daily does not accurately describe all Paxil CR dosing schedules because it may refer to immediate-release paroxetine or other formulations.
Older adults and patients with certain medical conditions, including severe kidney or liver impairment, may require lower doses.
Your healthcare provider will determine the appropriate dose and make adjustments based on your symptoms and treatment response.
Do not use a general dosage range to determine how much Paxil CR to take. Follow the specific dose prescribed for your condition and formulation.
Paxil CR is often started at a relatively low dosage to help the body adjust to the medication.
During the first few weeks of treatment, some patients may experience nausea, dizziness, headaches, sleep disturbances, or increased nervousness.
These effects may become less noticeable as the body adjusts, although this varies between individuals.
Starting with a lower dose allows your healthcare provider to assess how well you tolerate the medication before considering an increase.
If symptoms remain uncontrolled, your healthcare provider may gradually adjust the dose.
This process is called dose titration.
Dose adjustments are generally made at intervals of at least one week, depending on the condition being treated and the prescribing instructions.
Increasing the dosage too quickly may raise the risk of side effects without necessarily producing faster symptom relief.
Do not increase your Paxil CR dosage if you do not notice immediate improvement. Your healthcare provider will determine when and whether a dosage adjustment is appropriate.
Yes. Paxil CR can generally be taken with or without food.
Food does not need to be avoided for the medication to work effectively.
However, some patients may experience nausea or mild stomach discomfort when starting paroxetine.
Taking Paxil CR with breakfast may help reduce these symptoms.
Try to follow a consistent daily routine to make it easier to remember your medication.
Avoid excessive alcohol consumption during treatment because alcohol may worsen dizziness, drowsiness, and impaired judgment.
Paxil CR may be taken with or without food. If you experience mild nausea, taking the medication with a meal may improve comfort.
Paxil CR may be prescribed to manage premenstrual dysphoric disorder, a condition that causes significant emotional and physical symptoms before menstruation.
Symptoms may include severe irritability, mood swings, anxiety, sadness, difficulty concentrating, and sleep disturbances.
Your healthcare provider may prescribe Paxil CR using one of two treatment schedules.
Continuous Dosing
With continuous dosing, Paxil CR is taken once daily throughout the entire menstrual cycle.
This approach may be recommended when symptoms are persistent or when continuous treatment is considered more appropriate.
Intermittent Dosing
With intermittent dosing, Paxil CR is generally taken during the luteal phase of the menstrual cycle.
The luteal phase begins after ovulation and continues until menstruation starts.
Under established Paxil CR treatment schedules, intermittent dosing generally begins approximately 14 days before the expected onset of menstruation and continues through the first full day of menstrual bleeding.
Your healthcare provider will determine which schedule is appropriate based on your symptoms and menstrual cycle.
Do not begin or stop Paxil CR at different points in your cycle without medical guidance.
Paxil CR may be prescribed continuously or during the luteal phase for PMDD. Follow the specific schedule recommended by your healthcare provider.
If you forget to take a dose of Paxil CR, take it as soon as you remember, unless it is almost time for your next scheduled dose.
If your next dose is approaching, skip the missed dose and continue with your regular dosing schedule.
Do not take two doses together to make up for a missed tablet.
Taking additional paroxetine may increase the risk of nausea, dizziness, excessive sweating, agitation, and other adverse effects.
Because paroxetine can cause discontinuation symptoms when doses are missed, some patients may experience dizziness, irritability, or unusual sensations after an interruption in treatment.
If you miss several consecutive doses, contact your healthcare provider before restarting your usual schedule.
Never double your Paxil CR dose to make up for a missed dose. Contact your healthcare provider if you miss multiple doses or develop unusual symptoms.
Paxil CR does not usually provide immediate relief from depression or anxiety symptoms.
Although paroxetine begins affecting serotonin signaling after administration, the full therapeutic response generally develops gradually.
Some patients may notice improvements in sleep, appetite, or energy during the first one to two weeks of treatment.
However, significant improvement in depression, panic disorder, or social anxiety disorder may take approximately four to six weeks or longer.
Your healthcare provider will monitor your response and determine whether treatment adjustments are necessary.
Do not increase your dosage because you do not notice immediate improvement.
Continue taking Paxil CR consistently, even if you do not feel better right away. Several weeks may be necessary before the medication provides its full benefits.
Do not stop taking Paxil CR suddenly without consulting your healthcare provider, even if your symptoms have improved.
Paxil CR helps manage depression and certain anxiety disorders, but stopping treatment too early may allow symptoms to return.
Paroxetine is also associated with discontinuation symptoms, particularly when treatment is stopped abruptly or the dosage is reduced too quickly.
These symptoms occur because the nervous system needs time to adjust to changes in serotonin signaling.
Possible discontinuation symptoms include dizziness, nausea, headaches, unusual fatigue, irritability, anxiety, mood swings, and sleep disturbances.
Some patients may experience sensations resembling electric shocks, often described as brain zaps.
Other symptoms may include sweating, vivid dreams, restlessness, or difficulty concentrating.
The likelihood and severity of these symptoms depend on several factors, including dosage, duration of treatment, and individual sensitivity.
Your healthcare provider will generally recommend reducing the dosage gradually when treatment needs to be discontinued.
This process is called tapering.
The tapering schedule should be individualized, and some patients may require a slower reduction if symptoms develop.
Never stop Paxil CR abruptly or reduce your dosage without medical guidance. Gradual tapering helps reduce the likelihood of discontinuation symptoms.
Contact your healthcare provider if your depression, anxiety, panic symptoms, or other mental health symptoms become worse while taking Paxil CR.
Some patients may experience increased anxiety, agitation, irritability, restlessness, or sleep disturbances when treatment begins or the dosage is changed.
These symptoms may improve over time, but significant or worsening changes require medical assessment.
Antidepressants, including Paxil CR, may increase the risk of suicidal thoughts or behaviors in some younger patients, particularly during the early stages of treatment or following dosage adjustments.
Your healthcare provider should monitor for unusual changes in mood, behavior, or emotional well-being.
Paxil CR may also trigger mania or hypomania in susceptible individuals, particularly those with bipolar disorder.
Possible warning signs include unusually elevated mood, extreme irritability, racing thoughts, reduced need for sleep, or impulsive behavior.
Contact your healthcare provider promptly if you experience worsening depression, severe agitation, unusual behavioral changes, or symptoms of mania. Seek emergency help if you experience suicidal thoughts with an immediate risk of acting on them.
Paxil CR should only be used according to your healthcare provider’s instructions.
Do not combine Paxil CR with other medications that increase serotonin activity unless your healthcare provider confirms that the combination is appropriate.
Certain medications, including monoamine oxidase inhibitors (MAOIs), are contraindicated with Paxil CR because of the risk of serotonin syndrome.
Serotonin syndrome is a potentially serious condition caused by excessive serotonin activity. Symptoms may include agitation, confusion, fever, sweating, diarrhea, tremors, and muscle stiffness.
Tell your healthcare provider if you have bipolar disorder, seizures, liver disease, kidney disease, or a history of abnormal bleeding.
Paroxetine may also increase bleeding risk, particularly when combined with nonsteroidal anti-inflammatory drugs (NSAIDs), aspirin, or anticoagulants.
If you are pregnant, planning to become pregnant, or breastfeeding, discuss the potential benefits and risks of treatment with your healthcare provider.
Take Paxil CR consistently, swallow the controlled-release tablets whole, and do not change your dosage or discontinue treatment without medical guidance.
Paxil CR (Paroxetine) is available in the following forms and strength:
Paxil CR is a prescription antidepressant used to treat certain mental health conditions, including major depressive disorder, panic disorder, social anxiety disorder, and premenstrual dysphoric disorder (PMDD).
It belongs to a class of medications called selective serotonin reuptake inhibitors (SSRIs), which work by increasing the availability of serotonin, a chemical messenger involved in regulating mood, anxiety, and emotional responses.
Although Paxil CR can help improve symptoms of depression and anxiety, it may also cause serious side effects that require careful monitoring.
Some patients may be more susceptible to these effects because of their age, medical history, or other medications they take.
Paxil CR should only be used under medical supervision. Tell your healthcare provider about your mental health history, medical conditions, and all medications before starting treatment.
Paxil CR may increase the risk of suicidal thoughts and behavior in children, adolescents, and young adults, particularly those aged 24 years and younger.
This risk may be greater during the first few months of treatment or when the dosage is increased or decreased.
Although Paxil CR is prescribed to treat depression and certain anxiety disorders, some patients may initially experience increased agitation, restlessness, irritability, or changes in mood.
These symptoms may occasionally be associated with worsening depression or suicidal thoughts.
Patients, family members, and caregivers should watch for unusual changes in behavior, especially during the early stages of treatment.
Warning signs may include worsening depression, increased anxiety, panic attacks, severe agitation, unusual impulsiveness, or thoughts of self-harm.
Paxil CR is not approved for use in children and adolescents younger than 18 years.
However, adults of all ages should be monitored for worsening mood or suicidal thoughts during antidepressant treatment.
Contact your healthcare provider immediately if you experience new or worsening suicidal thoughts, severe agitation, or unusual behavioral changes. If there is an immediate risk of self-harm, seek emergency medical assistance.
Paxil CR may cause a potentially life-threatening condition called serotonin syndrome.
Serotonin syndrome occurs when excessive serotonin activity develops in the brain and nervous system.
Because Paxil CR increases serotonin availability, combining it with certain other medications may raise the risk of this condition.
Examples include other antidepressants, monoamine oxidase inhibitors (MAOIs), certain opioid medications such as tramadol and fentanyl, and triptans used to treat migraines.
Other substances, including linezolid, methylene blue, and St. John’s wort, may also increase serotonin-related risks.
Symptoms of serotonin syndrome may include agitation, confusion, hallucinations, rapid heartbeat, excessive sweating, fever, diarrhea, tremors, and muscle stiffness.
More severe cases may cause dangerously high body temperature, seizures, irregular heartbeat, or loss of consciousness.
Serotonin syndrome can occur when treatment begins, the dosage increases, or another serotonin-affecting medication is added.
Your healthcare provider will review your medication list to identify combinations that should be avoided.
Stop taking Paxil CR and seek emergency medical attention if you develop symptoms suggesting serotonin syndrome, particularly fever with confusion, muscle stiffness, tremors, or a rapid heartbeat. Do not restart treatment without medical guidance.
Paxil CR may increase the risk of abnormal bleeding.
Serotonin plays a role in platelet function, which helps the blood form clots and stop bleeding after an injury.
By affecting serotonin uptake into platelets, paroxetine may interfere with normal blood clotting.
The risk may increase when Paxil CR is combined with medications that also affect bleeding.
These include nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen and naproxen, aspirin, warfarin, and other anticoagulants.
Some patients may experience easy bruising, frequent nosebleeds, or bleeding gums.
More serious bleeding may involve the stomach, intestines, or other internal organs.
Warning signs include black or tarry stools, vomiting blood, blood in the urine, or unexplained heavy bleeding.
Patients with a history of bleeding disorders or stomach ulcers should inform their healthcare provider before starting Paxil CR.
Report unusual bruising, frequent nosebleeds, or persistent bleeding to your healthcare provider. Seek emergency medical attention if you vomit blood, pass black or bloody stools, or experience severe uncontrolled bleeding.
Paxil CR should be used during pregnancy only after a careful assessment of the potential benefits and risks.
Paroxetine has been associated with concerns about fetal development, particularly following exposure during early pregnancy.
Some studies have reported an increased risk of certain congenital heart defects when paroxetine is taken during the first trimester. However, the findings vary between studies, and the absolute risk for an individual pregnancy may remain relatively low.
Exposure to SSRIs during late pregnancy may also cause temporary symptoms in newborn babies.
These may include irritability, tremors, feeding difficulties, breathing problems, or unusual changes in muscle tone.
Some newborns may require additional medical monitoring after delivery.
SSRIs have also been associated with a rare but serious condition called persistent pulmonary hypertension of the newborn (PPHN), although the degree of risk varies across studies.
However, untreated depression and anxiety during pregnancy can also pose important risks to both the mother and developing baby.
Your healthcare provider will consider the severity of your condition, previous treatment response, and available alternatives before recommending whether Paxil CR should be continued.
If you are pregnant, planning to become pregnant, or become pregnant while taking Paxil CR, contact your healthcare provider promptly. Do not stop the medication suddenly because abrupt discontinuation may cause withdrawal symptoms or a return of your condition.
Tell your healthcare provider if you are breastfeeding or planning to breastfeed before taking Paxil CR.
Paroxetine passes into breast milk in relatively small amounts.
Available evidence generally suggests that infant exposure through breast milk is low, and paroxetine is often considered one of the preferred SSRIs when antidepressant treatment is needed during breastfeeding.
However, treatment decisions should still be individualized.
Some infants may require monitoring for unusual sleepiness, irritability, poor feeding, or inadequate weight gain.
Premature babies and infants with medical conditions may require additional precautions.
Your healthcare provider will assess the benefits of continued treatment, the importance of maternal mental health, and the potential risks to your baby.
Paxil CR may be used during breastfeeding when medically appropriate. Consult your healthcare provider before making treatment changes, and monitor your baby for unusual sleepiness or feeding difficulties.
Paxil CR may trigger mania or hypomania in patients who have bipolar disorder or are susceptible to manic episodes.
Bipolar disorder is a mental health condition involving episodes of depression and periods of unusually elevated or irritable mood.
Mania is characterized by a significant increase in energy, activity, or mood that may interfere with normal functioning.
Hypomania involves similar symptoms but is generally less severe.
Possible warning signs include unusually elevated mood, excessive energy, racing thoughts, reduced need for sleep, impulsive behavior, and increased risk-taking.
Some patients may also become unusually talkative, agitated, or irritable.
Antidepressant treatment can sometimes trigger these symptoms, particularly when bipolar disorder has not been recognized.
Before prescribing Paxil CR, your healthcare provider may ask about your personal and family history of bipolar disorder, mania, or hypomania.
Tell your healthcare provider if you have bipolar disorder or a family history of manic episodes. Contact your healthcare provider promptly if you develop unusually high energy, racing thoughts, impulsive behavior, or a significantly reduced need for sleep.
Paxil CR should be used cautiously in patients with a history of seizures or epilepsy.
Epilepsy is a neurological condition characterized by recurrent seizures caused by abnormal electrical activity in the brain.
A seizure may cause involuntary muscle movements, changes in awareness, confusion, or temporary loss of consciousness.
Paroxetine may increase the risk of seizures in susceptible individuals, although seizures are uncommon at recommended doses.
Patients with a history of seizure disorders were generally excluded from clinical studies of Paxil CR, so information about its safety in these patients is limited.
Before starting treatment, tell your healthcare provider if you have epilepsy, have previously experienced seizures, or take anticonvulsant medications.
Your healthcare provider will consider your seizure history and other risk factors before determining whether Paxil CR is appropriate.
If a seizure occurs during treatment, the prescribing information recommends discontinuing Paxil CR and arranging medical evaluation.
Tell your healthcare provider if you have epilepsy or a history of seizures. Seek emergency medical attention for a first-time seizure, a seizure lasting five minutes or longer, or repeated seizures without recovery.Â
Paxil CR may cause hyponatremia, a condition in which sodium levels in the bloodstream become abnormally low.
Sodium is an essential mineral that helps regulate fluid balance, nerve function, and muscle activity.
When sodium levels fall below the normal range, the body may experience neurological and physical symptoms.
In some patients, hyponatremia associated with Paxil CR develops because of a condition called syndrome of inappropriate antidiuretic hormone secretion (SIADH).
SIADH occurs when the body retains excessive water, diluting sodium in the bloodstream.
Early symptoms may include headaches, nausea, difficulty concentrating, memory problems, weakness, and confusion.
Some patients may also experience dizziness or unsteadiness, which can increase the risk of falls.
Severe hyponatremia may cause hallucinations, fainting, seizures, coma, or other life-threatening complications.
Older adults, patients taking diuretics, and individuals who are dehydrated or have reduced circulating fluid volume may be at greater risk.
Your healthcare provider may recommend blood tests if you develop symptoms suggesting low sodium levels.
Contact your healthcare provider promptly if you experience persistent headaches, confusion, weakness, or unusual unsteadiness. Seek emergency medical attention for seizures, severe confusion, fainting, or loss of consciousness.Â
Paxil CR should not be stopped suddenly without consulting your healthcare provider.
Although paroxetine is not generally considered addictive, the body can develop physical dependence on its effects after regular treatment.
Physical dependence means the nervous system has adapted to the medication and may react when the dosage is suddenly reduced or discontinued.
Abruptly stopping Paxil CR may cause a group of symptoms known as antidepressant discontinuation syndrome.
Possible symptoms include dizziness, nausea, headaches, sweating, irritability, anxiety, mood swings, and unusual fatigue.
Some patients may also experience insomnia, vivid dreams, difficulty concentrating, or sensations resembling electric shocks.
These electric-shock-like sensations are sometimes called brain zaps.
In rare cases, severe discontinuation reactions may include significant agitation, hypomania, or seizures.
Stopping Paxil CR may also allow symptoms of depression, panic disorder, or social anxiety disorder to return.
To reduce the risk of withdrawal symptoms, your healthcare provider will generally recommend gradually lowering the dosage.
This process is called tapering.
The appropriate tapering schedule depends on your current dosage, treatment duration, medical history, and previous response to dosage changes.
Some patients may require a slower taper if symptoms develop.
Never stop Paxil CR abruptly or reduce your dosage independently. Your healthcare provider can recommend a gradual tapering schedule to reduce discontinuation symptoms and monitor for a return of your condition.Â
Paxil CR may interact with several prescription medications, over-the-counter drugs, and herbal supplements.
Some interactions may increase serotonin activity, raise the risk of bleeding, or alter the concentration of other medications in the bloodstream.
Paroxetine is a strong inhibitor of the CYP2D6 enzyme, which helps the liver process certain medications.
By blocking this enzyme, Paxil CR may increase the concentration of some medications or reduce the effectiveness of drugs that require CYP2D6 activation.
Monoamine Oxidase Inhibitors (MAOIs)
Paxil CR must not be used together with MAOIs because the combination may cause life-threatening serotonin syndrome.
Examples include phenelzine, tranylcypromine, and isocarboxazid.
Certain other medications, including linezolid and intravenous methylene blue, can also produce dangerous serotonin-related interactions.
Specific waiting periods are required when switching between Paxil CR and MAOIs.
Thioridazine and Pimozide
Paxil CR should not be combined with thioridazine or pimozide.
Paroxetine may increase the concentration of these medications, potentially causing QT prolongation and serious abnormal heart rhythms.
These combinations are contraindicated.
Other Antidepressants and Serotonergic Medications
Combining Paxil CR with certain antidepressants, tramadol, fentanyl, triptans, or St. John’s wort may increase the risk of serotonin syndrome.
Your healthcare provider should review these combinations before treatment.
Blood-Thinning Medications
Aspirin, NSAIDs, warfarin, and other anticoagulants may increase bleeding risk when taken with Paxil CR.
Patients receiving warfarin may require additional international normalized ratio (INR) monitoring.
Tamoxifen
Paroxetine can interfere with the activation of tamoxifen, a medication used to treat or prevent certain types of breast cancer.
This interaction may reduce the amount of tamoxifen’s active metabolite, potentially affecting treatment effectiveness.
Your healthcare provider may recommend an alternative antidepressant when tamoxifen is necessary.
Other CYP2D6-Metabolized Medications
Paxil CR may interact with certain antipsychotics, antidepressants, and heart medications that are processed through the CYP2D6 pathway.
Dosage adjustments or additional monitoring may be necessary.
Tell your healthcare provider and pharmacist about all medications and supplements you take. Never combine Paxil CR with MAOIs, thioridazine, or pimozide, and do not stop other prescribed medications without medical advice.Â
Paxil CR is an antidepressant that can help manage depression, panic disorder, social anxiety disorder, and premenstrual dysphoric disorder.
However, treatment requires monitoring because serious complications may include suicidal thoughts, serotonin syndrome, abnormal bleeding, low sodium levels, seizures, and changes in mood or behavior.
Patients with bipolar disorder, epilepsy, bleeding disorders, or other significant medical conditions should discuss their history with their healthcare provider before starting treatment.
Pregnant or breastfeeding patients should also receive individualized advice about the potential benefits and risks.
Paxil CR must not be stopped suddenly because abrupt discontinuation may cause significant withdrawal symptoms.
Seek emergency medical attention if you develop suicidal thoughts with an immediate risk of self-harm, seizures, severe confusion, uncontrolled bleeding, or symptoms of serotonin syndrome. Contact your healthcare provider promptly if your mood worsens or you experience unusual behavioral changes.
These precautions are not an exhaustive list of all possible warnings, adverse effects, or medication interactions associated with Paxil CR.
Paxil CR is not classified as an addictive medication. It belongs to a class of antidepressants called selective serotonin reuptake inhibitors (SSRIs), which help regulate serotonin activity in the brain to improve symptoms of depression and certain anxiety disorders. Unlike medications associated with addiction, Paxil CR does not typically cause cravings, drug-seeking behaviour, or a desire to take increasing amounts for pleasurable effects. However, regular use of Paxil CR can lead to physical dependence, meaning the body adapts to the medication over time. If treatment is stopped suddenly or the dosage is reduced too quickly, patients may experience antidepressant discontinuation symptoms. These symptoms may include dizziness, nausea, headaches, irritability, anxiety, sleep disturbances, and unusual sensations resembling electric shocks, sometimes called brain zaps. Physical dependence is different from addiction. Experiencing discontinuation symptoms does not necessarily mean a person is addicted to Paxil CR. To reduce these symptoms, healthcare providers generally recommend gradually lowering the dosage when discontinuing treatment. Paxil CR is not considered addictive, but it can cause physical dependence and discontinuation symptoms. Never stop taking the medication suddenly without consulting your healthcare provider.
Paxil CR does not usually provide immediate relief from depression or anxiety symptoms. Although paroxetine begins affecting serotonin activity shortly after administration, noticeable improvements in mood and anxiety generally develop gradually. Some patients may experience early improvements in sleep, appetite, energy, or anxiety within the first one to two weeks of treatment. However, significant improvement in depression, panic disorder, or social anxiety disorder often requires approximately four to six weeks of consistent treatment. For some individuals, the full therapeutic benefits may take six to eight weeks or longer, depending on the condition being treated and individual response. During the early stages of treatment, some patients may temporarily experience nausea, headaches, sleep disturbances, restlessness, or increased anxiety. These effects may improve as the body adjusts, although persistent or worsening symptoms should be discussed with a healthcare provider. Your healthcare provider will monitor your progress and determine whether dosage adjustments are necessary. Do not increase your dosage if you do not notice immediate improvement. Paxil CR may begin improving certain symptoms within one to two weeks, but its full benefits often take four to six weeks or longer. Continue taking the medication consistently as prescribed.
Paxil CR may be taken with certain other medications, but some combinations can cause serious interactions. Paroxetine affects serotonin activity and inhibits a liver enzyme called CYP2D6, which helps the body process several medications. As a result, Paxil CR may increase the effects of certain drugs, reduce the effectiveness of others, or raise the risk of side effects. For example, combining Paxil CR with other medications that increase serotonin levels may raise the risk of serotonin syndrome, a potentially life-threatening condition caused by excessive serotonin activity. Medications that may contribute to this risk include certain antidepressants, tramadol, fentanyl, migraine medications called triptans, and the herbal supplement St. John’s wort. Paxil CR must not be combined with monoamine oxidase inhibitors (MAOIs), thioridazine, or pimozide because these combinations can cause serious adverse reactions. Paxil CR may also increase bleeding risk when combined with aspirin, nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen or naproxen, or anticoagulants such as warfarin. Additionally, paroxetine may reduce the effectiveness of tamoxifen, a medication used to treat certain types of breast cancer. Before starting Paxil CR, tell your healthcare provider and pharmacist about all prescription medications, over-the-counter products, vitamins, and herbal supplements you take. Your healthcare provider will determine whether these medications can be used together safely or whether dosage adjustments or alternative treatments are necessary. Paxil CR may interact with several medications. Always consult your healthcare provider or pharmacist before starting, stopping, or combining it with other medicines or supplements.
No. Paxil CR should not be stopped suddenly without consulting your healthcare provider. Abruptly discontinuing paroxetine may cause antidepressant discontinuation syndrome, a group of symptoms that can occur when the body adjusts to a sudden reduction in serotonin-related medication activity. Paxil CR is particularly associated with discontinuation symptoms because paroxetine has a relatively short elimination half-life. Possible symptoms include dizziness, headaches, nausea, sweating, irritability, anxiety, mood swings, and unusual fatigue. Some patients may experience insomnia, vivid dreams, difficulty concentrating, or electric-shock-like sensations. These symptoms may begin within a few days of stopping the medication or reducing the dosage too quickly. In addition to discontinuation symptoms, suddenly stopping Paxil CR may cause depression, panic attacks, or anxiety symptoms to return. To reduce these risks, your healthcare provider will generally recommend a gradual dosage reduction, known as tapering. The appropriate tapering schedule depends on your current dosage, how long you have been taking Paxil CR, and your response to previous dosage changes. Some patients may require a slower taper over several weeks or months. If significant discontinuation symptoms develop, your healthcare provider may recommend adjusting the tapering schedule. Do not attempt to split, crush, or chew Paxil CR tablets to reduce your dose because this can interfere with the controlled-release formulation. Never stop Paxil CR abruptly or change your dosage without medical guidance. A gradual, individualized tapering schedule can help reduce withdrawal symptoms and the risk of your condition returning.
| Generic name: | Paroxetine, Paroxetine CR |
|---|---|
| Formulation: | ER Tablet |
| Strength(s): | 12.5mg, 25mg, 37.5mg |
| Quantities Available: | 30, 90 |
Our online Canadian Pharmacy is known for high standards of quality, safety, and efficiency when it comes to medications.
Our pharmacy offers lower prices on prescription drugs compared to traditional pharmacies.
When ordering Paxil CR (paroxetine) from a Canadian pharmacy, you can typically purchase up to a 90-day supply at one time, which is common for prescription medications to ensure adequate management of chronic conditions without frequent refills.
Here’s what you need to know:
Dosage and Quantity: Paxil CR is commonly prescribed in dosages of 12.5 mg or 25 mg, usually taken once daily. For a 90-day supply, you would order 90 tablets (90 days x 1 tablet per day).
Yes, we do sell paroxetine on our website. You can enjoy low prices on this medication. To purchase paroxetine, you will need a valid prescription from your healthcare provider. We require this to dispense the medication safely and appropriately. You can submit your prescription by mailing it to us, faxing it, or uploading it through your online account.
Yes, we ship Paxil CR (paroxetine) to both the United States and Puerto Rico.
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Online Pharmacies Canada has provided information from third parties intended to increase awareness and does not contain all the information about Paxil CR (Paroxetine). Talk to your doctor or other qualified medical practitioners for medical attention or advice, or if you have any concerns about Paxil CR (Paroxetine).
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