Paroxetine: uses, side effects and interactions

Paroxetine is a selective serotonin reuptake inhibitor. The NHS describes it as a treatment for depression and other mental health conditions, naming anxiety disorders, obsessive compulsive disorder and post-traumatic stress disorder. It also mentions hot flushes and other menopausal symptoms in people who have had breast cancer.

The shared mechanism is an increase in serotonin, a brain chemical that affects mood.

You swallow one tablet daily, normally in the morning, and taking it with food can calm nausea. A prescriber may start with a low dose and increase it over some weeks, so your first strength is often a starting point.

Missed a dose? Take it when you remember unless the next dose is close, in which case skip it. A double dose is never advised.

If you take more than prescribed, ring NHS 111 for advice and do not drive yourself to A&E.

The NHS says that most common effects ease within a couple of weeks. A pharmacist can help if one is persistent.

• Common: nausea, sexual difficulties, sleepiness, dizziness, agitation, insomnia, headaches, weight changes, digestive upset and blurred vision.

• Avoid driving or machinery if you feel dizzy, drowsy or your vision is blurred.

• Call 999 for anaphylaxis (swollen throat or tongue, rash, trouble breathing).

• Call NHS 111 for possible serotonin syndrome, mania, thoughts of self-harm, or unexplained bruising or bleeding.

The NHS says paroxetine may not be suitable if you have had a serious reaction to paroxetine or another SSRI, or if you have a history of mania. Heart, liver or kidney problems, epilepsy, bleeding disorders, diabetes and glaucoma are all things to mention beforehand.

Paroxetine has a longer interaction list than many antidepressants. The NHS includes other antidepressants, anticoagulants such as warfarin, anti-inflammatory painkillers, and strong painkillers including tramadol and buprenorphine. It also lists lithium and risperidone, pravastatin, tamoxifen, and some medicines for migraine, heart problems, epilepsy and Parkinson's disease.

St John's wort should be avoided. Alcohol raises the chance of side effects, so the NHS advises limiting it. Always give your pharmacist the full list of what you take, including anything bought without prescription.

Paroxetine can be used during pregnancy if the benefits outweigh the risks, and the NHS recommends a hospital birth. Breastfeeding is sometimes possible after speaking with a doctor, because some medicine reaches breast milk.

Never stop suddenly. A gradual reduction supervised by your prescriber helps avoid withdrawal symptoms. If you notice a side effect that is not in the leaflet, it can be reported to the MHRA Yellow Card scheme.