paroxetine paroxetine paroxetine, sold under the brand names paxil and seroxat among others, is an antidepressant of the selective serotonin reuptake inhibitor (ssri) class. it is used to treat major depressive disorder, obsessive-compulsive disorder, panic disorder, social anxiety disorder, posttraumatic stress disorder, generalized anxiety disorder and premenstrual dysphoric disorder. it has also been used in the treatment of premature ejaculation and hot flashes due to menopause. it is taken by mouth. paroxetineclinical datatrade namespaxil, seroxat, loxamineahfs/drugs.commonographmedlineplusa698032license data us dailymed: paroxetine us fda: paroxetine pregnancycategory au: d routes ofadministrationby mouthdrug classselective serotonin reuptake inhibitor (ssri)atc coden06ab05 (who) legal statuslegal status au: s4 (prescription only) ca: ℞-only uk: pom (prescription only) us: ℞-only in general: ℞ (prescription only) pharmacokinetic databioavailabilityextensively absorbed from the gi tract, but extensive first-pass metabolism in the liverprotein binding93–95%metabolismextensive, hepatic (mostly cyp2d6-mediated)elimination half-life21 hoursexcretionrenal (64%; 2% unchanged and 62% as metabolites), faecal (36%; <1% unchanged)identifiers iupac name (3s,4r)-3--4-(4-fluorophenyl)piperidine cas number61869-08-7 ypubchem cid43815iuphar/bps4790drugbankdb00715 ychemspider39888 yunii41vrh5220hkeggd02362 ychebichebi:7936 nchemblchembl490 ycomptox dashboard (epa)dtxsid3023425 echa infocard100.112.096 chemical and physical dataformulac19h20fno3molar mass329.371 g·mol−13d model (jsmol)interactive image smiles c1cc(ccc12ccnc2coc3ccc4c(c3)oco4)f inchi inchi=1s/c19h20fno3/c20-15-3-1-13(2-4-15)17-7-8-21-10-14(17)11-22-16-5-6-18-19(9-16)24-12-23-18/h1-6,9,14,17,21h,7-8,10-12h2/t14-,17-/m0/s1 ykey:ahoubrcznhfosl-yoehriqhsa-n y ny (what is this?) (verify) common side effects include drowsiness, dry mouth, loss of appetite, sweating, trouble sleeping, and sexual dysfunction. serious side effects may include suicidal thoughts in those under the age of 25, serotonin syndrome, and mania. while the rate of side effects appears similar compared to other ssris and snris, antidepressant discontinuation syndromes may occur more often. use in pregnancy is not recommended, while use during breastfeeding is relatively safe. it is believed to work by blocking the re-uptake of the chemical serotonin by neurons in the brain. paroxetine was approved for medical use in the united states in 1992 and initially sold by glaxosmithkline. it is on the world health organization's list of essential medicines. it is available as a generic medication. in 2020, it was the 82nd most commonly prescribed medication in the united states, with more than 9 million prescriptions. in 2018, it was in the top 10 of most prescribed antidepressants in the united states. in 2012, the united states department of justice fined glaxosmithkline $3 billion for withholding data, unlawfully promoting use in those under 18, and preparing an article that misleadingly reported the effects of paroxetine in adolescents with depression following its clinical trial study 329. medical uses paroxetine is primarily used to treat major depressive disorder, obsessive-compulsive disorder, post-traumatic stress disorder, social anxiety disorder, and panic disorder. it is also occasionally used for agoraphobia, generalized anxiety disorder, premenstrual dysphoric disorder and menopausal hot flashes. depression a variety of meta analyses have been conducted to evaluate the efficacy of paroxetine in depression. they have variously concluded that paroxetine is superior or equivalent to placebo and that it is equivalent to other antidepressants. despite this, there was no clear evidence that paroxetine was better or worse compared with other antidepressants at increasing response to treatment at any point in time. anxiety disorders paroxetine was the first antidepressant approved in the united states for the treatment of panic disorder. several studies have concluded that paroxetine is superior to placebo in the treatment of panic disorder. paroxetine has demonstrated efficacy for the treatment of social anxiety disorder in adults and children. it is also beneficial for people with co-occurring social anxiety disorder and alcohol use disorder. it appears to be similar to a number of other ssris. paroxetine is used in the treatment of obsessive-compulsive disorder. comparative efficacy of paroxetine is equivalent to that of clomipramine and venlafaxine. paroxetine is also effective for children with obsessive-compulsive disorder. paroxetine is approved for treatment of ptsd in the united states, japan and europe. in the united states it is approved for short-term use. paroxetine is also fda-approved for generalized anxiety disorder. menopausal hot flashes in 2013, low-dose paroxetine was approved in the us for the treatment of moderate-to-severe vasomotor symptoms such as hot flashes and night sweats associated with menopause. at the low dose used for menopausal hot flashes, side effects are similar to placebo and dose tapering is not required for discontinuation. fibromyalgia studies have also shown paroxetine "appears to be well-tolerated and improve the overall symptomatology in patients with fibromyalgia" but is less robust in helping with the pain involved. adverse effects