Paroxetine, sold under the brand name Paxil among others, is an antidepressant medication of the selective serotonin reuptake inhibitor (SSRI) class[6] used to treat major depressive disorder, obsessive–compulsive disorder (OCD), panic disorder, social anxiety disorder, post-traumatic stress disorder (PTSD), generalized anxiety disorder, and premenstrual dysphoric disorder.[6] It has also been used in the treatment of premature ejaculation, and hot flashes due to menopause.[6][7] It is taken orally (by mouth).[6]
Common side effects include drowsiness, dry mouth, loss of appetite, sweating, trouble sleeping, and sexual dysfunction.[6] In some patients, sexual dysfunction may persist even after the drug is discontinued, a condition known as post-SSRI sexual dysfunction; regulatory agencies including the European Medicines Agency and Health Canada have recommended that paroxetine's product labeling warn of this risk. Serious side effects may include suicidal thoughts in those under the age of 25, serotonin syndrome, and mania.[6]
Paroxetine was approved for medical use in the United States in 1992 and initially sold by GlaxoSmithKline.[6][8] It is on the World Health Organization's List of Essential Medicines.[9] It is available as a generic medication.[10] In 2023, it was the 72nd most commonly prescribed medication in the United States, with more than 9million prescriptions.[11][12] In 2018, it was in the top 10 of most prescribed antidepressants in the United States.[13]
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.[14][15][16][17][18]
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 to placebo and that it is equivalent to other antidepressants.[19][20][21] 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.[22]
Anxiety disorders
Paroxetine was the first antidepressant approved in the United States for the treatment of panic disorder.[23] Several studies have concluded that paroxetine is superior to placebo in the treatment of panic disorder.[21][24]
Paroxetine has demonstrated efficacy for the treatment of social anxiety disorder in adults and children.[25][26] It is also beneficial for people with co-occurring social anxiety disorder and alcohol use disorder.[27] It appears to be similar to a number of other SSRIs.[28]
Paroxetine is used in the treatment of obsessive-compulsive disorder.[29] Comparative efficacy of paroxetine is equivalent to that of clomipramine and venlafaxine.[30][31] Paroxetine is also effective for children with obsessive-compulsive disorder.[32]
Paroxetine is approved for the treatment of PTSD in the United States, Japan, and Europe.[33][34][35] In the United States, it is approved for short-term use.[34]
Paroxetine is also FDA-approved for generalized anxiety disorder.[36]
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.[7] At the low dose used for menopausal hot flashes, side effects are similar to placebo and dose tapering is not required for discontinuation.[37]
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.[38][39]
Premature ejaculation
Off-label paroxetine prolongs intravaginal ejaculatory latency time by about 5.6 minutes versus placebo and shows a relatively lower risk of adverse events compared to other pharmacologic treatments for premature ejaculation.[40]
Adverse effects
Common side effects include drowsiness, dry mouth, loss of appetite, sweating, insomnia, and sexual dysfunction.[6] Serious side effects may include suicide in those under the age of 25, serotonin syndrome, and mania.[6] While the rate of side effects appears similar compared to other SSRIs and SNRIs, antidepressant discontinuation syndromes may occur more often.[41][42] Use in pregnancy is not recommended, while use during breastfeeding is relatively safe.[43]
The Federal Aviation Administration (FAA), the U.S. agency responsible for regulating civil aviation, considers paroxetine to be an antidepressant medication that is ineligible for an FAA Authorization of Special Issuance (SI) or Special Consideration (SC) of a medical certificate.[44]
Paroxetine shares many of the common adverse effects of SSRIs, including (with the corresponding rates seen in people treated with placebo in parentheses):
Most of these adverse effects are transient and go away with continued treatment. Central and peripheral 5-HT3 receptor stimulation is believed to result in the gastrointestinal effects observed with SSRI treatment. Compared to other SSRIs, it has a lower incidence of diarrhea, but a higher incidence of anticholinergic effects (e.g., dry mouth, constipation, blurred vision, etc.), sedation/somnolence/drowsiness, sexual side effects, and weight gain.
Due to reports of adverse withdrawal reactions upon terminating treatment, the Committee for Medicinal Products for Human Use at the European Medicines Agency recommends gradually reducing over several weeks or months if the decision to withdraw is made.[45] See also Discontinuation syndrome (withdrawal).
Mania or hypomania may occur in 1% of patients with depression and up to 12% of patients with bipolar disorder.[46] This side effect can occur in individuals with no history of mania, but it may be more likely to occur in those with bipolar disorder or with a family history of mania.[47]
Paroxetine is described as a 'hepatoxic agent'[48] and has been associated with hepatoxicity and jaundice.[49]
- nausea 26% (9%)
- somnolence 23% (9%)
- dry mouth 18% (12%)
- headache 18% (17%)
- asthenia (weakness) 15% (6%)
- constipation 14% (9%)
- dizziness 13% (6%)
- insomnia 13% (6%)
- diarrhea 12% (8%)
- sweating 11% (2%)
- tremor 8% (2%)
- loss of appetite 6% (2%)
- nervousness 5% (3%)
- blurred vision 4% (1%)
- paraesthesia 4% (2%)
- hypomania 1% (0.3%)
- sexual dysfunction (≥10% incidence).[5]
Suicide
Like other antidepressants, paroxetine may increase the risk of suicidal thinking and behaviour in people under the age of 25.[50][51] The FDA conducted a statistical analysis of paroxetine clinical trials in children and adolescents in 2004 and found an increase in suicidality and ideation as compared to placebo, which was observed in trials for both depression and anxiety disorders.[52] In 2015, a paper published in The BMJ that reanalysed the original case notes argued that in Study 329,[53] assessing paroxetine and imipramine against placebo in adolescents with depression, the incidence of suicidal behavior had been under-reported and the efficacy exaggerated for paroxetine.[54][55][56][57][58]
Post-SSRI sexual dysfunction
Severe sexual dysfunction, including loss of libido, anorgasmia, lack of vaginal lubrication, and erectile dysfunction, is one of the most commonly encountered adverse effects of treatment with paroxetine and other SSRIs. While early clinical trials suggested a relatively low rate of sexual dysfunction, more recent studies in which the investigator actively inquires about sexual problems suggest that the incidence is higher than 70%.[59] Paroxetine has consistently been found to have the highest rate of sexual side effects among the SSRIs.
In some patients, these effects persist after discontinuation of the drug, a condition known as post-SSRI sexual dysfunction (PSSD).[60][61][62] Characteristic symptoms include genital numbness, pleasureless or weak orgasm, loss of libido, and erectile dysfunction; non-sexual symptoms such as emotional blunting and cognitive impairment may also occur.[62] The condition can arise after even brief exposure to a serotonin reuptake inhibitor and may persist indefinitely; there is currently no established treatment.[63] The DSM-5 noted in 2013 that serotonin reuptake inhibitor-induced sexual dysfunction may persist after the agent is discontinued.[64]
Paroxetine was among the earliest SSRIs to be associated with persistent sexual dysfunction in the peer-reviewed literature.[61][60] A 2023 retrospective cohort study of over 12,000 males estimated the risk of irreversible sexual dysfunction at approximately 0.46% of patients treated with serotonergic antidepressants, including SSRIs, though the actual prevalence remains uncertain and the condition is likely underreported.[65] A 2023 systematic review found that paroxetine was among the SSRIs most frequently reported in PSSD case reports, alongside escitalopram, citalopram, sertraline, and fluoxetine.[66] Paroxetine's high rate of on-treatment sexual dysfunction relative to other SSRIs, combined with its severe withdrawal profile, may make persistent post-discontinuation sexual effects particularly difficult for patients and clinicians to distinguish from withdrawal symptoms.[64]
In 2019, the European Medicines Agency's Pharmacovigilance Risk Assessment Committee (PRAC) recommended that product labels for all SSRIs and SNRIs, including paroxetine, be updated to state that sexual dysfunction may be long-lasting even after treatment is stopped.[67] Health Canada followed with similar label updates in 2021.[64] In 2024, Australia's Therapeutic Goods Administration aligned all SSRI and SNRI product information to reflect this risk.[68]
Pregnancy
Antidepressant exposure (including paroxetine) is associated with shorter duration of pregnancy (by three days), increased risk of preterm delivery (by 55%), lower birth weight (by 75 g), and lower Apgar scores (by <0.4 points).[69][70] The American College of Obstetricians and Gynecologists recommends that for pregnant women and women planning to become pregnant, paroxetine "be avoided, if possible", as it may be associated with increased risk of birth defects.[71][72]
Babies born to women who used paroxetine during the first trimester have an increased risk of cardiovascular malformations, primarily ventricular and atrial septal defects. Unless the benefits of paroxetine justify continuing treatment, consideration should be given to stopping or switching to another antidepressant.[73] Paroxetine use during pregnancy is associated with about 1.5– to 1.7-fold increase in congenital birth defects, in particular, heart defects, cleft lip and palate, clubbed feet, or any birth defects.[74][75][76][77][78]
Discontinuation syndrome
Many psychoactive medications can cause withdrawal symptoms upon discontinuation from administration. Paroxetine has among the highest incidence rates and severity of withdrawal syndrome of any medication of its class.[79] Common withdrawal symptoms for paroxetine include nausea, dizziness, lightheadedness and vertigo; insomnia, nightmares, and vivid dreams; feelings of electricity in the body, as well as rebound depression and anxiety. A liquid formulation of paroxetine is available and allows a very gradual decrease of the dose, which may prevent discontinuation syndrome. Another recommendation is to temporarily switch to fluoxetine, which has a longer half-life and thus decreases the severity of discontinuation syndrome.[80][81][82]
In 2002, the U.S. FDA published a warning regarding "severe" discontinuation symptoms among those terminating paroxetine treatment, including paraesthesia, nightmares, and dizziness. The agency also warned of case reports describing agitation, sweating, and nausea. In connection with a Glaxo spokesperson's statement that withdrawal reactions occur only in 0.2% of patients and are "mild and short-lived", the International Federation of Pharmaceutical Manufacturers Associations said GSK had breached two of the federation's codes of practice.[83]
Paroxetine prescribing information posted at GlaxoSmithKline has been updated related to the occurrence of a discontinuation syndrome, including serious discontinuation symptoms.[73]
Overdose
Acute overdosage is often manifested by vomiting, lethargy, ataxia, tachycardia, and seizures. Plasma, serum, or blood concentrations of paroxetine may be measured to monitor therapeutic administration, confirm a diagnosis of poisoning in hospitalized patients or to aid in the medicolegal investigation of fatalities. Plasma paroxetine concentrations are generally in a range of 40–400 μg/L in persons receiving daily therapeutic doses and 200–2,000 μg/L in poisoned patients. Postmortem blood levels have ranged from 1–4 mg/L in acute lethal overdose situations.[84][85] Along with the other SSRIs, sertraline and fluoxetine, paroxetine is considered a low-risk drug in cases of overdose.[86]
Interactions
Interactions with other drugs acting on the serotonin system or impairing the metabolism of serotonin may increase the risk of serotonin syndrome or neuroleptic malignant syndrome (NMS)-like reaction. Such reactions have been observed with SNRIs and SSRIs alone, but particularly with concurrent use of triptans, MAO inhibitors, antipsychotics, or other dopamine antagonists.
The prescribing information states that paroxetine should "not be used in combination with an MAOI (including linezolid, an antibiotic which is a reversible non-selective MAOI), or within 14 days of discontinuing treatment with an MAOI", and should not be used in combination with pimozide, thioridazine, tryptophan, or warfarin.[73]
Paroxetine interacts with the following cytochrome P450 enzymes:[87][88]
Paroxetine has been shown to be an inhibitor of G protein-coupled receptor kinase 2 (GRK2).
Pharmacology
Pharmacodynamics
Paroxetine is the most potent and one of the most specific selective serotonin (5-hydroxytryptamine, 5-HT) reuptake inhibitors (SSRIs).[90] It also binds to the allosteric site of the serotonin transporter, similarly to escitalopram, though less potently so.[91] Paroxetine also inhibits the reuptake of norepinephrine to a lesser extent (<50 nmol/L).[92] Based on evidence from four weeks of administration in rats, the equivalent of 20 mg paroxetine taken once daily occupies approximately 88% of serotonin transporters in the prefrontal cortex.[88] Paroxetine is a phenylpiperidine and might have some affinity for opioid receptors.[93][94]
Pharmacokinetics
Paroxetine is well-absorbed following oral administration.[88] It has an absolute bioavailability of about 50%, with evidence of a saturable first pass effect.[98] When taken orally, it achieves maximum concentration in about 6–10 hours[88] and reaches steady-state in 7–14 days.[98] Paroxetine exhibits significant interindividual variations in volume of distribution and clearance.[98] Less than 2% of an oral dose is excreted in urine unchanged.[98]
Paroxetine is a mechanism-based inhibitor of CYP2D6.[89][99]
Society and culture
Paroxetine was approved for medical use in the United States in 1992 and initially sold by GlaxoSmithKline.[6][100] It is available as a generic medication.[10] In 2022, it was the 92nd most commonly prescribed medication in the United States, with more than 7million prescriptions.[101][12] It is on the World Health Organization's List of Essential Medicines.[9]
GlaxoSmithKline has paid substantial fines, paid settlements in class-action lawsuits, and become the subject of several highly critical books about its marketing of paroxetine, in particular, the off-label marketing of paroxetine for children, the suppression of negative research results relating to its use in children, and allegations that it failed to warn consumers of substantial withdrawal effects associated with the use of the drug.
Marketing
In 2004, GSK agreed to settle charges of consumer fraud for $2.5 million.[102] The legal discovery process also uncovered evidence of deliberate, systematic suppression of unfavorable Paxil research results. One of GSK's internal documents read, "It would be commercially unacceptable to include a statement that efficacy [in children] had not been demonstrated, as this would undermine the profile of paroxetine".[103]
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.[104][105][106]
In February 2016, the UK Competition and Markets Authority imposed record fines of £45 million on companies that were found to have infringed European Union and UK Competition law by entering into agreements to delay the market entry of generic versions of the drug in the UK. GlaxoSmithKline received the bulk of the fines, being fined £37,600,757. Other companies that produce generics were issued fines which collectively total £7,384,146. UK public health services are likely to claim damages for being overcharged in the period where the generic versions of the drug were illegally blocked from the market, as the generics are over 70% less expensive. GlaxoSmithKline may also face actions from other generic manufacturers who incurred losses as a result of the anticompetitive conduct.[107] In April 2016, appeals were lodged with the Competition Appeal Tribunal by the companies which were fined.[108][109][110][111][112]
GSK marketed paroxetine through television advertisements in the 1990s and 2000s. Commercials also aired for the CR version of the drug beginning in 2003.[113]
Economics
In 2007, paroxetine was ranked 94th on the list of bestselling drugs, with over $1 billion in sales. In 2006, paroxetine was the fifth-most prescribed antidepressant in the U.S. retail market, with more than 19.7 million prescriptions.[114] In 2007, sales had dropped slightly to 18.1 million but paroxetine remained the fifth-most prescribed antidepressant in the U.S.[115][116]
Brand names
Brand names include Aropax, Paretin, Brisdelle, Deroxat, Paxil,[117][118] Pexeva, Paxtine, Paxetin, Paroxat, Paraxyl,[119] Sereupin, Daparox and Seroxat.
Research
There is evidence that paroxetine may be effective in the treatment of compulsive gambling[120] and hot flashes.[121]
Benefits of paroxetine prescription for diabetic neuropathy[122] or chronic tension headache[123] are uncertain.
Although the evidence is conflicting, paroxetine may be effective for the treatment of dysthymia, a chronic disorder involving depressive symptoms for most days of the year.[124]
There is evidence to support that paroxetine selectively binds to and inhibits G protein-coupled receptor kinase 2 (GRK2) in mice with heart failure. Since GRK2 regulates the activity of the beta adrenergic receptor, which becomes desensitized in cases of heart failure, paroxetine (or a paroxetine derivative) could be used as a heart failure treatment in the future.[125][126][127]
Paroxetine has been identified as a potential disease-modifying osteoarthritis drug.[128]
Veterinary use
Paroxetine may be useful in the treatment of canine or feline behavioral diagnoses and is effective in the treatment of social anxiety, depression, and agitation associated with depression.[129]
Other organisms
Paroxetine is a common finding in wastewater. It is highly toxic to the alga Pseudokirchneriella subcapitata (syn. Raphidocelis subcapitata).[130]
It also is toxic to the soil nematode Caenorhabditis elegans.[131]
Alberca et al., 2016 found that paroxetine acts as a trypanocide against T. cruzi.[132]
Alberca et al., 2016 finds a leishmanicide effect. Alberca finds that paroxetine produces cell death of the promastigotes of L. infantum. The mechanism of action remains unknown.[133]
Various types of bacteria can break down paroxetine in the environment. These include, for example Pseudomonas sp., Bosea sp., Shewanella sp., Species of Chitinophagaceae and Acinetobacter sp.[134][135]
External links
References
- Anvisa. RDC Nº 784 - Listas de Substâncias Entorpecentes, Psicotrópicas, Precursoras e Outras sob Controle Especial Diário Oficial da União, 31 March 2023, retrieved 3 August 2023^
- Sandoz Pty Ltd. Product Information Paroxetine Sandoz 20Mg Film-Coated Tablets Therapeutic Goods Administration, 18 January 2012, retrieved 22 November 2013^
- Mylan Institutional Inc. Paroxetine (paroxetine hydrochloride hemihydrate) tablet, film coated DailyMed, U.S. National Library of Medicine, January 2012, retrieved 22 November 2013^
- Sandoz Limited. Paroxetine 20 mg Tablets – Summary of Product Characteristics (SPC) electronic Medicines Compendium, Datapharm Ltd, 21 March 2013, retrieved 22 November 2013^
- Paxil, Paxil CR (paroxetine) dosing, indications, interactions, adverse effects, and more Medscape Reference, WebMD, retrieved 22 November 2013^
- Paroxetine Hydrochloride Monograph for Professionals Drugs.com, American Society of Health-System Pharmacists, retrieved 3 March 2019^
- FDA approves the first non-hormonal treatment for hot flashes associated with menopause Food and Drug Administration, 28 June 2013^
- Food and Drug Administration. Approved Drug Products with Therapeutic Equivalence Evaluations – FDA Orange Book 31st Edition (2011): FDA Orange Book 31st Edition (2011) DrugPatentWatch.com, 2011, retrieved 4 March 2019^
- The selection and use of essential medicines 2023: web annex A: World Health Organization model list of essential medicines: 23rd list (2023) World Health Organization, 2023^
- British national formulary: BNF 76 Pharmaceutical Press, 2018^
- Top 300 of 2023 ClinCalc, retrieved 12 August 2025^
- Paroxetine Drug Usage Statistics, United States, 2013 - 2023 ClinCalc, retrieved 18 August 2025^
- Top 25 Psychiatric Medications for 2018 psychcentral.com, 15 December 2019, retrieved 26 September 2020^
- Paroxetine: an update of its use in psychiatric disorders in adults Drugs, March 2002^
- Paroxetine controlled release was effective and tolerable for treating menopausal hot flash symptoms in women Evidence Based Medicine, 1 January 2004, retrieved 20 January 2017^
- Paroxetine: an antidepressant nhs.uk, 29 August 2018, retrieved 15 March 2020^
- Paroxetine 20 mg Tablets - Summary of Product Characteristics (SmPC) - (emc) medicines.org.uk, retrieved 15 March 2020^
- Product and Consumer Medicine Information Therapeutic Goods Administration, retrieved 15 March 2020^
- Comparative efficacy and acceptability of 12 new-generation antidepressants: a multiple-treatments meta-analysis Lancet, February 2009^
- A double-blind study of paroxetine, fluoxetine, and placebo in outpatients with major depression Annals of Clinical Psychiatry, December 1998^
- The efficacy of paroxetine and placebo in treating anxiety and depression: a meta-analysis of change on the Hamilton Rating Scales PLOS ONE, 27 August 2014^
- Paroxetine versus other anti-depressive agents for depression The Cochrane Database of Systematic Reviews, April 2014^
- Social Work Diagnosis in Contemporary Practice Oxford University Press US, 2005^
- Double-blind, fixed-dose, placebo-controlled study of paroxetine in the treatment of panic disorder The American Journal of Psychiatry, January 1998^
- Paroxetine treatment of generalized social phobia (social anxiety disorder): a randomized controlled trial JAMA, August 1998^
- Paroxetine improves social anxiety disorder in children and adolescents Evidence-Based Mental Health, May 2005, retrieved 20 January 2017^
- Paroxetine for social anxiety and alcohol use in dual-diagnosed patients Depression and Anxiety, 1 January 2001^
- The evidence-based pharmacotherapy of social anxiety disorder The International Journal of Neuropsychopharmacology, February 2013^
- Paroxetine hydrochloride Profiles of Drug Substances, Excipients, and Related Methodology, 2013^
- Paroxetine versus clomipramine in the treatment of obsessive-compulsive disorder. OCD Paroxetine Study Investigators The British Journal of Psychiatry, October 1996^
- A double blind comparison of venlafaxine and paroxetine in obsessive-compulsive disorder Journal of Clinical Psychopharmacology, December 2003^
- Pharmacotherapy for anxiety disorders in children and adolescents The Cochrane Database of Systematic Reviews, July 2009^
- Pharmacotherapy for Post-traumatic Stress Disorder In Combat Veterans: Focus on Antidepressants and Atypical Antipsychotic Agents P & T, January 2012^
- Evidence-based pharmacotherapy of post-traumatic stress disorder (PTSD) The International Journal of Neuropsychopharmacology, July 2012^
- Search results detail rad-ar.or.jp, retrieved 15 March 2019^
- FDA Approves Antidepressant For Generalized Anxiety Disorder Psychiatric News, 18 May 2001^
- FDA approval of paroxetine for menopausal hot flushes The New England Journal of Medicine, May 2014^
- A randomized, controlled, trial of controlled release paroxetine in fibromyalgia The American Journal of Medicine, May 2007^
- Efficacy and tolerability of paroxetine in patients with fibromyalgia syndrome: a single-blind study Current Therapeutic Research, December 1999^
- Efficacy and safety of pharmacological treatments in patients with premature ejaculation: an umbrella review of meta-analyses of randomized controlled trials The Journal of Sexual Medicine, June 2025^
- SSRIs and SNRIs: A review of the Discontinuation Syndrome in Children and Adolescents Journal of the Canadian Academy of Child and Adolescent Psychiatry, February 2011^
- Paroxetine: current status in psychiatry Expert Review of Neurotherapeutics, February 2007^
- Paroxetine Pregnancy and Breastfeeding Warnings Drugs.com, retrieved 3 March 2019^
- Guide for Aviation Medical Examiners Federal Aviation Administration, 2024-04-24, retrieved 2025-06-08^
- Press release, CHMP meeting on Paroxetine and other SSRIs European Medicines Agency, 9 December 2004, retrieved 24 August 2007^
- Prescribing Information Paxil (paroxetine hydrochloride) Tablets and Oral Suspension^
- Induction of mania in depression by paroxetine Human Psychopharmacology, October 2003^
- Paroxetine PubChem^
- Severe hepatotoxicity with jaundice associated with paroxetine The American Journal of Gastroenterology, August 2001^
- Medication Guide About Using Antidepressants in Children and Teenagers FDA^
- FDA Launches a Multi-Pronged Strategy to Strengthen Safeguards for Children Treated With Antidepressant Medications Food and Drug Administration, October 15, 2004^
- Review and evaluation of clinical data: relationship between psychotropic drugs and pediatric suicidality Joint Meeting of the Psychopharmacologic Drugs Advisory Committee and Pediatric Advisory Committee. 13–14 September 2004. Briefing Information., FDA, 16 August 2004, retrieved 27 January 2009^
- Efficacy of paroxetine in the treatment of adolescent major depression: a randomized, controlled trial Journal of the American Academy of Child and Adolescent Psychiatry, July 2001^
- Restoring Study 329: efficacy and harms of paroxetine and imipramine in treatment of major depression in adolescence BMJ, September 2015^
- Study 329 BMJ, 17 September 2015^
- No correction, no retraction, no apology, no comment: paroxetine trial reanalysis raises questions about institutional responsibility BMJ, September 2015^
- Liberating the data from clinical trials BMJ, September 2015^
- Seroxat study under-reported harmful effects on young people, say scientists The Guardian, 16 September 2015, retrieved 16 December 2016^
- Clinical inquiry: How do antidepressants affect sexual function? The Journal of Family Practice, November 2013^
- Persistent sexual dysfunction after discontinuation of selective serotonin reuptake inhibitors The Journal of Sexual Medicine, January 2008^
- Persistent sexual side effects after SSRI discontinuation Psychotherapy and Psychosomatics, 2006^
- Diagnostic criteria for enduring sexual dysfunction after treatment with antidepressants, finasteride and isotretinoin International Journal of Risk & Safety in Medicine, 2022^
- Enduring sexual dysfunction after treatment with antidepressants, 5-alpha-reductase inhibitors and isotretinoin: 300 cases International Journal of Risk & Safety in Medicine, 2018^
- Post-SSRI sexual dysfunction: barriers to quantifying incidence and prevalence Epidemiology and Psychiatric Sciences, 2024^
- Estimating the risk of irreversible post-SSRI sexual dysfunction (PSSD) due to serotonergic antidepressants Annals of General Psychiatry, April 2023^
- Selective serotonin reuptake inhibitors, post-treatment sexual dysfunction and persistent genital arousal disorder: A systematic review Pharmacoepidemiology and Drug Safety, October 2023^
- PRAC recommendations on signals adopted at the 13-16 May 2019 PRAC meeting European Medicines Agency, 11 June 2019, retrieved 8 April 2026^
- Updated warnings about persistent sexual dysfunction for antidepressants Therapeutic Goods Administration, 23 May 2024, retrieved 8 April 2026^
- Selected pregnancy and delivery outcomes after exposure to antidepressant medication: a systematic review and meta-analysis JAMA Psychiatry, April 2013^
- Selective serotonin reuptake inhibitor (SSRI) use during pregnancy and effects on the fetus and newborn: a meta-analysis Journal of Perinatology, September 2005^
- ACOG Committee Opinion No. 354: Treatment with selective serotonin reuptake inhibitors during pregnancy Obstetrics and Gynecology, December 2006^
- Antidepressant use in pregnant and postpartum women Annual Review of Clinical Psychology, 2014^
- PAXIL (paroxetine hydrochloride) Tablets and Oral Suspension: Prescribing Information GlaxoSmithKline, August 2007, retrieved 14 August 2007^
- Paroxetine use during pregnancy: is it safe? The Annals of Pharmacotherapy, October 2006^
- Safety of newer antidepressants in pregnancy Pharmacotherapy, April 2007^
- Serotonin reuptake inhibitors in pregnancy and the risk of major malformations: a systematic review Human Psychopharmacology, April 2007^
- The safety of antidepressant drugs during pregnancy Expert Opinion on Drug Safety, July 2007^
- Paroxetine and congenital malformations: meta-Analysis and consideration of potential confounding factors Clinical Therapeutics, May 2007^
- Withdrawal Symptoms after Selective Serotonin Reuptake Inhibitor Discontinuation: A Systematic Review Psychotherapy and Psychosomatics, 2015^
- Antidepressant discontinuation syndromes Drug Safety, March 2001^
- Recognising and managing antidepressant discontinuation symptoms Advances in Psychiatric Treatment, November 2007^
- Dependence on Antidepressants & Halting SSRIs benzo.org.uk, retrieved 23 April 2013^
- Withdrawal from paroxetine can be severe, warns FDA BMJ, February 2002^
- Postmortem forensic toxicology of selective serotonin reuptake inhibitors: a review of pharmacology and report of 168 cases Journal of Forensic Sciences, May 2000^
- R. Baselt,Disposition of Toxic Drugs and Chemicals in Man, 8th edition, Biomedical Publications, Foster City, CA, 2008, pp. 1190–1193.^
- Suicidal antidepressant overdoses: a comparative analysis by antidepressant type Journal of Medical Toxicology, December 2008^
- Pharmacotherapy of Depression Humana Press, 2011^
- A comparative review of escitalopram, paroxetine, and sertraline: Are they all alike? International Clinical Psychopharmacology, July 2014^
- Metabolism-guided drug design MedChemComm, 2013^
- High affinity binding of 3H-paroxetine and 3H-imipramine to rat neuronal membranes Psychopharmacology, July 1986^
- Allosteric modulation of the effect of escitalopram, paroxetine and fluoxetine: in-vitro and in-vivo studies The International Journal of Neuropsychopharmacology, February 2007^
- [Second generation SSRIS: human monoamine transporter binding profile of escitalopram and R-fluoxetine] L'Encephale, 1 August 2002^
- Paroxetine Increases δ Opioid Responsiveness in Sensory Neurons eNeuro, 2022^
- Possible Involvement of Opioidergic and Serotonergic Mechanisms in Antinociceptive Effect of Paroxetine in Acute Pain Journal of Pharmacological Sciences, 2004, retrieved 8 January 2025^
- Goodman and Gilman's The Pharmacological Basis of Therapeutics McGraw-Hill Professional, 2010^
- Second-generation SSRIs: human monoamine transporter binding profile of escitalopram and R-fluoxetine Biological Psychiatry, September 2001^
- PDSP Ki Database Psychoactive Drug Screening Program (PDSP), University of North Carolina at Chapel Hill and the United States National Institute of Mental Health, 12 January 2011, retrieved 22 November 2013^
- A review of the metabolism and pharmacokinetics of paroxetine in man Acta Psychiatrica Scandinavica. Supplementum, 1989^
- Identification of cytochrome P450 isoforms involved in the metabolism of paroxetine and estimation of their importance for human paroxetine metabolism using a population-based simulator Drug Metabolism and Disposition, March 2010^
- Food and Drug Administration. Approved Drug Products with Therapeutic Equivalence Evaluations – FDA Orange Book 31st Edition (2011): FDA Orange Book 31st Edition (2011) DrugPatentWatch.com, 2011, retrieved 4 March 2019^
- The Top 300 of 2022 ClinCalc, retrieved 30 August 2024^
- Drug Companies & Doctors: A Story of Corruption New York Review of Books, 15 January 2009^
- Drug company experts advised staff to withhold data about SSRI use in children CMAJ, March 2004^
- GlaxoSmithKline to Plead Guilty and Pay $3 Billion to Resolve Fraud Allegations and Failure to Report Safety Data United States Department of Justice, Office of Public Affairs, 2 July 2012, retrieved 6 October 2015^
- https://www.justice.gov/sites/default/files/opa/legacy/2012/07/02/us-complaint.pdf 26 October 2011^
- Glaxo Agrees to Pay $3 Billion in Fraud Settlement The New York Times, 2 July 2012, retrieved 28 February 2017^
- CMA fines pharma companies £45 million retrieved 15 July 2016^
- GlaxoSmithKline Summary retrieved 15 July 2016^
- Generics Summary retrieved 15 July 2016^
- Xellia Summary retrieved 15 July 2016^
- Merck Summary retrieved 15 July 2016^
- Actavis Summary retrieved 15 July 2016^
- Paxil CR -- Nametag -- (2003) :30 (USA) | Adland 3 April 2004, retrieved 24 February 2020^
- The paroxetine prescriptions were calculated as a total of prescriptions for Paxil CR and generic paroxetine using data from the charts for generic and brand-name drugs. Top 200 generic drugs by units in 2006. Top 200 brand-name drugs by units Drug Topics, 5 March 2007, retrieved 8 April 2007^
- The paroxetine prescriptions were calculated as a total of prescriptions for Paxil CR and generic paroxetine using data from the charts for generic and brand-name drugs. Top 200 generic drugs by units in 2007 Drug Topics, 18 February 2008, retrieved 23 October 2008^
- Top 200 brand drugs by units in 2007 Drug Topics, 18 February 2008, retrieved 23 October 2008^
- Paroxetine-The Antidepressant from Hell? Probably Not, But Caution Required Psychopharmacology Bulletin, March 2016^
- Dictionary of Psychology Oxford University Press, 2006^
- Dictionary of Psychology Oxford University Press, 2006^
- A double-blind placebo-controlled study of the efficacy and safety of paroxetine in the treatment of pathological gambling The Journal of Clinical Psychiatry, June 2002^
- A pilot trial of paroxetine for the treatment of hot flashes and associated symptoms in women with breast cancer Journal of Pain and Symptom Management, April 2002^
- The selective serotonin reuptake inhibitor paroxetine is effective in the treatment of diabetic neuropathy symptoms Pain, August 1990^
- Sulpiride and paroxetine in the treatment of chronic tension-type headache. An explanatory double-blind trial Headache, January 1994^
- Comparative benefits and harms of second-generation antidepressants: background paper for the American College of Physicians Annals of Internal Medicine, November 2008^
- Paroxetine is a direct inhibitor of g protein-coupled receptor kinase 2 and increases myocardial contractility ACS Chemical Biology, November 2012^
- Structure-Based Design of Highly Selective and Potent G Protein-Coupled Receptor Kinase 2 Inhibitors Based on Paroxetine Journal of Medicinal Chemistry, April 2017^
- Common antidepressant may hold key to heart failure reversal ScienceDaily, retrieved 19 April 2022^
- Paroxetine-mediated GRK2 inhibition is a disease-modifying treatment for osteoarthritis Science Translational Medicine, February 2021^
- Pharmacological Treatment in Behavioural Medicine: The Importance of Neurochemistry, Molecular Biology and Mechanistic Hypotheses The Veterinary Journal, 2001^
- Susceptibility of phytoplankton to the increasing presence of active pharmaceutical ingredients (APIs) in the aquatic environment: A review Aquatic Toxicology, Elsevier, May 2021 Mixture and single-substance toxicity of selective serotonin reuptake inhibitors toward algae and crustaceans Environmental Toxicology and Chemistry, John Wiley & Sons, Inc., January 2007^
- Breakthroughs in Medicinal Chemistry: New Targets and Mechanisms, New Drugs, New Hopes-3 Molecules, MDPI AG, June 2018 Sertraline, Paroxetine, and Chlorpromazine Are Rapidly Acting Anthelmintic Drugs Capable of Clinical Repurposing Scientific Reports, Springer Science and Business Media LLC, January 2018^
- This review cites this study. Current trends in the pharmacological management of Chagas disease International Journal for Parasitology: Drugs and Drug Resistance, Elsevier BV, April 2020 Discovery of novel polyamine analogs with anti-protozoal activity by computer-guided drug repositioning Journal of Computer-Aided Molecular Design, Springer Science and Business Media LLC, April 2016^
- This review cites this research. Leishmaniasis treatment: update of possibilities for drug repurposing Frontiers in Bioscience, IMR Press, January 2018 Discovery of novel polyamine analogs with anti-protozoal activity by computer-guided drug repositioning Journal of Computer-Aided Molecular Design, Springer Science and Business Media LLC, April 2016^
- Assessing the Microbiological Health of Ecosystems Wiley, 19 December 2022^
- Potential of bacterial consortia obtained from different environments for bioremediation of paroxetine and bezafibrate Journal of Environmental Chemical Engineering, August 2020^