List of adverse effects of paroxetine

This is a list of adverse effects of the antidepressant paroxetine, sorted by frequency of occurrence.[1][2][3][4]

## Contents

* 1 Very common
* 2 Common
* 3 Uncommon
* 4 Rare
* 5 Very rare
* 6 References

## Very common[edit | edit source]

Very common (>10% incidence) adverse effects include:

* Nausea
* Sexual dysfunction (including anorgasmia (difficulty achieving an orgasm), erectile dysfunction, genital anaesthesia, ejaculation disorder, loss of libido etc.). Paroxetine is associated with a higher rate of sexual dysfunction than other SSRIs.[5][page needed]
* Impaired concentration
* Somnolence is more common with paroxetine than with other SSRIs.[6][page needed]
* Insomnia
* Headache
* Dry mouth

## Common[edit | edit source]

Common (1–10% incidence) adverse effects include:

* Changes in appetite
* Dyspepsia (indigestion)
* Tooth disorder
* Stomatitis
* Oropharyngeal disorder
* Flatulence
* Impaired urination
* Urinary frequency
* Agitation
* Abnormal dreams (including intense dreams or nightmares)
* Hypercholesterolaemia (elevated blood cholesterol)
* Dizziness
* Tremor
* Blurred vision
* Yawning
* Diarrhoea which is less common with paroxetine than with other SSRIs.
* Constipation (if chronic may lead to hemorrhoids)
* Vomiting
* Anxiety
* Nervousness
* Hypomania,[7][unreliable medical source][8][9][unreliable medical source] may occur in as many as 8% of patients being treated with paroxetine. May be more common in those with bipolar disorder.
* Asthenia
* Weight gain or loss. Usually gain, paroxetine tends to produce more weight gain than other SSRIs.[6]: 58
* Confusion
* Emotional lability
* Myoclonus
* Myopathy
* Myalgia
* Myasthenia
* Drugged feeling
* Hyperthesia
* Respiratory disorder
* Pharyngitis
* Increased cough
* Rhinitis
* Taste perversion
* Abnormal vision
* Pruritus (itching)
* Sweat gland disorder
* Abdominal pain
* Fever
* Chest pain
* Trauma
* Back pain
* Malaise
* Pain
* Palpitations
* Vasodilatation
* Postural hypotension (a drop in blood pressure upon standing up)
* Hypertension (high blood pressure)
* Syncope (fainting)
* Tachycardia (high heart rate)

## Uncommon[edit | edit source]

Uncommon (0.1–1% incidence) adverse effects include:

* Abnormal bleeding, predominantly of the skin and mucous membranes (mostly ecchymosis)
* Confusion
* Hallucinations
* Extrapyramidal disorders (which occurs more commonly in paroxetine-treating patients than patients treated with other SSRIs)
* Sinus tachycardia
* Transient changes in blood pressure
* Urinary retention
* Urinary incontinence
* Allergic reaction
* Chills
* Face oedema
* Infection
* Bradycardia
* Conduction abnormalities
* Abnormal ECG
* Hypotension
* Ventricular extrasystoles
* Acne
* Alopecia (hair loss)
* Dry skin
* Eczema
* Furunculosis
* Herpes simplex
* Urticaria
* Bruxism
* Buccal cavity disorders
* Dysphagia
* Eructation
* Gastroenteritis
* Gastrointestinal flu
* Glossitis
* Increased salivation
* Abnormal liver function tests
* Mouth ulceration
* Rectal haemorrhage
* Miscarriage
* Amenorrhoea (lack of menstrual cycles)
* Breast pain
* Cystitis
* Dysmenorrhoea
* Dysuria
* Menorrhagia
* Nocturia
* Polyuria
* Urinary tract infection
* Urinary urgency
* Vaginitis
* Anaemia
* Leucopenia
* Lymphadenopathy
* Purpura
* White blood cell abnormality
* Oedema
* Hyperglycaemia (high blood sugar)
* Peripheral oedema
* Thirst
* Arthralgia
* Arthritis
* Traumatic fracture
* Abnormal thinking
* Akinesia
* Alcohol use disorder[10]
* Amnesia (memory loss)
* Ataxia
* Convulsion
* Lack of emotion
* Paranoid reaction
* Asthma
* Bronchitis
* Dyspnoea (air hunger)
* Epistaxis
* Hyperventilation
* Pneumonia
* Respiratory flu
* Sinusitis
* Abnormality of accommodation
* Conjunctivitis
* Ear pain
* Eye pain
* Mydriasis
* Otitis media
* Tinnitus
* Keratoconjunctivitis

## Rare[edit | edit source]

Rare (0.01–0.1% incidence) adverse effects include:

* Mania,[7][8][9] may be more common in those that either have or have a family history of bipolar disorder.[11]
* Depersonalisation
* Panic disorder
* Akathisia[12][13]
* Restless legs syndrome
* Elevated liver enzymes
* Hyperprolactinaemia (elevated serum prolactin)
* Galactorrhoea (lactation that is not associated with pregnancy or breastfeeding)
* Abnormal laboratory value
* Abscess
* Adrenergic syndrome
* Cellulitis
* Chills and fever
* Cyst
* Hernia
* Intentional overdose
* Neck rigidity
* Pelvic pain
* Peritonitis
* Substernal chest pain
* Ulcer
* Angina pectoris
* Arrhythmia
* Atrial arrhythmia
* Atrial fibrillation
* Bundle branch block
* Cerebral ischaemia
* Cerebrovascular accident (stroke)
* Congestive heart failure
* Extrasystoles
* Low cardiac output
* Myocardial infarct (heart attack)
* Myocardial ischaemia
* Pallor
* Phlebitis
* Pulmonary embolus
* Supraventricular extrasystoles
* Thrombophlebitis
* Thrombosis
* Varicose vein
* Vascular headache
* Angioedema
* Contact dermatitis
* Erythema nodosum
* Herpes zoster
* Hirsutism
* Maculopapular rash
* Photosensitivity
* Skin discolouration
* Skin ulcer
* Diabetes mellitus
* Hyperthyroidism
* Hypothyroidism
* Thyroiditis
* Aphthous stomatitis
* Bloody diarrhoea
* Bulimia
* Colitis
* Duodenitis
* Oesophagitis
* Faecal impaction
* Faecal incontinence
* Gastritis
* Gingivitis
* Haematemesis (vomiting blood)
* Hepatitis
* Ileus
* Jaundice
* Melaena (black faeces as a result of bleeding in the stomach)
* Salivary gland enlargement
* Stomach ulcer
* Stomatitis
* Tongue oedema
* Tooth caries
* Tooth malformation
* Breast atrophy
* Female lactation
* Haematuria (blood in the urine)
* Kidney calculus (kidney stones)
* Abnormal kidney function
* Kidney pain
* Mastitis
* Nephritis
* Oliguria
* Urethritis
* Urine abnormality
* Vaginal candidiasis
* Eosinophilia
* Iron deficiency anaemia
* Leucocytosis
* Lymphoedema
* Lymphocytosis
* Microcytic anaemia
* Monocytosis
* Normocytic anaemia
* Increased alkaline phosphatase
* Bilirubinaemia
* Dehydration
* Gout
* Hyperphosphataemia (elevated levels of phosphate in the blood)
* Hypocalcaemia (low blood calcium)
* Hypoglycaemia (low blood sugar)
* Hypokalaemia (low blood potassium)
* Hyponatraemia (low blood sodium)
* Obesity
* Arthrosis
* Bursitis
* Cartilage disorder
* Myositis
* Osteoporosis (brittle bones)
* Tetany
* Abnormal electroencephalograph
* Abnormal gait
* Choreoathetosis
* Circumoral paraesthesia
* Delirium
* Delusions
* Diplopia
* Drug dependence
* Dysarthria
* Euphoria
* Fasciculations
* Grand mal convulsions
* Hyperalgesia
* Hysteria
* Increased libido
* Manic depressive reaction
* Meningitis
* Myelitis
* Neuralgia
* Neuropathy
* Nystagmus
* Psychosis
* Psychotic depression
* Increased reflexes
* Stupor
* Withdrawal syndrome
* Hiccup
* Lung fibrosis
* Increased sputum
* Voice alteration
* Emphysema
* Pulmonary oedema
* Amblyopia
* Specified cataract
* Conjunctival oedema
* Corneal lesion
* Corneal ulcer
* Exophthalmos
* Eye haemorrhage
* Glaucoma
* Hyperacusis[14]
* Otitis externa
* Photophobia
* Retinal haemorrhage (bleeding into the retina)
* Taste loss
* Anisocoria
* Deafness
* Activation syndrome[15][16]

## Very rare[edit | edit source]

Rare (<0.01% incidence) adverse effects include:

* Thrombocytopenia
* Syndrome of inappropriate secretion of antidiuretic hormone (SIADH)
* Serotonin syndrome (symptoms may include agitation, confusion, diaphoresis, hallucinations, hyperreflexia, myoclonus, shivering, tachycardia and tremor)[17][18]
* Gastrointestinal bleeding
* Hepatic events (such as hepatitis, sometimes associated with jaundice and/or liver failure)
* Priapism
* Severe cutaneous adverse reactions (including erythema multiforme, Stevens–Johnson syndrome and toxic epidermal necrolysis)
* Photosensitivity reactions

## References[edit | edit source]

1. ↑ "PRODUCT INFORMATION PAROXETINE SANDOZ 20mg FILM-COATED TABLETS" (PDF). TGA eBusiness Services. Sandoz Pty Ltd. 18 January 2012. Archived from the original on 4 September 2015. Retrieved 22 November 2013.
2. ↑ "PAROXETINE (paroxetine hydrochloride hemihydrate) tablet, film coated [Mylan Institutional Inc.]". DailyMed. Mylan Institutional Inc. January 2012. Archived from the original on 23 October 2013. Retrieved 22 November 2013.
3. ↑ "Paroxetine 20 mg Tablets - Summary of Product Characteristics (SPC)". electronic Medicines Compendium. Sandoz Limited. 21 March 2013. Archived from the original on 3 December 2013. Retrieved 22 November 2013.
4. ↑ "Paxil, Paxil CR (paroxetine) dosing, indications, interactions, adverse effects, and more". Medscape Reference. WebMD. Archived from the original on 10 November 2015. Retrieved 22 November 2013.
5. ↑ Taylor, David; Paton, Carol; Shitij, Kapur (2012). The Maudsley prescribing guidelines in psychiatry. Prescribing guidelines in psychiatry (11th ed.). West Sussex: Wiley-Blackwell. ISBN 978-0-470-97948-8. OCLC 780368001.
6. ↑ 6.0 6.1 Ciraulo, Domenic A.; Shader, Richard Irwin, eds. (2011). Pharmacotherapy of Depression (2nd ed.). New York, NY: Humana Press. doi:10.1007/978-1-60327-435-7. ISBN 978-1-60327-434-0. OCLC 697508697.
7. ↑ 7.0 7.1 Vesely C, Fischer P, Goessler R, Kasper S (February 1997). "Mania associated with serotonin selective reuptake inhibitors". J Clin Psychiatry. 58 (2): 88. doi:10.4088/JCP.v58n0206e. PMID 9062382.
8. ↑ 8.0 8.1 Ramasubbu R (November 2004). "Antidepressant treatment-associated behavioural expression of hypomania: a case series". Prog Neuropsychopharmacol Biol Psychiatry. 28 (7): 1201–7. doi:10.1016/j.pnpbp.2004.06.015. PMID 15610935.
9. ↑ 9.0 9.1 Grubbs JH (April 1997). "SSRI-induced mania". J Am Acad Child Adolesc Psychiatry. 36 (4): 445. doi:10.1097/00004583-199704000-00003. PMID 9100415.
10. ↑ "PAXIL (paroxetine hydrochloride) Tablets and Oral Suspension: PRESCRIBING INFORMATION" (PDF). Research Triangle Park, NC: GlaxoSmithKline. August 2007. Archived from the original (PDF) on 2011-08-25. Retrieved 2007-08-14.
11. ↑ Morishita S, Arita S (October 2003). "Induction of mania in depression by paroxetine". Hum Psychopharmacol. 18 (7): 565–8. doi:10.1002/hup.531. PMID 14533140.
12. ↑ Olivera AA (1996). "A case of paroxetine-induced akathisia". Biol. Psychiatry. 39 (10): 910. doi:10.1016/0006-3223(96)84504-5. PMID 8860197.
13. ↑ Baldassano CF, Truman CJ, Nierenberg A, Ghaemi SN, Sachs GS (1996). "Akathisia: a review and case report following paroxetine treatment". Compr Psychiatry. 37 (2): 122–4. doi:10.1016/S0010-440X(96)90572-6. PMID 8654061.
14. ↑ Tabachnick, Barbara (September 1998). "Sound Sensitivity" (PDF). Tinnitus Today. Archived from the original (PDF) on 2013-11-01. Retrieved 2013-10-30.
15. ↑ "Important Safety Information about Paxil CR". GlaxoSmithKline. Archived from the original on July 15, 2007.
16. ↑ Nishida T, Wada M, Wada M, Ito H, Narabayashi M, Onishi H (2008). "Activation syndrome caused by paroxetine in a cancer patient". Palliat Support Care. 6 (2): 183–5. doi:10.1017/S1478951508000278. PMID 18501054.
17. ↑ Ochiai Y, Katsu H, Okino S, Wakutsu N, Nakayama K (2003). "[Case of prolonged recovery from serotonin syndrome caused by paroxetine]". Seishin Shinkeigaku Zasshi (in 日本語). 105 (12): 1532–8. PMID 15027311.
18. ↑ Terao T, Hikichi T (2007). "Serotonin syndrome in a case of depression with various somatic symptoms: the difficulty in differential diagnosis". Prog. Neuropsychopharmacol. Biol. Psychiatry. 31 (1): 295–6. doi:10.1016/j.pnpbp.2006.07.007. PMID 16916568.