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Is Paroxetine A Good SSRI Medicine?
Question: Hello Doc
I was taking fluvoxamine 200mg for OCD for last 7 yrs but it was not working so i my doctor canged it to paroxetine 60mg per day for OCD. I have researched about paroxetine and it says it is the most potent SSRI.Also many websites say it is associated with 36 % increase in breast cancer risk..Many websites says it is not associated with any increased risk..It also says it the inhibitor of tamoxifen so it may be associated with increased breast cancer risk so it is not advisable to give it to someone with family history of breast cancer..I dont know wy tere is so much confusion and panic on use of paroxetine..No studies give a definite answer..Kindly help me with this..I would also like to know that do u prescribe paroxetine in your practice and is it a good SSRI? Kindly revert asap..I would also like to know your name and qualification sir..
Thanks
I was taking fluvoxamine 200mg for OCD for last 7 yrs but it was not working so i my doctor canged it to paroxetine 60mg per day for OCD. I have researched about paroxetine and it says it is the most potent SSRI.Also many websites say it is associated with 36 % increase in breast cancer risk..Many websites says it is not associated with any increased risk..It also says it the inhibitor of tamoxifen so it may be associated with increased breast cancer risk so it is not advisable to give it to someone with family history of breast cancer..I dont know wy tere is so much confusion and panic on use of paroxetine..No studies give a definite answer..Kindly help me with this..I would also like to know that do u prescribe paroxetine in your practice and is it a good SSRI? Kindly revert asap..I would also like to know your name and qualification sir..
Thanks
Brief Answer:
The drug is safe to use.
Detailed Answer:
Hello,
I can understand your concern. Paroxetine is a good SSRI drug and has great efficacy. If I have to choose a SSRI for OCD then I would choose Fluoxetine than Paroxetine.
Paroxetine is a safe drug and I am not really aware of its association with Breast cancer. We prescribe this drug to a lot of patients and it’s safe. But at high doses the drug is associated with weight gain, sedation, sexual side effects like delayed ejaculation reduced libido.
If Fluoxamine is not working then you can go with Paroxetine without worries. The drug is safe to use.
Thanks
Please let me know if you need more help.
The drug is safe to use.
Detailed Answer:
Hello,
I can understand your concern. Paroxetine is a good SSRI drug and has great efficacy. If I have to choose a SSRI for OCD then I would choose Fluoxetine than Paroxetine.
Paroxetine is a safe drug and I am not really aware of its association with Breast cancer. We prescribe this drug to a lot of patients and it’s safe. But at high doses the drug is associated with weight gain, sedation, sexual side effects like delayed ejaculation reduced libido.
If Fluoxamine is not working then you can go with Paroxetine without worries. The drug is safe to use.
Thanks
Please let me know if you need more help.
Above answer was peer-reviewed by :
Dr. Prasad
Dear Doc Actually the research says that it leads to disruption in estrogen levels and increased prolactin thats why it might lead to increased risk of BC..If u say drug is safe to use i would definitely try it alteast for a year and see how it goes..I would like to know whether paroxetine itself cause weight gain or excessive eating in anxiety disorders and lack of exercise lead to weight gain ? kindly reply..
Brief Answer:
The drug causes weight gain by direct effects
Detailed Answer:
Hello,
There is no direct disruption of estrogen levels. It can lead to increased prolactin by dopamine effects but this effect is also not direct. This can theoretically increase the risk but I am not aware of any case report suggesting direct risk of breast cancer with Paroxetine.
The drug due to anti cholinergic and anti histaminic effects can lead to increased appetite and weight gain. But that can be controlled with exercise. If we consider SSRIs then the drug falls in high risk category if weight gain is considered.
Thanks.
The drug causes weight gain by direct effects
Detailed Answer:
Hello,
There is no direct disruption of estrogen levels. It can lead to increased prolactin by dopamine effects but this effect is also not direct. This can theoretically increase the risk but I am not aware of any case report suggesting direct risk of breast cancer with Paroxetine.
The drug due to anti cholinergic and anti histaminic effects can lead to increased appetite and weight gain. But that can be controlled with exercise. If we consider SSRIs then the drug falls in high risk category if weight gain is considered.
Thanks.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
I got reviews that paroxetine is the best drug for controlling intrusive thoughts and obsessions as it the most potent ssri and highly selective serotonin inhibitor..What are your experiences of paroxetine in treating OCD patients?
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Thank you doc my doctor has also added L methyl for augmentation effect of Paroxetine. He told 15 mg per day. So is it worth a try. Its expensive though. Thank you
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Thank you doc my doctor has also added L methyl for augmentation effect of Paroxetine. He told 15 mg per day. So is it worth a try. Its expensive though. Thank you
Brief Answer:
Yes. Paroxetine is a good drug.
Detailed Answer:
Hello,
If we consider drug of choice for OCD as per studies then best is Fluoxetine followed by Fluvoxamine. But over all we can use any SSRI, the choice depends upon patient profile, side effects profile etc.
Paroxetine has great efficacy in controlling unwanted thoughts and you can give this drug a try without hesitation. I am using the drug in some patient and the drug has good results. I usually use the doses of 37.5 to 50 mg controlled release in my patients. I avoid using the doses more than 50 mg per day.
Thanks.
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Brief Answer:
L methylfolate is a good supplement
Detailed Answer:
Hello,
L methylfolate is a supplement and the supplement is known to potentiate the actions of antidepressants. I am neither in favour of this and not against it. If you take this drug with Paroxetine then that will surely help you but if you miss the drug even then there is no significant loss.
I hope this helps. You can give this a try. I usually advise Methylcobalamine in my patients apart from advising them to increase animal food intake.
Thanks.
Yes. Paroxetine is a good drug.
Detailed Answer:
Hello,
If we consider drug of choice for OCD as per studies then best is Fluoxetine followed by Fluvoxamine. But over all we can use any SSRI, the choice depends upon patient profile, side effects profile etc.
Paroxetine has great efficacy in controlling unwanted thoughts and you can give this drug a try without hesitation. I am using the drug in some patient and the drug has good results. I usually use the doses of 37.5 to 50 mg controlled release in my patients. I avoid using the doses more than 50 mg per day.
Thanks.
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Brief Answer:
L methylfolate is a good supplement
Detailed Answer:
Hello,
L methylfolate is a supplement and the supplement is known to potentiate the actions of antidepressants. I am neither in favour of this and not against it. If you take this drug with Paroxetine then that will surely help you but if you miss the drug even then there is no significant loss.
I hope this helps. You can give this a try. I usually advise Methylcobalamine in my patients apart from advising them to increase animal food intake.
Thanks.
Note: For further guidance on mental health, Click here.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
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