Paxidep CR tablets uses and side effects

Paxidep CR is an Indian brand of SSRI (Selective serotonin reuptake inhibitor) antidepressant. Its generic name is paroxetine. It is prescribed for depression, panic disorder and other anxiety disorders. It is especially prescribed for breastfeeding mothers due to low concentration of the medication in breast milk. CR is shortened name for controlled release. It means once the medication is ingested, tablet will release the active drug into the blood  slowly. Therefore it will cause less side effects. 

However, this medication is having side effects common to SSRI class medications such as nausea, heartburn and headache. In addition, compared to other SSRI medications, it can cause more fetal malformations. Therefore, this medication should be discontinued in pregnancy.

Paxidep controlled release tablets can  be used less frequently and at low doses to minimize side effects

Pregnant women should not take this medication due to risk to the baby

Uses of Paxidep CR

This medication is prescribed for major depression, panic disorder and other anxiety disorders. Clinical depression is characterized by persistent low mood, low energy, and lack of enjoyment of previously enjoyable activities lasting for more than two weeks. In addition, depression can cause suicidal ideation.

Depression is a common indication for this medication

Panic and other anxiety disorders are characterized by inappropriate anxiety (“a feeling of worry, nervousness, or unease, typically about an imminent event or something with an uncertain outcome.”) that can cause severe functional impairment in the affected individual.

Panic disorder can be treated with Paxidep

In addition, Paxidep CR is effective in obsessive compulsive disorders (OCD). Obsessive compulsive disorder is characterized by inappropriately repetitive behavior which is senseless and resisted by the individual. E.g Repetitive hand washing to wash away germs.

This medication is preferred antidepressant in breastfeeding due to minimal drug concentration in breast milk. However, it should not be used by pregnant women. Therefore, breast feeding women should take adequate contraception during treatment.

What are the common side effects of Paxidep CR?

1. Nausea
2. Heartburn
3. Headache
4. Loss of appetite
5. Sexual dysfunction
6. Yawning
7. Abnormal dreams
8. Sleep problems
9. Increased blood cholesterol

What are the rare side effects of this medication?

1. Heart problems
2. Documented harm to the baby when the mother takes this medication.
3. Initial increase of anxiety when prescribed for anxiety disorders. Due to this risk many doctors prescribe low doses at the initial period of illness. But this effect usually wanes after that.
4. Hives and allergic reaction
5. Risk of mania (Opposite of depression with excessive energy, elevated self-esteem that can cause severe social malfunction)
6. Reduced salt levels in blood
7. Increased risk of bleeding
8. Serotonin syndrome

Most of the side effects go off after some time. But most troublesome side effects such as sexual dysfunction, may persist. It is characterized by erectile dysfunction in men and reduced sexual desire in females. In addition, this medication can cause delayed ejaculation which can be used in the treatment of premature ejaculation.

Since depression can also cause sexual dysfunction, some will experience elevated sexual activity due to reduced depression. So it is a balance of effects of depression and medication.

In anxiety disorders, at the initial period of treatment, this medication can cause elevated anxiety. This usually wanes over time.  

How Paxidep CR is prescribed?

This medication is available as tablets. Usual dose range is between 12.5 to 37.5mg per day. Elderly patients will get maximum daily dose of 25mg. Usually the medication is prescribed in morning due to the disturbance of sleep associated with this medication.

This medication should be taken with meals to minimize side effects. It should be taken with a full glass of water and the tablet should not be crushed/broken.

What the doctor should know before prescribing this medication

1. Bipolar affective disorder
2. Liver problems
3. Kidney problems
4. Pregnancy status (should not be given in first trimester of pregnancy)
5. Bleeding problems
6. Long standing gastritis

"If you are a woman in reproductive age then this medication should be taken with adequate contraception to prevent exposure to baby. "

Oxat is another paroxetine brand that is popular in India. 

Summary

Paxidep CR is a controlled release SSRI class medication prescribed for depression and anxiety disorders. Main side effects are nausea, heart burn and sexual dysfunction. This medication should not be prescribed for pregnant women who are in their first trimester.