Patient/caregiver was educated on contraindications for using Paroxetine as follows:
- Serotonin is one chemical in the brain, which in permissible amounts, is believed to reduce anxiety and promote happiness and well-being. Very excessive concentrations of serotonin in the brain can lead to serotonin syndrome. Individuals with serotonin syndrome can present with mania, excitement, hallucinations, agitation, insomnia, pounding heartbeat, very rapid heart rate, overactive reflexes, and diarrhea. Paroxetine use, especially along with other antidepressants acting on the same lines, such as, fluoxetine, citalopram, and sertraline, can significantly increase the serotonin levels in the body and lead to development of serotonin syndrome. Paroxetine use along with a few other antidepressants, such as, phenelzine, selegiline, and tranylcypromine can also significantly increase the serotonin levels in the body and lead to development of serotonin syndrome. Paroxetine use is discouraged along with these medications. Caution must be exercised even when discontinuing on any of the above mentioned antidepressant medications with potential to increase serotonin levels and starting on paroxetine, by observing a window period of atleast 2 weeks, before the transition to paroxetine is made. This helps with complete elimination of these medications from the body, reduce the risk for interaction with paroxetine, and reduce risk for development of serotonin syndrome.
- Paroxetine use in expectant mothers could harm the unborn baby and result in birth defects. So, paroxetine should be avoided for an alternative drug during pregnancy and in women planning for pregnancy. Women in the child-bearing age group, taking paroxetine on a regular basis, must employ effective contraceptive measures in order to avoid getting pregnant.
