Paroxétine

Chemistry

Paroxétine is a derivative of the Phénylpipéridine group of the selective inhibiting of recaptures serotonin. Its empirical Formule is C ₁₉ H ₂₀ F NR O ₃, with a molecular Mass of 374,8 for its hydrochlorate (329,3703 as a free Base).

It is identified by the PubChem database under code 9619 and by the DrugBank database under code APRD00364.

Pharmacology

It is a selective Antidépresseur of the subclass of the Inhibiteurs of recaptures serotonin.

It reaches its maximum concentration of 4,9 H (if the catch is made during a meal) with 6,4 H (if the catch is done with jeun).

Medical use

Indications

It is prescribed for the depression S and the states anxieux.

Also prescribed for the compulsif obsessional Disorder and the post-traumatic Disorder of stress, it is often described like a Médicament against timidity.

In the majority of the countries, it is prescribed only under ordinance.

Counter-indications

Paroxétine could have an effect Tératogène (to date the whole of the studies are insufficient to exclude it completely): the use in the course of Grossesse is résevée with the cases where the molecule is strictly indicated.

It is advised not to drive vehicles and not to use machines during the first two weeks.

The alcohol has an action of potentiation.

Side effects

The Side effects of Paroxétine generally appear between the first and the fourth week which follow the first catch; it is about the period during which the body adapts to the drug.

Paroxétine can involve some, all or any the undesirable effects described hereafter, and the majority of them disappear or attenuate by continuing the treatment; however some of between-them do not disappear for the period from treatment.

In addition, the drug could generate suicidal ideas at the teenagers. In the United States, the Food and Drug Administration ordered the seizure of several million compressed of Paxil® in 2005. These side effects are often discussed but they worry the scientific community.

Side effects:

Apathy
Dilation of the pupil
Nauseas
Tératogenicité: This drug is disadvised to the expectant mothers because of possible cardiac anomalies * Somnolence
Headaches
Modifications of the weight and the appetite
Changes of the sexual behavior
Increase in the feelings of depression and anxiety (initially)
Dryness of the mouth
aggressive Behavior (especially in the children)
possible congenital Malformations
Erythema
psychomotor Instability/akathisy
Itchings
Déplétion (Sodium)
suicidal Sweats
Ideas
muscular Weakness
muscular Pains
unusual Levels of serotoninergic aggression
Syndrome

The information records to the patients on Paroxétine seems to vary from one country to another.

It is recommended to consult if one suffers from one of the symptoms according to:

muscular Spasmes of the jaw, the neck, the back
Fièvre, shivers, evils of throat, grippaux symptoms
Jaunissement of the skin or the eyes
black Selles, tar spraying machines (what can be sign of digestive bleeding high)

It was proven that Paroxétine and other ISRS have undesirable effects at the sexual level at the majority of the patients, men and women. Although usually reversible, these side effects last sometimes of the months, of the years or definitively, even after the molecule was definitively eliminated; this phenomenon is known as Dysfonction sexual post ISRS.

Specialities

In Belgium: Aropax®, Merck-paroxétine®, Paroxétine (Bexal®, EG®, Ratiopharm®, Sandoz®, Teva®, Topgen®), Seroxat®;
In France: Deroxat® (Compressed S and drinkable suspension), Divarius®, Paroxétine (Arrow®, Biogaran®, EG®, G GAM®, Irex®, Ivax®, Merck®, Qualimed®, Ratiopharm®, RPG®, Sandoz®);
In Swiss: Deroxat®, Dexantol®, Parexat®, Paronex®, Paroxétine (HelvePharm®, Mepha®, Sandoz®), Paroxetop®.

Discusses

partial since the English page, version of the 26 11 2007 October 6th, 2006, a court of justice of the United States approved the qualification in " class action" continuations of any person of the United States having bought of Paxil (R) gold Paxil CR (TM) prescribed for the consumption of a minor. GlaxoSmithKline is continued to have recommended Paxil (R) gold Paxil CR (TM) to the regulation for the children and teenagers while occulting related informations with the job security and the effectiveness of the drug on the minors, which GSK refutes.

The current legal decision allows any person of the United States, having bought of Paxil or Paxil CR for children or teenagers, to be refunded 100% of its expenditure on document in proof, or up to 100$ if no document in proof were preserved.

In the United Kingdom, since 2001, of the similar continuations are in hand against Glaxo-Smithkline concerning Seroxat, on the basis which it would have of the effest undesirable low registers, which Glaxo-Smithkline undervalues in the information made to the patients.

In March 2004 the FDA imposed that a stringcourse of alarm is affixed on all the inhibiters of recaptures serotonin and the other antipédresseurs, informing risk of suicidal thoughts at the children and teenagers. , The regulation of these drugs to the child dropped thereafter by 20%. .

Since the active substance was approved by the FDA in 1992, approximately 5000 citizens of the United States continued GSK. Majority of them insufficiently feeling prevented side effects - inter alia the symptoms of habituation, GSK having spédifié that this drug " dépendant" did not return;

The 29 01 a 2007 emission of the BBC having for subject Seroxat exploited the data of the clinical trials of GSK; they show that one cannot prove that it functions on the teenagers, but that gives them 6 times more chances to become suicidal.

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