NationMaster - Encyclopedia: Paroxetine

Paroxetine (Paxil, Seroxat, Pexeva) is a selective serotonin reuptake inhibitor (SSRI) antidepressant. It was released in 1992 by the pharmaceutical company GlaxoSmithKline. In 2006 it was the fifth-most prescribed antidepressant in the United States retail market, with more than 19.7 million prescriptions.^[1] The prescription of this drug is controversial because of side effects such as suicidal ideation and withdrawal syndrome which have resulted in legal proceedings against the manufacturer. In pharmacology and toxicology, a route of administration is the path by which a drug, fluid, poison or other substance is brought into contact with the body. ... SSRI redirects here; for other uses, see SSRI (disambiguation). ... Prozac, a selective serotonin reuptake inhibitor (SSRI) Serotonin-norepinephrine reuptake inhibitor, Venlafaxine An antidepressant, is a psychiatric medication or other substance (nutrient or herb) used for alleviating depression or dysthymia (milder depression). ... Year 1992 (MCMXCII) was a leap year starting on Wednesday (link will display full 1992 Gregorian calendar). ... GlaxoSmithKline plc (LSE: GSK NYSE: GSK) is a British based pharmaceutical, biological, and healthcare company. ... Suicidal ideation is common medical term for the mere thoughts about and of plans of committing suicide, not the actual following through or act itself. ... Paroxetine (Paxil, Seroxat) is a selective serotonin reuptake inhibitor (SSRI) antidepressant. ...

Indications

Approved

Paroxetine is primarily used to treat the symptoms of depression, obsessive-compulsive disorder (OCD), post-traumatic stress disorder (PTSD), panic disorder, generalized anxiety disorder (GAD), ^[2] social phobia/social anxiety disorder, ^[3] and premenstrual dysphoric disorder (PMDD).^[4] On the Threshold of Eternity. ... OCD redirects here. ... Post-traumatic stress disorder (PTSD) is a term for certain severe psychological consequences of exposure to, or confrontation with, stressful events that the person experiences as highly traumatic. ... Post-traumatic stress disorder (PTSD) is a term for certain severe psychological consequences of exposure to, or confrontation with, stressful events that the person experiences as highly traumatic. ... Panic Disorder is a psychiatric condition characterized by recurring panic attacks in combination with significant behavioral change or at least a month of ongoing worry about the implications or concern about having other attacks. ... Generalized anxiety disorder (GAD) is an anxiety disorder that is characterized by excessive, uncontrollable and often irrational worry about everyday things, which is disproportionate to the actual source of worry. ... Generalized anxiety disorder (GAD) is an anxiety disorder that is characterized by excessive, uncontrollable and often irrational worry about everyday things, which is disproportionate to the actual source of worry. ... Social anxiety, sometimes known as social phobia or social anxiety disorder (SAD), is a common form of anxiety disorder that causes sufferers to experience intense anxiety in some or all of the social interactions and public events of everyday life. ... Premenstrual dysphoric disorder (PMDD) is a severe form of premenstrual syndrome, afflicting 8% of all women. ... Premenstrual dysphoric disorder (PMDD) is a severe form of premenstrual syndrome, afflicting 8% of all women. ...

It was the first antidepressant formally approved in the United States for the treatment of social anxiety disorder ^{[citation needed]}. Social anxiety is an experience of fear, apprehension or worry regarding social situations and being evaluated by others. ...

According to the prescribing information provided by the manufacturer of Paxil brand of paroxetine GlaxoSmithKline and approved by the FDA^[5], the effectiveness of paroxetine in major depressive disorder has been proven by six placebo-controlled clinical trials. For panic disorder, three 10-12-week studies indicated paroxetine superiority to placebo.^[5] Similarly, three 12-week trials for adult outpatients with social anxiety disorder demonstrated better response to paroxetine than to placebo.^[5]

Unapproved/off-label/investigational

Double-blind studies indicated that paroxetine can also be used in the treatment of premature ejaculation. After receiving paroxetine for several weeks, intravaginal ejaculation latency time (IELT) of the study subjects increased 6-13-fold, which was longer than the delay achieved by the treatment with other SSRIs (fluvoxamine, fluoxetine, sertraline and citalopram).^[6]^[7]^[8] However, paroxetine taken acutely ("on demand") 3–10 hours before coitus resulted only in a "clinically irrelevant and sexually unsatisfactory" 1.5-fold delay of ejaculation and was inferior to clomipramine, which induced a four-fold delay.^[8] This article or section is in need of attention from an expert on the subject. ... Clomipramine (brand-name AnafranilÂ®) is a tricyclic antidepressant. ...

There is also evidence that paroxetine may be effective in the treatment of compulsive gambling^[9] and hot flashes.^[10] Compulsive gambling is an urge or addiction to gamble despite harmful negative consequences or a desire to stop. ... A Hot flush (sometimes hot flash or night sweat) is a symptom of Menopause and changing hormone levels which typically expresses itself at night as periods of intense heat with sweating and rapid heartbeat and may typically last from two to thirty minutes on each occasion. ...

In two double-blind studies of bipolar disorder patients, addition of paroxetine to a mood stabilizer had no advantages over addition of placebo.^[11]^[12] Benefits of paroxetine prescription for diabetic neuropathy^[13] or chronic tension headache.^[14] are uncertain. Diabetic neuropathies are neuropathic disorders that are associated with diabetes mellitus. ... Tension headaches, which were renamed tension-type headaches by the International Headache Society in 1988, are the most common type of primary headaches. ...

Pharmacology

Paroxetine is the most potent and one of the most specific selective serotonin (5-hydroxytryptamine, 5-HT) reuptake inhibitors (SSRI).^[15] This activity of the drug on brain neurons is thought to be responsible for its antidepressant effects. Serotonin (pronounced ) (5-hydroxytryptamine, or 5-HT) is a monoamine neurotransmitter synthesized in serotonergic neurons in the central nervous system (CNS) and enterochromaffin cells in the gastrointestinal tract of animals including humans. ... Neurons (also called nerve cells) are the primary cells of the nervous system. ...

Paroxetine is a phenylpiperidine derivative which is chemically unrelated to the tricyclic or tetracyclic antidepressants. In receptor binding studies, paroxetine did not exhibit significant affinity for the adrenergic (α₁, α₂, β), dopaminergic, serotonergic (5HT₁, 5HT₂), or histamine receptors of rat brain membrane. A weak affinity for the muscarinic acetylcholine and noradrenaline receptors was evident. The predominant metabolites of paroxetine are essentially inactive as 5-HT reuptake inhibitors. Chemical structure of the tricyclic antidepressant amitriptyline. ... There are also several chemically unrelated tetracyclic antibiotics based on Tetracycline. ... An adrenergic is a drug, or other substance, which has effects similar to, or the same as, epinephrine (adrenaline). ... Dopaminergic means related to the neurotransmitter dopamine. A synapse is dopaminergic if it uses dopamine as its neurotransmitter. ... The histamine receptors are a class of G-protein coupled receptors with histamine as their endogenous ligand. ... Amanita muscaria from which muscarine was isolated Acetylcholine - natural agonist of muscarinic and nicotinic receptors. ... Norepinephrine, known as noradrenaline outside the USA, is a catecholamine and a phenethylamine with chemical formula C8H11NO3. ...

Chemistry

Paroxetine hydrochloride is an odorless, off-white powder, having a melting point range of 120° to 138°C and a solubility of 5.4 mg/mL in water.

Formulations

Paxil CR (paroxetine extended release) is available in 12.5, 25, and 37.5 mg tablets.

Paroxetine CR (controlled release) was shown to be associated with a lower rate of nausea during the first week of treatment than paroxetine immediate release. However, the rate of treatment discontinuation due to nausea was not significantly different.^[16]

Side effects

General side effects are mostly present during the first 1-4 weeks while the body adapts to the drug. Almost all SSRIs are known to cause either one or more of these symptoms. A person receiving paroxetine treatment may experience a few, all, or none of the following side-effects, and most side-effects will disappear or lessen with continued treatment, though some may last throughout the duration. Side effects are also often dose-dependent, with fewer and/or less severe symptoms being reported at lower dosages, and more and/or more severe symptoms being reported at higher dosages. Increases or changes in dosage may also cause symptoms to reappear or worsen. ^[5]

9 December 2004 European Medicines Agency (EMEA), i.e. the Committee for Medicinal Products for Human Use (CHMP), informed patients, prescribers and parents that paroxetine should not be prescribed to children. CHMP gave a warning to prescribers recommending close monitoring of adult patients at high risk of suicidal behaviour and/or suicidal thoughts. In other words, CHMP does not prohibit use of paroxetine with adults but stresses extreme caution in actual usage. Also withdrawal reactions upon stopping treatment is mentioned and therefore it is recommended to gradually reduce the dose over several weeks or months if decision of withdrawal is made. ^[17] Look up December in Wiktionary, the free dictionary. ... Year 2004 (MMIV) was a leap year starting on Thursday of the Gregorian calendar. ... The European Medicines Agency (EMEA) is a European agency for the evaluation of medicinal products. ...

Most common

A headache (cephalalgia in medical terminology) is a condition of pain in the head; sometimes neck or upper back pain may also be interpreted as a headache. ... For other uses, see Nausea (disambiguation). ... Xerostomia is the medical term for a dry mouth due to a lack of saliva. ... Perspiration (also called sweating or sometimes transpiration) is the production and evaporation of a fluid, consisting primarily of water as well as a smaller amount of sodium chloride (the main constituent of table salt), that is excreted by the sweat glands in the skin of mammals. ... Somnolence (or drowsiness, or hypersomnia) is a state of near-sleep, a strong desire for sleep, or sleeping unusually long periods. ... Somnolence (or drowsiness) is a state of near-sleep, a strong desire for sleep, or sleeping for unusually long periods. ... This article is about the sleeping disorder. ... Constipation or irregularity, is a condition of the digestive system where a person (or animal) experiences hard feces that are difficult to egest; it may be extremely painful, and in severe cases (fecal impaction) lead to symptoms of bowel obstruction. ... Types 5-7 on the Bristol Stool Chart are often associated with diarrhea Diarrhea (in American English) or diarrhoea (in British English) is a condition in which the sufferer has frequent watery, loose bowel movements (from the Greek word Î´Î¹Î¬ÏÏÎ¿Î¹Î±; literally meaning through-flowing). Acute infectious diarrhea is a common cause... // An orgasm (sexual climax) is the conclusion of the plateau phase of the sexual response cycle, and is experienced by both males and females. ... For other uses, see Libido (disambiguation). ... Erectile dysfunction (ED) or impotence is a sexual dysfunction characterized by the inability to develop or maintain an erection of the penis. ... For the film see Tremors (film). ... For other uses, see Vertigo. ... // Pre-syncope is a sensation of feeling faint. ... Motion sickness or kinetosis is a condition in which a disagreement exists between visually perceived movement and the vestibular systems sense of movement. ...

Less common

In everyday language depression refers to any downturn in mood, which may be relatively transitory and perhaps due to something trivial. ... what up?? Anxiety is a physiological state characterized by cognitive, somatic, emotional, and behavioral components (Seligman, Walker & Rosenhan, 2001). ... This article does not cite any references or sources. ... Not to be confused with Pity, Sympathy, or Compassion. ... For the band, see Saliva (band). ... Bruxism (from the Greek Î²ÏÏ…Î³Î¼ÏŒÏ‚ (brugmÃ³s), gnashing of teeth) is the grinding of the teeth, typically accompanied by the clenching of the jaw. ... Asthenia (Greek: Î±ÏƒÎ¸ÎÎ½ÎµÎ¹Î±, lit. ... See also Muscle Atrophy Muscle weakness (or lack of strength) is a direct term for It is the inability to exert force with ones muscles to the degree that would be expected given the individuals general physical fitness. ... An itch (Latin: pruritus) is an uncomfortable sensation felt on an area of skin that causes a person or animal to desire to scratch that area. ... A rash is a change in skin which affects its color, appearance, or texture. ... The current usage of the term nightmare refers to a dream which causes the sleeper a strong unpleasant emotional response. ... Taste is one of the traditional five senses and refers to the ability to detect the flavor of foodstuffs and other substances (e. ...

Rare

Myoclonus is brief, involuntary twitching of a muscle or a group of muscles. ... The electrolyte disturbance hyponatremia or hyponatraemia exists in humans when the sodium level in the plasma falls below 135 mmol/l. ... Akathisia (or acathisia) is an often extremely unpleasant subjective sensation of inner restlessness that manifests itself with an inability to sit still or remain motionless, hence the origin of its name: Greek a (without) + kathesis (sitting). ... In psychology and other social and behavioral sciences, aggression refers to behavior that is intended to cause harm or pain. ... Lets talk about risk control strategies, anyone with more information and willing to share, please do so. ...

Very rare but serious

Suicidal ideation is common medical term for the mere thoughts about and of plans of committing suicide, not the actual following through or act itself. ... For other uses, see Suicide (disambiguation). ... Serotonin syndrome is a rare, but potentially life-threatening adverse drug reaction that results from intentional self-poisoning, therapeutic drug use, or inadvertent interactions between drugs. ... This article is an expansion of a section entitled Mania from within the main article Bipolar disorder. ... Hypomania is a mood state characterized by persistent and pervasive elated or irritable mood, and thoughts and behaviors that are consistent with such a mood state. ... A spasm is a sudden, involuntary contraction of a muscle, a group of muscles, or a hollow organ, or a similarly sudden contraction of an orifice. ... An analogue medical thermometer showing the temperature of 38. ... Influenza, commonly known as flu, is an infectious disease of birds and mammals caused by RNA viruses of the family Orthomyxoviridae (the influenza viruses). ... Jaundice, also known as icterus (attributive adjective: icteric), is a yellowing of the skin, conjunctiva (a clear covering over the sclera, or whites of the eyes) and mucous membranes caused by hyperbilirubinemia (increased levels of bilirubin in red blooded animals). ... Gastrointestinal bleeding or gastrointestinal hemorrhage describes every form of hemorrhage (loss of blood) in the gastrointestinal tract, from the pharynx to the rectum. ...

Other

Paroxetine and other SSRIs have been shown to cause sexual side effects in most patients, both males and females^[19]. Although usually reversible, these sexual side effects can sometimes last for months, years or possibly indefinitely even after the drug has been completely withdrawn. This disorder is known as Post SSRI Sexual Dysfunction. Teratogenesis is a medical term from the Greek, literally meaning monster-making, which derives from teratology, the study of the frequency, causation, and development of congenital malformationsâ€”misleadingly called birth defects. ... Post SSRI Sexual Dysfunction (PSSD) is a type of sexual dysfunction caused by the previous use of SSRI antidepressants. ...

Withdrawal syndrome

Many psychoactive medications can cause withdrawal symptoms upon discontinuation from administration. Evidence has shown that paroxetine has among the highest incidence rates and severity of SSRI discontinuation syndrome of any medication of its class.[1],[2] Common paroxetine withdrawal symptoms include repeated electrical shock sensations of the brain and body (see "brain zaps"), vertigo and hot flashes.^[20] Suicidal ideation is a frequently reported experience in those withdrawing from SSRIs.^[21] For those experiencing extreme and unusual difficulty discontinuing paroxetine, it is recommended that an SSRI with a longer half-life, such as fluoxetine, be administered for approximately two weeks, then discontinued, to lessen symptoms.^[22]^[23] SSRI discontinuation syndrome, also known as SSRI withdrawal syndrome or SSRI cessation syndrome, is a condition that can occur during or following the interruption, lowering of dose or discontinuation of regular SSRI or SNRI antidepressant drug usage. ... SSRI discontinuation syndrome, also known as SSRI withdrawal syndrome or SSRI cessation syndrome, is a condition that can occur during or following the interruption, lowering of dose or discontinuation of regular SSRI or SNRI antidepressant drug usage. ... Brain zaps, (proposed name: myalotinasis from Greek for brain + jolt) also known as the electric brain thing, brain shivers, brain shocks, battery head, blips, or brain spasms, are a fairly common and notorious withdrawal symptom experienced during discontinuation (or reduction of dose) of SSRI and SNRI antidepressant drugs. ... Prozac redirects here. ...

For 10 years, GlaxoSmithKline's marketing of the drug stated falsely that it was "not habit forming."[3],[4] In 2002, the U.S. FDA published a new product warning about the drug, and the International Federation of Pharmaceutical Manufacturers Associations (IFPMA) declared GSK guilty of misleading the public about paroxetine on US television.[5] The British Medical Journal quoted Charles Medawar, head of Social Audit: "This drug has been promoted for years as safe and easy to discontinue.... The fact that it can cause intolerable withdrawal symptoms of the kind that could lead to dependence is enormously important to patients, doctors, investors, and the company. GlaxoSmithKline has evaded the issue since it was granted a licence for paroxetine over 10 years ago, and the drug has become a blockbuster for them, generating about a tenth of their entire revenue. The company has been promoting paroxetine directly to consumers as 'non-habit forming' for far too long." [6] As of 2007, GlaxoSmithKline's prescribing information acknowledges the symptoms but eschews the term "withdrawal" in favor of the phrases "serious discontinuation symptoms" and "discontinuation syndrome."[7] GlaxoSmithKline plc (LSE: GSK NYSE: GSK) is a British based pharmaceutical, biological, and healthcare company. ... The United States Food and Drug Administration is the government agency responsible for regulating food, dietary supplements, drugs, cosmetics, medical devices, biologics and blood products in the United States. ... The IFPMA is the International Federation of Pharmaceutical Manufacturers and Associations. ... GlaxoSmithKline plc (LSE: GSK NYSE: GSK) is a British based pharmaceutical, biological, and healthcare company. ...

Patients considering paroxetine should be warned in advance of these risks, and withdrawal from any SSRI should be closely medically supervised by the prescribing provider.

Warning for pregnant women

Pregnant women and those who might become pregnant should avoid taking the antidepressant Paxil because of a high risk of birth defects, according to a committee of obstetricians who published their opinion in the December 2006 issue of the journal Obstetrics & Gynecology.^[24]

The obstetric practice committee of the American College of Obstetricians and Gynecologists said pregnant women should not take Paxil because two previous studies found that the drug posed up to double the risk of heart defects in fetuses.

Nearly a year ago, the U.S. Food and Drug Administration (FDA) and GlaxoSmithKline -- which makes Paxil -- changed the warnings on the drug to include the results of the studies. The FDA then advised pregnant women to merely switch from Paxil to another SSRI drug, such as Prozac or Zoloft. Background Fluoxetine hydrochloride (brand names include Prozac®, Symbyax® (compounded with olanzapine), Sarafem®, Fontex® (Sweden), Fluctine (Austria, Germany), Prodep (India), Fludac (India)) is an antidepressant drug used medically in the treatment of depression, obsessive-compulsive disorder, bulimia nervosa, premenstrual dysphoric disorder, and many other disorders. ... Sertraline hydrochloride (Zoloft®, Lustral®, Apo-Sertral®, Asentra®, Gladem®, Serlift®, Stimuloton®) is an orally administered antidepressant of the selective serotonin reuptake inhibitor (SSRI) type. ...

The FDA's enhanced warning on Paxil followed the results of a review of Sweden's birth registry that found pregnant women who took Paxil were 1.5 to 2 times more likely to give birth to a baby with heart defects than women who took other SSRIs or who did not take antidepressants at all.

Neonatal withdrawal symptoms from Paxil have also been documented from mothers taking Paxil during pregnancy.^[25]

Controversy

In May 2007 a US court approved a settlement in a class action lawsuit brought on behalf of everyone in the United States who purchased Paxil or Paxil CR prescribed for a minor. The lawsuit alleged that GlaxoSmithKline promoted Paxil or Paxil CR for prescription to children and adolescents while withholding and concealing material information about the medication's safety and effectiveness for minors. GSK denied all claims. The settlement terms entitled everyone, who previously purchased Paxil or Paxil CR for the child or ward, to recover up to 100% of the documented out-of-pocket expenses or $100, if the documentation was not available.^[26] ^[27]

In the UK since 2001 lawsuits have been filed representing people who have been prescribed Seroxat. They allege that the drug has serious side effects, which GlaxoSmithKline downplayed in patient information.^[28]

In March 2004 the FDA ordered a black box warning placed on SSRI and other antidepressants, warning of the risk for potential suicidal thinking in children and adolescents.[8],[9] ABC News reported that the prescribing of these medications to children subsequently dropped by 20 percent. [10]. According to the Center for Disease Control and Prevention's Annual Summary of Vital Statistics, the suicide rate rose more than 18 percent in those 1 to 19 years old, from 2.2 per 100,000 in 2003 to 2.6 per 100,000 in 2004. In those 15 to 19 years old, the figures reflected a more than 12 percent rise in suicide, from 7.3 per 100,000 in 2003 to 8.2 per 100,000 in 2004.[11] This led many experts to conclude that the warning, and subsequent reduction in the use of antidepressants, led to an increased suicide rate in this age group.[12] The finding is consistent with an earlier finding, reported to the 2003 FDA Advisory Committee by Dr David Shaffer, that suicide rates in the United States fell during the 1990s, in line with the introduction of SSRIs.[13]

Since the FDA approved paroxetine in 1992, approximately 5,000 U.S. citizens have sued GSK. Most of these people feel they were not sufficiently warned in advance of the drug's side effects - including particularly the withdrawal syndrome discussed above, after GSK had specifically advertised the drug as "not habit forming."[14]

On January 29 2007, the BBC in the UK broadcast a fourth documentary in its 'Panorama' series about the drug Seroxat.^[29] This programme, entitled Secrets of the Drug Trials, focused on three GSK paediatric clinical trials on depressed children and adolescents. Data from the trials show that Seroxat could not be proven to work for teenagers. Also, one clinical trial indicated that adolescents were six times more likely to become suicidal after taking it.

Trade names

Paroxetine is marketed under several tradenames: A trade name, also known as a trading name or a business name, is the legal name of a business, or the name which a business trades under for commercial purposes. ...

Latin America consists of the countries of South America and some of North America (including Central America and some the islands of the Caribbean) whose inhabitants mostly speak Romance languages, although Native American languages are also spoken. ... Motto: Je Maintiendrai (Dutch: Ik zal handhaven, English: I Shall Uphold) Anthem: Wilhelmus van Nassouwe Capital Amsterdam1 Largest city Amsterdam Official language(s) Dutch2 Government Parliamentary democracy Constitutional monarchy - Queen Beatrix - Prime minister Jan Peter Balkenende Independence Eighty Years War - Declared July 26, 1581 - Recognised January 30, 1648 (by Spain...

Footnotes

^ The paroxetine prescriptions were calculated as a total of prescriptions for Paxil CR and generic paroxetine using data from the charts for generic and brand-name drugs.Top 200 generic drugs by units in 2006. Top 200 brand-name drugs by units.. Drug Topics, Mar 5, 2007. Retrieved on 2007-04-08.
^ Baldwin DS, Anderson IM, Nutt DJ, Bandelow B, Bond A, Davidson JR, den Boer JA, Fineberg NA, Knapp M, Scott J, Wittchen HU (2005). "Evidence-based guidelines for the pharmacological treatment of anxiety disorders: recommendations from the British Association for Psychopharmacology.". Journal of Psychopharmacology 19 (6): 567-596. PMID 16272179.
^ D Baldwin, J Bobes, DJ Stein, I Scharwachter and M Faure (1999). "Paroxetine in social phobia/social anxiety disorder. Randomised, double-blind, placebo-controlled study. Paroxetine Study Group". The British Journal of Psychiatry 175: 120-126. PMID 10627793.
^ Yonkers KA, Gullion C, Williams A, Novak K, Rush AJ. (1996). "Paroxetine as a treatment for premenstrual dysphoric disorder.". Journal of Clinical Psychopharmacology. 16 (1): 3-8. PMID 8834412.
^ ^a ^b ^c ^d PAXIL® (paroxetine hydrochloride) Tablets and Oral Suspension: PRESCRIBING INFORMATION (PDF). GlaxoSmithKline (August 2007). Retrieved on 2007-08-14.
^ Waldinger MD, Hengeveld MW, Zwinderman AH, Olivier B (1998). "Effect of SSRI antidepressants on ejaculation: a double-blind, randomized, placebo-controlled study with fluoxetine, fluvoxamine, paroxetine, and sertraline". Journal of clinical psychopharmacology 18 (4): 274–81. PMID 9690692.
^ Waldinger MD, Zwinderman AH, Olivier B (2001). "SSRIs and ejaculation: a double-blind, randomized, fixed-dose study with paroxetine and citalopram". Journal of clinical psychopharmacology 21 (6): 556–60. PMID 11763001.
^ ^a ^b Waldinger MD, Zwinderman AH, Olivier B (2004). "On-demand treatment of premature ejaculation with clomipramine and paroxetine: a randomized, double-blind fixed-dose study with stopwatch assessment". Eur. Urol. 46 (4): 510–5; discussion 516. doi:10.1016/j.eururo.2004.05.005. PMID 15363569.
^ Kim SW, Grant JE, Adson DE, Shin YC, Zaninelli R (2002). "A double-blind placebo-controlled study of the efficacy and safety of paroxetine in the treatment of pathological gambling". Journal of Clinical Psychiatry 63 (6): 501-507. PMID 12088161.
^ Weitzner MA, Moncello J, Jacobsen PB, Minton S. (2002). "A pilot trial of paroxetine for the treatment of hot flashes and associated symptoms in women with breast cancer.". Journal of Pain and Symptom Management 23 (4): 337-345. PMID 11997203.
^ Nemeroff CB, Evans DL, Gyulai L, Sachs GS, Bowden CL, Gergel IP, Oakes R, Pitts CD (2001). "Double-blind, placebo-controlled comparison of imipramine and paroxetine in the treatment of bipolar depression". The American journal of psychiatry 158 (6): 906–12. PMID 11384898.
^ Sachs GS, Nierenberg AA, Calabrese JR, Marangell LB, Wisniewski SR, Gyulai L, Friedman ES, Bowden CL, Fossey MD, Ostacher MJ, Ketter TA, Patel J, Hauser P, Rapport D, Martinez JM, Allen MH, Miklowitz DJ, Otto MW, Dennehy EB, Thase ME (2007). "Effectiveness of adjunctive antidepressant treatment for bipolar depression". N. Engl. J. Med. 356 (17): 1711–22. doi:10.1056/NEJMoa064135. PMID 17392295.
^ Vieta E, Martinez-Aran A, Goikolea JM, Torrent C, Colom F, Benabarre A, Reinares M (1999). "The selective serotonin reuptake inhibitor paroxetine is effective in the treatment of diabetic neuropathy symptoms". Pain 42 (2): 135-144. PMID 2147235.
^ Langemark M, Olesen J (1994). "Sulpiride and paroxetine in the treatment of chronic tension-type headache. An explanatory double-blind trial". Headache 34 (1): 20–4. PMID 8132436.
^ Mellerup, Erling T.; Plenge, Per (July 1986). "High affinity binding of3H-paroxetine and3H-imipramine to rat neuronal membranes". Psychopharmacology 89 (4): 436-439. Springer Berlin / Heidelberg. doi:10.1007/BF02412117.
^ Golden RN, Nemeroff CB, McSorley P, Pitts CD, Dube EM. (2002). "Efficacy and tolerability of controlled-release and immediate-release paroxetine in the treatment of depression.". Journal of Clinical Psychiatry 63 (7): 577-584. PMID 12143913.
^ Press release, CHMP meeting on Paroxetine and other SSRIs. European Medicines Agency (2004-12-09). Retrieved on 2007-08-24.
^ Paroxetine hydrochloride (marketed as Paxil) Information: Persistent Pulmonary Hypertension. Food and Drug Administration (July 2006).
^ Clayton, A; Keller A, McGarvey EL. (2006). "Burden of phase-specific sexual dysfunction with SSRIs". Journal of Affective Disorders 91: 27-32. PMID 16430968.
^ Skaehill, Penny A.; Welch, E.B. (October 1997). Clinical Reviews: SSRI Withdrawal Syndrome. American Society of Consultant Pharmacists. Retrieved on 2007-08-15.
^ Yerevanian B, Koek R, Feusner J, Hwang S, Mintz J (2004). "Antidepressants and suicidal behaviour in unipolar depression". Acta Psychiatr Scand 110 (6): 452-8. PMID 15521830.
^ Haddad P (2001). "Antidepressant discontinuation syndromes". Drug Saf 24 (3): 183-97. PMID 11347722.
^ Quitpaxil.info. Frank W. Streicher. Retrieved on 2007-08-15.
^ "ACOG Committee Opinion No. 354: Treatment with selective serotonin reuptake inhibitors during pregnancy". The American College of Obstetricians and Gynecologists. PMID 17138801.
^ Haddad, PM; Pal BR, Clarke P, Wieck A, Sridhiran S.. "Neonatal symptoms following maternal paroxetine treatment: serotonin toxicity or paroxetine discontinuation syndrome?". PMID 16166193.
^ Hoorman, et al. v. SmithKline Beecham Corp.: Paxil® Pediatric Settlement. Retrieved on 2007-08-15.
^ The Litigation Group: Paxil Pediatric Settlement. Public Citizen. Retrieved on 2007-08-15.
^ The Chemistry of Happiness. The Guardian. Retrieved on 2007-09-09.
^ Secrets of the drug trials. BBC (2007-01-29). Retrieved on 2007-08-15.

Year 2007 (MMVII) is the current year, a common year starting on Monday of the Gregorian calendar and the AD/CE era in the 21st century. ... April 8 is the 98th day of the year (99th in leap years) in the Gregorian calendar. ... GlaxoSmithKline plc (LSE: GSK NYSE: GSK) is a British based pharmaceutical, biological, and healthcare company. ... Year 2007 (MMVII) is the current year, a common year starting on Monday of the Gregorian calendar and the AD/CE era in the 21st century. ... is the 226th day of the year (227th in leap years) in the Gregorian calendar. ... A digital object identifier (or DOI) is a standard for persistently identifying a piece of intellectual property on a digital network and associating it with related data, the metadata, in a structured extensible way. ... A digital object identifier (or DOI) is a standard for persistently identifying a piece of intellectual property on a digital network and associating it with related data, the metadata, in a structured extensible way. ... A digital object identifier (or DOI) is a standard for persistently identifying a piece of intellectual property on a digital network and associating it with related data, the metadata, in a structured extensible way. ... Year 2007 (MMVII) is the current year, a common year starting on Monday of the Gregorian calendar and the AD/CE era in the 21st century. ... is the 236th day of the year (237th in leap years) in the Gregorian calendar. ... â€œFDAâ€ redirects here. ... Year 2007 (MMVII) is the current year, a common year starting on Monday of the Gregorian calendar and the AD/CE era in the 21st century. ... is the 227th day of the year (228th in leap years) in the Gregorian calendar. ... Year 2007 (MMVII) is the current year, a common year starting on Monday of the Gregorian calendar and the AD/CE era in the 21st century. ... is the 227th day of the year (228th in leap years) in the Gregorian calendar. ... Year 2007 (MMVII) is the current year, a common year starting on Monday of the Gregorian calendar and the AD/CE era in the 21st century. ... is the 227th day of the year (228th in leap years) in the Gregorian calendar. ... Public Citizen is a U.S. non-governmental organization, founded by Ralph Nader in 1971 and based in Washington, DC. Its activities span across a diverse range of issues, including energy policy, trade policy, campaign finance reform and accountability, consumer protection, medical malpractice, and public health. ... Year 2007 (MMVII) is the current year, a common year starting on Monday of the Gregorian calendar and the AD/CE era in the 21st century. ... is the 227th day of the year (228th in leap years) in the Gregorian calendar. ... For other uses, see Guardian. ... Year 2007 (MMVII) is the current year, a common year starting on Monday of the Gregorian calendar and the AD/CE era in the 21st century. ... is the 252nd day of the year (253rd in leap years) in the Gregorian calendar. ... For other uses, see BBC (disambiguation). ... Year 2007 (MMVII) is the current year, a common year starting on Monday of the Gregorian calendar and the AD/CE era in the 21st century. ... is the 227th day of the year (228th in leap years) in the Gregorian calendar. ...

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Categories: All articles with unsourced statements | Articles with unsourced statements since September 2007 | Selective serotonin reuptake inhibitors For other uses, see BBC (disambiguation). ... Panorama is a long-running current affairs documentary series on BBC television, launched on 11 November 1953 and focusing on investigative journalism. ... In pharmacology, a psychoanaleptic is a medication which produces an arousing effect upon the patient. ... Prozac, a selective serotonin reuptake inhibitor (SSRI) Serotonin-norepinephrine reuptake inhibitor, Venlafaxine An antidepressant, is a psychiatric medication or other substance (nutrient or herb) used for alleviating depression or dysthymia (milder depression). ... A section of the Anatomical Therapeutic Chemical Classification System containing Psychoanaleptics. ... MAOI redirects here. ... Iproclozide is a monoamine oxidase inhibitor antidepressant. ... Iproniazid is a monamine oxidase inhibitor (MAOI) that was developed as the first anti-depressant (Also first psychiatric drug). ... Isocarboxazid is a nonselective hydrazine-derived monoamine oxidase inhibitor used in treatment resistant depression. ... Nialamide (EsprilÂ®, NiamidÂ®, NiaquitilÂ®, NuredalÂ®, NyazinÂ®, and PsicodistenÂ®) was one of the first MAOI (monoamine oxidase inhibitor) antidepressants. ... Pargyline is a monoamine oxidase B (MAO-B) inhibitor indicated for the treatment of moderate to severe hypertension. ... Phenelzine (brand name Nardil) is an antidepressant drug that belongs to the monoamine oxidase inhibitor (MAOI) class of drugs. ... Rasagiline (trade name AzilectÂ®) is a irreversible inhibitor of monoamine oxidase used as a monotherapy in early Parkinsons disease or as an adjunct therapy in more advanced cases. ... Selegiline (l-deprenyl, EldeprylÂ® or AniprylÂ® [veterinary]) is a drug used for the treatment of early-stage Parkinsons disease and senile dementia. ... Toloxatone is a monoamine oxidase inhibitor antidepressant. ... Tranylcypromine (sold under the brand name ParnateÂ®) is a monoamine oxidase inhibitor (MAOI) used as an antidepressant drug. ... These drugs, a subset of monoamine oxidase inhibitors (MAOIs), inhibit only isoenzyme A and are reversible. ... Brofarmine is a psychiatric drug primarily used to treat depression and anxiety. ... Î²-Carboline (9H-pyrid-[3,4-b]-indole) is an organic amine that is the prototype of a class of compounds known as Î²-Carbolines. ... Harmala, also known at various times as Telepathine and Banisterine, is a blanket term for a group of naturally occurring beta-carbolines including harmine, harmaline, and others. ... Moclobemide (sold as AurorixÂ®, ManerixÂ®) is a psychiatric drug primarily used to treat depression and social anxiety. ... A neurotransmitter uptake inhibitor is a drug which inhibits the reuptake of the neurotransmitter, thus extending the duration of its effect. ... A serotonin uptake inhibitor is a drug which acts as a neurotransmitter uptake inhibitor on serotonin receptors. ... SSRI redirects here; for other uses, see SSRI (disambiguation). ... Alaproclate is an antidepressant that increases serotonin levels by inhibiting the uptake of 5-HT. Today, its primarily used to stagment the cravings for cocaine. ... Citalopram is an antidepressant drug used to treat depression associated with mood disorders. ... Dapoxetine is the International Nonproprietary Name of a drug currently being considered for approval by the FDA for the treatment of premature ejaculation in men, which would make it the first drug approved for such treatment. ... Lexapro pills Escitalopram (Lexapro, Cipralex, Sipralexa and Seroplex)[1] is an antidepressant of the selective serotonin reuptake inhibitor (SSRI) class. ... Etoperidone is a 5-HT agonist used primarily in the 1970s to impede the effects of LSD. ... Prozac redirects here. ... Fluvoxamine (brand name as LuvoxÂ®, FaverinÂ®, FevarinÂ® and DumyroxÂ®) is an antidepressant which functions pharmacologically as a selective serotonin reuptake inhibitor. ... Zoloft bottles, with blue and green tablets Sertraline hydrochloride (also sold under brand names Zoloft, Lustral, Apo-Sertral, Asentra, Gladem, Serlift, Stimuloton, Xydep, Serlain, Concorz) is an antidepressant of the selective serotonin reuptake inhibitor (SSRI) class. ... // General Remars and History Zimelidine is a pyridylallylamine and has a structure different from other antidepressants. ... Chemical structure of the tricyclic antidepressant amitriptyline. ... There are also several chemically unrelated tetracyclic antibiotics based on Tetracycline. ... Clomipramine (brand-name AnafranilÂ®) is a tricyclic antidepressant. ... Nefazodone hydrochloride (trade name Serzone) is an antidepressant drug marketed by Bristol-Myers Squibb. ... Trazodone (trade names Desyrel, Molipaxin, Trittico, Thombran, Trialodine) is a psychoactive compound with sedative, anxiolytic, and antidepressant properties. ... Norepinephrine reuptake inhibitors (NRIs) are compounds that increase amounts of the neurotransmitter norepinephrine in the brain by inhibiting its reuptake at synapses. ... A adrenergic uptake inhibitor is a drug which blocks the reuptake of adrenergic neurotransmitters. ... Atomoxetine is the first non-stimulant drug approved for the treatment of attention-deficit hyperactivity disorder (ADHD). ... To meet Wikipedias quality standards, this article may require cleanup. ... Reboxetine is an antidepressant drug used in the treatment of clinical depression, panic disorder and ADD/ADHD. Its mesilate ( methanesulfonate) salt is sold under tradenames including EdronaxÂ®, NoreboxÂ®, ProliftÂ®, SolvexÂ® or VestraÂ®. Reboxetine has two chiral centers, but it only exists as two enantiomers, (R,R)-(-)- and (S,S)-(+)-reboxetine. ... Viloxazine is a bicyclic antidepressants[2] that inhibits the reuptake of serotonin, and to a lesser extent, dopamine and norepinephrine. ... Chemical structure of the tricyclic antidepressant amitriptyline. ... There are also several chemically unrelated tetracyclic antibiotics based on Tetracycline. ... Amitriptyline (or Amitryptyline) hydrochloride (sold as Elavil, Tryptanol, Endep, Elatrol, Tryptizol, Trepiline, Laroxyl) is a tricyclic antidepressant drug. ... Amoxapine (Asendin®; Asendis®; Defanyl®; Demolox®; Moxadil®) is a tricyclic antidepressant of the dibenzoxazepine class. ... Butriptyline (Dl-10,11-Dihydro-N,N,beta-trimethyl-5H-dibenzo[a,d]cycloheptene-5-propylamine) is a tricyclic antidepressant with sedative properties and uses similar to that of amitriptyline. ... Desipramine is a tricyclic antidepressant (TCA) that inhibits the reuptake of norepinephrine. ... Lofepramine (trademarked Gamanil) is a tricyclic antidepressant prescribed primarily for sleeping and eating disorders. ... Dibenzepin (NoverilÂ®) is a muscarinic antagonist. ... Dosulepin hydrochloride (sometimes known outside the USA as dothiepin hydrochloride) is an antidepressant of the tricyclic family. ... Doxepin is a tricyclic antidepressant, known under many brand-names such as AponalÂ®, the original preparation by Boehringer-Ingelheim, now part of the Roche group; AdapineÂ®, SinquanÂ® and SinequanÂ® (Pfizer Inc. ... This article does not cite any references or sources. ... Iprindole (C19H28N2), a 5-HT2 antagonist, is a tricyclic antidepressant that can be fatal when combined with MDMA. Categories: | ... Melitracen (or melitracene) is a tricyclic antidepressant. ... Nortriptyline is a tricyclic antidepressant marketed under the tradenames Aventyl® and Pamelor®. It is used to treat depression. ... Opipramol (Opipramol-neuraxpharmÂ®, InsidonÂ®), 4-[3-(5H-Dibenz[b,f]azepin-5-yl)propyl]-1-piperazinethanol, is a anxiolytic primarily used in Germany. ... Protriptyline (VivactilÂ®) is a tricyclic antidepressant indicated for depression and ADHD. Categories: | ... Trimipramine is an tricyclic antidepressant with sedative and anxiolytic properties. ... To meet Wikipedias quality standards, this article may require cleanup. ... This does not cite any references or sources. ... Vanoxerine, also known as GBR-12909, is a piperazine derivative which is a potent and selective dopamine reuptake inhibitor. ... Phenmetrazine is an amphetamine-like drug. ... Chemical structure of the tricyclic antidepressant amitriptyline. ... Amineptine is an atypical tricyclic antidepressant that selectively inhibits the reuptake of dopamine and to a lesser extent norepinephrine, thus exerting a powerful and fast-acting antidepressant effect. ... Serotonin Norepinephrine Serotonin-norepinephrine reuptake inhibitors (SNRIs) are a class of antidepressant used in the treatment of clinical depression and other affective disorders. ... Desvenlafaxine succinate, marketed under the name Pristiq, is an antidepressant of the serotonin-norepinephrine reuptake inhibitor class from Wyeth. ... Duloxetine (brand names Cymbalta, Yentreve, and in parts of Europe, Xeristar or Ariclaim) is a drug which primarily targets major depressive disorder (MDD), generalized anxiety disorder (GAD), pain related to diabetic peripheral neuropathy and in some countries stress urinary incontinence (SUI). ... Milnacipran is an antidepressant of the serotonin-norepinephrine reuptake inhibitor class. ... Nefazodone hydrochloride (trade name Serzone) is an antidepressant drug marketed by Bristol-Myers Squibb. ... Venlafaxine hydrochloride (Effexor) is an antidepressant of the serotonin-norepinephrine reuptake inhibitor (SNRI) class. ... A Norepinephrine-dopamine reuptake inhibitor is a class of drugs that is both: Dopamine reuptake inhibitor Norepinephrine reuptake inhibitor An example is Bupropion. ... Bupropion (INN; also amfebutamone,[1] brand names Wellbutrin, Zyban, Budeprion and Buproban) is an atypical antidepressant, which acts as a norepinephrine reuptake inhibitor and dopamine reuptake inhibitor,[2] and a nicotinic antagonist. ... Serotonin-norepinephrine-dopamine-reuptake-inhibitors (SNDRI) are a class of psychoactive antidepressants. ... Brasofensine is a serotonin-noradrenaline-dopamine reuptake inhibitor. ... Tesofensine is a serotonin-noradrenaline-dopamine reuptake inhibitor, which also seems to increase the action of acetylcholine in the brain, probably due to downstream effects. ... Nomifensine is a dopamine reuptake inhibitor that increases the amount of synaptic dopamine available to receptors by blocking dopamines re-uptake transporter. ... Tianeptine (INN) (StablonÂ®, CoaxilÂ®, TatinolÂ®), is structurally similar to the tricyclic antidepressants. ... Tianeptine (INN) (StablonÂ®, CoaxilÂ®, TatinolÂ®), is an SSRE, or Selective Serotonin Reuptake Enhancer, structurally similar to the tricyclic antidepressants. ... An Adrenergic antagonist is a pharmaceutical substance that acts to inhibit the action of the adrenergic receptors. ... There are also several chemically unrelated tetracyclic antibiotics based on Tetracycline. ... Mianserin is a tetracyclic antidepressant that has antihistaminic and hypnosedative, but almost no anticholinergic, effect. ... Mirtazapine is an antidepressant introduced by Organon International in 1996 used for the treatment of mild to severe depression. ...

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