| Obsessive-compulsive disorder; social anxiety disorder. View labelExact | Adults (IR): typical start is 50 mg at bedtime; increase by 50 mg every 4–7 days based on response. Usual range 100–300 mg/day (divide doses above 150 mg/day). | Selective serotonin reuptake inhibitor (SSRI). | CYP1A2, CYP2D6, CYP2C19 | Single-dose mean 15 h; Steady-state mean 22 h | No | | - Sedation: assess next-day impairment and fall risk, especially with other CNS depressants.
| No | 2025-10-05 |
|---|
| MDD; OCD; panic disorder; PTSD; social anxiety disorder. View labelExact | Start 50 mg once daily for major depressive disorder (clinical depression) or anxiety; titrate by 25–50 mg increments every ≥1 week to 100–200 mg/day (max 200 mg/day). | Selective serotonin reuptake inhibitor (SSRI). | Multiple CYPs | Steady-state mean 26 h | No | — | - Suicidality and psychiatric activation during initiation and dose changes, especially in younger patients and in bipolar-spectrum illness.
- Sodium in older adults or patients on diuretics if symptoms suggest hyponatremia (confusion, fatigue, falls).
- Bleeding/bruising risk when combined with NSAIDs, antiplatelets, or anticoagulants; reinforce early symptom reporting.
- Medication reconciliation when TCAs, antipsychotics, or other serotonergic agents are co-prescribed; anticipate switching washout needs when regimens change.
| No | 2025-12-28 |
|---|
| Major depressive disorder; OCD; panic disorder; use with olanzapine for bipolar depression. View labelExact | Typical adult start is 20 mg once daily (often morning); may increase to 40–60 mg/day after several weeks if needed and tolerated. | Selective serotonin reuptake inhibitor (SSRI). | CYP2D6 (inhibitor) | No | — | - Suicidality and psychiatric activation (anxiety, agitation, mood elevation) during initiation and dose changes, especially in younger patients.
- Sodium in older adults or patients on diuretics if symptoms suggest hyponatremia (confusion, fatigue, gait change).
- Bleeding/bruising risk when combined with NSAIDs, antiplatelets, or anticoagulants; early symptom reporting is often reinforced.
- Medication reconciliation to avoid serotonergic combinations and to anticipate prolonged interaction windows after stopping.
| No | 2026-02-01 |
|---|
paroxetineAdjunctive therapyBrands: Paxil, Paxil CR | Major depressive disorder; obsessive-compulsive disorder; panic disorder; social anxiety disorder; generalized anxiety disorder; posttraumatic stress disorder; premenstrual dysphoric disorder. View labelExact | Start 20 mg once daily (morning); titrate by 10 mg weekly to 20–50 mg/day (IR). | Selective serotonin reuptake inhibitor (SSRI). | CYP2D6 | Single-dose mean 21 h; Steady-state mean 24 h | No | | - Suicidality and psychiatric activation during initiation and dose changes; align follow-up cadence with clinical risk.
- Weight and metabolic trends when appetite increases or weight gain becomes clinically meaningful; lifestyle supports are often introduced early.
- Discontinuation symptoms during tapering (dizziness, paresthesias, irritability); taper steps are often kept predictable to reduce abrupt stoppage.
- Sodium in older adults or diuretic users if symptoms suggest hyponatremia.
- Drug–drug interaction review at every visit due to potent CYP2D6 inhibition (TCAs, antipsychotics, tamoxifen).
- Anticholinergic adverse effects (constipation, urinary retention, cognitive clouding), especially in older adults and when other anticholinergics are on the medication list.
| No | 2025-10-05 |
|---|