Editing Paroxetine (section)

==Medical uses==
Paroxetine is primarily used to treat [[major depressive disorder]], [[obsessive-compulsive disorder|obsessive–compulsive disorder]], [[post-traumatic stress disorder]], [[social anxiety disorder]], and [[panic disorder]]. It is also occasionally used for [[agoraphobia]], [[generalized anxiety disorder]], [[premenstrual dysphoric disorder]], and menopausal [[hot flash]]es.<ref>{{cite journal | vauthors = Wagstaff AJ, Cheer SM, Matheson AJ, Ormrod D, Goa KL | title = Paroxetine: an update of its use in psychiatric disorders in adults | journal = Drugs | volume = 62 | issue = 4 | pages = 655–703 | date = March 2002 | pmid = 11893234 | doi = 10.2165/00003495-200262040-00010 | s2cid = 195692589 }}</ref><ref>{{Cite journal|vauthors=Lotke P, Garcia F, Stearns V, Beebe KL, Iyengar M |title=Paroxetine controlled release was effective and tolerable for treating menopausal hot flash symptoms in women |url=http://ebm.bmj.com/content/9/1/23.full|journal=Evidence Based Medicine |date=1 January 2004 |issn=1473-6810 |pages=23 |volume=9 |issue=1 |doi=10.1136/ebm.9.1.23 |doi-access=free |access-date=20 January 2017 |archive-url=https://web.archive.org/web/20160214212936/http://ebm.bmj.com/content/9/1/23.full |archive-date=14 February 2016 |url-status=live}}</ref><ref>{{Cite web|url=https://www.nhs.uk/medicines/paroxetine/|title=Paroxetine: an antidepressant |date=29 August 2018 |website=nhs.uk |access-date=15 March 2020 |archive-url=https://web.archive.org/web/20200514090938/https://www.nhs.uk/medicines/paroxetine/ |archive-date=14 May 2020 |url-status=live}}</ref><ref>{{Cite web |url=https://www.medicines.org.uk/emc/product/4168/smpc |title=Paroxetine 20 mg Tablets - Summary of Product Characteristics (SmPC) - (emc) |website=medicines.org.uk |access-date=15 March 2020 |archive-date=28 August 2021 |archive-url=https://web.archive.org/web/20210828205844/https://www.medicines.org.uk/emc/product/4168/smpc |url-status=live }}</ref><ref>{{Cite web|url=https://www.ebs.tga.gov.au/ebs/picmi/picmirepository.nsf/PICMI?OpenForm&t=&q=paroxetine|title=Product and Consumer Medicine Information|publisher=Therapeutic Goods Administration|access-date=15 March 2020|archive-date=28 August 2021|archive-url=https://web.archive.org/web/20210828205845/https://www.ebs.tga.gov.au/ebs/picmi/picmirepository.nsf/PICMI?OpenForm=&t=&q=paroxetine|url-status=live}}</ref>

===Depression===
A variety of meta-analyses have been conducted to evaluate the efficacy of paroxetine in depression. They have variously concluded that paroxetine is superior or equivalent to placebo and that it is equivalent to other antidepressants.<ref>{{cite journal | vauthors = Cipriani A, Furukawa TA, Salanti G, Geddes JR, Higgins JP, Churchill R, Watanabe N, Nakagawa A, Omori IM, McGuire H, Tansella M, Barbui C | title = Comparative efficacy and acceptability of 12 new-generation antidepressants: a multiple-treatments meta-analysis | journal = Lancet | volume = 373 | issue = 9665 | pages = 746–758 | date = February 2009 | pmid = 19185342 | doi = 10.1016/S0140-6736(09)60046-5 | s2cid = 35858125 }}</ref><ref>{{cite journal | vauthors = Fava M, Amsterdam JD, Deltito JA, Salzman C, Schwaller M, Dunner DL | title = A double-blind study of paroxetine, fluoxetine, and placebo in outpatients with major depression | journal = Annals of Clinical Psychiatry | volume = 10 | issue = 4 | pages = 145–150 | date = December 1998 | pmid = 9988054 | doi = 10.3109/10401239809147030 }}</ref><ref name="ReferenceF">{{cite journal | vauthors = Sugarman MA, Loree AM, Baltes BB, Grekin ER, Kirsch I | title = The efficacy of paroxetine and placebo in treating anxiety and depression: a meta-analysis of change on the Hamilton Rating Scales | journal = PLOS ONE | volume = 9 | issue = 8 | pages = e106337 | date = 27 August 2014 | pmid = 25162656 | pmc = 4146610 | doi = 10.1371/journal.pone.0106337 | doi-access = free | bibcode = 2014PLoSO...9j6337S }}</ref> Despite this, there was no clear evidence that paroxetine was better or worse compared with other antidepressants at increasing response to treatment at any point in time.<ref>{{cite journal | vauthors = Purgato M, Papola D, Gastaldon C, Trespidi C, Magni LR, Rizzo C, Furukawa TA, Watanabe N, Cipriani A, Barbui C | title = Paroxetine versus other anti-depressive agents for depression | journal = The Cochrane Database of Systematic Reviews | issue = 4 | pages = CD006531 | date = April 2014 | volume = 2014 | pmid = 24696195 | doi = 10.1002/14651858.cd006531.pub2 | pmc = 10091826 | doi-access = free }}</ref>

=== Anxiety disorders ===
<!-- Panic disorder -->
Paroxetine was the first antidepressant approved in the United States for the treatment of panic disorder.<ref>{{cite book|title=Social Work Diagnosis in Contemporary Practice | vauthors = Turner FJ |year=2005 |publisher=Oxford University Press US |isbn=978-0-19-516878-5}}</ref>{{page needed|date=January 2017}} Several studies have concluded that paroxetine is superior to placebo in the treatment of panic disorder.<ref name="ReferenceF"/><ref>{{cite journal | vauthors = Ballenger JC, Wheadon DE, Steiner M, Bushnell W, Gergel IP | title = Double-blind, fixed-dose, placebo-controlled study of paroxetine in the treatment of panic disorder | journal = The American Journal of Psychiatry | volume = 155 | issue = 1 | pages = 36–42 | date = January 1998 | pmid = 9433336 | doi = 10.1176/ajp.155.1.36 | doi-access = free }}</ref>

<!-- Social anxiety disorder -->
Paroxetine has demonstrated efficacy for the treatment of social anxiety disorder in adults and children.<ref>{{cite journal | vauthors = Stein MB, Liebowitz MR, Lydiard RB, Pitts CD, Bushnell W, Gergel I | title = Paroxetine treatment of generalized social phobia (social anxiety disorder): a randomized controlled trial | journal = JAMA | volume = 280 | issue = 8 | pages = 708–713 | date = August 1998 | pmid = 9728642 | doi = 10.1001/jama.280.8.708 | doi-access = free }}</ref><ref>{{cite journal | vauthors = Manassis K | title = Paroxetine improves social anxiety disorder in children and adolescents | journal = Evidence-Based Mental Health | volume = 8 | issue = 2 | pages = 43 | date = May 2005 | pmid = 15851806 | doi = 10.1136/ebmh.8.2.43 | url = http://ebmh.bmj.com/content/8/2/43.full | access-date = 20 January 2017 | url-status = live | doi-access = free | archive-url = https://web.archive.org/web/20170827171952/http://ebmh.bmj.com/content/8/2/43.full | archive-date = 27 August 2017 }}</ref> It is also beneficial for people with co-occurring social anxiety disorder and [[alcohol use disorder]].<ref>{{cite journal | vauthors = Randall CL, Johnson MR, Thevos AK, Sonne SC, Thomas SE, Willard SL, Brady KT, Davidson JR | title = Paroxetine for social anxiety and alcohol use in dual-diagnosed patients | journal = Depression and Anxiety | volume = 14 | issue = 4 | pages = 255–262 | date = 1 January 2001 | pmid = 11754136 | doi = 10.1002/da.1077 | s2cid = 23395959 | doi-access = free }}</ref> It appears to be similar to a number of other SSRIs.<ref>{{cite journal | vauthors = Blanco C, Bragdon LB, Schneier FR, Liebowitz MR | title = The evidence-based pharmacotherapy of social anxiety disorder | journal = The International Journal of Neuropsychopharmacology | volume = 16 | issue = 1 | pages = 235–249 | date = February 2013 | pmid = 22436306 | doi = 10.1017/S1461145712000119 | quote = There were no significant differences between the three SSRIs that had been tested in placebo-controlled studies: paroxetine; sertraline; fluvoxamine. | doi-access = free }}</ref>

<!-- Obsessive-compulsive disorder -->
Paroxetine is used in the treatment of obsessive-compulsive disorder.<ref>{{cite journal | vauthors = Germann D, Ma G, Han F, Tikhomirova A | title = Paroxetine hydrochloride | journal = Profiles of Drug Substances, Excipients, and Related Methodology | volume = 38 | pages = 367–406 | date = 2013 | pmid = 23668408 | doi = 10.1016/B978-0-12-407691-4.00008-3 | isbn = 978-0-12-407691-4 | series = Analytical Profiles of Drug Substances and Excipients | s2cid = 205143838 | veditors = Brittain HG }}</ref> Comparative efficacy of paroxetine is equivalent to that of [[clomipramine]] and [[venlafaxine]].<ref>{{cite journal | vauthors = Zohar J, Judge R | title = Paroxetine versus clomipramine in the treatment of obsessive-compulsive disorder. OCD Paroxetine Study Investigators | journal = The British Journal of Psychiatry | volume = 169 | issue = 4 | pages = 468–474 | date = October 1996 | pmid = 8894198 | doi = 10.1192/bjp.169.4.468 | s2cid = 19698156 }}</ref><ref>{{cite journal | vauthors = Denys D, van der Wee N, van Megen HJ, Westenberg HG | title = A double blind comparison of venlafaxine and paroxetine in obsessive-compulsive disorder | journal = Journal of Clinical Psychopharmacology | volume = 23 | issue = 6 | pages = 568–575 | date = December 2003 | pmid = 14624187 | doi = 10.1097/01.jcp.0000095342.32154.54 | s2cid = 23260081 }}</ref> Paroxetine is also effective for children with obsessive-compulsive disorder.<ref>{{cite journal | vauthors = Ipser JC, Stein DJ, Hawkridge S, Hoppe L | title = Pharmacotherapy for anxiety disorders in children and adolescents | journal = The Cochrane Database of Systematic Reviews | issue = 3 | pages = CD005170 | date = July 2009 | pmid = 19588367 | doi = 10.1002/14651858.CD005170.pub2 }}</ref>

<!-- Posttraumatic stress disorder -->
Paroxetine is approved for the treatment of PTSD in the United States, Japan, and Europe.<ref>{{cite journal | vauthors = Alexander W | title = Pharmacotherapy for Post-traumatic Stress Disorder In Combat Veterans: Focus on Antidepressants and Atypical Antipsychotic Agents | journal = P & T | volume = 37 | issue = 1 | pages = 32–38 | date = January 2012 | pmid = 22346334 | pmc = 3278188 }}</ref><ref name=Ip2011>{{cite journal | vauthors = Ipser JC, Stein DJ | title = Evidence-based pharmacotherapy of post-traumatic stress disorder (PTSD) | journal = The International Journal of Neuropsychopharmacology | volume = 15 | issue = 6 | pages = 825–840 | date = July 2012 | pmid = 21798109 | doi = 10.1017/S1461145711001209 | doi-access = free }}</ref><ref>{{Cite web|url=http://www.rad-ar.or.jp/siori/english/kekka.cgi?n=34488|title=Search results detail{{!}} Kusurino-Shiori (Drug information Sheet)|website=rad-ar.or.jp|access-date=15 March 2019|archive-date=28 August 2021|archive-url=https://web.archive.org/web/20210828205845/https://www.rad-ar.or.jp/siori/english/kekka.cgi?n=34488|url-status=live}}</ref> In the United States, it is approved for short-term use.<ref name=Ip2011/>

Paroxetine is also FDA-approved for generalized anxiety disorder.<ref>{{Cite journal|date=18 May 2001|title=FDA Approves Antidepressant For Generalized Anxiety Disorder|journal=Psychiatric News|volume=36|issue=10|pages=14|doi=10.1176/pn.36.10.0014b}}</ref>

=== Menopausal hot flashes ===
In 2013, low-dose paroxetine was approved in the US for the treatment of moderate-to-severe [[vasomotor symptoms]] such as hot flashes and [[night sweats]] associated with menopause.<ref name=FDA2013/> At the low dose used for menopausal hot flashes, side effects are similar to placebo and dose tapering is not required for discontinuation.<ref name="OrleansLi2014">{{cite journal | vauthors = Orleans RJ, Li L, Kim MJ, Guo J, Sobhan M, Soule L, Joffe HV | title = FDA approval of paroxetine for menopausal hot flushes | journal = The New England Journal of Medicine | volume = 370 | issue = 19 | pages = 1777–1779 | date = May 2014 | pmid = 24806158 | doi = 10.1056/NEJMp1402080 | doi-access = free }}</ref>

=== Fibromyalgia ===
Studies have also shown paroxetine "appears to be well-tolerated and improve the overall symptomatology in patients with fibromyalgia", but is less robust in helping with the pain involved.<ref>{{cite journal | vauthors = Patkar AA, Masand PS, Krulewicz S, Mannelli P, Peindl K, Beebe KL, Jiang W | title = A randomized, controlled, trial of controlled release paroxetine in fibromyalgia | journal = The American Journal of Medicine | volume = 120 | issue = 5 | pages = 448–454 | date = May 2007 | pmid = 17466657 | doi = 10.1016/j.amjmed.2006.06.006 | doi-access = free }}</ref><ref>{{cite journal| vauthors = Giordano N, Geraci S, Santacroce C, Mattii G, Battisti E, Gennari C |date=December 1999|title=Efficacy and tolerability of paroxetine in patients with fibromyalgia syndrome: a single-blind study |journal=Current Therapeutic Research|volume=60|issue=12|pages=696–702|doi=10.1016/S0011-393X(99)90008-5 }}</ref>