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What is paroxetine?

Paroxetine is an antidepressant that’s part of the drug type known as selective serotonin reuptake inhibitors (SSRIs). Paroxetine affects chemicals in the brain which may be unbalanced in people with the following conditions or disorders:

  • Depression
  • Anxiety disorders, including generalized anxiety, panic disorder, obsessivecompulsive disorder (OCD), post-traumatic stress disorder (PTSD), and social anxiety disorder
  • Premature dysphoric disorder (PMDD)

Paroxetine can be used in men who experience premature ejaculation (PE), though this is an off-label use, which means it has not been specifically approved by the U.S. Food & Drug Administration (FDA) for this specific purpose.

What is premature ejaculation?

Premature ejaculation (PE) is a male sexual dysfunction characterized by the following symptoms:

  1. Ejaculation which always or nearly always occurs prior to or within about one minute of vaginal penetration.
  2. The inability to delay ejaculation during all or nearly all vaginal penetrations.
  3. The presence of negative personal consequences, such as distress, bother, frustration and/or the avoidance of sexual intimacy.

How common is premature ejaculation?

Approximately 1 in 5 men experience premature ejaculation. Studies from the National Health and Social Life Survey indicate that, in the U.S., 21 percent of men aged 18-59 experience PE.

What causes premature ejaculation?

The exact causes of PE are not known. However, psychological, behavioral, and biogenic causes have been proposed. As such, the treatment of PE encompasses interventions that range from psychological and behavioral to pharmacologic.

Current treatments are based on decreasing sensory input (numbing creams), behavior modification therapies, and the use of medications, such as paroxetine.

How is premature ejaculation diagnosed?

Premature ejaculation is a self-reported diagnosis. A sexual history is the fundamental basis of making a diagnosis of premature ejaculation, of which time-to-ejaculation is the most important characteristic.

In addition, a partner’s opinion can contribute significantly to clinician understanding.

A complete description of sexual history is vital in order to distinguish PE from erectile dysfunction (ED) – the inability to maintain an erection – because PE and ED often coexist. Moreover, some men are unaware that loss of erection after ejaculation is normal; thus, a patient may erroneously complain of ED when the true problem is PE.

How is premature ejaculation treated?

Several antidepressants known to cause anorgasmia and delayed ejaculation have been evaluated in the management of PE. These antidepressants include selective antidepressants (SSRIs) — fluoxetine, paroxetine, and sertraline – as well as the tricyclic antidepressant clomipramine. The SSRIs have been successfully utilized in the management of PE. As a group, in clinical trials, the SSRIs have provided significant benefit over placebo.

The use of SSRIs for the treatment of PE is considered off-label.

How is paroxetine used for premature ejaculation?

Taking paroxetine for the treatment of premature ejaculation (PE) is considered off-label. Clinical trials show paroxetine to be a very effective treatment for PE. Doses of paroxetine for the off-label use of PE treatment are significantly less than doses intended for anxiety and depression.

Paroxetine is an oral tablet that is taken daily. Appropriate dosing depends on several factors, which your REGENX Health provider will determine after reviewing your medical history.

What does off-label use mean?

Off-label use refers to the practice of prescribing a medication for a condition other than the medication is intended or approved to treat. A healthcare provider may prescribe a medication for a different condition or a different dosage other than what’s approved by the U.S. Food & Drug Administration (FDA), if medically appropriate for the patient.

Paroxetine FAQs

How is REGENX Health different from other online service providers?

REGENX Health is different from other online clinics. We take pride in educating you – our patients – about the therapy you are undergoing. In our experience, the more you know about your health, the better results you’ll obtain.

Here’s what makes REGENX Health stand out:

  • Your healthcare is always expert. That’s because every virtual meeting you’ll have is with a boardcertified urologist who specializes in men’s health, including testosterone replacement therapy and related conditions. Other online men’s health clinics rely on mid-level health providers, nurse practitioners, or non-urologic physicians.
  • Your health and treatment are always physicianguided, in order to ensure your health and optimize your performance results. Each visit with a physician, scheduled every three months via video teleconference, provides a personable and convenient experience for our members, so we get to know you and you get to know us. (This timing is significantly more frequent than other providers.) Know that your therapy, management, and concerns will always be fully addressed.
  • Our pricing is always inclusive. Unlike other online men’s health clinics, there are no hidden fees or surprise prices. Your low, monthly investment includes everything you’ll need during your therapy:
    • Online physician visits
    • Medications
    • Supplies
    • Delivery
    • Comprehensive lab work

As always, there are no long-term commitment requirements, so you can cancel anytime. All medication and supplies are mailed discreetly to your home or office. Unlike other providers, you’ll never have to visit a clinic weekly to get an injection. Instead, your labs are performed on your time at a location most convenient to you and you’ll handle your personalized treatment in your own time and privacy.

What is the best way to take paroxetine?

Paroxetine is an oral pill. Swallow the medication whole. Do not crush, break, or chew the tablet. Our REGENX Health providers will determine your specific dosage and frequency.

Take paroxetine exactly as prescribed by your physician or healthcare professional. Never share paroxetine with others, even if their symptoms are similar, as it may cause serious harm.

Can I take paroxetine as-needed?

Paroxetine is not suitable for on-demand use because it has a slow onset of action (five hours) as well as a long half-life (1–3 days), and daily dosing is required to maintain efficacy. Daily SSRI dosing is more effective than on-demand treatment and is therefore favored by patients because spontaneity of sex is maintained; however, compliance issues can occur with long-term use.

How long does it take for paroxetine to take effect?

Paroxetine for the purpose of treating PE can take up to 3 weeks to take effect in some men, though other men may experience an appropriate delay in ejaculation sooner.

Most SSRI medications take six weeks, on average, to reach peak and steady levels in the body, at which point the medication likely has maximum efficacy.

What should I do if paroxetine is not working?

If the medication is not working after several weeks, please consult with REGENX Health, as your dosage may need to be increased.

What should I do if paroxetine results in too strong an effect?

In some men taking paroxetine, their current dosage may be too strong, resulting in a significantly delay in ejaculation. In those cases, reducing the dosage by half is a common starting point. Consider taking half your prescribed dosage before contacting REGENX Health.

Can I take paroxetine with alcohol?

Drinking alcohol with paroxetine can cause side effects.

What is the best way to store paroxetine?

Keep paroxetine at room temperature, between 68°F and 77°F (20-25°C). Always store paroxetine and all medications out of reach from children.

Paroxetine Safety Information

Who should take Paroxetine?

Paroxetine is not right for everyone. Only your healthcare provider can decide if Paroxetine is right for you.

Do not take paroxetine if you are allergic to paroxetine or also taking pimozide, thioridazine, or tryptophan.

Do not use paroxetine 14 days before or 14 days after you have taken a MAO inhibitor, such as isocarboxazid, linezolid, phenelzine, rasagiline, selegiline, tranylcypromine or methylene blue injection. When stopping taking paroxetine, you must wait at least 14 days before taking a MAO inhibitor.

Notify your REGENX Health doctor if you are taking any other psychiatric or anti-depressant medications or if you take medication for migraine headaches.

Some younger patients have thoughts about suicide when first taking an antidepressant, including paroxetine. Stay alert to changes in your mood or symptoms and alert family members to pay attention to your progress. Report any new or worsening symptoms to your REGENX Health doctor.

Children under the age of 18 are not approved to take paroxetine. Only those who have specifically been prescribed paroxetine should take it. Never share paroxetine with others, even if their symptoms are similar, as it may cause serious harm.

Is paroxetine contraindicated (mix poorly) with other drugs?

Taking paroxetine with other drugs that make you sleepy can worsen this effect. Ask your doctor before taking a sleeping pill, narcotic medication, muscle relaxer, or medicine for anxiety, depression, or seizures.

Ask your doctor before taking paroxetine in combination with a nonsteroidal anti-inflammatory drug (NSAID) for pain, arthritis, fever, or swelling. This includes aspirin, ibuprofen (Advil, Motrin), naproxen (Aleve), celecoxib (Celebrex), diclofenac, indomethacin, meloxicam, and others. Using an NSAID with paroxetine may cause you to bruise or bleed easily.

Tell your doctor about all your current medicines and any you start or stop using, especially:

  • Pimozide, thioridazine, or tryptophan
  • Isocarboxazid, linezolid, phenelzine, rasagiline, selegiline, tranylcypromine, or methylene blue injection
  • Cimetidine (Tagamet), St. John's wort, tamoxifen, tryptophan (sometimes called Ltryptophan), or warfarin (Coumadin, Jantoven)
  • Heart rhythm medicine
  • HIV or AIDS medications
  • Certain medicines to treat narcolepsy or ADHD, including amphetamine, atomoxetine, dextroamphetamine, Adderall, Dexedrine, Evekeo, Vyvanse, and others
  • Narcotic pain medicines including fentanyl and tramadol
  • Medicines to treat anxiety, mood disorders, thought disorders, or mental illness, such as buspirone, lithium, other antidepressants, or antipsychotics
  • Migraine headache medicines, including sumatriptan, rizatriptan, zolmitriptan, and others
  • Seizure medicines, including phenobarbital and phenytoin

This list is not complete. Other drugs may interact with paroxetine, including prescription and over-the-counter medicines, vitamins, and herbal products. Not all possible interactions are listed in this medication guide.

What are the common side effects of Paroxetine?

Paroxetine can cause common side effects including:

  • Headache
  • Vision changes
  • Weakness
  • Dizziness
  • Nausea or vomiting
  • Sweating or shaking
  • Anxiety
  • Sleep problems (insomnia) or drowsiness
  • Loss of appetite
  • Constipation
  • Diarrhea
  • Dry mouth or yawning
  • Decreased sex drive, impotence, or difficulty having an orgasm

Seek medical help immediately if you experience:

  • Signs of an allergic reaction, including skin rash or hives, difficulty breathing, or swelling of your face, lips, tongue, or throat
  • Agitation
  • Hallucinations
  • Muscle stiffness or twitching
  • Loss of coordination
  • Dizziness
  • Warm or tingly feeling
  • Diarrhea
  • Fever
  • Sweating
  • Tremors
  • Racing heartbeats
  • Seizure or convulsions

Stop taking paroxetine and seek help immediately if you experience:

  • Racing thoughts, decreased need for sleep, unusual risktaking behavior, feelings of extreme happiness or sadness, being more talkative than usual;
  • Blurred vision, tunnel vision, eye pain or swelling, or seeing halos around lights;
  • Unusual bone pain or tenderness, swelling or bruising;
  • Changes in weight or appetite;
  • Easy bruising, unusual bleeding (nose, mouth, vagina, or rectum), coughing up blood;
  • Agitation, hallucinations, fever, fast heart rate, overactive reflexes, nausea, vomiting, diarrhea, loss of coordination, fainting;

Report any new or worsening symptoms to your doctor, such as:

  • Mood or behavior changes
  • Anxiety
  • Panic attacks
  • Trouble sleeping
  • If you feel impulsive, irritable, agitated, hostile, aggressive, restless, hyperactive (mentally or physically), more depressed, or have thoughts about suicide or hurting yourself

What are the uncommon side effects of paroxetine?

Uncommon side effects of paroxetine may include, but are not limited to, the following:

  • Cardiovascular conditions such as hypertension, vasodilation, peripheral edema, chest pain, ischemic heart disease, myocardial infarction, or thrombophlebitis
  • Psychiatric conditions such as anxiety, depression, or disturbance in mood
  • Respiratory conditions such as dyspnea, increased frequency of coughs, pharyngitis, bronchitis, rhinitis, or sinusitis
  • Hematologic conditions such as anemia, deep vein thrombosis, leukopenia, or thromboembolic disorder
  • Immunologic conditions such as immune hypersensitivity reaction or lymphedema
  • Neurologic conditions such as cerebral ischemia
  • Musculoskeletal, bone, and connective tissue conditions such as joint paint or stiffness, trigger finger, reductions in bone mineral density, arthralgia, arthritis, backache, osteoporosis, fracture of bone, or bone pain
  • Nervous system conditions such as asthenia, headache, insomnia, somnolence, carpal tunnel syndrome, dizziness, or sensory disturbances (including taste loss, taste perversion, and paresthesia)
  • Gastrointestinal conditions such as nausea, vomiting, or diarrhea
  • Skin and subcutaneous tissue conditions such as rash, allergic reactions, hair thinning (alopecia), urticaria, erythema multiforme, anaphylactic reaction, StevensJohnson Syndrome, or angioedema
  • Hepatobiliary disorders such as increases in alkaline phosphatase, alkaline aminotransferase, aspartate amino-transferase, gamma-GT and bilirubin, or hepatitis
  • Metabolism and nutritional conditions such as anorexia or hypercholesterolemia
  • Other conditions such as pain, cancer, tumor flare, urinary tract infections, or cataracts

Is there a warning on ability to drive or use machinery?

Paroxetine may impair your thinking or reactions. Be careful if you drive, operate machine, or do anything that requires you to be alert.

What happens if I miss a dose?

Take the missed dose as soon as you remember. Skip the missed dose only if it is almost time for your next scheduled dose. Do not take an extra dose to make up the missed dose.

What happens if I overdose?

Seek emergency medical attention or call the Poison Help line at 1-800-222-1222. An overdose of paroxetine can be fatal. Signs and symptoms of an overdose may include excessive tiredness, nausea, vomiting, shaking, confusion, dizziness, fainting, or seizures.

What does my healthcare provider need to know before I take paroxetine?

Your physician or healthcare provider must know all medications and non-prescription drugs or medicines you are currently as well as all your medical problems, particularly including:

  • Heart disease, high blood pressure, or history of stroke
  • Liver or kidney disease
  • A bleeding or blood clotting disorder
  • Seizures or epilepsy
  • Migraine headaches
  • Bipolar disorder (manic depression) or a history of drug abuse or suicidal thoughts
  • Narrowangle glaucoma
  • Low levels of sodium in your blood