济民药业,关爱无限 www.pidrug.com
香港济民药业微信二维码
198 9654 1773
当前位置:首页 > 药品资讯 > 精神科 > 帕罗西汀Paxil

帕罗西汀Paxil

[ 人气:57 | 日期: 2020-08-04 | 返回 | 打印 ]
帕罗西汀Paxil
药品名称:帕罗西汀Paxil
药品别名:
英 文 名:
药品价格:$ 美国市场售价 6 美元
研发公司:
适 用 症:用于治疗抑郁症, 亦可用于原恐障碍、社交恐怖症及强迫症的治疗
型号规格:每片含有效成份12.5mg/25mg,每瓶30片装。
药品详情:

【帕罗西汀Paxil 简述】
 
    帕罗西汀Paxil是一种苯基呃啶衍生物,是SSRI,可选择性地抑制5-HT转运体,阻断突触前膜对5-HT的再摄取, 延长和增加5-HT的作用,从而产生抗抑郁作用。


帕罗西汀Paxil_香港济民药业
 
【帕罗西汀Paxil 适应症】
 
    ①用于治疗抑郁症。适合治疗伴有焦虑症的抑郁症患者,作用比TCAs快,而且远期疗效比丙米嗪好。
 
    ②亦可用于原恐障碍、社交恐怖症及强迫症的治疗。
 
【帕罗西汀Paxil 规格】
 
    本品为片剂,每片含有效成份12.5mg/25mg,每瓶30片装。
 
【帕罗西汀Paxil 服用方法】
 
    由于剂型及规格不同,用法用量请仔细阅读药品说明书或遵医嘱。
 
【帕罗西汀Paxil 注意事项】
 
    ①服用本药前后两周内不能使用 MA0Is。
 
    ②有癫痫或躁狂病史、闭角型青光眼、有出血倾向、有自杀倾向者或严重抑郁状态病史者慎用。肝、肾功能不全者仍可安全使用,但应降低剂量。
 
    ③一次性给药后,可出现轻微的心率减慢、血压波动,一般无临床意义,但对有心血管疾病或新发现有心肌梗死者,应注意其反应。
 
    ④服用1?3周后方可显效。用药时间足够长才可巩固疗效。抑郁症、强迫症、惊恐障碍的维持治疗期均较长。
 
    ⑤有报道迅速停药可引起综合征:睡眠障碍、激惹或焦虑、恶心、出汗、意识模糊。为避免停药反应,推荐撤药方案:根据患者耐受情况,如果能够耐受,以每周10mg的速度减量,至每日20mg的剂量应维持口服1周再停药。如果不能耐受可降低所减剂量,如患者反应强烈,则可考虑回复原剂量。
 
【帕罗西汀Paxil 不良反应】
 
    本品可引起轻微而短暂的不良反应。常见的有轻度口干、恶心、厌 食、便秘、头疼、震颤、乏力、失眠和性功能障碍。偶见神 经性水肿、荨麻疹、体位性低血压。罕见锥体外系反应的报道。

Paxil(Paroxetine)

 
Paroxetine, sold under the brand names Paxil and Seroxat among others, is an antidepressant of the selective serotonin reuptake inhibitor(SSRI) class.[5] It is used to treat major depressive disorder, obsessive-compulsive disorder, panic disorder, social anxiety disorder, posttraumatic stress disorder, generalized anxiety disorder and premenstrual dysphoric disorder.[5] It has also been used in the treatment of hot flashes due to menopause and premature ejaculation.[6][5] It is taken by mouth.[5]
 
Common side effects include drowsiness, dry mouth, loss of appetite, sweating, trouble sleeping, and sexual dysfunction.[5] Serious side effectsmay include suicide in those under the age of 25, serotonin syndrome, and mania.[5] While rate of side effects appear similar compared to other SSRIs and SNRIs, antidepressant discontinuation syndromes may occur more often.[7][8] Use in pregnancy is not recommended while use during breastfeeding is relatively safe.[9] It believed to work by blocking the re-uptake of the chemical serotonin by neurons in the brain.[5]
 
Paroxetine was approved for medical use in the United States in 1992 and initially sold by GlaxoSmithKline.[5][10] It is currently avaliable as a generic medication.[11] A month supply in the United Kingdom costs the NHS about 1.10 £ per month as of 2019.[11] In the United States the wholesale cost of this amount is about 2.40 USD.[12] In 2016, it was the 64th most prescribed medication in the United States, with more than 12 million prescriptions.[13] The United States Department of Justice fined GlaxoSmithKline $3 billion in 2012, for withholding data, unlawfully promoting use in those under 18, and preparing an article that misleadingly reported the effects of paroxetine in adolescent with depression following its clinical trial study 329.[14][15][16]
 
Medical uses
 
Paroxetine is primarily used to treat major depressive disorder, obsessive-compulsive disorder, post-traumatic stress disorder, social anxiety disorder, panic disorder, agoraphobia, generalized anxiety disorder, premenstrual dysphoric disorder and menopausal hot flashes.[17][18]
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 or inferior to other antidepressants.[19][20][21] Despite this, there was no clear evidence that paroxetine was better or worse compared with other antidepressants at increasing response to treatment at any time point.[22]
Anxiety disorders
Paroxetine was the first antidepressant approved in the United States for the treatment of panic disorder.[23][page needed] Several studies have concluded that paroxetine is superior to placebo in the treatment of panic disorder.[24][25]
 
Paroxetine has demonstrated efficacy for the treatment of social anxiety disorder in adults and children.[26][27] It is also beneficial for people with co-occurring social anxiety disorder and alcohol use disorder.[28] It appears to be similar to a number of other SSRIs.[29]
 
Paroxetine is used in the treatment of obsessive-compulsive disorder.[30] Comparative efficacy of paroxetine is equivalent to that of clomipramine and venlafaxine.[31][32] Paroxetine is also effective for children with obsessive-compulsive disorder.[33]
 
Paroxetine is approved for treatment of PTSD in the United States, Japan and Europe.[34][35][36] In the United States it is approved for short term use.[35]
Paroxetine has also FDA approval for Generalized anxiety disorder.[37]
Menopausal hot flashes
On June 28, 2013, the U.S. Food and Drug Administration approved low-dose paroxetine for the treatment of moderate-to-severe vasomotor symptoms such as hot flashes and night sweats associated with menopause.[6] At the low dose used for menopausal hot flashes, side effects are similar to placebo and dose tapering is not required for discontinuation.[38]
 
Adverse effects
 
Common side effects include drowsiness, dry mouth, loss of appetite, sweating, trouble sleeping, and sexual dysfunction.[5] Serious side effects may include suicide in those under the age of 25, serotonin syndrome, and mania.[5] While rate of side effects appear similar compared to other SSRIs and SNRIs, antidepressant discontinuation syndromes may occur more often.[39][40] Use in pregnancy is not recommended while use during breastfeeding is relatively safe.[9]
 
Paroxetine shares many of the common adverse effects of SSRIs, including (with the corresponding rates seen in people treated with placebo in parentheses): nausea 26% (9%), diarrhea 12% (8%), constipation 14% (9%), dry mouth 18% (12%), somnolence 23% (9%), insomnia 13% (6%), headache 18% (17%), hypomania 1% (0.3%), blurred vision 4%(1%), loss of appetite 6% (2%), nervousness 5% (3%), paraesthesia 4% (2%), dizziness 13% (6%), asthenia (weakness; 15% (6%)), tremor 8% (2%), sweating 11% (2%), and sexual dysfunction (≥10% incidence).[4] Most of these adverse effects are transient and go away with continued treatment. Central and peripheral 5-HT3 receptor stimulation is believed to result in the gastrointestinal effects observed with SSRI treatment.[41] Compared to other SSRIs, it has a lower incidence of diarrhea, a higher incidence of anticholinergic effects (e.g., dry mouth, constipation, blurred vision, etc.), sedation/somnolence/drowsiness, sexual side effects, and weight gain.[42]
 
Due to reports of adverse withdrawal reactions upon terminating treatment, the Committee for Medicinal Products for Human Use (CHMP) at the European Medicines Agencyrecommends gradually reducing over several weeks or months if the decision to withdraw is made.[43] See also Discontinuation syndrome (withdrawal).
 
Mania or hypomania may occur in 1% of patients with depression and up to 12% of patients with bipolar disorder.[44] This side effect can occur in individuals with no history of mania but it may be more likely to occur in those with bipolar or with a family history of mania.[45]
 
Suicide
Like other antidep
ressants, paroxetine may increase the risk of suicidal thinking and behaviour in children and adolescents.[46][47] The FDA conducted a statistical analysis of paroxetine clinical trials in children and adolescents in 2004 and found an increase in suicidality and ideation as compared to placebo, which was observed in trials for both depression and anxiety disorders.[48] In 2015 a paper published in The BMJ that reanalysed the original case notes argued that in Study 329,[49] assessing paroxetine and imipramine against placebo in adolescents with depression, the incidence of suicidal behavior had been under-reported and the efficacy exaggerated for paroxetine.[50]
 
Sexual dysfunction
 
Sexual dysfunction, including loss of libido, anorgasmia, lack of vaginal lubrication, and erectile dysfunction, is one of the most commonly encountered adverse effects of treatment with paroxetine and other SSRIs. While early clinical trials suggested a relatively low rate of sexual dysfunction, more recent studies in which the investigator actively inquires about sexual problems suggest that the incidence is higher than 70%.[51] Symptoms of sexual dysfunction have been reported to persist after discontinuing SSRIs, although this is thought to be occasional.[52][53][54]
 
Pregnancy
 
The American College of Obstetricians and Gynecologists recommends that for pregnant women and women planning to become pregnant, "treatment with all SSRIs or selective norepinephrine reuptake inhibitors or both during pregnancy be individualized and paroxetine use among pregnant women or women planning to become pregnant be avoided, if possible".[55] It may be associated with a slightly increased risk of birth defects.[55][56]
 
According to the prescribing information, "epidemiological studies have shown that infants born to women who had first trimester paroxetine exposure had an increased risk of cardiovascular malformations, primarily ventricular and atrial septal defects (VSDs and ASDs). In general, septal defects range from those that are symptomatic and may require surgery to those that are asymptomatic and may resolve spontaneously. If a patient becomes pregnant while taking paroxetine, she should be advised of the potential harm to the fetus. Unless the benefits of paroxetine to the mother justify continuing treatment, consideration should be given to either discontinuing paroxetine therapy or switching to another antidepressant."[57] These conclusions are supported by multiple systematic reviews and meta-analyses that found that, on average, the use of paroxetine during pregnancy is associated with about 1.5–1.7-fold increase in congenital birth defects, in particular, heart defects.[58][59][60][61][62]
 
Discontinuation 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 withdrawal syndrome of any medication of its class.[63] Common withdrawal symptoms for paroxetine include nausea, dizziness, lightheadedness and vertigo; insomnia, nightmares and vivid dreams; feelings of electricity in the body, as well as rebound depression and anxiety. Liquid formulation of paroxetine is available and allows a very gradual decrease of the dose, which may prevent discontinuation syndrome. Another recommendation is to temporarily switch to fluoxetine, which has a longer half-life and thus decreases the severity of discontinuation syndrome.[64][65][66]
 
Overdose
 
Acute overdosage is often manifested by emesis, lethargy, ataxia, tachycardia, and seizures. Plasma, serum, or blood concentrations of paroxetine may be measured to monitor therapeutic administration, confirm a diagnosis of poisoning in hospitalized patients or to aid in the medicolegal investigation of fatalities. Plasma paroxetine concentrations are generally in a range of 40–400 μg/L in persons receiving daily therapeutic doses and 200–2,000 μg/L in poisoned patients. Postmortem blood levels have ranged from 1–4 mg/L in acute lethal overdose situations.[67][68] Along with the other SSRIs, sertraline and fluoxetine, paroxetine is considered a low-risk drug in cases of overdose.[69]
 
 




注:药品如有新包装,以新包装为准。以上资讯仅供医护人员内部讨论,不作任何用药依据,具体用药指引,请咨询主治医师。

更多相关资讯:返回顶部
最新药品资讯
  • Venclyxto(维奈妥拉)联合MabThera治疗慢淋白血病,患者死亡风险降低!
  • Tagrisso(Osimertinib)在英国获批用于两种肺癌适应症的治疗
  • ziritaxestat治疗弥漫性皮肤系统性硬化症(dcSSc)2期概念验证研究成功!
  • 美国FDA批准GSK三联疗法:可同时治疗哮喘和慢阻肺
  • NBIb-1817一次性治疗帕金森病(PD)显著改善运动功能、延长ON时间
  • 口服抗生素tebipenem HBr治疗cUTI和AP关键III期临床成功,疗效不劣于ertapenem
  • 下一代选择性免疫调节剂IMU-838治疗多发性硬化症(RRMS)具有显著疗效,有良好的安全性和耐受性!
  • Fintepla(芬氟拉明)口服溶液治疗Dravet综合征相关癫痫的第三项3期研究结果:抽搐发作显著减少
  • 视神经脊髓炎谱系障碍(NMOSD)创新药Enspryng(satralizumab)获美FDA批准
  • Fasenra与标准类固醇同时治疗鼻息肉三期临床结果积极
  • Darzalex Faspro申请新适应症,治疗轻链(AL)淀粉样变性!
  • 地诺单抗(Xgeva,denosumab)治疗实体瘤骨转移疗效怎样?
  • 新药IDH1抑制剂Tibsovo治疗胆管癌效果怎么样?
  • 拜耳Nubeqa(达罗他胺)治疗非转移性去势抵抗性前列腺癌显著延长患者生存!
  • FDA对罗氏Tecentriq治疗三阴性乳腺癌研究发出警告!
  • 加码多发性硬化症!罗氏启动三项临床试验研究
  • Xeglyze说明书-价格-功效与作用-副作用
  • 赛诺菲/再生元Dupixent(达必妥®)显著延缓哮喘患者肺功能下降:疗效维持3年!
  • 默沙东止咳药gefapixant2项关键III期临床试验成功:咳嗽频率显著降低
  • Ryplazim(纤溶酶原)再次申请上市:首个先天性纤溶酶原缺乏症(C-PLGD)治疗药物!
  • 拜耳Adempas用于经PDE5i治疗反应不足的肺动脉高压(PAH)患者IV期临床成功
  • Midostaurin(米哚妥林)适应症是什么?优势在哪里?
  • 艾普利Apixaban可以在哪里买到正品?
  • 维奈妥拉/维奈托克(VENETOCLAX)怎么服用?注意事项是什么?
  • 芦可替尼Ruxolitinib治疗特应性皮炎效果好不好?
  • 巯嘌呤片(6-MP)Puri-nethol治疗急性白血病效果如何?
  • 晚期HCC患者能从Ramucirumab中获益吗?
  • 赫赛汀+拉帕替尼治疗乳腺癌效果更好
  • 欧盟批准Imfinzi(英飞凡):一线治疗广泛期小细胞肺癌(ES-SCLC)!
  • 第三代强效COMT抑制剂Ongentys(opicapone)用于治疗帕金森病(PD)的新药在日本上市!


  • 如您发现本网站有文字编辑或内容错误,请点击此处发送(需要安装有foxmail或outlook支持),


    或发邮件至:info@morecare.hk,香港济民药业感谢您的到访!


    欢迎您添加香港济民药业微信,或在公众号内留言。

    香港济民微信公众号
    • 香港济民药业友情链接
    • 友情链接

    联系我们:

    地址:
    Rm. 314, Sun Ling Plaza, 30 On Kui Street, Fanling, HONG KONG
    邮箱:
    info@pidrug.com
    电话:
    198 9654 1773
    粤ICP备17150936号
    香港济民药业官方网站
    • 关注我们 :
    • 香港济民药业微博
    • 关注香港济民药业博客
    • 香港济民药业微信公众号