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Pharmacy and Medications

Are the side effects of Paxil long term?

08/25/2004

Question:

Do the sexual side effects of Paxil go away with time?

Answer:

Another name for PaxilÒ is paroxetine (puh - rocks - uh - teen). Sexual dysfunction has been reported in both men and women receiving paroxetine as well as other selective serotonin-reuptake inhibitors (SSRIs). The medical literature indicates that up to 50 % of patients receiving SSRIs describe some form of sexual dysfunction during treatment, but the actual incidence may be even higher. However, results of various studies in men and women suggest that Paxil has a higher incidence of sexual dysfunction than other SSRIs The true incidence and severity of sexual dysfunction in patients using SSRI's is difficult to determine because doctors and patients are reluctant to discuss the situation. In addition, sexual dysfunction, such as changes in sexual performance, sexual desire, and sexual satisfaction, often occur as a result of depression

Reported types of sexual dysfunction include delayed ejaculation and erectile disturbances in males and delayed or absent orgasm in women. Decreased libido was reported in 6-15% of male and 0-5% of women receiving paroxetine for depression, obsessive-compulsive disorder, panic disorder, social phobia, and generalized anxiety disorder.

Sexual dysfunction is a one of the more common reasons given for discontinuing treatment with SSRI's. However, with some adjustment, continued use of the medicine may be possible. Some patients report a reduction in sexually related side effects after 2-4 weeks of therapy. Patience during the initial phase of therapy is probably the best approach during this period. Other strategies include dose reduction, or changing the medication to an antidepressant that is less likely to cause sexual dysfunction (WellbutrinÒ , RemeronÒ ). Adding Viagra, Cialis, or Levitra to the treatment regimen may help patients whose main complaint is impotence. Sexual dysfunction related to paroxetine typically abates within 1-3 days after stopping the drug. Your doctor or a pharmacist who knows you should be able to provide additional information if you have additional questions about paroxetine.

This response was prepared in part by Elizabeth Balenovich, a PharmD student at the University of Cincinnati College of Pharmacy.

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Response by:

Robert James Goetz, PharmD, DABAT
Assistant Professor of Pharmacy Practice
College of Medicine
University of Cincinnati