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Paxil (Paroxetinum, Paroxetine) - antidepressant. Selectively blocks the reuptake of serotonin, increases its concentration in the synaptic cleft and causing an antidepressant effect. It has low affinity for muscarinic cholinergic receptors, alpha-1, alpha-2, beta-adrenergic receptors as well as 5-NT_1 -like 5-NT_2 -like and histamine (H_1) receptors. It does not violate psychomotor function and does not potentiate the inhibitory effect of ethanol on them. The antidepressant effect is in 7-14 days systemically administered. The treatment of anxiety observed decrease, depression, sleep normalization.
Pregnancy and breast-feeding:
In experimental studies revealed no teratogenic or embryotoxic effect of paroxetine. Data on a small number of women who took paroxetine during pregnancy, showed no increased risk of congenital malformations in the newborn. There have been reports of premature birth in women who received paroxetine during pregnancy, but a causal relationship to drug intake has not been established. Paxil should not be used during pregnancy except in cases where the potential benefit of treatment exceeds potential risks associated with taking the drug.
It is necessary to monitor the state of health of newborns whose mothers took paroxetine in late pregnancy, as there are reports of complications in children (though not established a causal relationship to drug intake). Described respiratory distress, cyanosis, apnea, seizures, temperature instability, feeding difficulty, vomiting, hypoglycemia, arterial hyper- or hypotension, hyperreflexia, tremor, irritability, lethargy, constant crying, somnolence. Some reports have been described as symptoms of neonatal withdrawal symptoms. In most cases described complications arose immediately after birth or shortly thereafter (within 24 hours). Paroxetine in small amounts excreted in breast milk. Therefore you should not use the drug during lactation, except in cases where the potential benefit of treatment exceeds potential risks associated with taking the drug.
It should be used with caution in patients with renal and hepatic failure, angle-closure glaucoma, prostatic hyperplasia, mania, heart disease, epilepsy, convulsive states, in conjunction with electro-therapy, in patients receiving drugs that increase the risk of bleeding, with risk factors for increased bleeding. During treatment should refrain from drinking alcohol. Be wary of during the drivers of vehicles and people skills relate to the high concentration of attention. In abrupt cancellation - dizziness, sensory disturbances, sleep disturbances, agitation, anxiety, nausea and sweating. Caution should be exercised when administered in combination with lithium preparations. At the time of treatment should refrain from the use of ethanol.
Inductors microsomal oxidation (phenobarbital, phenytoin) reduce the concentration in blood and activity inhibitors (cimetidine) - increase. Increases in plasma protsiklidina. Incompatible with MAO inhibitors. Co-administration with indirect anticoagulants can cause increased bleeding at unchanged value of prothrombin time. It enhances the effect of alcohol.
Inside, in the morning - 20 mg. With insufficient effects may increase the dose to 10 mg / day at intervals of at least 1 week (maximum dose - 50 mg / day). Elderly, malnourished patients, as well as kidney function and liver initial dose - 10 mg / day, the maximum - 40 mg / day.
Drowsiness or insomnia, tremors, nervousness, increased excitability of the central nervous system, impaired concentration, emotional lability, amnesia, dizziness, paresis of accommodation, mydriasis, eye pain, noise and ear pain, increase or decrease in blood pressure, fainting, tachycardia or bradycardia, violation of cardiac conduction and peripheral blood circulation, cough, rhinitis, dipnoe, tachypnea, nausea, loss of appetite, indigestion, increase in liver transaminases, stomatitis, arthralgia, arthritis, dysuria, polyuria, urinary incontinence, urinary retention, amenorrhea, dysmenorrhea, miscarriage, mastitis , abnormal ejaculation, decreased libido and potency, peripheral edema, decrease or increase in body weight, anemia, leukopenia, allergic reactions (itching, rash, chills). Seldom - thought disorder, akinesia, ataxia, seizures, hallucinations, hyperkinesia, manic or paranoid reactions, delirium, euphoria, grand mal seizures, aggressiveness, nystagmus, stupor, autism, blurred vision, cataract, conjunctivitis, glaucoma, exophthalmos, angina, myocardial infarction, cerebrovascular accident, heart rhythm disorders, eosinophilia, leukocytosis, lymphocytosis, monocytosis, hematuria, nefrourolitiaz, renal dysfunction, dermatitis, erythema nodosum, depigmentation.
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