In the United States, it is marketed paroxetine hydrochloride (e.g., Paxil®, Paxil CR®) and as paroxetine mesylate (i.e., Pexeva®). The two salts are pharmacologically similar, but cannot be interchaged at the same dose.
The drug is approved by the U.S. Food and Drug Administration for depression, generalized anxiety disorder, obsessive-compulsive disorder, panic disorder, post-traumatic stress disorder and social phobia. It is often prescribed for the "off-label" indications of Depression associated with manic depressive disorder, fibromyalgia, premenstrual dysphoric disorder and vasomotor symptoms associated with menopause.
There have been limited trials with the drug as a prophylactic for migraine. While the second-generation antidepressants generally have not shown effectiveness in chronic pain, while tricyclic antidepressants often are useful, paroxetine has been compared to the tricyclic imipramine and appeared, in a small trial, to be more effective.
Paroxetine is metabolized in the liver by cytochrome P-450 CYP2D6.
- Kelly, Catherine M; David N Juurlink, Tara Gomes, Minh Duong-Hua, Kathleen I Pritchard, Peter C Austin, Lawrence F Paszat (2010-02-08). "Selective serotonin reuptake inhibitors and breast cancer mortality in women receiving tamoxifen: a population based cohort study". BMJ 340 (feb08_1): c693. DOI:10.1136/bmj.c693. Retrieved on 2010-02-10. Research Blogging.