paroxetine / Generic mfg. - LARVOL DELTA

SSRI-Induced Galactorrhea in Adolescents. (PubMed, J Child Adolesc Psychopharmacol) - "Reports show that SSRI-induced galactorrhea and hyperprolactinemia, though uncommon, can occur in adolescents. Clinicians should be aware that SSRI-related galactorrhea may occur even when prolactin levels are normal or mildly elevated and should actively inquire about this adverse effect. Further research is needed to clarify prevalence, risk factors, and mechanisms involved."

Journal

Selective serotonin reuptake inhibitor and serotonin-norepinephrine reuptake inhibitor use and sexual dysfunction: a pharmacovigilance analysis. (PubMed, Sex Med) - "Comparative analysis of antidepressant-related adverse events in the FAERS database showed that while sexual dysfunction was associated with all studied SSRIs/SNRIs (sertraline, citalopram/escitalopram, paroxetine, fluoxetine, venlafaxine, and duloxetine), symptom profiles varied markedly. But the limitation is FAERS' passive surveillance nature, which may involve underreporting or insufficient clinical context, restricting causal inference. While previous studies have not fully elucidated antidepressant-related sexual dysfunction, our findings delineate distinct sexual adverse effect profiles between SSRIs and SNRIs, contributing valuable evidence for personalized treatment approaches."

Adverse events • Journal • Sexual Disorders

An update on the pharmacokinetic and pharmacodynamic interactions between antidepressants and antiseizure medications. (PubMed, Expert Opin Drug Metab Toxicol) - "Some antidepressants, including fluoxetine, paroxetine, fluvoxamine, are moderate to strong inhibitors of various cytochrome P450 (CYP) isoenzymes and may cause clinically relevant interactions with ASMs metabolized by these pathways. First-generation ASMs with enzyme-inducing properties (e.g. carbamazepine, phenobarbital, and phenytoin) or enzyme-inhibiting effects (e.g. valproic acid) may alter the PK profile of several antidepressants, potentially leading to reduced therapeutic efficacy or dose-dependent toxicity...Antidepressants and ASMs are associated with a considerable risk of clinically significant DDIs. A thorough understanding of the underlying PK and PD mechanisms, combined with complementary strategies including therapeutic drug monitoring, consultation of interaction databases, and careful clinical monitoring, is essential to anticipate, prevent, and effectively manage adverse DDIs."

Journal • PK/PD data • Review • CNS Disorders • Epilepsy

Asprosin Infusion Modulates Central Circuits to Rescue SSRI-Induced Male Dysfunction. (PubMed, Reproduction) - "Rfrp-3 and Kiss1 mRNA levels were not altered by paroxetine, while it counteracted the asprosin-induced elevations in the ARC and DMH. Our findings indicate that asprosin exerts pro-fertility effects and modulates central reproductive circuits, suggesting that asprosin is a key regulator of metabolic status and male reproduction."

Journal • Metabolic Disorders • Sexual Disorders

Paroxetine as a Therapeutic Agent in Inflammatory Osteolysis: Mechanistic Insights and Efficacy. (PubMed, Drug Des Devel Ther) - "These data indicate that paroxetine may represent a potential therapeutic candidate for osteolytic bone diseases. However, further validation is required to confirm its efficacy and safety in more complex pre-clinical models and in humans."

Journal • CNS Disorders • Mental Retardation • Orthopedics • Osteoporosis • Psychiatry • PIK3CA

Effect of Paroxetine or Escitalopram Co-administered with Oxycodone vs Oxycodone Alone on Ventilation During Hypercapnia: A Randomized Clinical Trial. (PubMed, Anesthesiology) - "Both paroxetine and escitalopram, alone and co-administered with oxycodone, decrease hypercapnic ventilation after 21 days suggesting that selective serotonin reuptake inhibitors may have a class effect on hypercapnic ventilation that persists with chronic use."

Clinical • Journal • CNS Disorders • Depression • Psychiatry

A Novel Approach to Estimating the Risk of Gastrointestinal Bleeding for Patients on Oral Anticoagulants and Other Medications Including Non-Steroidal Anti-Inflammatory Drugs and Antidepressants (THSNA 2026) - " Risk of GIB for OAC products obtained from pivotal studies were: 1.99% for apixaban; 3.15% for rivaroxaban; 2.99% for dabigatran; 3.31% for edoxaban; and 2.00% for warfarin. The odds of GIB for NSAIDs ranged from 1.16 (95% CI:0.84-1.61) for celecoxib to 20.67 (95% CI:14.56-29.34) for ketorolac. Odd ratios for GIB among SSRI/SNRI ranged from 1.31 (95% CI:1.07-1.62) for paroxetine to 1.50 (95% CI:1.32-1.70) for venlafaxine. Risk of GIB for other factors included: persons over 65 years of age (OR=2.50, 95% CI:1.2–5.5); previous history of GIB (OR=5.13, 95% CI:3.95–6.67); aspirin use (OR=1.31, 95% CI:0.93-1.85); antiplatelets use (OR=1.95, 95% CI:1.68-2.27); and corticosteroids use (OR=1.68, 95% CI:1.49-1.90)... The DIOAC-GIB incorporates drug interactions with OACs and had good correlation with other bleeding risk scores. DIOAC-GIB may help identify high-risk patients that benefit from tailored prescribing. No part of this publication may be reproduced, distributed, or..."

Clinical • Gastroenterology

Hippocampal energy metabolism reprogramming underlies individual differences in paroxetine-facilitated contextual fear extinction. (PubMed, Behav Brain Res) - "Subsequent targeted metabolite quantification further implicated multiple energy-related pathways, including the pentose phosphate pathway, purine metabolism, and the tricarboxylic acid cycle, as metabolic features associated with divergent contextual fear extinction phenotypes, accompanied by altered levels of pathway-specific metabolites. These results suggest that adaptive hippocampal energy metabolism reprogramming may support divergent fear extinction phenotypes following chronic paroxetine treatment, providing mechanistic insight into differential treatment effects in fear-related disorders."

Journal • Mood Disorders • Psychiatry

Comparative Efficacy of Elinzanetant Versus Other Non-Hormonal Pharmaceutical Therapies for the Treatment of Moderate-to-Severe Vasomotor Symptoms Associated With Menopause: A Network Meta-Analysis. (PubMed, BJOG) - "In this indirect comparison, elinzanetant showed superior or comparable efficacy to NKT or nHT in reducing the frequency and severity of VMS, along with improving sleep disturbances, supporting its role in VMS management."

Journal • Retrospective data • Review • CNS Disorders • Sleep Disorder

Case Report: Four cases for cariprazine and alcohol use disorder. (PubMed, Front Psychiatry) - "All four patients were treated during the years with many different pharmacologic protocols, involving antipsychotics (olanzapine, quetiapine), mood stabilizers (carbamazepine, lamotrigine), anxiolytics (clonazepam, bromazepam), SSRI antidepressants (fluoxetine, paroxetine, escitalopram), but without achieving of the alcohol abstinence. The consistent achievement of full abstinence across all four patients suggests that it may have potential relevance in the management of alcohol use disorder (AUD). However, in the future, well conducted and highly controlled studies are needed to explore a potential cariprazine's role and its place in the management of alcohol dependence."

Journal • Addiction (Opioid and Alcohol) • CNS Disorders

Antifungal effects of paroxetine and fluoxetine, synergism with antifungal drugs, and mode of action against Candida spp. (PubMed, Mycologia) - "The minimum inhibitory concentrations (MICs) were determined for PRX, FLX, and for the antifungals fluconazole, itraconazole, and amphotericin B (AMB), and checkerboard assay was performed to analyze the interactions between them. Additionally, their mechanisms of action can be related to the induction of severe oxidative stress that leads to apoptosis in fungal cells showing a synergistic effect when combined with AMB. Thus, the use of PRX and FLX may be an alternative to treat infections caused by resistant microorganisms, by enhanced effects at lower concentrations when combined with AMB, possibly reducing the risk of toxicity of both drugs."

Journal • Infectious Disease

Neuroprotective Role of Morin Hydrate in Stress-Re-stress (SRS) Rat Model of PTSD: Mitigation of Cognitive Dysfunction, Anxiety, and Depression via Regulation of Oxidative Stress and Neuroinflammation. (PubMed, Neurochem Res) - "Male Wistar rats were exposed to repeated stress cues and then treated with vehicle, paroxetine (10 mg/kg, p.o.), or MH (15 and 30 mg/kg, p.o.)...Histological analysis confirmed preservation of neuronal density in CA1 and CA2 regions of the hippocampus. In summary, MH produced behavioral, biochemical, and structural improvements in the SRS model, suggesting its value as a natural therapeutic candidate for PTSD."

Journal • Preclinical • Alzheimer's Disease • CNS Disorders • Cognitive Disorders • Depression • Inflammation • Post-traumatic Stress Disorder • Psychiatry • BDNF • CAT • IL1B • TNFA

Chronic schizophrenia with aggravation of psychiatric symptoms after cancer surgery: A case report and mini literature review. (PubMed, Ann Palliat Med) - "Patients with comorbid schizophrenia and cancer may present severe psychiatric symptoms in the cancer perioperative period, even if schizophrenia is in a chronic phase. Postoperative delirium, withdrawal delirium, and exacerbation of schizophrenia were speculated to be the possible contributing factors in this case. When patients with cancer also have schizophrenia, oncologists and liaison psychiatrists need to carefully monitor their mental status to prevent interruptions in cancer treatment."

Journal • CNS Disorders • Mental Retardation • Oncology • Ovarian Cancer • Psychiatry • Schizophrenia • Solid Tumor

Association between concomitant use of direct oral anticoagulants with antidepressants and an increased risk of hemorrhage: analysis of the food and drug administration adverse event reporting system database. (PubMed, Front Med (Lausanne)) - "Selective serotonin reuptake inhibitors (SSRIs) presented the highest class risk (ROR 1.78, 95% CI 1.54-2.04), with apixaban plus paroxetine showing the strongest signal (ROR 14.12, 95% CI 7.62-26.15). Co-administration of antidepressants and DOACs significantly elevates bleeding risk, especially for the nervous system. Clinicians must exercise heightened caution, particularly with SSRIs and when using mirtazapine, and further validation studies are needed."

Adverse events • Journal • Hematological Disorders • ROR1

Clinical Evaluation of Drug-Drug Interactions With Aficamten. (PubMed, Clin Transl Sci) - "Aficamten as a victim of DDIs was studied using a moderate-to-strong P450 inducer (carbamazepine) and CYP inhibitors-itraconazole (strong CYP3A), paroxetine (strong CYP2D6), fluconazole (strong CYP2C19 and moderate 2C9 and 3A), and fluoxetine (strong CYP2D6 and 2C19). Aficamten's potential for P-glycoprotein (P-gp) inhibition was assessed using dabigatran etexilate (sensitive P-gp substrate)...In conclusion, aficamten is metabolized by multiple P450 enzymes, limiting its DDI liability. Only weak DDIs (< 2-fold) are likely from strong inhibition of any one pathway, and only moderate (< 5-fold) impact on aficamten exposure is expected with strong multi-pathway inhibitors or inducers."

Journal • Cardiomyopathy • Cardiovascular • Congestive Heart Failure • Heart Failure • Hypertrophic Cardiomyopathy • Obstructive Hypertrophic Cardiomyopathy • CYP2C19 • CYP2C9

Efficacy of Selective Serotonin Reuptake Inhibitors for the Treatment of Chronic Pain and Comorbid Depression in Individuals With Fibromyalgia: A Systematic Review and Meta-Analysis of Randomized Controlled Trials. (PubMed, Cureus) - "However, the overall evidence quality was found to be very low to low due to heterogeneity and risk of bias. Future RCT designs should adhere to a strict methodology in order to strengthen the available evidence on the efficacy of SSRIs in treating fibromyalgia."

Journal • Retrospective data • Review • Anesthesia • CNS Disorders • Depression • Fatigue • Fibromyalgia • Mood Disorders • Musculoskeletal Pain • Pain • Psychiatry • Rheumatology • Sexual Disorders • Xerostomia

Investigational drugs in PTSD. (PubMed, Neuropsychopharmacology) - "Despite decades of research, only sertraline and paroxetine are FDA-approved, both with modest efficacy...Ketamine produces symptom reductions within hours, MDMA-assisted psychotherapy has demonstrated Phase 3 efficacy, and neurosteroids offer novel approaches to targeting hyperarousal...Brexpiprazole's recent FDA rejection, despite supportive early data, underscores persistent regulatory hurdles. While traditional approaches remain standard of care, breakthrough therapies represent paradigm shifts toward disease modification. Future progress depends on biomarker-guided precision medicine, novel trial designs to mitigate placebo effects, and integration of pharmacologic innovations with evidence-based psychotherapies."

Journal • Review • CNS Disorders • Mood Disorders • Post-traumatic Stress Disorder • Psychiatry • B3GAT1

Effect of the antidepressant drug paroxetine in downregulating the biofilm-adhering genes in Staphylococcus aureus: In vitro and in silico studies. (PubMed, Medicine (Baltimore)) - "In silico docking revealed that paroxetine's mode of action was mediated through binding with proteins and penicillin-binding protein, thereby inducing cell death. These results suggest that the paroxetine-HA combination may serve as a promising adjunctive strategy for treating biofilm-associated infections caused by S aureus."

Journal • Preclinical • Infectious Disease • Inflammation

Predicting drug-drug interactions between ayahuasca alkaloids and SSRIs using physiologically based pharmacokinetic modeling. (PubMed, Front Mol Biosci) - "The increasing concomitant use of ayahuasca with selective serotonin reuptake inhibitors (SSRIs) has raised concerns about potential pharmacokinetic and pharmacodynamic interactions, particularly because fluoxetine and paroxetine are strong CYP2D6 inhibitors and DMT and HRM undergo CYP-mediated metabolism. The findings suggest a clinically relevant interaction between ayahuasca and SSRIs, as even modest increases in DMT exposure may intensify serotonergic effects in individuals receiving antidepressant therapy. This study provides a mechanistic and quantitative framework for assessing interaction risks between ayahuasca alkaloids and SSRIs, supporting clinical decision-making and harm-reduction strategies in contexts where controlled drug-drug interaction studies are not feasible."

Journal • PK/PD data

TOP 5 QT-PROLONGING DRUG-DRUG INTERACTIONS (QT-DDIS) IN ELDERLY PSYCHIATRY INPATIENTS RECEIVING PSYCHOTROPICS: A CROSS-SECTIONAL EVALUATION FROM NORTHEAST INDIA (ISPOR 2026) - "The top five QT-DDIs were escitalopram-quetiapine (n=3), escitalopram-olanzapine (n=2), escitalopram-paroxetine (n=2), escitalopram-donepezil (n=2), and escitalopram-mirtazapine (n=2). QT-prolonging DDIs are common among elderly psychiatric inpatients and represent a preventable source of adverse cardiac events and cost escalation. Incorporation of clinical decision support systems (CDSS) such as MedSafety Scan (MSS) hosted by AZCERT's CredibleMeds utilizing AZCERT and DDI databases can optimize prescribing, reduce iatrogenic risk, and improve cost-effectiveness in psychotropic management for the elderly. Such reliable clinical support tools, can provide comprehensive analyses of TdP risk, drug interactions, and duplicate therapies, and produce a detailed patient-specific report that allows for documentation of management plans and pharmacotherapeutic adjustments."

Clinical • CNS Disorders • Psychiatry

AntiGAD65-associated Progressive Encephalopathy with Rigidity and Myoclonus (PERM) Mimicking Serotonin Syndrome (AAN 2026) - "She was started on paroxetine and tizanidine, after which she developed profound rigidity, tremor, and hyperthermia (Tmax 107 °F) with encephalopathy and autonomic instability contributing to intubation and ICU admission...She received IV methylprednisolone (5 days), IVIG (5 days), plasma exchange (5 sessions), and rituximab (1g × 2 doses), eventually with gradual improvement...She regained independent ambulation with PT and has remained free of recurrent spasms on prednisone 10 mg daily, diazepam 5 mg q6h, and levetiracetam 1500 mg BID... This case illustrates that anti–GAD65–associated PERM can present with hyperthermia and AMS, mimicking serotonin syndrome. Recognition of persistent rigidity and stimulus-induced myoclonus with negative EEG correlation should prompt autoimmune evaluation and early multimodal immunotherapy."

CNS Disorders • Immunology • Movement Disorders • Musculoskeletal Pain

Perceived effectiveness of non-hormonal treatment for vasomotor symptoms associated with menopause from the perspective of postmenopausal women and healthcare providers (ISGE 2026) - "However, apart from paroxetine, nearly all NHTs are used off-label and discontinuation is common...NHTs include selective serotonin reuptake inhibitors (SSRIs), serotonin-norepinephrine reuptake inhibitors (SNRIs); with other NHTs including anticonvulsants (gabapentin), antimuscarinics (oxybutynin), and antiadrenergics (clonidine)... Discontinuation of NHTs when prescribed for VMS remains common. There is perceived lack of efficacy and dissatisfaction with primarily off-label treatment, in both HCPs and women. This highlights a potential unmet need for other treatment options with improved efficacy in VMS management."

Clinical

Abstract for REasonS for DiscONtinuation of Non-HormonAl Therapy in MenopausE (RESONATE) Study (ISGE 2026) - "NHTs included antidepressants (selective serotonin reuptake inhibitors [SSRIs] and serotonin–norepinephrine reuptake inhibitors [SNRIs]), anticonvulsants (gabapentin), and α2A-adrenergic receptor agonists (clonidine)...Median treatment duration ranged from 1.4 months for paroxetine (SSRI) to 5.5 months for sertraline (SSRI)...There is a need for additional, effective treatment options for menopausal women experiencing VMS. Abstract previously presented at TMS 2025."

Development of an Enteric-Coated Sustained-Release Powder for Oral Suspension of Paroxetine Based on Cation Exchange Resin. (PubMed, Pharm Dev Technol) - "These pharmacokinetic improvements provide a 'peak-blunting' effect that suggests a potential to minimize concentration-dependent side effects. Consequently, this formulation emerges as a promising, patient-centric alternative for vulnerable populations requiring long-term antidepressant therapy."

Journal • CNS Disorders • Depression • Gastrointestinal Disorder • Major Depressive Disorder • Mood Disorders • Psychiatry

Early antidepressant exposure rewrites the script of coping. (PubMed, J Hazard Mater) - "Paroxetine (PAR), a selective serotonin reuptake inhibitor antidepressant, has been increasingly detected in water systems worldwide, raising concerns about its impact on biota, as it has been shown to affect fish behaviour...After exposure, embryos were transferred to clean media and allowed to develop until the larval stage (8 days post-fertilisation, dpf) and the juvenile stage (45 dpf). Transient embryonic exposure to PAR disrupted the normal development of coping styles, with early behavioural alterations progressing into more pronounced, phenotype-specific disruptions in behaviour, monoaminergic and endocrine regulations at the juvenile stage."

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