Does drowsiness from Paxil go away? (+3 evidences)

In this article, we will discuss if Paxil-induced drowsiness goes away. Paxil is often used in the treatment of obsessive-compulsive disorder, post-traumatic disorder, and generalized anxiety disorder. Increased drowsiness can often impair the quality of life of the patient.

Does drowsiness from Paxil go away?

Yes, the drowsiness caused by Paxil goes away. It is a common trait for an antidepressant to make you feel drowsy. Amongst other SSRIs, Paxil appears to induce the most drowsiness (1). However, this normally subsides after a few weeks.

Paxil can make you feel drowsy and impair your ability to make judgments, react quickly, or think clearly. You should not drive, operate heavy machinery, or engage in other tasks that need you to be alert at all times.

How does Paxil cause drowsiness?

Paxil is a selective serotonin reuptake inhibitor (SSRI). Paxil has the highest affinity for the serotonin transporter which results in the availability of serotonin in the synapse. Thus it inhibits dopamine release throughout the central nervous system (2).

A rise in the central serotonin-to-dopamine ratio is connected with sensations of drowsiness and lethargy. On the flip side, a low ratio promotes improved performance by maintaining motivation and arousal (3).

Which factors contribute to the Paxil-induced drowsiness?

The following factors can also contribute to increased drowsiness while taking Paxil:

  • Work lifestyle: increased drowsiness may result from some lifestyle choices, such as working for long hours or switching jobs to a night shift.
  • Boredom: another well-known reason for tiredness and drowsiness is boredom. 
  • Disease conditions: diabetes, hyponatremia and hypothyroidism are known to cause drowsiness. 
  • Medication: sedatives, tranquillizers, and antihistamines can cause sedation and increased drowsiness.
  • Food: high-fat and high-cholesterol food can increase drowsiness. Eating too much food at once also worsens the feeling of fatigue.

What are the signs of Paxil-induced drowsiness?

While everyone experiences drowsiness or exhaustion at some point in their lives, persistent sleepiness and drowsiness at unsuitable times can signal a drug side effect, sleep issue or other medical concern.

Drowsiness, often known as excessive sleeping, can have the following signs:

  • Lethargy,
  • Weakness, and
  • Loss of mental agility.

What does the research suggest?

Patients treated with Paxil for depressive disorder showed increased drowsiness and hypersomnia. The authors found it pharmacologically beneficial as the patients experiencing drowsiness showed a higher rate of clinical improvement within two weeks (4).

In another study, the authors established that the incidence of drowsiness was dose-dependent. The patients taking 20 mg/day of Paxil showed fewer symptoms of lethargy and drowsiness as compared to the patients taking 40 mg/day (5).

How long does the Paxil-induced drowsiness last?

Paxil-induced drowsiness typically lasts for a few weeks after the beginning of the therapy. The drowsiness wears off after this time as the body adjusts to the medication. If drowsiness persists, consult the doctor immediately.

A doctor would most likely make a follow-up plan with the patient to see if the drowsiness persists for a longer period than expected. If it does, a doctor can devise an alternative treatment plan, or adjust the dose of paroxetine.

How to lessen Paxil-induced drowsiness?

Lifestyle modification can help reduce the occurrence of drowsiness. Consider the following strategies:

  • Take a brief nap in the daytime,
  • Take paroxetine at night,
  • Do some walking and exercise,
  • Do not consume alcohol or other sedating substances,

Which other drugs might cause drowsiness?

Apart from Paxil, other prescription drugs can also cause increased drowsiness, including:

  • Antihistamines,
  • Antipsychotics,
  • High blood pressure medication, 
  • Other antidepressants like fluoxetine.

Which SSRIs cause lesser drowsiness than Paxil?

Some SSRIs cause the least drowsiness, including:

  • Prozac (fluoxetine),
  • Celexa (citalopram), 
  • Lexapro (escitalopram),
  • Zoloft (sertraline), and
  • Fluoxamine.

When to consult the doctor?

The doctor should be consulted if drowsiness begins to affect the daily routine or the patient experiences hypersomnia for more than a week. The doctor might consider the following clinical interventions:

  • Reduce the dose of Paxil,
  • Change the timing of your dose,
  • Correlate increased drowsiness with other medical conditions, or
  • Select an alternate antidepressant.

Conclusion

In this article, I discussed Paxil-induced drowsiness and its mechanism. I would recommend that you should always consult your doctor if you experience increased drowsiness with Paxil. Your doctor will reduce your dose or try another antidepressant to lessen the side effects.

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References

1.-

Marken PA, Munro JS. Selecting a selective serotonin reuptake inhibitor: clinically important distinguishing features. Primary care companion to the Journal of clinical psychiatry. 2000 Dec;2(6):205. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC181142

2.-

Nevels RM, Gontkovsky ST, Williams BE. Paroxetine—the antidepressant from hell? Probably not, but caution required. Psychopharmacology bulletin. 2016 Mar 3;46(1):77. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5044489/

3.-

Meeusen R, Watson P, Hasegawa H, Roelands B, Piacentini MF. Central fatigue: the serotonin hypothesis and beyond. Sports Medicine. 2006 Oct;36:881-909. https://pubmed.ncbi.nlm.nih.gov/17004850

4.-

Murata Y, Kamishioiri Y, Tanaka K, Sugimoto H, Sakamoto S, Kobayashi D, Mine K. Severe sleepiness and excess sleep duration induced by paroxetine treatment is a beneficial pharmacological effect, not an adverse reaction. Journal of affective disorders. 2013 Sep 25;150(3):1209-12. https://pubmed.ncbi.nlm.nih.gov/23809402/

5.-

Robbe HW, O’Hanlon JF. Acute and subchronic effects of paroxetine 20 and 40 mg on actual driving, psychomotor performance and subjective assessments in healthy volunteers. European Neuropsychopharmacology. 1995 Mar 1;5(1):35-42. https://www.sciencedirect.com/science/article/abs/pii/0924977X94001304

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