Is Paxil CR better than Paxil? (5 factors)
By
Ivan Kahwa
Author bio
Mr Ivan Kahwa is a chemist and phytopharmaceutical scientist with expertise in chemistry, pharmacology, phytochemistry, and Nanobiotechnology. He writes and reviews content on these topics.
Mr Ivan Kahwa’s Highlights:
Guest Researcher at the University of Leipzig, Senior Research Fellow/Scientist, and Lecturer at the Department of Pharmacy, Faculty of Medicine, Mbarara University of Science and Technology.
Professional Experience:
Mr Ivan joined PHARMBIOTRAC as a research fellow/scientist during his master of science tenure. He contributed to the development of most of the phytopharmaceutical products in the project. Furthermore, he participated in carrying out the pharmacological activities of the developed products in laboratory animals such as mice and rats in order to develop proper doses hence leading to pre-clinical studies.
With the above relevant research experience, Ivan started to work with the University of Leipzig on collaborative projects with Mbarara University to develop the chemistry of Ugandan Medicinal plants and their pharmacological activities. This was coupled with several consultative positions by different German NGOs. Mr. Kahwa is also a supporting in the teaching and learning at the Departments of Pharmacy and Pharmaceutical Sciences, Faculty of Medicine, Mbarara University of Science and Technology.
With the increase in antimicrobial resistance globally, Ivan retooled his thinking towards developing new naturally derived antibiotic regimens from Ugandan propolis with the assistance of nanotechnology to improve their delivery to microbial cells. Kahwa has also published over 28 articles in peer-reviewed journals and he is currently reviewing for many journals.
Education:
2023-2027: PhD in Pharmaceutical Sciences (ongoing) with a focus on Pharmaceutical Microbiology and Nanobiology at Mbarara University of Science and Technology.
2022: 2Msc. in Pharmacognosy and Natural Medicine Science at Mbarara University of Science and Technology.
2018: Bachelor of Science (Chemistry) at Mbarara University of Science and Technology.
Publications:
▪ Iqbal, S., Jabeen, F., Kahwa, I., & Omara, T. 2023. Suberosin Alleviates Thiazolidinedione-Induced Cardiomyopathy in Diabetic Rats by Inhibiting Ferroptosis via Modulation of ACSL4-LPCAT3 and PI3K-AKT Signaling Pathways. Cardiovascular Toxicology. https://doi.org/10.1007/s12012-023-09804-7
▪ Gupta, A. K., Yadav, R., Sharma, S., Sawale, J., & Kahwa, I. 2023. Anti-ageing Activity and Antioxidant Activity of Methanol Extracts of Leaves and Flowers of Salvia officinalis and Rosmarinus officinalis. Journal of Young Pharmacists, 15(3), 448–455. https://doi.org/10.5530/jyp.2023.15.60
▪ Tolo, C.U., Kahwa, I., Nuwagira, U., Weisheit, A. and Ikiriza, H., 2023. Medicinal plants used in treatment of various diseases in the Rwenzori Region, Western Uganda. Ethnobotany Research and Applications, 25, pp.1-16.
https://ethnobotanyjournal.org/index.php/era/article/view/4683
▪ Kahwa, I., Ajayi, C.O., Yadav, R., Chauhan, N.S., Shah, K., Abdelgadir, A.A., Shegena, E.A., Daniel, S., Omara, T., Asiimwe, J.B. and Ikiriza, H., 2023. Pharmacognostic and phytochemical studies as an invaluable approach for correct identification of medicinal plants: The case of Artemisia vulgaris L. substituted for Artemisia annua L. in Western Uganda. TMR Integr Med, 7, p.e23004.
https://doi.org/10.53388/TMRIM202307004
▪ Nalimu, F., Oloro, J., Kahwa, I. and Ogwang, P.E., 2021. Review on the phytochemistry and toxicological profiles of Aloe vera and Aloe ferox. Future Journal of Pharmaceutical Sciences, 7, pp.1-21.
https://doi.org/10.1186/s43094-021-00296-2
▪ Elamin, O.H.S., Ali, M.A., Elgezuli, I.A.A., Bashir, M.A. and Kahwa, I., 2021. Diagnosis of pre-and post-treatment of echinococcus granulosus with counter current immune electrophoresis and bacterial co-agglutination. Journal of Microbiology and Infectious Diseases, 11(02), pp.88-94.
https://doi.org/10.5799/jmid.951600
Published book Chapter
▪ Kahwa, I., Ayesiga, I., Nakalema, S., Alinaiswe, R., Mbabazi, R. and Iqbal, S., 2023. Natural products in the management of onchocerciasis. In Natural Products in Vector-Borne Disease Management (pp. 63-80). Academic Press. Book Chapter.
https://doi.org/10.1016/B978-0-323-91942-5.00012-4
Submitted manuscripts Under Review:
▪ Comparison of the Wound Healing Activity of the Leaf and Leaf Ash Extracts of Vernonia amygdalina in Rats. Journal name: Clinical Phytoscience
▪ Ethnobotanical Survey of Medicinal plants used in the management of cancer in Uganda. Journal name: Journal of Herbal Medicine
▪ Ethnobotanical survey and phytochemical screening of medicinal plants used in treatment of epilepsy by PROMETRA-Uganda Traditional Health Practitioners in Mpigi District, Uganda. Journal name: Journal of Ethnopharmacology
Submitted book chapters under review
1.Book title: Algae as a Natural Solution for Water-Food-Energy Nexus, Section 4: Microalgae and cyanobacteria for food applications, Chapter 4.6: Safety, toxicological and allergenic aspects of using algae for food. Authors: Christine Kyarimpa, Tom Omute, Caroline K. Nakiguli, Alice V. Khanakwa4, Christopher Angiro, Ivan Kahwa, Fortunate Ahumuza, Timothy Omara*. Publisher: Springer Nature Singapore Pte Ltd. 152 Beach Road, #21-01/04 Gateway East, Singapore 189721, Singapore.
2.Book title: Nutraceuticals Inspiring the Contemporary Therapy for Lifestyle Diseases. Chapter: Nutraceutical applications of Seaweeds and their Phytocompounds in Nutrition and Treatment of Diseases. Authors: Ivan Kahwa, Timothy Omara , Innocent Ayesiga , Gael Noel Neh Neba Ambe , Zehbanaz Javidbhai Panwala , Rachel Mbabazi , Shabnoor Iqbal , Christine Kyarimpa , Christine Betty Nagawa , Kamal Shah ,Nagendra Singh Chauhan* Publisher: CRC Press
You can view my works on the following professional sites:
Research Gate: https://www.researchgate.net/profile/Ivan-Kahwa
Google Scholar: https://scholar.google.com/citations?user=tOwrvqoAAAAJ&hl=en
ORCID: https://orcid.org/0000-0002-6440-3437
Linkedin: https://de.linkedin.com/in/ivan-kahwa-865450159
In this article, we will explore whether Paxil CR is better than Paxil. Furthermore, we will also discuss how Paxil CR is superior to Paxil, examining differences in onset and duration of action, and exploring factors influencing the choice between these two dosage forms.
Is Paxil CR better than Paxil?
Yes, Paxil CR is better than Paxil. Paxil CR is a controlled-release formulation, whereas Paxil is an immediate-release formulation. Paxil is available in both tablet and liquid forms.
Paxil, also known as Paroxetine, is a selective serotonin reuptake inhibitor (SSRI) approved by the FDA to treat anxiety, depression, panic disorders, and other related mental health conditions.
Paxil works by inhibiting the reuptake of serotonin in the brain cells. Serotonin is a chemical neurotransmitter that regulates the sleep, mood, appetite, and stress response of the body (1).
How is Paxil CR better than Paxil?
Paxil CR is better than Paxil in the following ways:
Low medical costs
A 6-month research study comparing the total expenses of Paxil CR and Paxil revealed that Paxil’s immediate-release formulation was more expensive. Paxil CR proved to be more cost-effective for all the diagnoses for which Paxil is prescribed (2).
Lower risk of side effects
Paxil CR is safer than Paxil, associated with fewer adverse drug reactions. The controlled-release formulation of Paxil causes a lower risk of side effects, especially gastrointestinal effects.
This is because the controlled-release formulation releases the drug into the bloodstream slowly, therefore blood levels do not fluctuate suddenly. Approximately 70% of patients reported satisfaction with Paxil CR, with only a few patients experiencing common side effects, such as nausea, dry mouth, dizziness, tiredness, or insomnia (3,4).
More efficacy
Paxil CR is effective in patients who do not respond well to the immediate-release formulation of Paxil. Patients reported improved symptoms of anxiety and depression while taking Paxil CR compared to Paxil, particularly for major depressive disorder (MDD) and social anxiety disorder (SAD) (3).
Lower rate of dropouts
During comparative studies, the dropout rate of patients was higher with Paxil immediate-release compared to Paxil controlled-release. Patients withdrew from the treatment with Paxil IR due to the incidence of bothersome side effects.
Paxil CR demonstrated effectiveness even in the early phase of treatment, with a milder onset of nausea in the first week. This led to higher patient adherence to Paxil CR compared to Paxil IR (4).
Elderly people may show increased adherence to Paxil CR compared to Paxil IR due to factors such as slower metabolism, individual sensitivity, and other health-related issues (5).
What are the differences between Paxil and Paxil CR?
Paxil CR and Paxil differ from each other in terms of onset and duration of action. Paxil’s immediate-release formulation releases the drug immediately into the bloodstream, causing rapid fluctuations in blood levels. Paxil IR is beneficial for patients requiring quick relief from anxiety and depression symptoms with a short duration of action.
Paxil controlled-release, on the other hand, releases the drug slowly into the bloodstream, leading to gradual increases in blood levels and a lower incidence of side effects. Paxil CR has a longer duration of action compared to Paxil IR, providing prolonged therapeutic effects (4).
What factors influence the choice between Paxil CR and Paxil?
The factors which may impact the choice between Paxil CR and Paxil IR are as follows:
- If quick relief is necessary, Paxil IR may be prescribed.
- For consistent and prolonged therapeutic effects, Paxil CR is preferred.
- In case you experience bothersome side effects, Paxil CR, with a lower risk of side effects, is more beneficial.
- Elderly patients, with slower metabolism and other health conditions, may prefer Paxil CR.
- The once-daily dosing of Paxil CR enhances patient adherence to antidepressant therapy (4,6).
Conclusion
As per my analysis, Paxil CR is better than Paxil IR due to various reasons. Paxil CR has sustained therapeutic effects, cost-effectiveness, and a lower risk of side effects.
However, the decision to choose the appropriate dosage form either Paxil IR or Paxil CR is the responsibility of your healthcare provider. Do not take or stop taking any antidepressant without consulting your healthcare provider.
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References
1.-
Shrestha P, Fariba KA, Abdijadid S. Paroxetine. 2023 Jul 17. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jan–. PMID: 30252278. Available from: https://pubmed.ncbi.nlm.nih.gov/30252278/
2.-
Sheehan DV, Eaddy MT, Shah MB, Mauch RP. Differences in total medical costs across the SSRIs for the treatment of depression and anxiety. Am J Manag Care. 2005 Oct;11(12 Suppl):S354-61. PMID: 16236017. Available from: https://pubmed.ncbi.nlm.nih.gov/16236017/
3.-
Otsubo T, Watanabe Y, Hongo S, Inoue M, Akimoto K, Murakami K, Takahashi R, Kikuchi T. Comparative effectiveness of switching paroxetine formulation for treatment of major depressive disorder: an open-label multicenter study. Neuropsychiatr Dis Treat. 2018 Apr 6;14:955-966. doi: 10.2147/NDT.S152985. PMID: 29670356; PMCID: PMC5896672. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5896672/
4.-
Bang LM, Keating GM. Paroxetine controlled release. CNS Drugs. 2004;18(6):355-64; discussion 365-6. doi: 10.2165/00023210-200418060-00003. PMID: 15089103. Available from: https://pubmed.ncbi.nlm.nih.gov/15089103/
5.-
Keene MS, Eaddy MT, Nelson WW, Sarnes MW. Adherence to paroxetine CR compared with paroxetine IR in a Medicare-eligible population with anxiety disorders. Am J Manag Care. 2005 Oct;11(12 Suppl):S362-9. PMID: 16236018. Available from: https://pubmed.ncbi.nlm.nih.gov/16236018/
6.-
Golden RN, Nemeroff CB, McSorley P, Pitts CD, Dubé EM. Efficacy and tolerability of controlled-release and immediate-release paroxetine in the treatment of depression. J Clin Psychiatry. 2002 Jul;63(7):577-84. doi: 10.4088/jcp.v63n0707. PMID: 12143913. Available from: https://pubmed.ncbi.nlm.nih.gov/12143913/
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