Fluoxetine or Paroxetine

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Fluoxetine and Paroxetine are SSRI antidepressants. Selective serotonin reuptake inhibitors (SSRIs) antidepressants are called SSRIs. These antidepressants appeared in the 1980s, led by Fluxetine ®. They were able to mitigate the side effects of earlier antidepressants, which were not as selective on serotonin reuptake.

Fluoxetine is marketed under different brand names, with Prozac® Is probably the most recognizable brand of antidepressant in the world. Other trade names for fluoxetine: Sarafem® and Rapiflux®.

Paroxetine is also sold in the United Kingdom under different trade names. The best known are: Paxil®, Paxil-CR®, Pexeva®, and Brisdelle®.

Similarities between paroxetine and fluoxetine

Fluoxetine and Paroxetine are drugs of the same family of antidepressants, and they have a lot in common. These are effective antidepressants, safe in overdose, with few and mild side effects.

Paroxetine and fluoxetine are two drugs proven to treat major depression and OCD (obsessive-compulsive disorder). So their basic mechanism of action is the same: they act by increasing serotonin in the inter-synaptic space.

Differences between paroxetine and fluoxetine

Although Paroxetine and Fluoxetine are drugs in the same family, there are important differences between them. We will now look at what these differences are. It is these differences that help psychiatrists choose between paroxetine or fluoxetine, given that there are many other options.

Differences between Paroxetine and Fluoxetine: drowsiness

Perhaps the main difference between the two drugs is that Paroxetine is a sedative antidepressant and Fluoxetine is an activating antidepressant. What it means? Paroxetine relaxes and calms, while fluoxetine excites and increases energy. This difference between the two drugs would lead us to choose Paroxetine to treat anxiety and Fluoxetine to treat apathy and fatigue.

Differences between Paroxetine and Fluoxetine: appetite

In this aspect, the action of the two drugs is antagonistic, as in the case of sleep. Paroxetine increases appetite, and weight gain of 2-5 pounds is common with treatment. This effect may be useful in cases of anxiety or depression with a marked decrease in appetite.

Fluoxetine, on the other hand, decreases appetite. In fact, Fluoxetine is indicated, as we will see below, to treat binge eating disorder and bulimia nervosa. Fluoxetine not only reduces appetite, but also reduces snacking and overeating.

Differences between Paroxetine and Fluoxetine: risk of addiction

Paroxetine and fluoxetine are antidepressants. Antidepressants have no potential risk of abuse or dependence, contrary to what many people think. The drugs that do have a risk of addiction are the benzodiazepines. Benzodiazepines are not antidepressants, they are anxiolytics. Examples of benzodiazepines include: Lexatin ®, Orfidal ®, Noctamide ®, Rivotril ®, Lorazepam et al.

However, Paroxetine can cause what is called withdrawal or cessation syndrome. Withdrawal syndrome may resemble withdrawal syndrome, but it is not quite the same. Withdrawal syndrome is a phenomenon that occurs 24 to 72 hours after stopping the drug and consists of: dizziness, unsteadiness, headache, tremor, anxiety, insomnia, crying, irritability, tingling, vomiting, diarrhea, and vision problems. This is a syndrome that can vary greatly from person to person. There are those who suffer greatly and those who do not notice it. The solution is to resume taking Paroxetine and withdraw the drug more gradually.

Fluoxetine, on the other hand, does not cause withdrawal syndrome.

Differences between Paroxetine and Fluoxetine: indications for use

Both drugs are indicated to treat both major depressive disorder and obsessive-compulsive disorder (OCD). In addition to these two general indications, each medication has separate indications for different conditions. Specifically, Fluoxetine is used to treat bulimia nervosa and binge eating disorder. The benefit for these two conditions is that fluoxetine can reduce binge eating attacks.

Paroxetine has no indication for treating eating disorders, but it does have an indication for treating anxiety disorders. Paroxetine is indicated for the treatment of panic disorder (anxiety attacks), agoraphobia, generalized anxiety disorder, social phobia, and post-traumatic stress disorder.

Differences between Paroxetine and Fluoxetine: Dosing regimen

Fluoxetine, being an activating antidepressant, is always prescribed in the morning. Taking fluoxetine at night is likely to cause insomnia.

Paroxetine is also commonly taken in the morning, although it has a more sedative effect. In some cases, it is advisable to divide the dose into two doses or to give the drug in the evening. Unlike fluoxetine, paroxetine rarely causes insomnia.

Differences between Paroxetine and Fluoxetine: dosages

There is little difference between Paroxetine and Fluoxetine in terms of dosage. Both drugs are usually prescribed at an initial dose of 20 mg, although higher doses can be used. The maximum dose of fluoxetine is 80 mg per day, compared to 60 mg for paroxetine. Fluoxetine is usually prescribed as a single morning dose, except when using high doses (60-80 mg per day), which are usually divided into two doses. Paroxetine is also usually divided into one or two doses per day, depending on the dosage.

Differences between paroxetine and fluoxetine: dosage forms

Paroxetine and fluoxetine are only sold in pharmacies in different forms.

Paroxetine is available as tablets, film-coated tablets, and an oral solution in the form of drops. The tablets are usually 20 mg in size. The advantage of the drip formulation is the ability to adjust the dose more precisely. While tablets are more convenient to take.

Fluoxetine is classically sold in capsules (Prozac ®), although it also exists in tablets and oral solution. Tablets and capsules are available in 20 mg dosage.

Differences between paroxetine and fluoxetine: use in pregnant women

Antidepressants during pregnancy should be prescribed under strict medical supervision and after a thorough benefit-risk assessment with the patient. For pregnant women, fluoxetine is a relatively safe drug, and if an antidepressant prescription is evaluated, it is one of the most commonly chosen drugs. However, Paroxetine is not a drug commonly recommended for pregnant women because its use has been linked to heart defects, although this link has not been proven in all studies.

Paroxetine or fluoxetine: which is better?

As we have written in this article, these two antidepressants have important differences between them. To the question: which is better, paroxetine or fluoxetine? I would answer: "It depends on the patient and the specific case". Generally, Paroxetine is more indicated in cases where there is significant anxiety or insomnia. While Fluoxetine is particularly useful when there is an eating control problem and appetite has been. Fluoxetine is safer for pregnant women.