جستجوی مقالات مرتبط با کلیدواژه « paroxetine » در نشریات گروه « پزشکی »

Psychiatric disorders are chronic in nature which require medications for a long duration. These medications have been associated with many adverse events. Failure to recognize an adverse drug reaction (ADR) exposes the patient to continuing risk of ADR, leading to a significant impact on patient’s quality of life. Thus, the present study carried out to identify the pattern of ADRs reported due to psychotropic medication.

This was a cross‑sectional study conducted to analyze ADRs reported from the psychiatry department of a tertiary care teaching hospital from October 2021 to March 2022.

A total of 137 ADRs were identified from 102 patients. Majority of the ADRs were reported from antidepressants, with paroxetine being the leading offending drug. The central nervous system was most commonly affected, and dizziness (13.13%) was the most common ADR noted. On causality assessment, 97 ADRs (70.8%) were of “possible” type. Almost half of the patients with ADRs (47.5%) recovered spontaneously. No ADR encountered turned out to be fatal.

The present study revealed that the majority of ADRs reported from psychiatry OPD were mild in nature. We reinforce the identification of ADR is crucial in the hospital setting process as it gives an insight into the risk‑benefit ratio for rational use of the drug.

The purpose of this study was to compare the effectiveness of Dapoxetine, and Paroxetine as well as Dapoxetine/Tadalafil and Paroxetine/Tadalafil combinational therapies, for the treatment of patients with prema-ture ejaculation.

In this clinical trial study, 120 patients with premature ejaculation were randomly divided into 4 groups: The first group was treated with Paroxetine (Pa), while the second group received Dapoxetine(Da). The third group received Paroxetine combined with Tadalafil(PT) whereas the fourth group's treatment involved the use of Dapoxetine and Tadalafil(DT) for one month. In the next 2 and 4 weeks, the cases were evaluated in terms of ejaculation duration, frequency of intercourse per week, and drug side effects.

The mean age of the Da, Pa, PT, DT groups was 32 ± 6.9, 32.4 ± 7.2, 31.6 ± 1.9, and 32.9 ± 7.7 years, respectively. There was a significant difference between the Da and DT groups (p = .029) in the ejaculation latency in the 4-week follow-up. In the two weeks follow-up, a significant difference was observed between DA and DT (p = 0.043), Pa and PT (p = 0.006), and Pa and DT groups (p = 0.004) in terms of ejaculation latency. Four weeks after the intervention, a significant difference was detected in the intercourse frequency of Da and PT groups (p =0.033), Pa and PT groups (p = 0.043), Pa and DT groups (p = 0.02), and Da and DT groups (p = 0.016).

Combination therapy (Tadalafil plus Paroxetine or Dapoxetine) was more effective in IELT (Intra ejaculation latency time) than mono-therapy especially in younger patients despite its slightly more side effects.

Paroxetine has been a commonly prescribed antidepressant for treatment of major depression and various anxiety disorders for almost 30 years due to its fewer side effects and toxicity compared with its counterparts. Despite several investigations performed, the paroxetine immunoregulatory effect in healthy subjects is still controversial. In this study, the paroxetine effect on the cell proliferation along with IL-4 and interferon-gamma (IFN-γ) secretion in peripheral blood mononuclear cells (PBMCs) of physically and mentally healthy subjects is investigated.

Blood was drawn from 20 healthy subjects and PBMCs were isolated. Cells were treated with paroxetine and/or phytohemagglutinin (PHA) for 72 h. IL-4 and IFN-γ concentrations were assessed in the supernatant using an enzyme-linked immunosorbent assay. The BrdU cell proliferation assay was also performed to evaluate the paroxetine effect on PBMCs in the absence or presence of PHA.

Paroxetine (25 μM) significantly inhibited the production of IL-4 and IFN-γ in PHA-stimulated human PBMC cultures. Surprisingly, paroxetine suppressed cell proliferation in the unstimulated culture in a dose-independent manner. Paroxetine also attenuated cell proliferation in the PHA-stimulated culture, especially at 25 μM concentration.

The obtained results suggest that paroxetine can be a potent therapeutic option in inflammatory diseases by balancing immune responses.

Neuropathic pain due to damage to the peripheral nerve has influenced millions of people living all over the world. It has been shown that paroxetine can relieve neuropathic pain. Recently, the role of some proteins like BDNF, GABAA receptor, and KCC2 transporter in the occurrence of neuropathic pain has been documented. In the current study, the expression of these proteins affected by paroxetine was evaluated.

Male Wistar rats were allocated into two main groups ofpre- and post-injury. Rats in each main group received paroxetine before nerve injury and at day seven after nerve damage till day 14, respectively. The lumbar spinal cord of animals was extracted to assess the expression of target genes and proteins.

In the preventive study, paroxetine decreased BDNF and increased KCC2 and GABAA gene and protein expression, while in the post-injury paradigm, it decreased BDNF and increased KCC2 genes and protein expression. In this regard, an increase in the protein expression of GABAA was observed.

It seems that paroxetine with a change in the expression of three significant proteins involved in neuropathic pain could attenuate this type of chronic pain.

Rare cases of akathisia have been reported with paroxetine in the literature. However, accurate diagnosis for early treatment is important since untreated akathisia can result in poor patient’s compliance, treatment failure, aggressive or suicidal acts. We present a case of a 25-year- old female patient, suffering from akathisia, who was treated with paroxetine and olanzapine due to hypomania and general anxiety disorder. Our finding shows that side effects like akathisia could be addressed by the timing of the peak level of paroxetine. Thus, shifting the time of paroxetine consumption to reach its peak level at the sleeping period could be a rational approach for many patients. More research is required to confirm that the observation of this case report was not accidental.

This randomized clinical trial was aimed to evaluate the effect of oral use of tamarind seed powder as an herbal product in patients affected by premature ejaculation (PE).

In this study, 75 patients randomized in tamarind group (25 patients received daily 130 mg tamarind seed powder), paroxetine group (25 patients received daily 20 mg paroxetine), and placebo group (25 patients). Patients received the treatment regimen for 4 weeks. The primary outcome was intravaginal ejaculatory latency time (IELT). The secondary outcomes were PE diagnostic tool score, sexual function using International Index of Erectile Function (IIEF), and complications. Studied sexual functions include erectile function, orgasmic function, sexual desire, intercourse satisfaction, and overall satisfaction.

The mean of IELT in tamarind, paroxetine, and placebo groups at baseline was 35.2 ± 26.5, 38 ± 27.6, and 44 ± 34.9 s and at the end of study was 49.5 ± 48.2, 147.4 ± 209.6, and 46.9 ± 37.6 s, respectively, which in paroxetine group signifi cantly increased compared to other groups. IIEF scores for orgasmic function and intercourse satisfaction for paroxetine after treatment signifi cantly increased than that of other groups. The differences between tamarind and placebo groups for studied variables were not statistically signifi cant. The mean of increases in IELT for tamarind, paroxetine, and placebo groups was 14.35 ± 34.3, 109.4 ± 213.4, and 2.9 ± 9.3 s, respectively, which in paroxetine group was signifi cantly higher than other groups and in tamarind group was signifi cantly higher than placebo.

Paroxetine was signifi cantly better than tamarind seed powder and placebo although side effect in paroxetine was more frequent. IELT signifi cantly more increased in tamarind group compared to placebo.

Several medical therapies have been proposed for the treatment of premature ejaculation (PE). Paroxetine and tramadol were both reported to be effective in treatment of PE. In this study, the therapeutic effects of tramadol, paroxetine and placebo were compared in treatment of primary PE.
In this randomized, double-blind, placebo-controlled clinical trial, 150 patients were divided into 3 groups. One group was treated with tramadol 50 mg on- demand, the other group took paroxetine 20 mg on-demand and the third group was treated with placebo. Before starting treatment and after 12 weeks, patients were asked to measure their average intravaginal ejaculation latency time (IELT) and fill the PEP (Premature Ejaculation Profile) questionnaire.
At the end of the 12th week, the mean IELT and average of PEP scores improved in all 3 groups. The increase in tramadol group was significantly higher than the paroxetine and placebo groups (p The results showed that despite an increase in mean IELT and PEP scores in all 3 groups, the rate of improvement in tramadol group was significantly more than the others. Thus, tramadol may be considered as an appropriate alternative therapeutic option for lifelong PE.

Aims:Memory deficit is the most visible symptom of cerebral ischemia. The hippocampus is sensitive against cerebral ischemia. Oxidative stress and inflammation are involved in the pathological process after cerebral ischemic injury. Paroxetine has anti-oxidative and anti-inflammatory effects. In this study the effect of paroxetine on memory deficit after cerebral ischemia was investigated.
Cerebral ischemia/reperfusion (I/R) injury model was established using the bilateral occlusion of common carotid artery method. Paroxetine (10 mg/kg) was intraperitoneally injected into rats, 24 hours before surgery or once a day for 7 days after surgery. Learning and memory were evaluated using the Morris water maze task, then the brain tissue was fixed and hippocampal CA1 pyramidal cells damage was analyzed using the Nissl staining method.
In the ischemia group the escape latency time (ELT) and the swimming path length (SPL) were significantly increased and the time spent in target quadrant (TSTQ) was significantly decreased compared with the control group. The ELT and the SPL were significantly shortened and the TSTQ was significantly increased compared with the ischemia group after Pre- or post-ischemic administration of paroxetine. The percentage of viable pyramidal cells in the ischemia group was significantly decreased compared with the control group. The percentage of viable cells was significantly increased following pre-or post-ischemic administration of paroxetine compared with the ischemia group.
Memory deficit due to I/R was improved and the percentage of viable cells in CA1 region was increased after administration of paroxetine. Therefore, paroxetine may have a neuroprotective effect against cerebral ischemia.

Children and adolescents are prone to develop psychiatric problems after stressful life events. These problems need appropriate treatment because of negative consequences like disease-related suicide. Antidepressants (especially "Serotonin Selective Reuptake Inhibitors") are common treatments for psychiatric problems of children and adolescents; but different side effects, including drug-induced suicide, have been reported.
Case Report: In this article, we describe a nine-year-old girl who developed depression after parental divorce and was prescribed paroxetine. During pharmacotherapy, she had suicidal thoughts and several unsuccessful attempts which have been neglected and finally last attempt was successful. This report is an evidence for physicians to prescribe antidepressants cautiously with reasonable indication. As still there is no certain contraindication of using antidepressants in pediatric patients, importance of follow-ups and screening of suicide in pediatric patients during treatment with antidepressants seems essential.
This study discloses the magnitude of explaining the side effects of antidepressants to caregivers of children with psychiatric problems.
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Some antidepressant drugs can promote neuronal cell proliferation in vitro as well as hippocampal neurogenesis in human and animal models. Furthermore, adipose tissue is an available source of adult stem cells with the ability to differentiate in to multiple lineages. Therefore, human Adipose-Derived Stem Cells (hADSCs) may be a suitable source for regenerative medical applications. Since there is no evidence for the effect of Paroxetine as the most commonly prescribed antidepressant drug for neurogenic potential of hADSCs, an attempt was made to determine the effect of Paroxetine on proliferation and neural differentiation of hADSCs.
ADSCs were isolated from human abdominal fat. These cells differentiated to neuron-like cells and were treated with Paroxetine. 3-[4, 5-dimethylthiazol-2-yl]-2, 5-diphenyl tetrazolium bromide (MTT) assay and immunofluorescence technique were used for assessment of cell proliferation and neurogenic differentiation potential of induced cells, respectively.
MTT assay analysis showed that Paroxetine significantly increased the proliferation rate of induced hADSCs (p Our results provide evidence that Paroxetine can promote proliferation and differentiation rate during neurogenic differentiation of hADSCs. Moreover, Paroxetine can reduce gliogenesis of induced hADSCs during neurogenic differentiation.

Obsessive-compulsive disorder (OCD) is a debilitating chronic disease with an estimated prevalence rate of 2 to 3 percent in the general population. The first patient was a 34-year-old female with a diagnosis of OCD according to DSM-V from about seven years ago with the Yale-Brown score 31. She referred to our center with simultaneous infertility and PCO since 11 years. The second patient was a 32-year-old female with a diagnosis of OCD according to DSM-V with Yale-Brown score 34 since 5 years ago. In two patients, paroxetine may lead to successful pregnancy in addition to reducing the OCD symptoms. According to this initial report and the randomness of pregnancy in patient treated with paroxetine, there may be a hope to develop new protocols for the treatment of infertility using paroxetine.

Several recent studies have investigated the therapeutic role of phosphodiesterase type 5 (PDE5) inhibitors in premature ejaculation (PE) used in the treatment of erectile dysfunction. In the present research, the efficacy of paroxetine alone and paroxetine plus tadalafil was compared in patients referred because of premature ejaculation.Patients and This quasi-experimental study was performed on 100 consecutive 17 to 49-year-old potent men with premature ejaculation and without any clear organic disease. All patients had lifelong PE with an intravaginal ejaculation latency time (IELT) shorter than 1.5 minutes. Informed consent was obtained from all patients who were randomly divided into two groups using a computer-generated random tabulation list. In group A, patients received 10 mg paroxetine daily, in addition to four hours before planned sexual activity. In group B, 10 mg paroxetine was taken daily, plus 10 mg tadalafil one hour before planned sexual activity. The duration of the intervention was six months and patients were evaluated for IELT three and six months after the beginning of therapy. The mean age of patients in groups A and B were 33 ± 9.6 and 31.2 ± 9.3 years, respectively (P = 0.368). The mean number of intercourses were 1.08 ± 0.6 and 1.12 ± 0.6 per week in groups A and B, respectively (P = 0.791). Mean IELT at the 3-month follow up in groups A and B was 4.5 ± 1.5 and 5 ± 2.4 minutes, respectively (P = 0.285) and at the 6-month follow up was 4.8 ± 1 and 5.3 ± 2 minutes, respectively (P = 0.278). The results of the study show that tadalafil can increase the mean IELT and can be used for treatment of premature ejaculation in combination with paroxetine.

P2X4 receptor (P2X4R)، a purinoceptor expressed in activated spinal microglia، plays a key role in the pathogenesis of neuropathic pain. Spinal nerve injury induces up-regulation of P2X4R on activated microglia in the spinal cord، and blockade of this receptor can reduce neuropathic pain. The present study was undertaken to determine whether paroxetine، an inhibitor of P2X4R، could attenuate allodynia and hyperalgesia in chronic constriction injury (CCI) model of neuropathic pain when used preemptively or after the sciatic nerve injury. Male Wistar rats (150-200 g، n = 6) were divided into 3 different groups: 1- CCI vehicle-treated group، 2- Sham group، and 3- CCI paroxetine-treated group. Paroxetine (10 mg/kg، i. p.) was administered 1 h before surgery and continued daily until day 14. In other part of the study، paroxetine (10 mg/kg، i. p.) was administered at day 7 post injury and continued daily until day 14. von Frey filaments for mechanical allodynia and analgesia meter for thermal hyperalgesia were used to assay pain behavior. In a preventive paradigm، paroxetine significantly attenuated both mechanical allodynia and thermal hyperalgesia (P<0. 001). A significant decrease in pain behavior was seen with paroxetine on existing allodynia (P<0. 001) and hyperalgesia (P<0. 01) when initiated at day 7 post injury. It seems that paroxetine can attenuate pain behavior when administered before and also after sciatic nerve injury in CCI model of neuropathic pain.

Although the effectiveness of paroxetine and Attention Modification Program has been studied separately in treating social anxiety disorder, there has been no research comparing them according to the literature. The aim of this study was to compare the effectiveness of paroxetine, Attention Modification Program (AMP) and combination of both on improving the Social Anxiety Symptoms. 33 patients meeting DSM-IV-TR criteria for social anxiety disorder were randomly assigned in 3 groups: 11 in paroxetine group, 11 in AMP group and 11 in combined group. Treatment intervention was done during 8 weeks period. Social Phobia Inventory (SPIN), Beck Depression Inventory (BDI-II) and Sheehan Disability Scale (SDS) were administered before and after treatment intervention. One-way Analysis of Covariance (ANCOVA) was used to determine the differences and efficacy of treatment interventions between groups. Data analysis was done by SPSS-16 software. 28 participants completed the treatment period. One-way ANCOVA results showed statistically significant differences in post-treatment scores of social phobia (p=0/007), depressive symptoms (p=0.007) and daily life functioning (p=0.011) between three groups. Bonferroni correction showed that combined treatment is significantly more effective than AMP in reducing social phobia symptoms (p=0.007), depressive symptoms (p=0.022) and enhancing daily life functioning (0.019). Yet, there were no significant differences between Paroxetine and combined treatment in all post-treatment scores (p=0.890, p=1.000, p=1.000 for social phobia, depressive symptoms and daily life functioning respectively). Paroxetine showed more significant improvement of depressive symptoms (p=0.016) and enhancing daily life functioning (p=0.045) than AMP. Also, there were no significant differences between paroxetine and AMP in reducing social anxiety symptoms. It seems that paroxetine has wider effect in reducing social anxiety symptoms, depressive symptoms and enhancing daily life functioning than AMP and adding the AMP to paroxetine does not make significant changes than medicating with paroxetine alone.