Paxil questions

[prayerbear]

I heard at my clinic that OCD ers sometimes have to take 90mg of Paxil.

Isnt that overmedicated? I take 75mg Cr. My doctor said me might up my dose to 90 mg. due to severe anxiety last July(plus I was really down!)

The rest of the time, though, I was fine!

First question, Is Paxil bad for the liver, and I have taken and liked Paxil for the last 5 years, but sometimes I get (no make that every day) soooo sleepy that I have to lay down and take a nap in the middle of the day! If I am that sleepy on this dose, how would 90 mg do?

 

[prayerbear]

I heard at my clinic that OCD ers sometimes have to take 90mg of Paxil.

Isnt that overmedicated? I take 75mg Cr. My doctor said me might up my dose to 90 mg. due to severe anxiety last July(plus I was really down!)

The rest of the time, though, I was fine!

First question, Is Paxil bad for the liver, and I have taken and liked Paxil for the last 5 years, but sometimes I get (no make that every day) soooo sleepy that I have to lay down and take a nap in the middle of the day! If I am that sleepy on this dose, how would 90 mg do?

 

[Daniel E.]

You should find some of the answers here:
Paxil Prescribing Information (41-page PDF)

Your doctor may be prescribing based on his professional experience with the medication, info from drug reps, or new clinical trials. Doctors do sometimes go above the recommended maximum dosage. In this case that would be anything above 60mg/day for OCD. However, 75 mg/day (or even 90 mg/day) may be fine since up to 75 mg/day is recommended for panic disorder:

Obsessive Compulsive Disorder: Usual Initial Dosage: PAXIL should be administered as a single daily dose with or without food, usually in the morning. The recommended dose of PAXIL in the treatment of OCD is 40 mg daily. Patients should be started on 20 mg/day and the 35 dose can be increased in 10-mg/day increments. Dose changes should occur at intervals of at least 1 week. Patients were dosed in a range of 20 to 60 mg/day in the clinical trials demonstrating the effectiveness of PAXIL in the treatment of OCD. The maximum dosage should not exceed 60 mg/day.

Panic Disorder: Usual Initial Dosage: PAXIL CR should be administered as a single daily dose, usually in the morning. Patients should be started on 12.5 mg/day. Dose changes should occur in 12.5-mg/day increments and at intervals of at least 1 week. Patients were dosed in a 38 range of 12.5 to 75 mg/day in the clinical trials demonstrating the effectiveness of PAXIL CR. The maximum dosage should not exceed 75 mg/day.
Patients should be cautioned that PAXIL CR should not be chewed or crushed, and should be swallowed whole.

Paxil Prescribing Information

Regarding liver damage, this may put your mind at ease:

Liver Function Tests: In placebo-controlled clinical trials, patients treated with PAXIL exhibited abnormal values on liver function tests at no greater rate than that seen in placebo-treated patients. In particular, the PAXIL-versus-placebo comparisons for alkaline phosphatase, SGOT, SGPT, and bilirubin revealed no differences in the percentage of patients with marked abnormalities.

Paxil Prescribing Information

The largest known ingestion [of overdose] involved 2,000 mg of paroxetine [Paxil] (33 times the maximum recommended daily dose) in a patient who recovered.

Paxil Prescribing Information

 

[Daniel E.]

You should find some of the answers here:
Paxil Prescribing Information (41-page PDF)

Your doctor may be prescribing based on his professional experience with the medication, info from drug reps, or new clinical trials. Doctors do sometimes go above the recommended maximum dosage. In this case that would be anything above 60mg/day for OCD. However, 75 mg/day (or even 90 mg/day) may be fine since up to 75 mg/day is recommended for panic disorder:

Obsessive Compulsive Disorder: Usual Initial Dosage: PAXIL should be administered as a single daily dose with or without food, usually in the morning. The recommended dose of PAXIL in the treatment of OCD is 40 mg daily. Patients should be started on 20 mg/day and the 35 dose can be increased in 10-mg/day increments. Dose changes should occur at intervals of at least 1 week. Patients were dosed in a range of 20 to 60 mg/day in the clinical trials demonstrating the effectiveness of PAXIL in the treatment of OCD. The maximum dosage should not exceed 60 mg/day.

Panic Disorder: Usual Initial Dosage: PAXIL CR should be administered as a single daily dose, usually in the morning. Patients should be started on 12.5 mg/day. Dose changes should occur in 12.5-mg/day increments and at intervals of at least 1 week. Patients were dosed in a 38 range of 12.5 to 75 mg/day in the clinical trials demonstrating the effectiveness of PAXIL CR. The maximum dosage should not exceed 75 mg/day.
Patients should be cautioned that PAXIL CR should not be chewed or crushed, and should be swallowed whole.

Paxil Prescribing Information

Regarding liver damage, this may put your mind at ease:

Liver Function Tests: In placebo-controlled clinical trials, patients treated with PAXIL exhibited abnormal values on liver function tests at no greater rate than that seen in placebo-treated patients. In particular, the PAXIL-versus-placebo comparisons for alkaline phosphatase, SGOT, SGPT, and bilirubin revealed no differences in the percentage of patients with marked abnormalities.

Paxil Prescribing Information

The largest known ingestion [of overdose] involved 2,000 mg of paroxetine [Paxil] (33 times the maximum recommended daily dose) in a patient who recovered.

Paxil Prescribing Information