Paroxetine
(brand names Paxil & Pexeva)
How Paxil Works in Weight Loss
Paroxetine (brand names Paxil & Pexeva)
is in a class of drugs called
selective serotonin reuptake inhibitors (SSRIs).
When one
nerve cell (also called a neuron)
signals another nerve cell it releases chemicals called
neurotransmitters.
There is a space these chemicals must cover called the synapse. When the first neuron is finished sending a signal to the second neuron, it must take up all the left over neurotransmitters in the synapse.
SSRIs like Paroxetine (Paxil & Pexeva),
fluoxetine (Prozac),
and
sertraline (Zoloft)
block the signaling neuron’s ability to take up the left over neurotransmitter called
serotonin.
This means the receiving neuron is exposed to the serotonin signal for a longer amount of time. This excess serotonin is what makes people feel better/happier and is why SSRIs are antidepressants. It is not clear exactly how SSRIs, like Paxil, help in weight loss, but is is believed that serotonin helps regulate your appetite. The more serotonin in the synapse, the less hungry you should be.Pros Studies have shown that these medicines help people lose weigh in the short run. Many other antidepressants cause people to gain weight. Prozac, Zoloft, and Paxil generally cause people to lose weight. Because these are antidepressants, these medicines may also help you to feel better, especially if you have depression. However, the doses are different, so you should discuss this with your doctor. Cons The amount of weight loss to expect has a wide range. Some people who do not have much of an appetite because they are depressed may begin eating once they feel better and actually gain weight. After the first six months of treatment, most people regain half of the weight they lost within the next six months. The dose of Prozac for weight loss is three times higher than the dose generally given for depression, which may or may not be the same for Paxil. A higher dose means that more of the medicine has to be in your body. Therefore, there is more of a risk for side effects. Most doctors’ experience is with the lower dose used for depression. These medicines carry a warning from the FDA that they may actually increase the risk of suicide.
Mania
and
serotonin syndrome
are also among some of their side effects. Other Comments In most studies, a diet was also given with the medicine and some included exercise. Diet and exercise should be continued with medicines only serving as a weight loss aid. Most of the studies on weight loss were done on fluoxetine. It is harder to make a recommendation about using sertraline or paroxetine.
Return to Home Page or Weight Loss Drugs.
It is important you discuss any weight loss or exercise plan with your doctor. Only you and your physician can decide what is best for you. Some people have certain conditions that prevent them from doing all exercises, and goal body weights may be different for different people. You need to discuss all these things with your physician before starting any weight loss or exercise program. This article was written byJohn Vickery, MD.
References
Ann Intern Med 2005;142:525-531
“Drug therapy of Obesity” UpToDate version 15.3
Treatment Guidelines from The Medical Letter 2003;1:101
The Medical Letter on Drugs and Therapeutics 1994;36:107-108
Epocrates Online @ http://www.epocrates.com accessed on 3/3/2008
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