파록세틴
Paroxetine
Paroxetine HCl
다른 이름: Paxil CR · Pexeva · Seroxat · BRL-29060 · FG-7051 · Paroxetine hydrochloride · Paroxetina · Paroxetinum
VetSheet 수의사 팀 검수업데이트 2026년 4월 5일근거 기반 수의학 참고자료
용량은 수의사 전문가를 위한 임상 참고자료입니다. 반드시 최신 약물 정보 및 개별 환자에 따라 확인하시기 바랍니다.
동물 종별 용량
🌎 NA — North America🌍 EU — Europe
개
| 적응증 | 용량 | 경로 | 빈도 | 기간 | 지역 |
|---|---|---|---|---|---|
| Compulsive disorders | 1 mg/kg (up to 3 mg/kg) PO once daily (q24h) | PO | q24h | — | 🌎 NA |
| Generalized anxiety disorder | 1-1.5 mg/kg q24h | PO | q24h | — | 🌎 NA |
| Adjunctive treatment of phobias, fears, and anxieties | 0.5-1 mg/kg PO once daily | PO | q24h | — | 🌎 NA |
| Generalized anxiety and impulsivity | 1-2 mg/kg | PO | q24h | Long-term as needed | 🌍 EU |
- Generalized anxiety and impulsivity: Fluoxetine or clomipramine may be preferable due to authorized veterinary status.
고양이
| 적응증 | 용량 | 경로 | 빈도 | 기간 | 지역 |
|---|---|---|---|---|---|
| SSRI responsive behavior problems | 0.5-1 mg/kg q24h (2.5-5 mg per cat q24h) | PO | q24h | — | 🌎 NA |
| Compulsive disorders | 0.5-1 mg/kg PO once daily (q24h) | PO | q24h | — | 🌎 NA |
| Generalized anxiety disorder | 0.5-1.5 mg/kg q24h | PO | q24h | — | 🌎 NA |
| Marking | 0.5-1 mg/kg PO once daily | PO | q24h | — | 🌎 NA |
| Intercat aggression | 0.5-1 mg/kg PO once daily | PO | q24h | — | 🌎 NA |
| SSRI responsive behavior problems | 0.5-1.5 mg/kg PO q24-48h | PO | q24-48h | — | 🌎 NA |
| Urine marking (especially with overt aggression) | 0.5-1 mg/kg | PO | q24h | Long-term as needed | 🌍 EU |
- Urine marking (especially with overt aggression): Can be increased to 2 mg/kg PO q24h but close monitoring is required. Monitor urination frequency.
용량은 수의사 전문가를 위한 임상 참고자료입니다. 반드시 최신 약물 정보 및 개별 환자에 따라 확인하시기 바랍니다.
개요
파록세틴은 강력한 선택적 세로토닌 재흡수 억제제(SSRI)로, 수의학에서는 주로 행동 교정을 위해 허가 외(off-label)로 사용됩니다. 플루옥세틴과 구조적으로 관련이 있으나 약동학 및 약력학적 특성이 다릅니다.
- 개: 공격성, 상동증, 강박 장애(OCD) 및 범불안 장애 치료에 사용됩니다.
- 고양이: 소변 마킹, 고양이 간의 공격성 및 불안과 관련된 수면 장애 관리에 도움이 됩니다.
임상 요점: 플루옥세틴과 비교할 때 파록세틴은 반감기가 짧고 활성 대사 산물이 없어 부작용 발생 시 휴약 기간(washout period)이 더 짧을 수 있습니다. 그러나 가벼운 항콜린성 특성을 가지고 있어 특히 고양이에서 변비가 더 흔한 부작용으로 나타납니다.
작용 기전
Paroxetine acts by selectively blocking the serotonin transporter (SERT) on the presynaptic neuronal membrane in the central nervous system.
- Inhibition of SERT → Decreased reuptake of serotonin (5-HT) from the synaptic cleft → Increased concentration and prolonged activity of 5-HT at postsynaptic 5-HT receptors.
- This potentiation of serotonergic neurotransmission helps regulate mood, anxiety, and compulsive behaviors.
- Paroxetine has minimal affinity for dopamine or norepinephrine receptors, but does exhibit mild affinity for muscarinic acetylcholine receptors, contributing to its anticholinergic side effect profile.
안전성·주의사항
금기사항
- Patients with known hypersensitivity to paroxetine
- Patients receiving monoamine oxidase inhibitors (MAOIs)
- Known hypersensitivity to paroxetine or other SSRIs
- History of seizures or epilepsy
- Concurrent use of Monoamine Oxidase Inhibitors (MAOIs)
- Concurrent use of other serotonergic agents (due to serotonin syndrome risk)
부작용
- Anorexia (common, usually transient)
- Lethargy
- GI effects
- Irritability
- Insomnia/hyperactivity
- Panting
- Aggressive behavior in previously unaggressive dogs
- Constipation (especially in cats)
- Changes in elimination patterns
- Changes in blood glucose levels
- Reduced seizure threshold
- Decreased appetite
- Vomiting
- Trembling
- Restlessness
- Gastrointestinal disturbance
- Paradoxical increase in anxiety
- Potential increase in aggression
- Changes in urination frequency (cats)
주의
Use with caution in patients with seizure disorders, or severe cardiac, hepatic, or renal disease. Dosages may need to be reduced in patients with severe hepatic or renal impairment.
If paroxetine is rapidly discontinued, withdrawal reactions can occur. If the patient has been receiving the drug for an extended period, a gradual withdrawal is recommended. Safety during pregnancy has not been established (FDA Category C in humans); use caution in nursing patients as the drug is excreted into milk at low levels.
약물 상호작용
Increased risk for serotonin syndrome
May increase paroxetine levels
May decrease or reverse the effects of SSRIs
Paroxetine (in humans) can decrease digoxin AUC by 15%
May alter insulin requirements
Increased risk for serotonin syndrome
High risk for serotonin syndrome; use contraindicated. A 5-week washout period is required after discontinuing paroxetine, and a 2-week washout if discontinuing the MAOI first.
Serotonin syndrome-like adverse effects possible
May decrease paroxetine levels
Increased plasma levels of phenytoin possible; may decrease paroxetine levels
Paroxetine may increase these beta-blockers' plasma levels and cause hypotension; atenolol may be safer
SSRIs can inhibit the metabolism of tramadol to active metabolites, decreasing efficacy and increasing toxicity risk (serotonin syndrome, seizures)
Paroxetine may increase TCA blood levels and may increase the risk for serotonin syndrome
Increased plasma levels of theophylline possible
Paroxetine may increase the risk for bleeding
High risk of fatal serotonin syndrome. Do not use paroxetine within 2 weeks of an MAOI, and do not use an MAOI within 6 weeks of stopping paroxetine.
Paroxetine antagonizes the effects of anticonvulsants and lowers the seizure threshold.
May lower seizure threshold and increase risk of adverse neurological events.
Increased risk of bleeding in the case of tissue trauma.
Increased risk of bleeding.
Increased risk of serotonin syndrome. Use only in exceptional cases with careful monitoring.
모니터링
- Efficacy of behavioral modification
- Adverse effects (including appetite and weight changes)
- Behavioral changes (efficacy, paradoxical anxiety, or increased aggression)
- Frequency of urination (especially in cats)
- Signs of serotonin syndrome (tremors, agitation, hyperthermia)
- Gastrointestinal tolerance (appetite, vomiting)
약동학
반감기
흡수
No veterinary data located. In humans, slowly but nearly completely absorbed from the GI tract. High first-pass effect means relatively small amounts reach systemic circulation unchanged. Food does not impair absorption.
분포
About 95% bound to plasma proteins.
대사
Extensively metabolized, probably in the liver.
배설
Excreted primarily in urine as metabolites, with some fecal excretion.
과다투여
Experience with overdoses in humans yields a mixed picture; while not as toxic as tricyclic antidepressants, fatalities and significant morbidity have occurred.
- Clinical Signs: ASPCA APCC data (2008-2009) reported common findings in dogs including hyperactivity, lethargy, mydriasis, and trembling. In cats, mydriasis was commonly noted.
- Treatment: In small animal overdoses, err on the safe side. Employ gut evacuation (if not contraindicated) followed by supportive care. Activated charcoal is very effective in binding paroxetine.
- Serotonin Syndrome: If serotonin syndrome develops, phenothiazines and cyproheptadine can be effective for control. Contact an animal poison control center for additional guidance.
제품
제형
- Controlled-release oral tablets
- Oral suspension
- 20 mg oral tablet
- 30 mg oral tablet
- 2 mg/ml oral liquid suspension
인용의약품
- Paroxetine Oral Tablets: 10 mg, 20 mg, 30 mg & 40 mg; Paxil® (GlaxoSmithKline); Pexeva® (Synthon); generic; (Rx)
- Paroxetine Oral Tablets Controlled-release: 12.5 mg, 25 mg & 37.5 mg; Paxil® CR (GlaxoSmithKline); generic; (Rx)
- Paroxetine Oral Suspension: 2 mg/mL in 250 mL; Paxil® (GlaxoSmithKline); generic; (Rx)
- Paxil 20 mg, 30 mg tablets
- Seroxat 20 mg, 30 mg tablets
- Seroxat 2 mg/ml oral suspension
규제 현황
POM (Prescription Only Medicine). Used under the prescribing cascade.
POM (Prescription Only Medicine). Used under the prescribing cascade.
규제 데이터 없음: 🇺🇸 US · 🇭🇰 HK · 🇹🇼 TW · 🇯🇵 JP · 🇰🇷 KR · 🇦🇺 AU
보관·안정성
Paroxetine oral tablets should be stored at 15-30°C. The oral suspension should be stored below 25°C.
보호자 정보
- 인내심이 필요합니다: 파록세틴과 같은 행동 교정 약물은 완전한 효과를 나타내기까지 몇 주(보통 4~8주)가 걸릴 수 있습니다. 수의사의 지시 없이 갑자기 약물 투여를 중단하지 마십시오.
- 투여 방법: 음식과 함께 또는 빈속에 투여할 수 있습니다. 반려동물이 위장 장애를 겪는 경우, 약간의 간식이나 식사와 함께 주면 도움이 될 수 있습니다.
- 부작용: 식욕 변화(초기에는 식욕 감소가 흔함), 무기력 또는 위장 장애가 있는지 관찰하십시오. 고양이의 경우 변비나 화장실 습관의 변화가 없는지 주의 깊게 확인하십시오.
- 안전: 약물은 어린이와 다른 반려동물의 손이 닿지 않는 곳에 엄격히 보관하십시오. 용량이 크게 다르므로 수의사의 승인 없이 반려동물에게 사람의 약을 절대 주지 마십시오.
VetSheet 의약품 참고자료는 수의사 전문가의 임상 의사결정 지원을 위한 것이며, 전문적 판단이나 제조사의 최신 약물 정보를 대체할 수 없습니다.