帕羅西汀
Paroxetine
Paroxetine HCl
別名: Paxil CR · Pexeva · Seroxat · BRL-29060 · FG-7051 · Paroxetine hydrochloride · Paroxetina · Paroxetinum
由 VetSheet 獸醫團隊審訂更新於 2026年4月5日本內容以實證獸醫文獻為本
劑量為持牌獸醫專業人員的臨床參考。請務必對照最新藥品說明書及個別病患確認。
各物種劑量
🌎 NA — North America🌍 EU — Europe
狗
| 適應症 | 劑量 | 途徑 | 頻次 | 療程 | 地區 |
|---|---|---|---|---|---|
| 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.
貓
| 適應症 | 劑量 | 途徑 | 頻次 | 療程 | 地區 |
|---|---|---|---|---|---|
| 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.
劑量為持牌獸醫專業人員的臨床參考。請務必對照最新藥品說明書及個別病患確認。
概覽
帕羅西汀 (Paroxetine) 是一種強效的選擇性血清素再攝取抑制劑 (SSRI)，在獸醫學中常以仿單標示外使用 (off-label use) 的方式來進行行為修飾治療。
- 犬隻：用於治療攻擊行為、刻板行為、強迫症 (OCD) 以及廣泛性焦慮症。
- 貓咪：有助於改善尿液記號行為 (亂尿尿)、貓咪間的攻擊行為以及與焦慮相關的睡眠障礙。
臨床要點：與氟西汀 (Fluoxetine) 相比，帕羅西汀的半衰期較短且無活性代謝物，若出現不良反應，其藥物清除期較短。然而，它具有輕微的抗膽鹼作用，因此便秘是較常見的副作用，特別是在貓咪身上。
作用機制
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.
安全性與警告
禁忌症
- 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)
不良反應
- 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)
注意事項
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.
藥物相互作用
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.
監測
- 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)
藥物動力學
半衰期
吸收
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.
分佈
About 95% bound to plasma proteins.
代謝
Extensively metabolized, probably in the liver.
排除
Excreted primarily in urine as metabolites, with some fecal excretion.
過量
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.
可用產品
劑型
- Controlled-release oral tablets
- Oral suspension
- 20 mg oral tablet
- 30 mg oral tablet
- 2 mg/ml oral liquid suspension
人用標示
- 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
各地核准狀態
POM (Prescription Only Medicine). Used under the prescribing cascade.
POM (Prescription Only Medicine). Used under the prescribing cascade.
暫無法規資料: 🇺🇸 US · 🇭🇰 HK · 🇹🇼 TW · 🇯🇵 JP · 🇰🇷 KR · 🇦🇺 AU
儲存與穩定性
Paroxetine oral tablets should be stored at 15-30°C. The oral suspension should be stored below 25°C.
飼主須知
- 需要耐心：如帕羅西汀這類的行為藥物通常需要數週（通常為 4-8 週）才能發揮完全療效。除非獸醫師指示，否則請勿突然停藥。
- 給藥方式：可隨餐或空腹給予。如果您的寵物出現腸胃不適，與少量零食或食物一起餵食可能會有幫助。
- 副作用：請留意食慾變化（初期食慾減退很常見）、嗜睡或腸胃不適。對於貓咪，請特別留意是否有便秘或排泄習慣改變的情況。
- 安全須知：請將藥物嚴格存放在兒童和其他寵物接觸不到的地方。絕對不要在未經獸醫師同意的情況下給寵物服用人類藥物，因為劑量差異極大。
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