Xepar

✅ Treats depression
✅ Manages anxiety disorders
✅ Improves mood
✅ Enhances well-being
✅ Regulates serotonin levels

Xepar contains Paroxetine.

Artikelnummer: Ej tillgängligt Kategori: Kategoriöversikt, Kroniska tillstånd, Behandling av situationell ångest Tagg: Paroxetine, Xepar

✓ Medicinskt granskad av Morgan Ellis — Apoteksforskare · 8 års erfarenhet · Senast granskad: maj 2026

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⚡ Quick Answer — What is Xepar?

Xepar innehåller paroxetine 20 mg from a WHO-GMP certified manufacturer (Sun Pharma) — the SSRI with the broadest range of FDA-approved anxiety indications (MDD, GAD, social anxiety, panic, OCD, PTSD, PMDD). Standard adult dose: 20 mg once daily in the morning with food (range 10–50 mg/day). Of all SSRIs, paroxetine has the strongest discontinuation syndrome (very short half-life, no active metabolite) — tapering is mandatory; patients should never stop abruptly. Pregnancy category D — not used in pregnancy due to first-trimester cardiac defect signal. Most weight gain and sexual dysfunction of the common SSRIs. Strong CYP2D6 inhibitor — major interactions with metoprolol, codeine, tamoxifen.

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Important — this is not a situational-anxiety medication. Xepar is a selective serotonin reuptake inhibitor (SSRI), prescribed and titrated over weeks for major depressive disorder (MDD), generalised anxiety disorder (GAD), social anxiety, panic disorder, OCD, PTSD, and PMDD. It is not the right drug for acute, performance-related anxiety (flying, public speaking, exams) — for those use cases beta-blockers (propranolol), benzodiazepines, or hydroxyzine are clinically appropriate. If you do not have a diagnosed mood, anxiety, or psychiatric disorder, do not start this medication.

FDA black-box warning — suicidality. All antidepressants carry an FDA black-box warning for increased risk of suicidal thinking and behaviour in children, adolescents, and young adults under 25, particularly during the first weeks of treatment or after dose changes. Family members and prescribers should monitor closely for worsening mood, agitation, or suicidal ideation in this age group.

What Is Xepar?

Xepar is an oral tablet of paroxetine hydrochloride 20 mg manufactured by Sun Pharma. Paroxetine (US brand Paxil; UK brand Seroxat) is an SSRI launched by SmithKline Beecham in 1992 and one of the most-prescribed antidepressants in the 1990s and early 2000s. It potently and selectively blocks the serotonin transporter (SERT) and has the broadest range of FDA-approved indications across the SSRI class.

Approved Indications

Major depressive disorder (MDD)
Generalised anxiety disorder (GAD)
Social anxiety disorder (chronic / generalised)
Panic disorder — with and without agoraphobia
Obsessive-compulsive disorder (OCD)
Post-traumatic stress disorder (PTSD)
Premenstrual dysphoric disorder (PMDD)
Off-label: hot flashes (low-dose 7.5 mg paroxetine mesylate is FDA-approved for this; off-label for menopause vasomotor symptoms in women who cannot use HRT)

Dosing

Indication	Start	Target	Notes
MDD, GAD, social anxiety, PTSD	20 mg/day in the morning with food	20–50 mg/day	Increase by 10 mg/day at intervals of at least 1 week
Panic disorder	10 mg/day × 1 week	40–60 mg/day	Slow up-titration to avoid early panic exacerbation
OCD	20 mg/day	40–60 mg/day	Often requires upper end of range; 8–12 weeks for assessment
PMDD	12.5–25 mg/day	25–50 mg/day	Continuous or luteal-phase only dosing
Elderly / hepatic impairment	10 mg/day	Maximum 40 mg/day	Reduce starting dose; titrate slowly

Side Effects

Side-effect profile

Frequency	Effect	Notes
Common	Nausea, dry mouth, constipation, sweating	Anticholinergic burden is mild but more than other SSRIs
Common	Sedation	Take at bedtime if drowsy; can help if insomnia is a depressive symptom
Common	Sexual dysfunction (delayed orgasm, low libido, erectile difficulty)	Highest of the SSRIs — up to 60% of long-term users
Common	Weight gain (3–7+ kg over 6–12 months)	Highest of the SSRIs
Common	Dizziness, blurred vision	Anticholinergic
Less common	Bruising, GI bleeding	Caution with NSAIDs / anticoagulants
Less common	Hyponatraemia (SIADH)	Older adults at risk
Sällsynt	Serotonin syndrome	See interactions
Sällsynt	Akathisia (restless agitation), suicidal ideation	First weeks of treatment; black-box monitoring

Discontinuation Syndrome — the Paroxetine Problem

Paroxetine has the shortest half-life of all SSRIs (~21 h) and no active metabolite. This combination produces the worst discontinuation syndrome in the antidepressant class: dizziness, brain zaps, paraesthesia, anxiety, irritability, insomnia, nausea, and headache — often beginning within 24–48 hours of a missed dose. Symptoms can persist for weeks if stopped abruptly.

Mandatory taper: reduce by 10 mg every 2–4 weeks for short-term users; for long-term users (> 1 year), use much slower hyperbolic tapers (e.g. liquid formulation step-downs of 1–2 mg every 2–4 weeks below 10 mg). Never stop paroxetine abruptly outside a hospital setting.

Läkemedelsinteraktioner

Absolute contraindications: MAOIs, linezolid, methylene blue, thioridazine, pimozide. 14-day washout period.

CYP2D6 (strong inhibitor) — clinically meaningful: tamoxifen (reduces conversion to endoxifen — avoid in breast cancer survivors), codeine and tramadol (reduces analgesic activation), metoprolol and other 2D6 beta-blockers (raises plasma levels), atomoxetine, risperidone, aripiprazole (raises levels).

Serotonergic interactions: triptans, tramadol, dextromethorphan, St John’s wort, lithium — serotonin syndrome risk.

Anticoagulants and NSAIDs: increased bleeding risk (especially upper GI).

Pregnancy and Breastfeeding

Pregnancy category D — first-trimester paroxetine exposure has been associated with a small but reproducible signal for fetal cardiac malformations, particularly Ebstein’s anomaly. Paroxetine is not used in pregnancy when alternatives (sertraline, citalopram, escitalopram) are available. Women planning pregnancy should switch antidepressants well in advance.

Breastfeeding: low transfer; sertraline is preferred but paroxetine is reasonable if continuing what worked in pregnancy.

Vanliga frågor

How long does Xepar take to work?

Anxiety and panic symptoms often respond within 2–3 weeks; mood response in MDD typically appears at 4–6 weeks. OCD may require 8–12 weeks at higher doses.

Why is paroxetine harder to come off than other SSRIs?

Paroxetine has a very short half-life (about 21 hours) and no active metabolite, so plasma levels drop fast when doses are missed. This produces a sharper withdrawal than longer-half-life SSRIs (sertraline, citalopram) or those with active metabolites (fluoxetine).

Can I switch from Xepar to another SSRI?

Yes — common switch destinations are sertraline (cleaner profile) or escitalopram (better tolerated). Switches usually involve cross-tapering or a paroxetine taper followed by a brief washout. Always done under prescriber direction.

Is Xepar safe in pregnancy?

Paroxetine is generally avoided in pregnancy due to a small first-trimester cardiac defect signal. Women planning pregnancy should switch to sertraline or escitalopram in advance.

Will Xepar cause weight gain?

Yes — paroxetine causes the most weight gain of the SSRIs (commonly 3–7 kg over 6–12 months). This is a significant reason patients switch to sertraline, escitalopram, or bupropion.

Does paroxetine help with menopause hot flashes?

Low-dose paroxetine (7.5 mg paroxetine mesylate, sold as Brisdelle in the US) is FDA-approved for menopausal hot flashes — useful for women who cannot or prefer not to use hormone replacement.

What happens if I miss a dose?

Take it as soon as you remember; if you remember close to the next dose, skip the missed one. Do not double up. Missing more than one dose can produce noticeable withdrawal symptoms within 24–48 hours.

Can Xepar be combined with anti-anxiety medication?

In severe panic disorder, prescribers sometimes overlap a benzodiazepine for the first 2–4 weeks until the SSRI takes effect, then taper the benzodiazepine. This is a short-term bridging strategy, not chronic combination therapy.

How is Xepar different from sertraline?

Both are SSRIs with similar mechanism. Paroxetine has more sedation, more weight gain, more sexual dysfunction, worse discontinuation, and a stronger CYP2D6 interaction profile — but historically a marginally faster anxiety response. Sertraline is the cleaner first choice for most patients.

How should Xepar be stored?

Store at 15–30 °C in the original blister packaging, away from moisture and sunlight. Keep out of reach of children.

Medical disclaimer: Information on this page is intended for adults using prescribed psychiatric medication and is not a substitute for individualised medical care. Antidepressants, antipsychotics, and related medications can interact with other drugs, alcohol, and pre-existing conditions. Discuss any new medication, dose change, or planned discontinuation with a qualified prescriber. If you experience suicidal thoughts, mania, severe akathisia, signs of serotonin syndrome (high fever, confusion, muscle rigidity, rapid heart rate), or neuroleptic malignant syndrome, seek emergency care immediately.