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Paroxetine major haloperidol is metabolized by cyp2d6 and cyp3a4 and concurrent use with inhibitors of these isoenzymes may result in elevated haloperidol plasma concentrations and adverse effects including extrapyramidal symptoms or qt prolongation.
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Voluntary reports of adverse events in patients taking immediate-release paroxetine hydrochloride that have been received since market introduction and not listed above that may have no causal relationship with the drug include acute pancreatitis, elevated liver function tests the most severe cases were deaths due to liver necrosis, and grossly elevated transaminases associated with severe liver dysfunction , guillain-barr syndrome, toxic epidermal necrolysis, priapism, syndrome of inappropriate adh secretion, symptoms suggestive of prolactinemia and galactorrhea; extrapyramidal symptoms which have included akathisia, bradykinesia, cogwheel rigidity, dystonia, hypertonia, oculogyric crisis which has been associated with concomitant use of pimozide; tremor and trismus; status epilepticus, acute renal failure, pulmonary hypertension, allergic alveolitis, anaphylaxis, eclampsia, laryngismus, optic neuritis, porphyria, ventricular fibrillation, ventricular tachycardia including torsade de pointes , thrombocytopenia, hemolytic anemia, events related to impaired hematopoiesis including aplastic anemia, pancytopenia, bone marrow aplasia, and agranulocytosis , and vasculitic syndromes such as henoch-sch nlein purpura .
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In study 2, cgi improvement responders were 77 and 42 for the paroxetine- and placebo-treated patients, respectively.
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Paroxetine has neuromodulatory and analgesic properties independent of its psychotropic effect, which may set in relatively fast.
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