Are Xanax and Paroxetine the same? (Yes or No)

In this blog post, we are explaining where are Xanax and Paroxetine the same in matters of effects, contraindications, interactions and side effects. 

Are Xanax and Paroxetine the same drugs?

Although both drugs are used to treat anxiety symptoms and anxiety attacks, Xanax and Paraxone belong to different drug classes. 

Xanax is a sedative that contains the active substance alprazolam. It belongs to a group of medicines called benzodiazepines. Benzodiazepines affect chemical activity in the brain to support sleep and reduce anxiety and worry.

Xanax is used to treat anxiety, anxiety and depression panic, for prophylaxis and treatment in delirium tremens and in an alcohol withdrawal syndrome. Xanax tablets should only be used for the short-term treatment of depression. The total duration of treatment should not exceed 12 weeks, including the period during which the dose is reduced progressive (called the period of “gradual decrease” of the dose).

The mechanism of action of Xanax consists of binding to stereo-specific CNS receptors. It has anxiolytic, hypnotic, muscle relaxant and anticonvulsant properties, as well as a specific activity in panic attacks.

Paroxetine is an antidepressant that reinforces the serotonergic activity in the CNS, considering it a powerful and selective SSRI for the treatment of depression, obsessive-compulsive disorder and panic disorder.

Paroxetine belongs to a group of medicines called SSRIs (selective reuptake inhibitors) Pristiq is also among these drugs.

serotonin). Every human being has a substance in the brain called serotonin. It is not completely understood how paroxetine and other SSRIs work, but they can help by increasing the level of serotonin in the brain. Proper treatment of depression and anxiety disorders is important to help you feel better. 

Xanax and Paroxetine – Therapeutic indications

Indicated for the treatment of anxiety associated with other psychiatric disorders, such as depression, dementia, psychotic disorders, personality disorders. Also for the treatment of depression of various types: including severe reactive depression, and depression accompanied by anxiety.

Contraindications for Paroxetine + alprazolam

Known hypersensitivity to paroxetine, alprazolam or any component of the formulation, and in children under 18 years of age. It should not be used in combination with MAOI or within two weeks after finishing treatment with MAOIs. 

MAOIs should also not be prescribed within two weeks after termination of paroxetine therapy; It should not be used in combination with thioridazine because, as with other drugs that inhibit the liver enzyme CYP450 2D6, paroxetine can raise plasma levels of thioridazine.

Paroxetine + alprazolam – Warnings and precautions

Paroxetine: MAOIs should not be used within two weeks of stopping paroxetine therapy; caution in patients with a history of mania; great care in patients receiving oral anticoagulants; it should not be used in combination with tryptophan; patients with heart conditions; patients with epilepsy; it should be suspended in any patient who develops seizures; caution in patients with angle-closure glaucoma.

The same precautions should be taken with patients with depressive disorders as when dealing with patients with psychiatric disorders; patients already receiving neuroleptics as symptoms suggestive of the neuroleptic malignant syndrome have been reported with this combination.

Caution in patients who are being treated concomitantly with drugs that give an increased risk of bleeding and in patients with a known tendency to bleed or those with predisposing conditions; patients should be warned about their ability to drive and operate machinery; it is advisable to decrease the dose gradually when the treatment is to be discontinued; caution is recommended when treating patients with impaired kidney or liver function.

Alprazolam: Emotional/physical habit and dependence may develop, the risk of dependency increases with higher doses and long-term use, and subsequently increases in patients with a history of alcoholism or drug abuse; 

The dose should be reduced slowly when treatment is discontinued, not more than 0.5 mg every 3 days, some patients may require an even slower dose reduction; symptoms of suppression by a rapid decrease or abrupt suspension may range from mild dysphoria and insomnia to a major syndrome that may include abdominal and muscle cramps vomiting sweating tremors and seizures.

Panic disorders have been associated with major primary and secondary depressive disorders and increased suicide reports among untreated patients when using higher doses of alprazolam prolonged-release tablets to treat patients with panic disorders should have the same precaution observed with the use of any psychotropic drug in the treatment of depressed patients or those in whom there is reason to expect hidden suicidal ideas or plans.

Administration to severely depressed or suicidal patients should be done with adequate precautions and the appropriate dosage of the prescription; Patients should be warned about the use of alprazolam while operating motor vehicles or machines in other dangerous activities until it is established that they do not experience drowsiness or dizziness when taking the drug.

Paroxetine + alprazolam Interactions

Paroxetine: Coadministration with serotonergic drugs (eg MAOIs tryptophan or other SSRIs) can lead to a high incidence of effects associated with serotonin, symptoms have included agitation, confusion, diaphoresis, hallucinations, hyperreflexia, myoclonus, chills, tachycardia and tremor, L-tryptophan can cause an incident of effects associated with 5HT (serotonin syndrome).

When paroxetine is coadministered with drugs known as metabolism inhibitors, consideration should be given to reducing doses to the lower limit of the therapeutic range; 

Concomitant use of paroxetine and alcohol is not recommended in patients; concomitant administration of paroxetine and lithium should be started with caution; 

Co-administration of paroxetine with phenytoin is associated with decreased plasma concentrations of paroxetine and increased adverse experiences, co-administration of paroxetine with other anticonvulsants may also be associated with an increased incidence of adverse experiences; 

Paroxetine should be administered with great caution in patients receiving oral anticoagulants; The joint use of paroxetine with tricyclic antidepressants should be established with caution; 

Paroxetine can significantly increase plasma procyclidine levels, the procyclidine dose should be reduced if anticholinergic effects appear; 

Paroxetine inhibits the hepatic enzyme CYP2D6 of cytochrome P450, inhibition of CYP2D6 could lead to increased plasma concentrations of co-administered drugs metabolized by this enzyme, the drugs included are various tricyclic antidepressants (for example, amitriptyline nortriptyline imipramine and desipramine) (eg, perphenazine and thioridazine) risperidone and type 1c antiarrhythmics (eg, propafenone and flecainide) and metoprolol a? -adrenergic blocking agent.

Alprazolam: Benzodiazepines produce CNS depressant effects when co-administered with alcohol or other drugs that cause CNS depression; Compounds that inhibit certain liver enzymes (especially cytochrome P450 3A4) can increase the concentration of alprazolam and increase its activity;

 Co-administration of alprazolam with ketoconazole itraconazole or other azole-type antifungals is not recommended; Caution and consideration of dose reduction is recommended when alprazolam is coadministered with nefazodone fluvoxamine and cimetidine; 

Caution is advised when alprazolam is co-administered with fluoxetine propoxyphene diltiazem oral contraceptives or macrolide antibiotics such as erythromycin and troleandomycin; low dose ritonavir resulted in a large decrease in alprazolam clearance, prolonged its elimination half-life and increased clinical effects.

FAQ on Are Xanax and paroxetine the same

Conclusions

In this blog post, we explained where are Xanax and Paroxetine the same in matters of effects, contraindications, interactions and side effects. 

Although both drugs are used to treat anxiety symptoms and anxiety attacks, Xanax and Paraxone belong to different drug classes. 

Xanax is a sedative that contains the active substance alprazolam. It belongs to a group of medicines called benzodiazepines. Benzodiazepines affect chemical activity in the brain to support sleep and reduce anxiety and worry.

Paroxetine is an antidepressant that reinforces the serotonergic activity in the CNS, considering it a powerful and selective SSRI for the treatment of depression, obsessive-compulsive disorder and panic disorder.

If you have any questions or comments, please let us know!

References

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3. Reus VI. Trastornos mentales. Sección 5: Trastornos psiquiátricos. En: Harrison. Principios de Medicina interna. 16a Ed. Mc. Mcgraw Hill Interamericana Editores; 2003, p. 2811.
4. Moffitt TE, Harrington H, Caspi A, Kim-Cohen J, Goldberg D, Gregory AM, Poulton R. Depression and Generalized anxiety disorder: cumulative and sequential comorbidity in a birth cohort followed prospectively to age 32 years. Arch Gen Psychiatry 2007; 64: 651-60.
5. Flockhart DA. Drug Interactions: Cytochrome P450 Drug Interaction Table. Indiana University School of Medicine (2007).