Paxil and Valium: Is there any interaction?

In this blog post, we are going to talk about the possible interactions between paxil and Valium. Paxil is an antidepressant which is used to treat a variety of mental health conditions, whereas valium is a benzodiazepine. 

This blog is all about the safety and efficacy of the concomitant use of these two meds. 

Is there any interaction between Paxil and Valium? 

Paxil and valium may interact with each other and cause an increased risk of drowsiness, low mental alertness, impaired motor functions, confusion, forgetfulness etc. However, these interactions depend on the doses you’re at. 

Paxil is an antidepressant. It is a selective serotonin reuptake inhibitor (SSRI) and is used to treat mild to severe episodes of depression and generalised anxiety disorder. 

Paxil inhibits the reuptake of serotonin by blocking serotonin transporters (SERT). This results in increased serotonergic activity. Paxil and every other antidepressant take time to kick in. 

Valium, on the other hand, is a benzodiazepine. It is used to help control anxiety, convulsions and panic attacks. This medication basically mimics inhibitory chemicals in your brain, like GABA, to control the excessive neuronal activity. 

They don’t work overnight and your body may take up to 8 weeks to adjust to the medicine. This is exactly why it’s said that antidepressants might make you feel worse before making you feel better. This sensation and anxiousness is controlled by valium. 

Make sure you ask your healthcare provider before using any medication. It is not recommended to self medicate, as it may make your symptoms much worse. 

What is the clinical significance of using Paxil and valium together? 

Various studies suggest the valium can be used to help relieve anxiety and disturbed mood until your paxil starts to work. In fact, this combination can be used together for the treatment of comorbid anxiety and depression. 

Valium and other benzodiazepines can be used to control early anxiety caused by paxil. The treatment is usually continued till your antidepressant kicks in. These meds together can control multiple overlapping symptoms of anxiety and depression. 

These symptoms include:

• Restlessness 
• Extreme distress
• Irritability 
• Suicidal behavior 
• Inability to engage in daily life activities 
• Weight loss or gain, depending on the effect of the condition on eating habits
• Excessive sweating 
• An urge to get isolated
• Hopelessness 
• Worthlessness 
• Confusion 
• Social disconnection 

A few studies indicate that benzodiazepines may play an important role in the management of depression and can be used in combination with antidepressants for the treatment of major depressive disorder (MDD). 

The same study revealed that GABA can make an impact on your depression through GABA depression theory and benzodiazepines can control this effect. 

Another 2019 research study monitored the effects of this combination of antianxiety and antidepressants for the treatment of MDD. 

The study used various standardisation techniques and concluded that it is indeed an effective combination and can significantly help to reduce the early anxiety caused by antidepressants. 

Another study confirmed the early anxiogenic side effects of selective serotonin reuptake inhibitors (SSRIs) by experimenting on mice. The study monitored both control and test groups. Control groups only received SSRI and the test group received SSRI with diazepam. 

The study was based on two findings. The first one confirmed that SSRIs cause anxiety after acute administration, and the other finding indicated the beneficial effects of benzodiazepine in this situation. 

What are the risks associated with the use of Paxil and Valium together? 

Both paxil and valium are associated with few side effects, which can vary from person to person. Side effects are not just the effects of your drug but also how your body responds to the drug. 

Usually valium is well tolerated, but some people may suffer from the side effects and might even stop the treatment because of them. It depends on the pre-existing health conditions as well. One of the side effects of benzodiazepines include respiratory depression, which is dose dependent. 

A person with normal respiratory function might not even notice this side effect on the normal therapeutic dose, but people with chronic breathing disorders like asthma, chronic obstructive pulmonary disease (COPD) and emphysema etc, can suffer from significant breathing difficulties. 

Similarly, paxil is considered safe to be used in cardiac patients, but it could cause QT elongation and make pre-existing arrhythmia even worse. Valium is also known for causing an addiction, which is why it is not suitable for prolonged use. 

Doctors usually recommend using it as long as your antidepressant kicks in. After that, both anxiety and depression can be managed by paxil and valium is slowly tapered off because it is not safe to use benzodiazepines for a long period of time. 

Both pharmacodynamics (how a drug affects your body) and pharmacokinetics (how your body affects a drug) are considered. 

It is always best to consult your healthcare provider and be certain that the combination of meds you’re about to use is compatible with any underlying health condition you might have. It is also important to make sure that all of your meds are compatible with one another. 

How to ensure the proper use of Paxil and Valium? 

Immediately talk to your healthcare provider if you experience unusual side effects while taking paxil and Valium together. Do not recommend this combination to someone else and use it as long as your doctor has advised. 

Inform your doctor if you’re pregnant, trying to conceive. Valium should not be used by pregnant women and paxil can also be dangerous for the fetus, especially when used in the third trimester. 

Inform your doctor if you’re a breastfeeding mother. Both of these drugs are capable of passing into the breastmilk and may cause side effects in newborns. 

Paxil may induce suicidal behavior in users younger than 24 years of age. If you have someone who shows suicidal behavior or you see hopelessness in them, make sure you keep an eye on them and get medical attention as soon as you can. 

Do not stop paxil or valium abruptly. If it’s time for you to stop one or both of these meds, your doctor will simply recommend a taper schedule for you, which should be followed vigilantly if you wish to keep withdrawal symptoms at bay. 

Report any problems with bleeding or bruising to your doctor. If you see any unexplained blisters or rashes on your body, or experience any problems with urination, or if you feel changes in your vision, immediately report to your healthcare provider. 

If the combination of paxil and valium makes you sleepy, make sure you avoid the following activities:

• Do not drive when you’re feeling tired or drowsy. Driving requires your full physical and mental alertness and it’s in your best interest to avoid it when you’re tired and have low energy levels.

• If you’re an employee in some factory where you are supposed to operate heavy machinery, don’t! Your drowsiness might cause an accident and can make you or others around you severely injured. 

• Make sure you’re not taking any other medication that might be contributing to your drowsiness. Do not drink alcohol, or you’ll end up dulling your senses even more.

Conclusion 

In this blog, we have discussed the possible interactions associated with the use of Paxil and Valium together. They may interact with each other and cause an increased risk of drowsiness, low mental alertness, impaired motor functions, confusion, forgetfulness etc. 

However, these interactions depend on the doses you’re at. Several studies showed that valium and other benzodiazepines can be used to control early anxiety caused by paxil. The treatment is usually continued till your antidepressant kicks in. 

Both valium and paxil are associated with few side effects, which can vary from person to person. It is important to ask your mental healthcare professional before using any such medications along with your antidepressants. 

FAQs: paxil and valium 

Can I take Valium and Paxil together?

Yes, you can take paxil and Valium together only if the combination is prescribed by your healthcare provider. It is not recommended to start using any medication without your doctor’s approval. 

Does Valium interact with paroxetine?

Paxil (Paroxetine) and valium (Diazepam) may interact with each other and cause an increased risk of drowsiness, low mental alertness, impaired motor functions, confusion, forgetfulness etc. However, these interactions depend on the doses you’re at. 

What medications should not be taken with Paxil?

Do not take paxil with:

• Monoaminoxidase inhibitors (MAOIs). The combination use can increase the risk of serotonin syndrome. 
• Non-steroidal anti-inflammatory drugs (NSAIDS). The combination use can increase the risk of bleeding. 
• Pimozide. The concomitant use can increase the plasma concentration(availability of a drug in the blood) of pimozide to much higher levels. It can result in life-threatening arrhythmia.
• Controlled substances, including all narcotic analgesics. The concomitant use can cause severe psychological side effects. 
• Mood stabilisers 
• Alcohol 

What are the dangers of taking Paxil?

Paxil (Paroxetine) is also associated with some serious side effects, which may include:

• Allergic reaction associated with symptoms like redness of skin, itching, burning sensation, blisters, blue-purple patches, tightness of chest, wheezing, difficulty in breathing, hoarseness etc. 
• Auditory or visual hallucinations 
• Rapid or irregular heartbeat 
• Convulsions 
• Infections associated with sore throat, fever, flu and cough etc. 
• Black stools
• Painful and unusual erection in males
• Bone fracture 
• Swelling or tenderness in different parts of the body.

What medications are contraindicated with Valium?

• Other anti-anxiety medications or sleeping pills. The concomitant use can dangerously increase the sedation and may cause confusion. 
• Antipsychotic medications
• Opioid drugs, including painkillers and anti-tussive (cough relieving) medications. The concomitant use can cause serious psychological side effects and respiratory depression. 
• Alcohol

Can you take Valium with antidepressants?

Yes, you can take valium with antidepressants if your healthcare provider has prescribed these meds together. Valium and other benzodiazepines can be used to control early anxiety caused by antidepressants. 

The treatment is usually continued till your antidepressant kicks in. These meds are also used together for the treatment of comorbid anxiety and depression. 

References 

• Drug Interactions between diazepam and paroxetine https://www.drugs.com/drug-interactions/diazepam-with-paroxetine-862-0-1800-0.html
• F Petty et al. Biol Psychiatry. (1995) – Benzodiazepines as antidepressants: does GABA play a role in depression? https://pubmed.ncbi.nlm.nih.gov/8573660/
• Yusuke Ogawa, Nozomi Takeshima, and Cochrane (2019) – Antidepressants plus benzodiazepines for adults with major depression https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6546439/#__ffn_sectitle
• Melissa A Birkett et al. Pharmacol Biochem Behav. (2011) – Acute anxiogenic-like effects of selective serotonin reuptake inhibitors are attenuated by the benzodiazepine diazepam https://pubmed.ncbi.nlm.nih.gov/21397628/
• J W Tiller et al. Br J Psychiatry. (1989) – Is diazepam an antidepressant? https://pubmed.ncbi.nlm.nih.gov/2692764/ 
• Valium – Uses, Side Effects, and More https://www.webmd.com/drugs/2/drug-11116/valium-oral/details
• Paroxetine Hcl – Uses, Side Effects, and More https://www.webmd.com/drugs/2/drug-6969-9095/paroxetine-oral/paroxetine-oral/details
• Paroxetine oral route https://www.mayoclinic.org/drugs-supplements/paroxetine-oral-route/proper-use/drg-20067632