Is Paroxetine Any Good For Chronic Pain?

July 31, 2013 3:56 AM

Is Paroxetine Any Good For Chronic Pain?

I have chronic pain (Fibromyalgia and osteoarthritis). I'm currently on 600mg Lyrica, but still in pain. I don't have (and never have had) Anxiety or Depression, but I am a bit stressed by the severe pain.

My GP just prescribed Paroxetine (also known by the trade names Aropax, Paxil, Pexeva, Seroxat, Sereupin and Brisdelle) for pain. I'm dubious.

a) will it help with pain?
b) I'm concerned about sexual side effects and cognitive side effects.

Thoughts?

posted by Year of meteors to Health & Fitness (3 answers total)

Paroxetine and several other SSRI's have been shown to drastically help with fibromyalgia pain. In fact, the first drug approved by the FDA specifically for fibro pain is in a family of related drugs, the SNRIs, Savella.

Unfortunately, Paroxetine does have a fairly high rate of sexual side effects, even for an SSRI. However, if it doesn't work for you, or the side effects are too much, ask to be switched to a different SSRI. It may take a while to find the right one.

My husband takes Savella for his fibro, and its made a huge improvement in his quality of life since he started. They initially tried several SSRIs but he reacted badly to them, but the SNRIs didn't have the side effects he had experienced before (severe insomnia, paranoia, etc.).
posted by strixus at 4:07 AM on July 31, 2013

I am on a different SSRI for anxiety and depression, so I am on a higher level than that generally used for Fibromyalgia (I've known other people on it for help with pain control). However, when I tried to go off of it (under doctor supervision) I noticed that my pain levels went up quite a bit. I have constant pain between a 4 and 7 on a scale to 10 even on meds, so I wasn't sure it helped, until I was no longer taking it.

As far as cognitive effects, fibro and other conditions cause cognitive problems so it is hard to tell which are caused by what. This is something you are likely to only discover by trying it, as everyone is different and responds to meds differently.

I would recommend giving it a try, if you experience side effects you can't live with; or it does not seem to lessen pain; then ask your GP about trying another SSRI or an SNRI.

Also, if you are hoping to be totally pain free, you may need to lower your expectations a bit. From my own experience, and that of many friends and acquaintances with chronic pain, pain free is generally not attained, lessening pain by one or two "points" on the scale seems to be more realistic.
posted by batikrose at 3:26 PM on July 31, 2013

I've been on Paroxetine four times (it's great for my depression, does nothing for my fibro, and destroys my sex life). It can be very, very difficult to discontinue. The last two times I had to cross-taper with Prozac for a month, and I still experienced the electric zaps in my spine, nausea, and confusion.

The Hong Kong study linked above concluded "the evidence for efficacy of SSRIs in the treatment neuropathic pain is moderate at best," preferring SNRIs. This 2011 review of drugs for fibro is comprehensive and not funded by any drug companies.
posted by Jesse the K at 1:47 PM on August 15, 2013