Although the Cochrane Musculoskeletal Group is performing a systematic review to assess the efficacy of SSRIs versus placebo and other antidepressants, it is clear that further study is necessary. SSRIs appear to be an effective treatment in neurocardiogenic syncope refractory to standard therapies. Neurocardiogenic syncope, or vasovagal syncope, is a common disorder of transient autonomic nervous system dysfunction. Fludrocortisone Florinef and increased salt and fluid intake are commonly used as well.
One randomized, double-blind, placebo-controlled study involved the use of paroxetine in the treatment of neurocardiogenic syncope refractory to standard therapies. Of the 68 patients in the study, all of whom had a documented positive head-up tilt test initially, During the approximately two-year follow-up period, spontaneous syncope occurred in Paroxetine was generally well tolerated. Smaller, nonrandomized, prospective studies two involving pediatric patients involved the use of sertraline and fluoxetine in the treatment of refractory neurocardiogenic syncope.
Already a member or subscriber? Log in. Interested in AAFP membership? Learn more. He received his medical degree from the Medical University of South Carolina, Charleston, and completed a residency in family practice at Naval Hospital Jacksonville.
Address correspondence to Anthony J. Reprints are not available from the authors. The authors indicate that they do not have any conflicts of interest. Sources of funding: none reported. The opinions and assertions contained herein are the private views of the authors and are not to be construed as official or as reflecting the views of the U. Navy Medical Corps or the U. Navy at large. Similar effectiveness of paroxetine, fluoxetine, and sertraline in primary care: a randomized trial JAMA.
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A randomized, double-blind crossover trial of fluoxetine and amitriptyline in the treatment of fibromyalgia Arthritis Rheum. Citalopram in patients with fibromyalgia—a randomized, double-blind, placebo-controlled study Eur J Pain. A randomized controlled trial of citalopram in the treatment of fibromyalgia Pain. Effects of paroxetine hydrochloride, a selective serotonin reuptake inhibitor, on refractory vasovagal syncope: a randomized, double-blind, placebo-controlled study J Am Coll Cardiol.
Use of sertraline hydrochloride in the treatment of refractory neuro-cardiogenic syncope in children and adolescents J Am Coll Cardiol. Usefulness of fluoxetine hydrochloride for prevention of resistant upright tilt induced syncope Pacing Clin Electrophysiol. Goa KL, Ward A. A preliminary review of its pharmacological properties and therapeutic efficacy as an anxiolytic Drugs. Using Paxil or Zoloft in combination with other drugs that increase serotonin, as well as with other SSRIs, SNRIs, or tricyclic antidepressants can increase the risk of serotonin syndrome.
Many other drugs may interact with Paxil or Zoloft. Consult your healthcare provider for a complete list. All antidepressants, including Paxil and Zoloft, come with a boxed warning, which is the strongest warning required by the FDA. Antidepressants increase the risk of suicidal thoughts and behavior in children, adolescents, and young adults.
Depression and other psychological disorders also increase the risk for suicide. Patients of any age who take antidepressants should be closely monitored for signs of changes in behavior, and suicidality, especially during the first few months of treatment and if any changes in dose occur. Families and caregivers should also monitor the patient, and notify the prescriber of any issues.
Additionally, there are other warnings that come with both Paxil and Zoloft:. Exposure to Paxil in the first trimester of pregnancy can lead to cardiovascular malformations in the fetus and should generally be avoided.
Often, your doctor can find a safer alternative medication to use while you are pregnant. It is also used off-label to treat anxiety disorders. Paxil and Zoloft are similar, but not the same.
While they are both SSRIs and work in the same way, they have differences in indications, dosing, and side effects, as described above. Both drugs are well-tolerated and can be very effective in the treatment of depression as well as anxiety disorders. Although Zoloft is only indicated for depression, many doctors prescribe it for anxiety as well.
Ask your doctor if one of these drugs may be right for you. Paxil can be dangerous when used in the first trimester of pregnancy, and Zoloft can be dangerous when used in the third trimester. However, mental health is important—untreated depression and anxiety can also be dangerous. By Kathleen Esposito. Wellbutrin Side Effects. By Karen Schweitzer.
HBO Addiction Series. By LoveToKnow Staff. Gaming Addiction. Fiorinal Addiction. Drug Addiction Hotline. Addiction and Amphetamines. Signs That Recovery Is Working. Behavioral Interventions for Drug Addicts. By Lynsey Keep, RN. Does Chantix Work. Alcohol Withdrawal Symptoms. No significant differences between the two drugs were found. Both were well tolerated, although sexual side effects and weight gain were frequent.
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