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Paroxetine Hemihydrate side effects: what 33,112 FDA adverse event reports show

Paroxetine Hydrochloride Hemihydrate · 1,217 reaction terms · 140,223 drug–reaction co-reports · data 2026-09-14
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Drug class

Not stated in label

Label matched

Paroxetine Hydrochloride Hemihydrate (Paroxetine)

closest FDA label found for this product string; brand list suppressed because the label is a related product, not an exact match

Who reports

33,112 reports · 84% serious · 4,415 with death outcome · 64% female

openFDA FAERS counts, all years, deduplication not applied

Used for

Major Depressive Disorder Paroxetine tablets are indicated for the treatment of major depressive disorder. The efficacy of paroxetine tablets in the treatment of a major depressive episode was established in 6-week controlled trials of outpatients whose diagnoses corresponded most closely to the DSM-III category of major depressive disorder (see CLINICAL PHARMACOLOGY: Clinical Trials ).

FDA label, Indications and Usage

What it is

DESCRIPTION Paroxetine hydrochloride tablets, USP are an orally administered psychotropic drug. It is the hydrochloride salt of a phenylpiperidine compound identified chemically as (3 S - tran.

FDA label, Description section

Boxed warning

Suicidality and Antidepressant Drugs Antidepressants increased the risk compared to placebo of suicidal thinking and behavior (suicidality) in children, adolescents, and young adults in short-term studies of major depressive disorder (MDD) and other psychiatric disorders.

FDA label
How to read this page. FAERS is a spontaneous-reporting system: counts are not incidence rates and a signal is not proof of causation. Each reaction below is run through an automated screen — is the term in the FDA label (known), in the indications (the disease being treated), an administrative/coding term, or none of these (unlabeled)? That screen is mechanical text matching, not a causality assessment. The 30 hand-written Bradford Hill assessments are on the causality assessment page. Not medical advice.

Causality screen of the 40 strongest signals

Labeled adverse reaction 4Labeled (related wording) 2Likely indication confounding 8Reporting / coding artifact 1Lab value / disease marker 3Not in label — unassessed 22
What the badges mean

Strongest disproportionality signals

Flagged terms (PRR ≥ 2, χ² ≥ 4, n ≥ 10), ranked by PRR; infinite PRRs (no comparator reports) excluded. The EBGM column is a second, shrinkage-based estimate (MGPS) with its 5th percentile EB05 and the BCPNN IC025; a pair flagged by PRR alone is marked PRR-only and should be read as fragile. The strata column recomputes the PRR on serious reports only (and, for the 300 most-reported drugs, adjusted for age band), and flags pairs whose reports are unusually skewed by sex or come mostly from consumers. Each row also shows the PRR against the other drugs of the same FDA class, which removes most confounding by the condition being treated, and a calibrated p-value: on validation, known non-causes average an ROR of about 2, so significance is judged against that empirical null (✓ = p < 0.05 after calibration). 1,177 further terms are in the interactive explorer. Reaction links open the term's cross-drug page.

Show:
ReactionReportsPRR 95% CI · ROR · χ²/pEBGM EB05 · IC025Label screenSerious-only & strataTrial cross-check
Neonatal behavioural syndrome2456.7
37.3–86.1ROR 56.8 · calibrated p 1e-5 ✓
50.1 EB05 35.5 · IC025 +4.0
3/3 methods agree
Likely indication confounding
shares a disease stem with the indications wording
serious n=24 · 100% clinicianno trial arm names this drug
Cogwheel rigidity8454.8
43.9–68.5ROR 55.0 · calibrated p 9e-6 ✓
49.9 EB05 41.6 · IC025 +4.9
3/3 methods agree
Labeled adverse reaction
exact term
serious n=84 · 100% clinicianno trial arm names this drug
Congenital hydrocephalus3647.8
34.1–67.1ROR 47.8 · calibrated p 3e-5 ✓
43.5 EB05 32.8 · IC025 +4.2
3/3 methods agree
Not in label — unassessedserious n=36 · 100% clinicianno trial arm names this drug
Depersonalisation/derealisation disorder8535.3
28.3–43.9ROR 35.3 · calibrated p 1e-4 ✓
33.2 EB05 27.7 · IC025 +4.5
3/3 methods agree
Likely indication confounding
shares a disease stem with the indications wording
serious n=82no trial arm names this drug
Gastric ph decreased5032.3
24.3–42.9ROR 32.3 · calibrated p 2e-4 ✓
30.4 EB05 24.0 · IC025 +4.1
3/3 methods agree
Lab value / disease markerserious n=50 · ♀ 100% (drug 64%) · 100% clinicianno trial arm names this drug
Serotonin syndrome92232.0
30.0–34.2ROR 32.9 · calibrated p 2e-4 ✓
30.5 EB05 28.9 · IC025 +4.8
3/3 methods agree
Labeled adverse reaction
exact term
serious PRR 21.2no trial arm names this drug
Granuloma skin3830.4
22.0–42.1ROR 30.4 · calibrated p 3e-4 ✓
28.7 EB05 21.8 · IC025 +3.9
3/3 methods agree
Not in label — unassessedserious n=38 · ♀ 100% (drug 64%) · 100% clinicianno trial arm names this drug
Derealisation9730.0
24.5–36.8ROR 30.1 · calibrated p 3e-4 ✓
28.6 EB05 24.1 · IC025 +4.3
3/3 methods agree
Likely indication confounding
shares a disease stem with the indications wording
serious n=96no trial arm names this drug
Resting tremor2828.5
19.5–41.6ROR 28.5 · calibrated p 5e-4 ✓
26.9 EB05 19.5 · IC025 +3.6
3/3 methods agree
Not in label — unassessedserious n=28 · 100% clinicianno trial arm names this drug
Agoraphobia5727.5
21.1–35.8ROR 27.5 · calibrated p 5e-4 ✓
26.2 EB05 20.9 · IC025 +4.0
3/3 methods agree
Likely indication confounding
term in indications
serious n=56no trial arm names this drug
Anticholinergic syndrome6627.3
21.4–35.0ROR 27.4 · calibrated p 5e-4 ✓
26.0 EB05 21.2 · IC025 +4.1
3/3 methods agree
Not in label — unassessedserious n=66 · ♀ 0% (drug 64%)no trial arm names this drug
Poisoning deliberate38327.2
24.5–30.1ROR 27.5 · calibrated p 4e-4 ✓
26.0 EB05 23.9 · IC025 +4.5
3/3 methods agree
Not in label — unassessedserious PRR 17.9 · 96% clinicianno trial arm names this drug
Social anxiety disorder2525.0
16.7–37.2ROR 25.0 · calibrated p 0.001 ✓
23.6 EB05 16.8 · IC025 +3.4
3/3 methods agree
Likely indication confounding
term in indications; also in warnings
serious n=25no trial arm names this drug
Homicide6423.2
18.1–29.8ROR 23.3 · calibrated p 0.001 ✓
22.3 EB05 18.1 · IC025 +3.9
3/3 methods agree
Not in label — unassessedserious n=64 · ♀ 32% (drug 64%)no trial arm names this drug
H1n1 influenza5023.2
17.5–30.7ROR 23.2 · calibrated p 0.001 ✓
22.2 EB05 17.5 · IC025 +3.7
3/3 methods agree
Not in label — unassessedserious n=50 · ♀ 100% (drug 64%) · 100% clinicianno trial arm names this drug
Parasomnia2422.4
14.9–33.7ROR 22.4 · calibrated p 0.002 ✓
21.3 EB05 15.0 · IC025 +3.2
3/3 methods agree
Not in label — unassessedserious n=22no trial arm names this drug
Clonus9322.2
18.1–27.3ROR 22.3 · calibrated p 0.001 ✓
21.4 EB05 18.0 · IC025 +3.9
3/3 methods agree
Labeled adverse reaction
exact term
serious n=91no trial arm names this drug
Sopor44922.0
20.0–24.1ROR 22.3 · calibrated p 0.001 ✓
21.3 EB05 19.7 · IC025 +4.2
3/3 methods agree
Not in label — unassessedserious PRR 14.7 · 90% clinicianno trial arm names this drug
Prescription form tampering2420.4
13.6–30.6ROR 20.4 · calibrated p 0.003 ✓
19.4 EB05 13.6 · IC025 +3.2
3/3 methods agree
Likely indication confounding
shares a disease stem with the indications wording
serious n=24 · 100% clinicianno trial arm names this drug
Tearfulness13119.8
16.6–23.5ROR 19.8 · calibrated p 0.002 ✓
19.1 EB05 16.5 · IC025 +3.9
3/3 methods agree
Not in label — unassessedserious n=130no trial arm names this drug
Victim of crime3519.3
13.8–27.0ROR 19.3 · calibrated p 0.003 ✓
18.5 EB05 13.9 · IC025 +3.3
3/3 methods agree
Not in label — unassessedserious n=35 · ♀ 100% (drug 64%) · 100% clinicianno trial arm names this drug
Labelled drug-drug interaction issue4119.0
13.9–25.9ROR 19.0 · calibrated p 0.003 ✓
18.3 EB05 14.0 · IC025 +3.4
3/3 methods agree
Reporting / coding artifactserious n=40 · ♀ 0% (drug 64%)no trial arm names this drug
Reversible cerebral vasoconstriction syndrome5718.9
14.5–24.6ROR 18.9 · calibrated p 0.003 ✓
18.3 EB05 14.6 · IC025 +3.6
3/3 methods agree
Not in label — unassessedserious n=57 · 100% clinicianno trial arm names this drug
Antipsychotic drug level above therapeutic2618.9
12.8–27.9ROR 18.9 · calibrated p 0.004 ✓
18.1 EB05 12.8 · IC025 +3.1
3/3 methods agree
Lab value / disease markerserious n=26 · 100% clinicianno trial arm names this drug
Hypocoagulable state2617.2
11.7–25.4ROR 17.3 · calibrated p 0.005 ✓
16.5 EB05 11.6 · IC025 +3.0
3/3 methods agree
Not in label — unassessedserious n=26 · ♀ 100% (drug 64%) · 100% clinicianno trial arm names this drug
Blood parathyroid hormone decreased3816.5
12.0–22.8ROR 16.6 · calibrated p 0.006 ✓
15.9 EB05 12.0 · IC025 +3.2
3/3 methods agree
Lab value / disease markerserious n=38 · ♀ 100% (drug 64%) · 100% clinicianno trial arm names this drug
Bezoar3516.5
11.8–23.0ROR 16.5 · calibrated p 0.006 ✓
15.9 EB05 11.8 · IC025 +3.2
3/3 methods agree
Not in label — unassessedserious n=35 · ♀ 100% (drug 64%) · 100% clinicianno trial arm names this drug
Hyperreflexia8816.3
13.2–20.1ROR 16.4 · calibrated p 0.005 ✓
15.9 EB05 13.2 · IC025 +3.5
3/3 methods agree
Labeled adverse reaction
exact term
serious n=86no trial arm names this drug
Accidental poisoning3315.8
11.2–22.4ROR 15.9 · calibrated p 0.007 ✓
15.2 EB05 11.2 · IC025 +3.1
3/3 methods agree
Not in label — unassessedserious n=33no trial arm names this drug
Feeling of despair11315.7
13.1–19.0ROR 15.8 · calibrated p 0.006 ✓
15.3 EB05 13.1 · IC025 +3.5
3/3 methods agree
Likely indication confounding
shares a disease stem with the indications wording
serious n=112no trial arm names this drug
Head titubation3315.5
10.9–21.8ROR 15.5 · calibrated p 0.008 ✓
14.8 EB05 10.9 · IC025 +3.1
3/3 methods agree
Not in label — unassessedserious n=31 · ♀ 0% (drug 64%) · 100% clinicianno trial arm names this drug
Haematoma muscle2815.4
10.6–22.4ROR 15.4 · calibrated p 0.008 ✓
14.7 EB05 10.5 · IC025 +3.0
3/3 methods agree
Not in label — unassessedserious n=28 · 100% clinicianno trial arm names this drug
Emotional poverty4014.8
10.8–20.2ROR 14.8 · calibrated p 0.009 ✓
14.2 EB05 10.7 · IC025 +3.1
3/3 methods agree
Not in label — unassessedserious n=38 · ♀ 38% (drug 64%) · 100% consumerno trial arm names this drug
Flat affect5114.5
11.0–19.1ROR 14.5 · calibrated p 0.009 ✓
14.0 EB05 11.0 · IC025 +3.2
3/3 methods agree
Not in label — unassessedserious n=50no trial arm names this drug
Chronic kidney disease-mineral and bone disorder2414.4
9.6–21.6ROR 14.4 · calibrated p 0.011 ✓
13.6 EB05 9.3 · IC025 +2.8
3/3 methods agree
Not in label — unassessedserious n=24no trial arm names this drug
Chorea3713.8
10.0–19.1ROR 13.8 · calibrated p 0.012 ✓
13.2 EB05 9.8 · IC025 +3.0
3/3 methods agree
Not in label — unassessedserious n=37 · ♀ 100% (drug 64%) · 100% clinicianno trial arm names this drug
Generalised anxiety disorder3113.6
9.6–19.5ROR 13.7 · calibrated p 0.013 ✓
13.0 EB05 9.3 · IC025 +2.9
3/3 methods agree
Likely indication confounding
term in indications; also in warnings
serious n=31 · ♀ 100% (drug 64%) · 100% clinicianno trial arm names this drug
Neuroleptic malignant syndrome25013.6
12.0–15.4ROR 13.7 · calibrated p 0.010 ✓
13.3 EB05 11.9 · IC025 +3.5
3/3 methods agree
Not in label — unassessedserious PRR 9.2 · 92% clinicianno trial arm names this drug

Trial evidence (ClinicalTrials.gov)

No completed trial with posted adverse-event results was found on ClinicalTrials.gov for Paroxetine Hemihydrate (searched PAROXETINE HEMIHYDRATE).

Most frequently reported reactions

By raw co-report count, regardless of disproportionality. Common terms here are often the illness itself or generic outcomes.

ReactionReportsPRR 95% CI · ROR · χ²/pEBGM EB05 · IC025Label screenSerious-only & strataTrial cross-check
Drug ineffective (drug did not work)1,9480.9
0.9–1.0ROR 0.9 · calibrated p 0.264
0.9 EB05 0.9 · IC025 -0.2
PRR-only: not supported by EBGM or IC
Reporting / coding artifactserious PRR 1.3no trial arm names this drug
Drug interaction1,8947.6
7.3–8.0ROR 8.0 · calibrated p 0.066
7.5 EB05 7.3 · IC025 +2.8
3/3 methods agree
Reporting / coding artifactserious PRR 5.6no trial arm names this drug
Fatigue (tiredness)1,8151.5
1.4–1.5ROR 1.5 · calibrated p 0.647
1.5 EB05 1.4 · IC025 +0.5Likely indication confounding
term in indications
serious PRR 1.5no trial arm names this drug
Nausea1,7151.4
1.3–1.4ROR 1.4 · calibrated p 0.574
1.4 EB05 1.3 · IC025 +0.4Likely indication confounding
term in indications; also in warnings
serious PRR 1.4no trial arm names this drug
Toxicity to various agents1,6366.2
5.9–6.5ROR 6.5 · calibrated p 0.122
6.2 EB05 5.9 · IC025 +2.5
3/3 methods agree
Not in label — unassessedserious PRR 4.4no trial arm names this drug
Anxiety1,4893.3
3.2–3.5ROR 3.4 · calibrated p 0.503
3.3 EB05 3.2 · IC025 +1.6
3/3 methods agree
Likely indication confounding
term in indications; also in warnings
serious PRR 3.0no trial arm names this drug
Diarrhoea (diarrhea)1,4861.5
1.4–1.5ROR 1.5 · calibrated p 0.632
1.5 EB05 1.4 · IC025 +0.5Labeled adverse reaction
exact term
serious PRR 1.4no trial arm names this drug
Headache1,4121.4
1.4–1.5ROR 1.4 · calibrated p 0.607
1.4 EB05 1.4 · IC025 +0.4Labeled adverse reaction
exact term
serious PRR 1.6no trial arm names this drug
Off label use (used outside approved label)1,3571.0
0.9–1.0ROR 1.0 · calibrated p 0.300
1.0 EB05 0.9 · IC025 -0.1
PRR-only: not supported by EBGM or IC
Reporting / coding artifactserious PRR 1.0no trial arm names this drug
Dizziness1,3421.7
1.6–1.8ROR 1.7 · calibrated p 0.793
1.7 EB05 1.6 · IC025 +0.7Labeled adverse reaction
exact term
serious PRR 1.7no trial arm names this drug
Fall1,3132.5
2.4–2.6ROR 2.6 · calibrated p 0.784
2.5 EB05 2.4 · IC025 +1.2
3/3 methods agree
Not in label — unassessedserious PRR 1.9no trial arm names this drug
Drug abuse1,2869.9
9.4–10.4ROR 10.2 · calibrated p 0.030 ✓
9.7 EB05 9.3 · IC025 +3.2
3/3 methods agree
Reporting / coding artifactserious PRR 6.8no trial arm names this drug
Somnolence (drowsiness)1,2143.8
3.6–4.1ROR 3.9 · calibrated p 0.387
3.8 EB05 3.6 · IC025 +1.8
3/3 methods agree
Labeled adverse reaction
exact term
serious PRR 4.0no trial arm names this drug
Vomiting1,2071.6
1.5–1.7ROR 1.7 · calibrated p 0.742
1.6 EB05 1.6 · IC025 +0.6Labeled adverse reaction
exact term
serious PRR 1.5no trial arm names this drug

Unlabeled candidate signals

These flagged terms were not found in the FDA label text and do not match an artifact pattern. They are the pairs that would merit a structured assessment (temporality, dose-response, biological plausibility, consistency across databases, trial or cohort evidence). The screen has not done that; string-matching misses label wording, and a strong PRR can still be stimulated reporting, co-medication, or the disease itself.

✓ A hand-written Bradford Hill causality assessment exists for this drug: Paroxetine (SSRIs) ↔ Discontinuation (withdrawal) syndrome.

Want to assess one of these properly? The runbook describes the Bradford Hill / trial-evidence workflow used on the assessment page, and handoff_top1000_signals.csv lists the strongest unassessed pairs across all drugs.

Common questions

What are the most reported side effects of Paroxetine Hemihydrate?

In FDA FAERS, the most frequently co-reported reaction terms for Paroxetine Hemihydrate are fatigue, nausea, toxicity to various agents, anxiety, diarrhoea, headache. These are report counts, not rates: FAERS has no denominator, reporting is voluntary and uneven, and a term can be reported because of the illness being treated rather than the drug.

Does Paroxetine Hemihydrate have an FDA boxed warning?

Yes. The current FDA label carries a boxed warning: Suicidality and Antidepressant Drugs Antidepressants increased the risk compared to placebo of suicidal thinking and behavior (suicidality) in children, adolescents, and young adults in short-term studies of major depressive disorder (MDD) and other psychiatric disorders.

Do FAERS signals prove that Paroxetine Hemihydrate causes these side effects?

No. A disproportionality signal (PRR, ROR) means a reaction is reported more often with this drug than with others in the database. That can reflect a real effect, but also the disease being treated, stimulated reporting after news or litigation, co-medications, or how reports are coded. Causality needs temporality, dose-response, biological plausibility, consistency across data sources and, ideally, trial or cohort evidence. This page screens each term against the FDA label and ClinicalTrials.gov results; it does not establish causation.

Sources & methods

Page generated 2026-10-14. Label and PubChem text are retrieved automatically and may lag the current label; always check the current prescribing information. OpenPV is a beta research tool of the Open Source Medicine Foundation.