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Sandra N. Fisman


paroxetine, major depressive disorder, social anxiety disorder


Controversy  has  surrounded  the  use  of  the  selective  serotonin  reuptake  inhibitor  (SSRI) paroxetine in  children and  adolescents under  the  age  of  18  years.  Pending  further  review, paroxetine treatment for major depressive disorder (MDD) should not be initiated in youth under the age of 18 years. However, in the event that a youth with MDD has responded to paroxetine with good symptom resolution, it would be unwise to discontinue the drug. When discontinuation of paroxetine is desired, it should be undertaken with gradual tapering to prevent the emergence of  rebound  anxiety.  As  the  evidence  for  efficacy  in  social  anxiety  disorder  outweighs the evidence for use in MDD it may be appropriate to use paroxetine for social anxiety disorder in this age group with careful monitoring for the presence of suicidal ideation

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