Safety
Boxed warning: suicidal thoughts and behaviors. Antidepressants, including SSRIs, raised the risk of suicidal thoughts and behavior in children and young adults in trials, so watch for mood changes. Paroxetine may make tamoxifen less effective, can cause serotonin syndrome, and raises bleeding risk with NSAIDs, aspirin or blood thinners.
Talk to a licensed clinician about your health history and every medication you take before you start.
Legal status
Prescription only; FDA-approved. Prescription only; not a controlled substance. Using generic paroxetine for hot flashes is off-label.
What low-dose paroxetine is
Low-dose paroxetine contains paroxetine, made by Brisdelle (7.5 mg capsule). Brisdelle (paroxetine 7.5 mg) is the paroxetine product approved for hot flashes, and it is not approved for any psychiatric condition. Generic paroxetine at other strengths, such as the 10 mg some online clinics prescribe, is used off-label for hot flashes.
FDA-approved for Brisdelle 7.5 mg: moderate to severe hot flashes and night sweats associated with menopause.
Dosing
Capsule (Brisdelle 7.5 mg) or tablet (generic); Brisdelle at bedtime. Brisdelle: 7.5 mg once a day at bedtime. Wait at least 14 days between paroxetine and an MAO inhibitor. Your clinician sets the dose for you.
How well it works
In two trials of 1,174 postmenopausal women, Brisdelle 7.5 mg reduced moderate to severe hot flashes more than placebo. In the 12-week trial, the median daily count fell by 5.9 on Brisdelle and 5.0 on placebo at week 12, from about 10 a day. Individual results vary.
Low-dose paroxetine cost
None of the online providers we compare publishes a price for low-dose paroxetine. For a full breakdown, read How much does HRT cost without insurance?. For the steps, read How to get HRT online.