Rexetine

Who should take an antidepressant?

First of all, I want to write that I am not crazy. For some reason, many people, when they see “psychotropic” mentioned in the description of a drug, immediately imagine a schizophrenic or something else “more fun.” In fact, antidepressants help with many health problems, in particular treating sleep disorders.

Rexetine was recommended to me to suppress my fear of large crowds of people. Nothing terrible, but I really wanted to get rid of the panic that arises from concert halls, cinemas and other public places.

I went to the doctor. The specialist conducted testing and reported that I suffer from a mild form of agoraphobia. He said that this condition can be controlled by taking pharmacological drugs that affect the central nervous system. In particular, the doctor advised to pay attention to Rexetine.

“Don’t think that your problem is isolated.
Several dozen people come to me every day complaining of a fear of closed spaces and other phobias. Start treatment with a course of Rexetine. These pills are great for relieving panic. At least, reviews from my patients confirm the effectiveness of the drug" Oleg Efimovich, neurologist, psychiatrist, Moscow

I received a prescription, but before purchasing it I decided to make sure that the specialist prescribed the correct treatment. I went online and found out that Rexetine is indeed recommended for various panic conditions, prolonged depression, obsessiveness syndrome, and stress-related mental disorders.

How and why Rexetine works

I bought a package of the drug at the pharmacy and decided to study the instructions first. To be honest, I understood little from the description. Probably the terms are intended for specialists or chemists. In simple terms, the main component of Rexetine is paroxetine. This element is able to increase the concentration of serotonin in the central nervous system. Thus, improving mood and normalizing sleep. I read that many men even have their libido restored)))

I scrolled through the browser a little, looking for reviews from ordinary people about the drug. I read a lot of good things. It turns out that Rexetine has quite strong psychostimulating properties.

After taking the pills, the proper activity of brain cells is normalized and anxiety is significantly reduced. I was a little worried about side effects, but it turned out that the drug is metabolized in the liver and is excreted in equilibrium through urine and feces.

Food and antacids do not affect the absorption and pharmacokinetics of paroxetine.

Like other serotonin reuptake inhibitors, undesirable interactions between MAO inhibitors and paroxetine have been observed in animal studies.

The simultaneous use of paroxetine with tryptophan leads to headache, nausea, increased sweating and dizziness, so this combination should be avoided.

A pharmacodynamic interaction is expected between paroxetine and warfarin (increased bleeding was noted with unchanged prothrombin time); the use of such a combination requires caution.

When paroxetine is used together with sumatriptan, general weakness, hyperreflexia, and coordination problems are observed. If their simultaneous use is necessary, extreme caution should be exercised (medical supervision is required).

When used concomitantly, paroxetine may inhibit the metabolism of tricyclic antidepressants (due to inhibition of the CYP2D6 isoenzyme), so the use of this combination requires caution and a reduction in the dose of tricyclic antidepressants.

Drugs that enhance or inhibit the activity of liver enzyme systems may affect the metabolism and pharmacokinetics of paroxetine. When used concomitantly with inhibitors of metabolic liver enzymes, the lowest effective dose of paroxetine should be used. Combined use with liver enzyme inducers does not require adjustment of the initial dose of paroxetine; further changes in dosage depend on the clinical effect (efficacy and tolerability).

Paroxetine significantly inhibits the activity of the CYP2D6 isoenzyme. Therefore, special caution requires the simultaneous use of paroxetine with drugs whose metabolism occurs with the participation of this isoenzyme, incl. with some antidepressants (for example, nortriptyline, amitriptyline, imipramine, desipramine and fluoxetine), phenothiazines (for example, thioridazine), class 1 C antiarrhythmic drugs (for example, propafenone, flecainide and encainide) or with those drugs that block its action (for example, quinidine, cimetidine, codeine).

There are no reliable clinical data on the inhibition of the CYP3A4 isoenzyme by paroxetine, so use with drugs that inhibit this enzyme (for example, terfenadine) is possible.

Cimetidine inhibits some cytochrome P450 isoenzymes. As a result, the combined use of paroxetine with cimetidine increases the level of paroxetine in the blood plasma at the steady-state stage.

Phenobarbital increases the activity of some cytochrome P450 isoenzymes. When paroxetine is used together with phenobarbital, the concentration of paroxetine in the blood plasma decreases and its T1/2 is also shortened.

When paroxetine and phenytoin are used together, the concentration of paroxetine in the blood plasma decreases and the frequency of side effects of phenytoin may increase. When using other anticonvulsants, the incidence of their side effects may also increase. In patients with epilepsy treated for a long time with carbamazepine, phenytoin or sodium valproate, additional administration of paroxetine did not cause changes in the pharmacokinetic and pharmacodynamic properties of anticonvulsants; There was no increase in paroxysmal convulsive readiness.

Paroxetine is highly bound to plasma proteins. When used simultaneously with drugs that also bind to plasma proteins, side effects may increase due to an increase in the concentration of paroxetine in the blood plasma.

Due to the lack of sufficient clinical experience with the combined use of digoxin and paroxetine, the use of this combination requires caution.

Diazepam during a course of use does not affect the pharmacokinetics of paroxetine.

Paroxetine significantly increases the concentration of procyclidine in the blood plasma, therefore, if anticholinergic side effects occur, it is necessary to reduce the dose of procyclidine.

In clinical trials, paroxetine had no effect on propranolol blood levels.

In some cases, an increase in the concentration of theophylline in the blood was noted. Although the interaction between paroxetine and theophylline has not been proven in clinical studies, regular monitoring of theophylline blood levels is recommended.

An increase in the effect of ethanol when used simultaneously with paroxetine was not detected. However, due to the effect of paroxetine on the liver enzyme system, it is necessary to avoid drinking alcohol during treatment with paroxetine.

Reviews from buyers of the drug

I was worried that I might get hooked on pills. Movies constantly show that antidepressants are like drugs and are very difficult to give up. The doctor reassured me, saying that Rexetine is not addictive. I decided to make sure of this and look for other people’s reviews of my medicine.

“I am very glad that I found these pills. I have VSD (vegetative-vascular dystonia). For people unfamiliar with this disease, I will write that the main symptoms are a surge in blood pressure and panic attacks against this background. Rexetine really calms and relaxes. I took the course and haven’t had any problems with blood pressure for 6 months. I haven’t noticed any addiction, at least I don’t have any desire to constantly take the drug...”

A lot of reviews concerned seizures associated with VSD. I do not suffer from such a disease, but I think that this is an indicator of the effectiveness of the medicine. I know that dystonia is difficult to control, and if Rexetine succeeds in this, then we can hope for a good result with other diseases.

“I treated my husband with Rexetine. He became depressed after experiencing severe emotional overload. Don't think that mental fatigue is just inconvenient. A couple of times even an ambulance was called for attacks of tachycardia. The antidepressant really helped. Two weeks and my man began to smile at least sometimes and is gradually returning to normal life...”

Good reviews strengthened my confidence in the correctness of the prescribed treatment. I decided for myself that in a few months I would definitely stop being afraid of crowds and go to some interesting film in the cinema.

Reksetin® (Rexetin®)

Food, antacids: Food and antacids do not affect the absorption and pharmacokinetics of paroxetine.

MAO inhibitors: Like other serotonin reuptake inhibitors, undesirable interactions between MAO inhibitors and paroxetine have been observed in animal studies (See: Special Instructions).

Tryptophan: Headache, nausea, increased sweating and dizziness have been reported in patients treated concomitantly with tryptophan and paroxetine, so the combined use of paroxetine and tryptophan should be avoided.

Warfarin: A pharmacodynamic interaction is expected between paroxetine and warfarin (increased bleeding was noted with unchanged prothrombin time). Therefore, paroxetine should be prescribed with extreme caution to patients taking oral anticoagulants.

Sumatriptan: In a few cases of combined use, general weakness, hyperreflexia, and coordination problems were noted. If it is necessary to use sumatriptan and a serotonin reuptake inhibitor simultaneously, the latter must be done under strict medical supervision.

Tricyclic antidepressants (TCAs): As with the concomitant use of other serotonin reuptake inhibitors with TCA drugs, caution is required since paroxetine may inhibit the metabolism of TCAs through the isoenzyme (CYP) IID6. Therefore, the TCA dose must be reduced. (See: Combined use with drugs that induce and inhibit the metabolic enzyme system) Combined use with drugs that induce and inhibit the metabolic enzyme system:

Drugs whose metabolism is carried out with the participation of the CYP 2D6 isoenzyme.

Paroxetine significantly inhibits the activity of this enzyme. Therefore, special caution requires its simultaneous use with drugs whose metabolism occurs with the participation of this isoenzyme, including: some antidepressants (for example, nortriptyline, amitriptyline, imipramine, desipramine and fluoxetine), phenothiazines (for example, thioridazine), antiarrhythmic drugs of group 1C ( eg propafenone, flecainide and encainide) or which block its action (eg quinidine, cimetidine, codeine).

Drugs whose metabolism is carried out with the participation of the CYP3A4 isoenzyme:

There are no reliable clinical data on the inhibition of the CYP3A4 isoenzyme by paroxetine, so drugs that inhibit this enzyme (for example, terfenadine) can probably be used without problems.

Cimetidine: Cimetidine inhibits some cytochrome P450 isoenzymes. As a result, when used together, the level of paroxetine concentration in the blood plasma increases at the stage of dynamic equilibrium.

Phenobarbital: Phenobarbital increases the activity of some cytochrome P450 isoenzymes. When used together, the concentration of paroxetine in the blood plasma decreases and the half-life is shortened.

Anticonvulsants (Phenytoin): When paroxetine and phenytoin are used together, the concentration of paroxetine in the blood plasma is reduced, but the frequency of side effects of phenytoin may increase. When using other anticonvulsants, the incidence of their side effects may also increase. In patients with epilepsy treated for a long time with carbamazepine, phenytoin or sodium valproate, additional administration of paroxetine did not cause changes in the pharmacokinetic and pharmacodynamic properties of anticonvulsants; There was no increase in paroxysmal convulsive readiness.

Drugs that bind to plasma proteins:

Digoxin: Since there is insufficient clinical experience with concomitant use, caution is recommended during their simultaneous use.

Diazepam: Diazepam during a course of use does not affect the pharmacokinetics of paroxetine.

Procyclidine: Paroxetine significantly increases the concentration of procyclidine in the blood plasma, therefore, if anticholinergic side effects occur, it is necessary to reduce the dose of procyclidine.

Beta blockers: In clinical trials, paroxetine had no effect on propranolol blood levels.

Theophylline: In some cases, an increase in the concentration of theophylline in the blood has been noted. Although the interaction between paroxetine and theophylline has not been proven in clinical studies, regular monitoring of theophylline blood levels is recommended.

Alcohol: An increase in the effect of alcohol when used simultaneously with paroxetine was not detected. However, due to the effect of paroxetine on the liver enzyme system, it is necessary to avoid drinking alcohol during treatment with paroxetine.

How to take Rexetine

The instructions for the drug state that the dosage is purely individual. Most often, the doctor prescribes initial therapy with a single dose of the drug per day.

The tablet does not need to be chewed and can be taken at any convenient time (preferably in the morning), regardless of meals. In my particular case, the doctor advised me not to risk it and take half a tablet. After two weeks I had to slightly increase the volume of the medicine.

Average dosages of Rexetine:

severe depression – 20-30 mg per day;
social phobia - usually no more than 20 mg;
compulsive-obsessive disorders – up to 40 mg.

The treatment period is quite long. In the reviews, people wrote that it was impossible to suddenly stop taking the drug. Typically maintenance therapy lasts 4-5 months.

REXETINE (tablets)

in intensive care (he came here after taking Amitriptyline).
I am writing this so that you understand that depression is not just tears and snot, it is also serious problems with other organs, including the heart. Cardiologists shrugged their shoulders, surprised and unable to find any pathologies in the main human organ. Then my arms and legs began to go numb - they were icy. Then the husband began to choke - there was simply not enough air. In general, everything at once and most importantly - no one could help. Naturally, I tried to convince him to go to a psychotherapist, but he flatly refused. In the end, I achieved my goal and made an appointment for my husband to see a psychotherapist. After testing, the doctor diagnosed him with moderate depressive disorder. At that time, my beloved was in such a terrible state that you wouldn’t wish it on your enemy. He could lie on the couch all day long and stare at one point, trying to sleep. But sleep did not come. Neither day nor night. And this despite the fact that before he could sleep almost standing up. And sometimes he sat on the Internet and read article after article, trying to find at least some useful information about his illness. He also pestered me, forcing me to look for symptoms of his insomnia on websites and forums. And in general, it seemed to him that his case was unique, that he was the only one on the planet and that not a single doctor in the world could diagnose him.

After the diagnosis was made, my husband was prescribed the drug “Valdoxan,” which did not help, but only worsened the situation. And two weeks later, Valdoxan was replaced with Rexetine. These pills literally pulled my husband out of depression, but not immediately, but gradually.

At first there was no effect and the husband tried to give up everything. But I persuaded him to continue taking the medicine by reading reviews about Rexetine on the Internet. From reviews and from a doctor, we learned that the drug acts slowly and needs to accumulate in the body. It accumulated in my husband’s body for 1.5 months. After this time, I noticed that apathy was replaced by frantic energy. He finally forgot about the illness, although the insomnia did not completely subside. He stopped thinking negatively and started smiling. He also began to pay attention to me (and this was almost 6 months after the onset of the illness).

Now his energy is overflowing. Six months of voluntary house arrest are over. Now my husband can’t sit at home, he needs to do something, go somewhere, do something. There are still problems with sleep, but still the effect of “Rexetine” is colossal, the changes are global!

There are, however, side effects. In particular, sexual function was impaired and tremors appeared in the hands. As the doctor said, this is a temporary phenomenon that will disappear after o. And at the very beginning of taking it, there were problems with vision and perception of reality, but they went away after about a month.

I won’t say that the drug is suitable for everyone, everything is individual. And under no circumstances should you prescribe “Rexetine” to yourself - there may be dire consequences. Health and happiness to everyone!

Contraindications and analogues of the drug

Separately, I would like to highlight possible restrictions on taking an antidepressant. Unfortunately, there are quite a few contraindications due to the large list of side effects. I did not experience any complications during the treatment, but in the reviews there were often references to sleep disturbances, dizziness, and increased sweating. There were also records of allergic reactions. Some people have reported hives, swelling, itching and burning of the skin.

The ban on treatment with Rexetine applies to:

pregnant women;
young mothers feeding their babies with breast milk;
children (under 18 years old);
people suffering from severe pathologies of the kidneys and liver.

If you are at risk or experience side effects, immediately consult a doctor. I think a specialist can find analogues of the tablets. For example, Plizil, Paxil or Adepress.

The price of the pills and my first treatment results

What can I say about my feelings? Now 4 months have passed, there are definitely positive changes in my condition. I can move more or less calmly on public transport, and I started going to art exhibitions. I haven’t tried to force myself to go to the cinema yet, but I really hope that Rexetine will help with this. The drug has a cumulative effect, so I’ll give it another 2-3 months and I’ll try to “storm” the auditorium)))

Well, at the end of my review I want to please people with the relatively low cost of the product. I bought Rexetine at a pharmacy in Moscow for 795 rubles. This is the price for 30 tablets at a dosage of 20 mg. One package lasts me a month. I think this is more than good. I remind you once again that before buying an antidepressant you need to go to the hospital. The drug will not be sold to you without a prescription.

Votes: 3 3 points