Paxil (Paroxetine): Uses, Side Effects, Dosage

Published on: 28 Jun 2023
Clinically Reviewed by Bisma Anwar, LMHC
Side Effects of Paxil

Paxil medication (or the generic form paroxetine) is a selective serotonin reuptake inhibitor (SSRI) antidepressant. Paxil is FDA-approved for depression and other mental health conditions like obsessive-compulsive disorder (OCD), PTSD, panic disorder, and premenstrual dysphoric disorder (PMDD). Off-label, Paxil is used to treat OCD and social anxiety in children, AND postpartum depression.

Read on to learn all there is to know about this antidepressant — from what Paxil is used for, to how it works, to side effects you should be aware of, we’re covering it all here. 

What is Paxil?

Paxil is a type of antidepressant medication in the class of drugs known as selective serotonin reuptake inhibitors (SSRIs), which alter serotonin levels in the brain to regulate mood.  

Paxil can relieve sadness or a lack of interest in activities you once enjoyed. It can also help reduce feelings of worry or fear that may be causing physical symptoms like sweating or shaking. The drug can even boost sleep quality and increase energy. In addition, it can decrease restlessness and irritability commonly caused by anxiety disorders.

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How does Paxil work?

Paxil medication blocks chemicals in the brain that can produce symptoms of depression and anxiety. It was found in studies to be more effective than some other SSRIs in treating depression, and in more research, over 40% of the people who used Paxil saw their symptoms of depression completely eliminated.

How does Paxil make you feel?

Like any medication, there are mild to severe side effects you should be aware of if you’re taking Paxil. A common side effect is gastrointestinal issues like nausea. The same research also notes that most people can tolerate Paxil reasonably well. 

When Paxil works as expected, you’ll experience less anxiety and depression over time. You might find that you’re sleeping better, your appetite is healthier, and your energy and interest in daily life return. Paxil can reduce or eliminate fear, panic attacks, and unwanted thoughts. 

Paxil Uses

Paxil is FDA-approved to treat:

  • Major depressive disorder (MDD)
  • Generalized anxiety disorder (GAD)
  • Obsessive-compulsive disorder (OCD)
  • Panic disorder
  • Post-traumatic stress disorder (PTSD)
  • Premenstrual dysphoric disorder (PMDD)

Paxil for depression

Paxil treats major depressive disorder (MDD) by increasing serotonin levels in the brain to help regulate mood. Some of the side effects of Paxil for depression include nausea, drowsiness, dry mouth, constipation, decreased appetite, headache, and dizziness.

Paxil for anxiety  

Paxil is an antidepressant medication that studies show can successfully treat generalized anxiety disorder (GAD). Using Paxil for anxiety can relieve restlessness, difficulty concentrating, and irritability. 

Paxil for obsessive-compulsive disorder (OCD)

According to research, Paxil for OCD can be an effective form of treatment and reduce the chance of obsessive and compulsive impulses returning. SSRIs are the first-line medication for OCD, as they can boost serotonin levels, which are typically low in people with this condition.  

Paxil for panic disorder

Research found that Paxil is generally well-tolerated and effective in helping to reduce symptoms associated with panic disorder, like fear and avoidance.  

Paxil for post-traumatic stress disorder (PTSD)

Paxil has been demonstrated effective in diminishing the manifestations of PTSD, including intrusive musings, flashbacks, bad dreams, and evasive practices. Studies suggest that Paxil can result in a significant reduction of PTSD symptoms.  

Paxil for premenstrual dysphoric disorder (PMDD)

Paxil reduces symptoms linked to PMDD — like irritability — during the acute phase of treatment. In rare cases, serious reactions, including changes in behavior or mood swings, can occur. 

Off-label uses

Off-label uses for Paxil include treating symptoms of:

  • Bipolar depression
  • Premenstrual syndrome
  • Irritable bowel syndrome
  • OCD in children

Further research is necessary to determine the efficacy of Paxil uses in treating chronic pain and fibromyalgia.

Pros & Cons of Paxil

Pros of PaxilCons of Paxil
Increased effectivenessPotential withdrawal symptoms when stopped abruptly 
Easier dosing scheduleCould interact negatively with certain foods
Lower incidence of adverse effectsNot considered highly addictive, but some people do become dependent (especially if taking higher doses over more extended periods)
Can be more effective than other antidepressantsRisk of interaction with other drugs

Side Effects of Paxil

Paxil can cause a range of minor to severe adverse reactions. Anyone taking Paxil should be aware of the potential risks associated with the drug. 

“Paxil is effective for many people. However, it can take 4 to 6 weeks to build up in your system. It could cause side effects such as nausea, vomiting, or diarrhea.”

Talkspace Therapist Dr. Olga Molina, D.S.W., LCSW

If you’re thinking about taking this medication, be aware of the following common side effects of Paxil:

There are some more serious side effects, too. For example, Paxil has a risk of causing serotonin syndrome, which results in a potentially life-threatening build-up of excess serotonin in the body.

If you don’t taper off Paxil slowly, you can experience antidepressant discontinuation syndrome, which causes unpleasant Paxil withdrawal symptoms. 

Paxil Dosage

The recommended dose for Paxil can vary depending on individual factors like age and diagnosis being treated. Typically, initial doses range from 10 – 20 mg per day and may be increased to 50 – 60 mg if necessary. Following your doctor’s instructions exactly as directed is essential, as higher dosages can cause adverse effects. No one should self-adjust their dosage without consulting a healthcare professional first.

How to take Paxil

Take Paxil exactly as directed. Do not change your recommended dosage without talking to your doctor first.

Do not chew, crush, or break Paxil tablets. Instead, swallow them whole with water or another liquid. 

If you’re taking liquid Paxil, use the dosing instrument provided. Never measure liquid Paxil with a kitchen teaspoon — it will not be accurate. 

“In addition to taking Paxil, getting enough sleep, exercising, and avoiding alcohol, illicit drugs, and caffeine can help reduce anxiety. Joining a support group can help you connect with people who share your experiences so you can realize you are not alone.”

Talkspace Therapist Dr. Olga Molina, D.S.W., LCSW

Additional Considerations

If you’re thinking about or have started taking Paxil, there are several considerations to remember. Interactions with other medications can occur when taking this drug. It’s important to tell your doctor about all other medications you’re currently taking, including any over-the-counter drugs and supplements. To ensure Paxil is suitable and avoid potential interactions, your doctor needs to know everything you take.

Inform your doctor if you’ve had any of the following before taking Paxil:

  • Bleeding or blood clotting disorder
  • Heart disease
  • Stroke 
  • High blood pressure 
  • Epilepsy
  • Low sodium levels
  • Bipolar disorder


You shouldn’t drink while on Paxil unless you know how it will affect you. Ask your doctor about taking nonsteroidal anti-inflammatory drugs (NSAIDs): 

  • Advil or Motrin
  • Aspirin 
  • Diclofenac
  • Celebrex
  • Aleve
  • Indomethacin


Do not take Paxil if you take thioridazine or pimozide. Also, do not take Paxil if you’ve taken an MAO inhibitor (MAOI) within the past 14 days or if you plan to take one in the next 14 days. 

There is an increased risk of suicidal thoughts when taking antidepressants, especially in young people. 

Paxil Alternatives

Depending on your condition and symptoms, there may be alternatives to Paxil that could potentially provide relief. Some drugs you might consider instead of Paxil are:

  • Zoloft, another SSRI, is indicated for treating depression, anxiety disorders, OCD, PTSD, and premenstrual dysphoric disorder. Side effects might include nausea, dry mouth, insomnia, and drowsiness.
  • Prozac, also an SSRI, is typically used to treat major depressive disorder and OCD in adults and pediatric patients 7 or older with severe symptoms of depression or anxiety. Common side effects are headache, insomnia, nervousness, fatigue, decreased appetite, and nausea.
  • Celexa is a commonly prescribed SSRI to treat major depressive episodes in adults aged 18 and above. Possible adverse reactions include headache, lightheadedness, difficulty sleeping, perspiration, irritability, restlessness, trembling or shaking, loose bowels, blockage, dry mouth, weight changes, increased pulse rate, and sexual problems like delayed climaxing and erectile dysfunction (ED).
  • Lexapro is an SSRI that can treat major depressive episodes in adults 18 years or older with at least 1 prior episode. Common adverse reactions might include migraine, vertigo, insomnia, digestive discomfort/nausea, diminished libido, or difficulty climaxing.
  • Cymbalta is a dual reuptake inhibitor that targets both serotonin and norepinephrine receptors. It’s FDA-approved to treat chronic musculoskeletal pain caused by osteoarthritis and fibromyalgia. It’s also sometimes used off-label to help people cope with depression and anxiety. Side effects are dry mouth, nausea, dizziness, headache, constipation, sweating, fatigue, diarrhea, loss of appetite, weight changes, increased heart rate, and sexual problems.

Online Paxil Prescription Through Talkspace Psychiatry

Talkspace Psychiatry offers an online Paxil prescription for those prescribed it. Talkspace is an online therapy platform that gives you access to psychiatrists who can assess your mental health and prescribe the correct medication — including Paxil — if necessary.

Talkspace Psychiatry makes getting mental healthcare easy by providing convenient online access to qualified professionals who can evaluate your needs and determine the best type of treatment. The Talkspace team of experienced psychiatrists and therapists is available every day to answer questions quickly and effectively while offering personalized care tailored to your unique situation.


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Talkspace articles are written by experienced mental health-wellness contributors; they are grounded in scientific research and evidence-based practices. Articles are extensively reviewed by our team of clinical experts (therapists and psychiatrists of various specialties) to ensure content is accurate and on par with current industry standards.

Our goal at Talkspace is to provide the most up-to-date, valuable, and objective information on mental health-related topics in order to help readers make informed decisions.

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