Medication Guide
Paroxetine (Paxil) Side Effects and Uses
A plain-language guide to Paroxetine, an SSRI antidepressant. Learn how it helps, what it treats, how to take it and which side effects to know about.
Quick answer. Paroxetine (Paxil) is an SSRI antidepressant. Common paroxetine side effects include sleepiness or feeling sedated, nausea, dry mouth and constipation. The rare but serious ones, and when to get help, are listed under paroxetine side effects below. Never stop or change your dose on your own.
How Paroxetine Can Help You
Paroxetine (Paxil) is one of the most studied SSRIs. It is FDA approved for more anxiety conditions than most antidepressants. It raises the amount of serotonin the brain can use. This can calm constant worry, panic attacks, social fears, painful memories and obsessive thoughts. It can also lift low mood.
Paroxetine has a calming quality. That can help when anxiety feels physical. Think of a racing heart, tight muscles or restlessness. Some people also find it helps them sleep.
Benefits build over four to eight weeks. Some people feel less anxious within the first two weeks. Paroxetine leaves the body fairly quickly. So taking it every day matters more than with longer-acting SSRIs. Stopping should always be a slow, planned taper.
Uses for Paroxetine
- Major depressive disorder
- Generalized anxiety disorder
- Panic disorder
- Social anxiety disorder
- Obsessive-compulsive disorder (OCD)
- Post-traumatic stress disorder (PTSD)
- Premenstrual dysphoric disorder (PMDD), with the controlled-release form
- Menopausal hot flashes, with a separate low-strength product
How to Take Paroxetine
Your prescriber decides your dose based on your condition and response. Paroxetine comes as regular tablets, a controlled-release tablet (Paxil CR) and a liquid. The forms are not swapped one for one. It is usually taken once a day, with or without food. Some people take it at night because it can cause drowsiness. Others do well in the morning.
Take it at the same time each day and try not to miss doses. Missed one? Take it when you remember, unless the next dose is close. Then skip it and never double up. Swallow controlled-release tablets whole. Do not stop paroxetine on your own. Your prescriber will plan a slow taper when the time comes.
Paroxetine Side Effects
Common Side Effects
- Sleepiness or feeling sedated
- Nausea
- Dry mouth
- Constipation
- More sweating
- Weight gain with longer use
- Sexual side effects, such as lower desire or delayed orgasm
- Dizziness
Serious: Get Medical Help Promptly
- New or worse suicidal thoughts, mostly in people under 25 (boxed warning)
- Serotonin syndrome, with agitation, fever, fast heartbeat or stiff muscles
- Strong stopping symptoms if doses are missed or it is stopped suddenly
- Unusual bleeding or bruising
- Low sodium (hyponatremia), mostly in older adults
- Mania, with a very high or irritable mood
How Paroxetine Works
Paroxetine slows the reuptake of serotonin. So more of it stays active in the brain. Over weeks, the brain adjusts. That is when worry, panic and low mood tend to ease.
Paroxetine can cause more dry mouth, constipation and sleepiness than some other SSRIs. It also leaves the body faster than most SSRIs. That is why missed doses can be felt.
Before You Start Paroxetine
Paroxetine must never be taken with an MAOI antidepressant, thioridazine or pimozide. Other drugs that raise serotonin add to the risk of serotonin syndrome. Examples are triptans and tramadol. Paroxetine can also make tamoxifen work less well. Tell your prescriber if you take it. Aspirin, NSAIDs and blood thinners raise bleeding risk.
Tell your prescriber if you are pregnant or planning a pregnancy. It is usually avoided in early pregnancy. Even so, do not stop it on your own. Share any history of bipolar disorder, seizures or glaucoma. If you are thinking about harming yourself, call or text 988, or call 911. Learn about panic disorder care by telehealth in California.
Is Paroxetine Right for You?
Only a full evaluation with a prescriber can tell you if Paroxetine fits your symptoms, history and goals. Harpal Singh, PMHNP-BC offers psychiatric evaluations and ongoing medication management by telehealth anywhere in California.
SCHEDULE AN APPOINTMENT CALL (888) 457-8124
Related Medication Guides
Other guides in the same group, written the same simple way. Being in one group does not mean you can swap one medicine for another.
- Escitalopram (Lexapro), SSRI antidepressant
- Fluoxetine (Prozac), SSRI antidepressant
- Fluvoxamine (Luvox), SSRI antidepressant
- Mirtazapine (Remeron), Atypical antidepressant (noradrenergic and specific serotonergic)
- Nortriptyline (Pamelor), Tricyclic antidepressant (TCA)
- Sertraline (Zoloft), SSRI antidepressant
FAQ
Questions About Paroxetine
Why does paroxetine have a reputation for withdrawal symptoms?
Paroxetine leaves the body fairly quickly, so levels drop fast when a dose is missed or the medicine is stopped. This can cause dizziness, brain zaps, irritability and nausea. Taking it every day and following a slow, planned taper helps prevent this.
Is paroxetine more sedating than other SSRIs?
It often is, at least a little. That can help people whose anxiety gets in the way of sleep. If daytime drowsiness is a problem, taking it at bedtime often helps, so ask your prescriber about timing.
Does paroxetine cause weight gain?
Among SSRIs, paroxetine is more linked to weight gain with long-term use. Not everyone is affected, and healthy habits help. If weight becomes a concern, your prescriber can talk through other options.
Can I take paroxetine during pregnancy?
Paroxetine is usually avoided in pregnancy when possible. Early pregnancy exposure has been linked to a small added risk of certain heart defects. If you are pregnant or planning a pregnancy, tell your prescriber soon so you can review options together. Do not stop it on your own.
How long should I stay on paroxetine?
Many people stay on it for several months after they feel well, and longer if symptoms have come back before. When you and your prescriber decide to stop, a slow taper over several weeks or longer is the safe way to do it.
What is the difference between Paxil and Paxil CR?
Paxil CR is a controlled-release tablet that releases the medicine slowly. It is approved for some of the same conditions, plus PMDD. The two forms are not swapped one for one, so any change goes through your prescriber.
How long does paroxetine take to work?
Some people feel less anxious within the first couple of weeks. The full effect on mood and anxiety usually takes four to eight weeks of daily use. Keep taking it as prescribed during this time.
Can teens take paroxetine?
Paroxetine is not FDA approved for children or teens. Like all antidepressants, it has a boxed warning. It covers suicidal thoughts in young people. Your prescriber can explain other options that are approved for younger patients.