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Paxil (Paroxetine): Drug Uses, Warnings, Dosage, & More

Published: January 20, 2023 Updated: March 2, 2023
Published: 01/20/2023 Updated: 03/02/2023
Dr. Diana Rangaves PharmD
Written by:

Diana Rangaves

PharmD, RPh
Headshot of Benjamin Troy, MD
Reviewed by:

Heidi Moawad

MD
  • What Is Paxil (Paroxetine)?What Is Paxil?
  • How Is Paxil Administered?Forms It Comes In
  • Associated Risks of Taking PaxilAssociated Risks
  • Side Effects of PaxilSide Effects
  • Interactions With PaxilInteractions
  • What to Do If You OverdoseWhat If I Overdose?
  • What If I Miss a Dose of Paxil?What If I Miss a Dose?
  • Questions to Ask Your Health Team About PaxilQuestions to Ask
  • Final ThoughtsConclusion
  • Additional ResourcesResources
Dr. Diana Rangaves PharmD
Written by:

Diana Rangaves

PharmD, RPh
Headshot of Benjamin Troy, MD
Reviewed by:

Heidi Moawad

MD

Paxil is a medication used in the treatment of major depressive disorder, generalized anxiety disorder, and other mental health conditions. Paxil works to regulate users’ serotonin levels, leading to symptom improvements. However, taking the drug may result in side effects that range from mild to severe. Before considering Paxil, talk with your doctor to understand these associated risks.

Boxed Warning: Paroxetine (Paxil)

Boxed Warning: Paroxetine (Paxil) – Risk of Suicidal Thoughts and Behaviors in Certain People
Paroxetine, the active ingredient in Paxil, has a black box warning. These are the most serious types of warnings from the Food and Drug Administration (FDA). Paroxetine can increase the risk of suicidal thoughts and behaviors in children, adolescents, and young adults. Regardless of your age, you should talk with your doctor about serious risks with paroxetine and any other medications before starting treatment.

What Is Paxil (Paroxetine)?

Paxil (paroxetine) is FDA-approved for use in the treatment of depression and certain anxiety disorders, among other conditions.1 Paxil belongs to the selective serotonin reuptake inhibitors (SSRIs) class of drugs that regulates serotonin levels in the brain. Blocking serotonin reuptake creates a balance of this neurotransmitter, resulting in improved mood and emotional wellbeing. However, users may experience adverse side effects as their bodies adjust to the drug.

Paxil may be prescribed in the treatment of:2

  • Major depressive disorder (MDD)
  • Generalized anxiety disorder (GAD)
  • Obsessive-compulsive disorder (OCD)
  • Panic disorder
  • Social anxiety disorder (SAD)
  • Post-traumatic stress disorder (PTSD)

In some cases, a physician may consider prescribing Paxil for off-label use in the treatment of premature ejaculation or irritable bowel syndrome.

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How Is Paxil Administered?

Paxil is intended to be taken once daily in the morning, with or without food. The specific Paxil dose will vary depending on the condition being treated and the person’s age, but the standard is 20 mg daily.

Paxil comes in the form of tablets, suspension (liquid), and extended-release (long-acting) tablets.2 Your doctor may determine the best delivery method depending on one’s age, health condition, and severity of symptoms. Paxil should be taken as prescribed by a doctor to help prevent associated risks and side effects. If you do not experience symptom relief, your prescriber may adjust your dosage or suggest an alternative.

Dosages of Paxil may include:2

  • 10 mg (starting dose for PD)
  • 20 mg (starting dose for MDD, OCD, PTSD, SAD, GAD)
  • 50 mg (maximum dose for MDD, PTSD, GAD)
  • 60 mg (maximum dose for OCD, PD, SAD)

Associated Risks of Taking Paxil

Taking Paxil may result in side effects that can range in severity depending on how the drug interacts with a person’s body. It is important to disclose any current medications or pre-existing medical conditions with a doctor before taking the medication. Specific populations, including children, pregnant or breastfeeding women, and young adults, are at an increased risk for experiencing adverse reactions to Paxil.

Before taking Paxil, alert your doctor if you are or have:3,4,5

  • Pregnant
  • Breastfeeding
  • Using other substances
  • Seizures
  • Bleeding problems
  • Glaucoma
  • Bipolar disorder
  • Heart disease

Side Effects of Paxil

Side effects of Paxil are generally mild, but can be severe depending on how the drug interacts with one’s body, their age, and their overall health. Before starting Paxil, have a conversation with your physician to better understand these risks. Your doctor will decide if different treatment is needed and may suggest alternatives, such as Celexa or Zoloft.

Common side effects of Paxil may include:2

  • Drowsiness
  • Weight changes
  • Dry  mouth
  • Sexual problems
  • Sweating
  • Headaches
  • Dizziness
  • Constipation
  • Indigestion
  • Appetite issues

Severe side effects of Paxil that may require immediate attention include:2

  • Serotonin syndrome
  • Seizures
  • Manic episodes
  • Bleeding problems
  • Angle-closure glaucoma
  • Priapism

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Interactions With Paxil

Taking certain medications, herbs, or supplements alongside Paxil can change how Paxil works in your body or increase the risk for serious side effects. This article does not consider all the possible interactions. Please let your doctor, psychiatrists, and pharmacists know about all the products you currently use, such as prescription medication, nonprescription drugs, and herbal supplements. Do not start, stop, or change the dosage of any medicines without your doctor’s approval.

Life-threatening side effects may occur if Paxil is taken alongside other substances or medications. The interaction of these different chemical compounds in the body is detrimental to your health, as this can lead to overdose and sudden death. Patients taking Paxil should not consume alcohol.

Substances that might cause interactions with Paxil include:2

  • Orap (pimozide)
  • Mellaril (thioridazine)
  • Migraine medications
  • Other SSRIs
  • MAO inhibitors
  • Blood thinners

What to Do If You Overdose

Overdosing on Paxil may occur when large amounts are consumed or are taken alongside other antidepressants or substances. Long-term Paxil use can result in physical dependence. Taking more Paxil than prescribed or a suicide attempt using Paxil may result in overdose. If you have overdosed on Paxil, seek immediate medical assistance.2

What If I Miss a Dose of Paxil?

If you miss a dose of Paxil, take it as soon as possible. However, if it is closer to the time to take your next dose, wait and skip the missed dose before returning to your recommended prescription routine. It is important to stick to your Paxil schedule, as this helps prevent the risk of experiencing withdrawal symptoms.

Questions to Ask Your Health Team About Paxil

Before considering Paxil, a doctor will help you understand if it is or is not a suitable medication for you. If it is not, they can recommend a safe alternative.

Questions to ask your care team before taking Paxil include:

  • Is it safe to take Paxil with my other medications?
  • Will my insurance cover Paxil?
  • Does my medical history increase the risk for side effects?
  • How long do side effects last?
  • When should I seek immediate medical attention for side effects?
  • How often should I see you for checkups while taking Paxil?
  • Should I let my therapist know I am taking this medication?
  • What should I do if I want to stop taking Paxil?
  • Can I consume alcohol while taking Paxil?
  • What should I do if Paxil does not work for me?

Final Thoughts

Paxil is an effective medication used to manage symptoms of depression and anxiety. Taking this medication may result in side effects and users should be aware of any associated risks before beginning a Paxil prescription. Consult with your doctor to better understand these possibilities in order to ensure your physical and mental wellbeing.

Additional Resources

Education is just the first step on our path to improved mental health and emotional wellness. To help our readers take the next step in their journey, Choosing Therapy has partnered with leaders in mental health and wellness. Choosing Therapy may be compensated for marketing by the companies mentioned below.

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Talkiatry – Get help from a real doctor that takes your insurance. Talkiatry offers medication management and online visits with top-rated psychiatrists. Take the online assessment and have your first appointment within a week. Free Assessment

Hims / Hers – If you’re living with anxiety or depression, finding the right medication match may make all the difference. Get FDA approved medication prescribed by your dedicated Hims / Hers Healthcare Provider and delivered right to your door. Plans start at $25 per month (first month)*. Get Started

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Choosing Therapy partners with leading mental health companies and is compensated for marketing by Betterhelp, Hims / Hers, and  Talkiatry. *Hims / Hers Disclaimer: Subscription required. After first month, price is $85/month for a monthly subscription or $49/month for a three-month subscription ($123 for first order, $147 billed quarterly thereafter). Subscription automatically renews unless you cancel at least 7 days before renewal is processed.

5 sources

Choosing Therapy strives to provide our readers with mental health content that is accurate and actionable. We have high standards for what can be cited within our articles. Acceptable sources include government agencies, universities and colleges, scholarly journals, industry and professional associations, and other high-integrity sources of mental health journalism. Learn more by reviewing our full editorial policy.

  • PAXIL- paroxetine hydrochloride suspension PAXIL- paroxetine hydrochloride tablet, film coated. (2022). DailyMed. Retrieved from https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=584ace29-6e40-432f-950f-ab7e98653d32

  • Paroxetine: MedlinePlus drug information. (2021). MedlinePlus. Retrieved from https://medlineplus.gov/druginfo/meds/a698032.html

  • Drugs and Lactation Database. (2022).Paroxetine – Drugs and lactation database. Retrieved from https://www.ncbi.nlm.nih.gov/books/NBK501190

  • Pregnancy, breastfeeding and fertility while taking Paroxetine. (2022). NHS. Retrieved from https://www.nhs.uk/medicines/paroxetine/pregnancy-breastfeeding-and-fertility-while-taking-paroxetine/

  • Correia, P., et al. (2018). Negative myoclonus secondary to paroxetine intake. BMJ case reports, 2018, bcr2018224586. https://doi.org/10.1136/bcr-2018-224586

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Dr. Diana Rangaves PharmD
Written by:

Diana Rangaves

PharmD, RPh
Headshot of Benjamin Troy, MD
Reviewed by:

Heidi Moawad

MD
  • What Is Paxil (Paroxetine)?What Is Paxil?
  • How Is Paxil Administered?Forms It Comes In
  • Associated Risks of Taking PaxilAssociated Risks
  • Side Effects of PaxilSide Effects
  • Interactions With PaxilInteractions
  • What to Do If You OverdoseWhat If I Overdose?
  • What If I Miss a Dose of Paxil?What If I Miss a Dose?
  • Questions to Ask Your Health Team About PaxilQuestions to Ask
  • Final ThoughtsConclusion
  • Additional ResourcesResources
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