Both Paxil and Prozac are selective serotonin reuptake inhibitors (SSRIs) antidepressants, which means that they work in similar ways. While some treatment uses overlap between the two medications, there are distinct differences as well. Paxil is FDA-approved to treat depression, posttraumatic stress disorder (PTSD), obsessive compulsive disorder (OCD), panic disorder, and social and generalized anxiety disorders. Prozac is FDA-approved to treat depression, bulimia, OCD, and panic disorder.
Key Differences Between Paxil & Prozac
The key differences between Paxil (paroxetine) and Prozac (fluoxetine) center around the conditions they are used to treat and their side effects. While they are both approved to treat depression, OCD, and panic disorder, they also each treat additional disorders. Each medication’s potential side effects may also be a part of the decision of which medication is most appropriate. For example, if you have problems with sleep, your prescriber may choose Paxil and have you take it at bedtime due to its possible side effect of sleepiness.1
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Conditions Treated
Paxil and Prozac are not to be used interchangeably. Each medication has its potential risks and benefits, and each has been FDA-approved for specific disorders. FDA approval of a drug means that a medication has been found to be safe and effective for a specific use based on data from clinical trials.
Paxil has been FDA approved for treating the following conditions:
- Major depression
- Obsessive compulsive disorder (OCD)
- Posttraumatic stress disorder (PTSD)
- Panic disorder
- Social anxiety disorder
- Generalized anxiety disorder
Prozac has been FDA-approved for treating the following conditions:
- Major depression
- Obsessive compulsive disorder (OCD)
- Bulimia
- Panic disorder
Standard Dosages & Forms
Paxil and Prozac are both brand name medications. They both are available as generic medications that may have additional strengths and forms.
Brand-name Paxil is available as an immediate-release and as an extended-release version called Paxil CR. It is available in the following forms and strengths:
- Oral tablet: 10 milligrams (mg), 20 mg, 30 mg, 40 mg, 50 mg
- Oral suspension: 10 mg / 5 milliliters (ml)
- Extended-release tablet: 12.5 mg, 25 mg, 37.5 mg
Prozac is only available as an oral capsule in strengths of 10 mg, 20 mg, and 40 mg.
Side Effects
Despite both being SSRI medications, the most common side effects of Paxil vs Prozac differ. Prozac’s most common side effects include sleep disturbances such as insomnia and digestive symptoms. Whereas Paxil’s most common effects are more diverse and include headaches, lower libido, and nausea.
The table below summarizes the key differences between Paxil versus Prozac:
Key Components | Paxil | Prozac |
---|---|---|
What is the generic name? | paroxetine | fluoxetine |
What forms does it come in? | Tablet Oral suspension Extended-release tablet | Capsule |
What are the typical dosages? | 10 mg, 20 mg, 50 mg, 60 mg | 10 mg, 20 mg, 60 mg |
Who is approved to take it? | Paxil is approved for adults in the treatment of: - Major depressive disorder (MDD) - OCD - Panic disorder - Social anxiety disorder - Generalized anxiety disorder (GAD) - Posttraumatic stress disorder (PTSD) | Prozac is approved for the treatment of: Adults and certain children: -Major depressive disorder (MDD) - OCD Only adults: - Panic disorder - bulimia nervosa |
Add additional relevant comparisons, if any | Prozac is approved in combination with olanzapine (Zyprexa) which has been found to be effective in treating bipolar depression as well as treatment-resistant depression. |
What Is Paxil?
Paxil belongs to the selective serotonin reuptake inhibitors (SSRIs) class of drugs. It is thought to work by influencing the levels of serotonin, a neurotransmitter (brain chemical) linked with mood regulation. For some, the impact of Paxil may result in improved mood and emotional wellbeing. Some using Paxil may experience side effects, ranging from mild to serious. Some effects may disappear on their own as their bodies adjust to the medication.
What Is Prozac?
Prozac is also an SSRI antidepressant and it works similarly to Paxil. Prozac is FDA-approved as a treatment for several mental health conditions in adults and children.
What Are Paxil & Prozac Used to Treat?
Paxil and Prozac are both antidepressants approved as treatments for some of the same conditions. However, they are not interchangeable, and only Prozac is approved as a treatment for children.
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Paxil Uses
Paxil is FDA-approved as a treatment for depression, certain anxiety disorders, and other conditions in adults. It is not FDA approved for children or adolescents for any mental health or psychiatric disorder. Paxil comes in several forms, including tablets and oral suspension.1
Paxil is FDA-approved for treating:1
- Major depressive disorder (MDD)
- Generalized anxiety disorder (GAD)
- Obsessive-compulsive disorder (OCD)
- Panic disorder
- Social anxiety disorder
- Post-traumatic stress disorder (PTSD)
Prozac Uses
Prozac is used as both an antidepressant and anxiety medication for children and adults. Prozac is available as a capsule.
Prozac is FDA-approved for treating: .
- Major depressive disorder (MDD) in adults and certain children
- Obsessive-compulsive disorder (OCD) in adults and certain children
- Panic disorder in adults
- Binge-eating and vomiting behaviors in adult patients with moderate to severe bulimia nervosa
The table below compares the medical and mental health conditions Paxil and Prozac are used to treat:
Condition | Paxil | Prozac |
---|---|---|
Depression | Yes, FDA-approved | Yes, FDA-approved |
Panic disorder | Yes, FDA-approved | Yes, FDA-approved |
Obsessive-compulsive disorder (OCD) | Yes, FDA-approved | Yes, FDA-approved |
Generalized anxiety disorder(GAD) | Yes, FDA-approved | Not Approved |
Social anxiety disorder | Yes, FDA-approved | Not approved |
Post-traumatic stress disorder(PTSD) | Yes, FDA-approved | Not approved |
Bulimia nervosa | Not approved | Yes, FDA-approved |
Side Effects of Paxil & Prozac
The most common side effects of Prozac include disruptions in sleep and digestion, while Paxil side effects most often include headaches, lower libido, and nausea. Since these symptoms may occur with other common conditions or as a result of temporary life circumstances, it may be challenging to determine whether these are side effects of the medication.
This is not a comprehensive list of possible mild or serious side effects. You should talk with your prescriber and pharmacist about any potential side effects from either medication.
The table below compares the possible side effects of Paxil and Prozac*:1
Side Effects | Paxil | Prozac |
---|---|---|
Insomnia | Yes | Yes |
Sleepiness | Yes | Yes |
Unusual Dreams | Yes | Yes |
Dizziness | Yes | Yes |
Nausea | Yes | Yes |
Anxiety | Yes | Yes |
Flu symptoms | Yes | Yes |
Asthenia (weakness) | Yes | Yes |
Constipation | Yes | Yes |
Pharyngitis | Yes | Yes |
Sexual changes in orgasm or ejaculation | Yes | Yes |
Disclaimer: Taking certain medications, herbs, or supplements alongside Paxil and Prozac can change how these medications work 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.
*All medications, including Prozac and Paxil, can cause side effects which can be mild or serious. This is not a comprehensive list of all possible side effects. You should talk with your doctor about any questions you have and to understand the potential side effects and benefits of any medication.
Severe Side Effects & Allergic Reactions of Paxil & Prozac
Severe side effects are rare and highly unlikely to occur. However, they can occur for some patients and it’s essential to understand all the risks of taking these medications. While these adverse reactions may never happen it is important you know what to look for. Both Paxil and Prozac are associated with the following potential serious side effects:
- Suicidal thoughts
- Increased risk of bleeding
- Episodes of mania in people who have bipolar disorder
- Hyponatremia (low sodium levels in the blood)
- Serotonin syndrome
*All medications, including Paxil & Prozac, can cause side effects which can be mild or serious. This is not a comprehensive list of all possible side effects. You should talk with your doctor about any questions you have and to understand the potential side effects and benefits of any medication.
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Warnings and Precautions
There are several warnings and precautions associated with Paxil and Prozac. While rare, these serious risks may develop for anyone taking the medication and may be life-threatening or require medical care.
Risks to consider when taking Paxil and Prozac include:
- Increased risk of suicide: Children and young adults are at risk of increased suicidal thoughts with both medications. Adults may also experience worsening of their depression and be at an increased risk of suicidal thoughts and actions.
- Interactions with alcohol: Avoid drinking alcohol or using illegal drugs while you are taking antidepressant medications. They may decrease the benefits (e.g., worsen your condition) and increase adverse effects (e.g., sedation) of the medication. 6
- Pregnancy: The risks of using Paxil or Prozac during pregnancy are generally discouraged. SSRIs, and particularly Paxil, have shown to have effects on the fetus during pregnancy. However, untreated mental health conditions can also be harmful for pregnant parents and fetuses. Providers will consider the risks and benefits when prescribing either medication to pregnant parents.
- Breastfeeding: Like many other drugs, Paxil and Prozac are secreted in human milk, and caution should be exercised when Paxil or Prozac is administered to a nursing woman. The benefits and risks should be weighed with a healthcare professional to decide if it is safe to take either medication.
- Antidepressant withdrawal: Stopping an antidepressant abruptly can result in antidepressant discontinuation syndrome, potentially causing symptoms such as nausea, dizziness, headaches, and anxiety.
- Serotonin syndrome: concomitant use of other serotonergic drugs (including triptans, tricyclic antidepressants, fentanyl, lithium, tramadol, tryptophan, buspirone, amphetamines and St. John’s Wort) and with drugs that impair metabolism of serotonin.
- Activation of mania: If you have a history or bipolar disorder, both medications may increase the risk of having an episode of mania.
- Allergic reactions: There is a risk of mild and serious allergic reactions to any medication including Paxil and Prozac.
- Seizures: If you have a history of seizures, these medications may increase your risk of seizures.
- Angle-closure glaucoma: If you have a history of having eye issues, it may not be safe for you to take either medication as they can lead to angle closure attacks.
- Hyponatremia: Both medications can cause low levels of sodium in the body which can lead to dangerous side effects if left untreated. Examples of symptoms of hyponatremia include headache, difficulty concentrating, and decreased memory.
- Discontinuation syndrome: Neither Paxil or Prozac should be stopped suddenly. This can lead to discontinuation syndrome as your body has adjusted to having the medications. It is important to work with a healthcare professional to taper off of these medications rather than stopping abruptly.
Additional risks to consider when taking Paxil include:
- QT prolongation: Paxil can cause a dangerous heart condition known as QT prolongation. If you have a history of heart issues, it may not be safe to take Paxil.
Additional risks to consider when taking Prozac include:
- Decreased appetite and weight loss: Prozac may cause decreased appetite and weight loss which may be dangerous for certain patients who are underweight.
- Cognitive and motor impairment: Prozac has the potential to impair judgment, thinking, and motor skills including walking, driving, and operating machinery. You should not perform these activities until you know how the medication affects you.
Potential Drug Interactions With Paxil & Prozac
Paxil and Prozac will interact with any tricyclic antidepressant, SNRI, MAOI, or medication that affects serotonin, which may trigger symptoms of a potentially life-threatening condition called serotonin syndrome. This includes medications and substances including triptans, lithium, fentanyl, tramadol, or St. John’s Wort.1,2
Drugs that interfere with the process of slowing blood flow and forming clots may elevate the risk of bleeding. This includes pain relievers such as aspirin and non-steroidal anti-inflammatory drugs (NSAIDs) as well as warfarin, a medication used to prevent blood clots. Anticonvulsants like Tegretol and Dilantin may not be metabolized properly and can cause dangerous side effects.. Some antipsychotics may adversely affect heart rhythm and should not be taken with Prozac or Paxil, like thioridazine (Mellaril) or pimozide (Orap).
Medications and substances that have harmful interactions with Paxil and Prozac include:
Potential Interactions | Paxil | Prozac |
---|---|---|
Monoamine Oxidase Inhibitors (MAOIs) | X | X |
Other drugs affecting serotonin (SNRI’s, TCA’s, MAOI’s, St. John’s Wort) | X | X |
Lithium | X | X |
Fentanyl | X | X |
NSAIDs, Aspirin, Warfarin | X | X |
Drugs Tightly Bound to Plasma Proteins: | X | X |
Anticonvulsants like Tegretol and Dilantin | X | X |
Antipsychotics | X | X |
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Paxil & Prozac: Key Pros & Cons
Both Paxil and Prozac have been shown as beneficial treatments, but there are drawbacks and risks to consider. Comparing these aspects can help you understand which treatment may be most suitable for you.
Pros & Cons of Paxil
Paxil has many benefits and advantages to consider. It is FDA approved and is an effective treatment for several mental health conditions, some of which may occur together. It is also well-studied, widely available, and can be inexpensive even without insurance.
However, Paxil is not right for everyone. It is not approved as a treatment for children or adolescents. Also, a common side effect is sleepiness, which may affect daily functioning for some.
Pros & Cons of Prozac
Prozac is also approved for several conditions and has been on the market for many years. It may be particularly helpful managing poorly-controlled eating behaviors such as binge-eating with bulimia.
However, if you have anxiety or hyperawareness, this medication may not be a good fit. For some who take it, anxiety symptoms may worsen. Also, Prozac may cause insomnia for some who take it. If you are already not sleeping well, Prozac may not be a good fit for you.
Which Is Right for You?
The decision between using Paxil or Prozac comes down to you and your primary provider. Your provider will evaluate your symptoms and how they have affected your daily functioning, relationships, and major life activities. You may want to consider online psychiatry services if seeing a doctor in person isn’t feasible.
How to Get a Prescription for Paxil or Prozac
To get an antidepressant, begin with an appointment with a healthcare provider who can evaluate your situation and is authorized to prescribe medication. Several types of medical professionals may be authorized prescribers, including a primary care physician, psychiatrist, nurse practitioner, psychiatric mental health nurse, and physician assistant.
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Questions to Ask Your Health Team About Paxil & Prozac
You may have questions about your symptoms, conditions, and whether Prozac or Paxil may be helpful treatments. Here are several questions you may ask as you better understand your situation and consider treatment options.
Questions to ask your prescriber about Paxil and Prozac include:
- Is it safe to take Paxil or Prozac with my other medications?
- Will Paxil or Prozac be covered by my insurance? If I have any trouble or if I have questions can I call you?
- Which one has the best results as a treatment for depression?
- What happens if I lose my sex drive?
- Which one is the best for my treatment of anxiety?
- How often should I see you for checkups while taking Paxil or Prozac? Can I see you more than that at the beginning?
- What should I do if I feel uncomfortable or if I do not feel right?
- I tend to worry, when should I call you? I need clear directions.
- What alternative or holistic treatments would you recommend to treat this condition?
In My Experience
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DailyMed – PAXIL CR- paroxetine hydrochloride tablet, film coated, extended release. (2023). Dailymed.nlm.nih.gov. Retrieved from
https://www.accessdata.fda.gov/drugsatfda_docs/label/2021/020031s077lbl.pdf -
DailyMed – PROZAC- fluoxetine hydrochloride capsule. (2023). DailyMed.nlm.nih.gov. Retrieved from https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm
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