Paxil is the brand name of the generic drug paroxetine. It is an antidepressant in the selective serotonin reuptake inhibitor class. Doctors prescribe Paxil to treat major depressive disorder.
Paxil may benefit people with various mental health conditions. Side effects may include drowsiness, dry mouth, and appetite changes.
This article explains the various uses, potential side effects, warnings, and drug interactions of Paxil.
The active ingredient in Paxil is paroxetine, which is a selective serotonin reuptake inhibitor (SSRI). SSRIs help treat depression by
A disturbance in serotonin
- sleep disturbance
- a decrease in pleasure or interest
- feelings of guilt or worthlessness
- fatigue
- difficulty with attention and concentration
- changes in appetite or weight
- motor dysfunction
- suicidal thoughts
- depressed mood
SSRIs are effective treatments for major depressive disorder, but doctors can also prescribe Paxil for
- generalized anxiety disorder
- obsessive-compulsive disorder (OCD)
- panic disorder
- social anxiety disorder or social phobia
- post-traumatic stress disorder (PTSD)
- premenstrual dysphoric disorder (PDD)
People can also use Paxil to help relieve hot flashes and night sweats during menopause.
Doctors usually do not recommend that people under 18 years old use Paxil. However, they can prescribe Paxil to people under 18 off-label.
Paxil is available in three different oral dosage forms. The following table lists the dosages and strengths in milligrams (mg) and milligrams per milliliter (mg/ml) of Paxil.
| Dosage form | Strength |
|---|---|
| Paxil immediate-release tablets | • 10 mg • 20 mg • 30 mg • 40 mg |
| Paxil oral suspension | 10 mg/5 ml |
| Paxil CR (controlled release) tablets | • 12.5 mg • 25 mg • 37.5 mg |
The dose a doctor prescribes will depend on its intended use. They may recommend a starting dose and increase or decrease it depending on the person’s symptoms and side effects.
Major depressive disorder
People can use the immediate-release or controlled-release tablets for major depressive disorder.
Doctors will typically start adults on
The maximum daily dose of immediate-release Paxil for major depressive disorder is 50 mg for adults and 40 mg for older adults.
When using controlled-release tablets of Paxil, adults may begin on 25 mg once daily, and older adults will start on 12.5 mg once daily. Doctors may increase the dose by 12.5 mg every week, depending on the person’s response to treatment.
The maximum daily dose of Paxil CR in adults is 62.5 mg and 50 mg in older adults.
Generalized anxiety disorder
Doctors may recommend immediate-release tablets of Paxil for treating people with generalized anxiety disorder.
The starting dose for adults is
Older adults may start with a dose of 10 mg daily. This may increase by 10 mg per day up to a maximum dose of 40 mg daily.
OCD
When treating people with OCD, doctors will choose immediate-release tablets of Paxil.
Adults will typically start on
Older adults may start on a dose of 10 mg daily, which can increase by 10 mg per day to a maximum of 40 mg.
The Food and Drug Administration (FDA) does not approve the use of Paxil in children and adolescents. However, doctors may prescribe 10 mg to 50 mg of Paxil to people 7 years and older as an off-label use.
Panic disorder
Adults with panic disorder
The immediate-release dose for adults typically starts at 10 mg daily. Doctors may increase this by 10 mg per day at intervals of at least 1 week. People should not exceed 60 mg per day. Typically, doctors will aim for 40 mg daily.
When choosing controlled-release tablets, adults may start with 12.5 mg per day and will typically reach an effective dose between 12.5 mg and 75 mg.
Social phobia
People ages
The following table shows the starting dose, weekly increase, and maximum daily dose for each dosage form of Paxil for children, adults, and older adults.
| Starting daily dose | Weekly increase | Maximum daily dose | |
|---|---|---|---|
| Adults | • immediate release: 20 mg • controlled release: 12.5 mg | • immediate release: 10 mg • controlled release: 12.5 mg | • immediate release: 60 mg • controlled release: 37.5 mg |
| Older adults | immediate release: 10 mg | immediate release: 10 mg | immediate release: 40 mg |
| Children and adolescents 8 years and older | immediate release: 10 mg | immediate release: 10 mg | immediate release: 50 mg |
PTSD
Adults and older adults can use immediate-release Paxil to help with the symptoms of PTSD.
Adults will typically start on 20 mg per day, with a maximum dose of 50 mg. Older adults may begin with 10 mg per day up to a maximum dose of 40 mg.
PDD
People can take Paxil to help treat PDD. This is a depressive condition linked with the menstrual cycle. People will only take Paxil at certain times in their menstrual cycle, such as the luteal phase.
People can use controlled-release tablets for PDD. The effective dose is
The
- drowsiness
- sleep disturbances
- loss of appetite
- dry mouth
- sweating
- impotence
Serious side effects of Paxil may include:
- suicidal thoughts or actions
- serotonin syndrome
- severe allergic reactions
- bleeding
- seizures
- episodes of mania
- a decrease in sodium levels
- bone fractures
Paxil carries a boxed warning from the FDA stating that it can increase the risk of suicidal thoughts or actions.
Short-term studies have suggested that antidepressants may increase the risk of suicidal thoughts and behaviors in children, adolescents, and young adults. Studies do not show these effects in people over 24 years old.
Doctors will consider the individual benefits and risks of prescribing Paxil to anyone under 24 years old.
It is important for a person to speak with a doctor about any changes in their thoughts, feelings, and mood after starting to take antidepressants. They can change the dose or medication and help people manage their symptoms.
People should not take Paxil during pregnancy. Research suggests that infants had a
The drug can also pass into breast milk. A person should check with a doctor before taking Paxil while nursing.
Suicide prevention
If you know someone at immediate risk of self-harm, suicide, or hurting another person:
- Ask the tough question: “Are you considering suicide?”
- Listen to the person without judgment.
- Call 911 or the local emergency number, or text TALK to 741741 to communicate with a trained crisis counselor.
- Stay with the person until professional help arrives.
- Try to remove any weapons, medications, or other potentially harmful objects if it’s safe to do so.
If you or someone you know is having thoughts of suicide, a prevention hotline can help. The 988 Suicide and Crisis Lifeline is available 24 hours a day at 988. During a crisis, people who are hard of hearing can use their preferred relay service or dial 711 then 988.
Paxil
Thioridazine (Mellaril) and pimozide (Orap) are two antipsychotic medications that interact with Paxil. Paxil may inhibit how well the body breaks down thioridazine and pimozide, which may increase the levels of these two drugs in the blood.
High levels of thioridazine and pimozide may affect the heartbeat.
Other medications that may interact with Paxil include:
- other SSRIs
- anticoagulant medications, such as warfarin (Coumadin)
- tamoxifen (Nolvadex)
Withdrawal symptoms
When people stop taking Paxil, they may experience the following withdrawal symptoms:
- irritability
- dizziness
- electric shock sensations
- anxiety
- crying
- headaches
- lack of energy
- vivid dreams
- fever
- chills
- nausea
- vomiting
Doctors may prescribe Paxil for depression and other mental health conditions. The FDA does not recommend its use in people under 18 years old, but some doctors may prescribe Paxil off-label for younger people.
Paxil may not be appropriate for everyone, so it is important to speak with a doctor before taking this antidepressant. People should also talk with their doctor if they experience worsening symptoms or suicidal thoughts when taking Paxil or any antidepressant.
When coming off Paxil, it is essential to follow a tapering schedule to avoid withdrawal symptoms, such as anxiety, nausea and vomiting, and mood changes.