What You Need to Know About Paxil for Anxiety

By Arielle Mitton
Medically reviewed checkmarkMedically reviewed
March 9, 2022

Paxil is a brand name for an antidepressant called paroxetine hydrochloride, a medication used to treat anxiety disorders and conditions like depression, obsessive-compulsive disorder (OCD), and post-traumatic stress disorder (PTSD). 

If you’ve been diagnosed with an anxiety disorder or any of the conditions mentioned above, your doctor may recommend Paxil.

In this article, I’ll tell you more about Paxil, how it works, and what it’s used for.

I’ll talk about its use for generalized anxiety disorder, or GAD.

I’ll explain how Paxil is taken, outline some of its side effects, and list some possible risks associated with the medication.

I’ll also tell you about a few alternatives to Paxil that are available.

What is Paxil? 

Paxil is a type of medication called a selective serotonin reuptake inhibitor, or SSRI.

SSRIs work by increasing the amount of a chemical called serotonin that’s available to your brain.

By doing so, Paxil helps to improve mood and reduces symptoms of depression, anxiety, and other mental health conditions. 

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Your doctor may prescribe Paxil to you for any of these conditions

How Paxil Works

Serotonin is a type of chemical in the body called a neurotransmitter.

Neurotransmitters carry messages for our nervous systems between the brain and body.

When serotonin is present in the brain, it can have positive effects on our mood, sleep patterns, and pain perception.

Under normal circumstances, when serotonin has finished relaying its message, it is recycled by the brain, a process called “reuptake.”

SSRIs like Paxil increase the amount of serotonin in the brain by preventing, or inhibiting, the neurons from reabsorbing serotonin that’s already been released.

Experts think that an imbalance of serotonin may lead to mood disorders like anxiety and depression.

By interrupting the reuptake process, SSRIs increase the amount of serotonin available to your brain.

It usually takes four to six weeks for Paxil to start having positive effects.

Paxil for Generalized Anxiety Disorder 

Generalized anxiety disorder (GAD) is characterized by excessive worry and fear that is persistent for over six months.

People with GAD feel a lot of fear over everyday life situations, and the fear is usually out of proportion with the situation. 

If you have generalized anxiety disorder, you may feel restless, always on edge, easily fatigued, have difficulty concentrating, sleep disturbances, irritability, and muscle tension. 

Studies have shown that Paxil effectively treats general anxiety disorder in adults.

However, studies have not yet demonstrated Paxil’s usefulness in children or adolescents with generalized anxiety disorder.

Although it is effective for treating anxiety, studies show that patients on paroxetine are more likely to experience more adverse effects than those on other medications like escitalopram (Lexapro).

How to Take Paxil

Paxil comes as a tablet, capsule, liquid, and a controlled-release tablet.

It is usually taken once daily, either in the morning or at night—talk to your doctor about which timing is right for you. While it can be taken with or without food, it’s best to take it with food to avoid stomach upset. 

Regular and extended-release Paxil tablets should not be chewed or crushed—they should be swallowed whole.

If you’re taking the Paxil liquid, shake the bottle well before use to ensure the medication mixes evenly. 

Your doctor may start you on a small dose of Paxil and eventually increase your dose.

Don’t increase your dose on your own, even if you don’t see results yet.

Paxil takes several weeks to show benefits.

Never increase or decrease your dose on your own—or suddenly stop taking Paxil—without consulting your doctor. 

Take Paxil exactly as your doctor prescribes and ask questions where you’re unclear.

If you miss a dose of Paxil, take it as soon as you remember.

But if it’s a couple of hours to the next dose, skip the missed dose.

Never take 2 doses at the same time to make up for a forgotten one.

Talk to your doctor before stopping the medication, even if you feel better.

If you stop taking Paxil suddenly, you may experience serious withdrawal symptoms like:  

If you want to stop taking Paxil, your doctor will gradually reduce your dose until it’s safe to stop taking it to avoid these symptoms.

Potential Side Effects 

Paxil has several known side effects, including: 

These side effects are relatively common, with 1 in 100 people experiencing them.

The side effects usually improve over time as your body adjusts to the medication.

If you still feel them after a week or two, talk to your doctor. 

Here’s how you can cope with some of these side effects: 

  • Nausea: Take Paxil with food, or after food. Try to avoid overly spicy food and stick with simple meals. 
  • Diarrhea: Drink plenty of water to avoid getting dehydrated. Don’t take any drugs for diarrhea without speaking to your doctor first. 
  • Weakness: Get some rest if you feel weak while taking Paxil. Do not handle machinery or drive. 
  • Trouble sleeping: Take Paxil first thing in the morning instead of at night.

Drug Interactions

Tell your doctor about all the medications you’re taking or plan to take, including vitamins, supplements, over-the-counter medications, herbal remedies, and illicit drugs.

Paxil interacts with some medications when they’re taken together or within days of each other.

Paxil can also interact with some over-the-counter medications. 

Do not use Paxil with other antidepressants or other medications containing paroxetine.

Taking more than one medication containing paroxetine can lead to a dangerous overdose. 

Taking Paxil with monoamine oxidase inhibitors (MAOIs) or other antidepressants can lead to serotonin syndrome, a potentially life-threatening condition where your body has too much serotonin.

Symptoms of serotonin syndrome include: 

  • Confusion
  • Stiff muscles 
  • High fever
  • Uncontrolled muscle spasms 
  • Irregular heartbeat
  • Loss of consciousness 

Also, avoid taking Paxil if you stopped taking an MAOI less than two weeks ago.

Taking Paxil and an MAOI within two weeks of each other may lead to dangerous drug interactions. 

Paxil also interacts with: 

  • Thioridazine
  • Linezolid
  • Pimozide
  • NSAIDs
  • Tramadol
  • Fentanyl
  • Cimetidine
  • Theophylline 
  • Amphetamines
  • Risperidone
  • Quinidine 
  • Antiarrhythmics 
  • St. John’s wort
  • Intravenous methylene blue 

Risks & Warnings 

Aggression, panic attacks, and abnormal levels of excitement are all potential side effects of Paxil.

One in 1000 people experience new feelings of depression or worsened depression while on Paxil.

It can sometimes make anxiety feel worse rather than better, and can potentially cause suicidal thoughts or a desire to self-harm

Let your family or people around you know of this potential risk so that they can help look for concerning signs.

If you’re having a mental health emergency, call 911 or go to the nearest emergency room. You can also get free 24/7 support from a suicide and crisis expert by calling or texting 988. If you’d prefer to chat online, you can chat with a suicide and crisis expert by visiting the Lifeline Chat.

People who are pregnant, breastfeeding, or plan to become pregnant shouldn’t take Paxil, as it may cause severe congenital disabilities in children.

Talk to your doctor if you become pregnant while on Paxil. 

Other less common risks of Paxil include: 

  • Angle-closure glaucoma, a change in vision
  • Increased risk of bleeding 
  • Seizures
  • Bone fracture
  • Mania/hypomania
  • Hypersensitivity reactions to paroxetine

Are There Alternatives to Paxil? 

There are alternative medications to Paxil, and your doctor may prescribe them if you aren’t responding well to Paxil or if they believe you’d be better off taking something else.  

Some common alternatives to Paxil include other SSRI medications: 

These medications all have their own side effects, precautions, and warnings. 

Feeling down? Take our free assessment and learn about your options.

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How K Health Can Help 

Think you might need a prescription for Paxil (paroxetine)?

K Health has clinicians standing by 24/7 to evaluate your symptoms and determine if paroxetine is right for you.

Get started with our free assessment, which will tell you in minutes if treatment could be a good fit. If yes, we’ll connect you right to a clinician who can prescribe medication and have it shipped right to your door.

Frequently Asked Questions

How long does it take Paxil to work for anxiety?
It takes four to six weeks for Paxil to work for anxiety.
Is Paxil a good medication for anxiety?
Yes, but you should only take it with a prescription.

K Health articles are all written and reviewed by MDs, PhDs, NPs, or PharmDs and are for informational purposes only. This information does not constitute and should not be relied on for professional medical advice. Always talk to your doctor about the risks and benefits of any treatment.

Arielle Mitton

Dr. Mitton is a board certified internal medicine physician with over 6 years of experience in urgent care and additional training in geriatric medicine. She completed her trainings at Mount Sinai Hospital and UCLA. She is on the board of the Hyperemesis Research Foundation to help women suffering from hyperemesis gravidarum.

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