Paroxetine

Introduction

Written by Patricia Weiser, PharmD
Medically reviewed by Alex Brewer, PharmD, MBA
Updated on July 28, 2023

Paroxetine (pa ROKS e teen) is a generic medication prescribed for moderate or severe menopause symptoms and certain mental health conditions. Paroxetine belongs to a group of drugs called selective serotonin reuptake inhibitors (SSRIs).

The Food and Drug Administration (FDA) has approved paroxetine to treat the following conditions in adults:

• major depressive disorder (commonly called depression)
• panic disorder
• social anxiety disorder
• premenstrual dysphoric disorder
• obsessive-compulsive disorder
• generalized anxiety disorder
• post-traumatic stress disorder
• vasomotor symptoms of menopause

These approved uses differ based on the form of paroxetine your doctor prescribes.

This article doesn’t provide coupons for all forms of paroxetine. To find coupons for paroxetine extended-release oral tablet, see this article.

Boxed warning: Risk of suicidal thoughts and behaviors

Paroxetine has a boxed warning about the risk of suicidal thoughts and behaviors in certain people. Boxed warnings are the most serious warnings from the Food and Drug Administration (FDA).

For details, see the “Interactions and warnings for paroxetine” section.

Side effects of paroxetine

Paroxetine may cause mild or serious side effects. More common mild side effects of paroxetine and its serious side effects are listed below. This article doesn’t include all possible side effects of the drug. Side effects can vary based on your age, overall health, and any other medications you take.

To learn more about paroxetine’s side effects, ask your doctor or pharmacist. You can also refer to the prescribing information for paroxetine listed in the “Resources” section.

Mild side effects

More common mild side effects reported with some forms of paroxetine are listed below. These side effects may differ based on the form of paroxetine you take.

This article doesn’t include all possible mild side effects of the drug. To learn more about paroxetine’s side effects based on the form, refer to the prescribing information for paroxetine listed in the “Resources” section.

With many drugs, mild side effects may go away within a few days or a couple of weeks. If the side effects are bothersome, tell your doctor or pharmacist. They may be able to suggest ways to manage them.

Paroxetine oral tablet’s mild side effects include:

• weakness
• nausea
• diarrhea
• dry mouth
• mild allergic reaction*

Paroxetine oral capsule’s mild side effects include:

• headache
• fatigue
• nausea
• vomiting
• mild allergic reaction*

* For details about this side effect, see the “Interactions and warnings for paroxetine” section.

Serious side effects

Serious side effects of paroxetine are listed below. These side effects may differ based on the form of paroxetine you take.

This article doesn’t include all possible serious side effects of the drug. To learn more about paroxetine’s side effects based on the form, refer to the prescribing information for paroxetine listed in the “Resources” section.

With many drugs, serious side effects are possible but not common. If you have serious side effects from this drug, call your doctor right away. If you’re having severe symptoms or a medical emergency, call 911 or a local emergency number.

In general, paroxetine’s serious side effects include:

• bone fracture
• discontinuation syndrome (symptoms that may occur if you suddenly stop taking paroxetine)
• increased risk of bleeding
• low sodium levels in the blood
• seizures
• serotonin syndrome (too much serotonin in the body)
• sexual side effects, including inability to orgasm and decreased libido (sex drive)
• boxed warning: risk of suicidal thoughts and behaviors*
• severe allergic reaction*

* For details about this side effect, see the “Interactions and warnings for paroxetine” section.

If you or someone you know is in crisis and considering suicide or self-harm, please seek support:

• Call the 988 Suicide and Crisis Lifeline at 988.
• Text HOME to the Crisis Textline at 741741.
• Not in the United States? Find a helpline in your country with Befrienders Worldwide.
• Call 911 or your local emergency services number if you feel safe to do so.

If you’re calling on behalf of someone else, stay with them until help arrives. You may remove weapons or substances that can cause harm if you can do so safely.

If you are not in the same household, stay on the phone with them until help arrives.

Common questions about paroxetine

Below you’ll find answers to a few commonly asked questions about paroxetine.

What brand names are available for paroxetine?

There are a few different brand-name versions of paroxetine, including Paxil, Paxil CR, and Brisdelle.

Paxil comes as an oral tablet and an oral liquid suspension. Paxil CR comes as an extended-release oral capsule. (Extended release is when a drug slowly releases into your body over time.) Brisdelle comes as an oral capsule. All of these drugs contain the same active ingredient called paroxetine.

A generic medication is an identical copy of the active drug in a brand-name medication. (An active drug is the ingredient that makes a medication work.) Generic drugs are believed to be as effective and safe as brand-name drugs. And generic drugs typically cost less than brand-name drugs.

If you have questions about other brand-name drugs for paroxetine, talk with your doctor or pharmacist.

Can paroxetine cause withdrawal?

Possibly. If you suddenly stop taking paroxetine, you may experience withdrawal symptoms such as nausea, sweating, irritability, and dizziness. (Withdrawal refers to symptoms that can occur when you stop taking a drug your body is dependent on.) Suddenly stopping paroxetine may cause discontinuation syndrome, a serious side effect of antidepressant drugs, including paroxetine.

If you need to stop taking paroxetine, your doctor will typically have you slowly decrease the amount you take over time. This can help prevent these withdrawal symptoms from occurring. You should not stop taking paroxetine before consulting with your doctor.

If you have questions about withdrawal with paroxetine, talk with your doctor or pharmacist.

Is paroxetine similar to Xanax?

No. Paroxetine is a type of antidepressant medication. Xanax isn’t an antidepressant. Instead, it’s a benzodiazepine.

Paroxetine and Xanax have some similar uses but have key differences as well. For example, paroxetine is a daily medication typically taken long term to treat generalized anxiety disorder. In comparison, Xanax is only meant for short-term treatment of anxiety, usually on an “as needed” basis.

To learn more about paroxetine and Xanax, talk with your doctor or pharmacist.

How does paroxetine work? And how long does it take to start working?

How paroxetine treats certain mental health conditions and symptoms of menopause is not entirely clear. It’s thought to work by balancing the amount of serotonin, an important chemical messenger, in the brain.

Paroxetine does not start working right away. It usually starts working within 2–4 weeks of starting treatment. But it may take up to 6 weeks to reach its full effect.

If you’d like to learn more about how paroxetine works, talk with your doctor or pharmacist.

Uses of paroxetine

The Food and Drug Administration (FDA) approves prescription drugs such as paroxetine for certain conditions. Approved uses for paroxetine are described below. These uses differ based on the form of paroxetine prescribed.

Use for certain mental health conditions

Doctors may prescribe paroxetine oral tablet, extended-release tablet, or oral liquid suspension for treating certain mental health conditions. It’s used for these purposes in adults. It’s usually prescribed as a long-term treatment.

Specifically, paroxetine oral suspension and oral tablet are prescribed to treat the following conditions:

• major depressive disorder (commonly called depression)
• panic disorder
• social anxiety disorder
• obsessive-compulsive disorder (OCD)
• generalized anxiety disorder
• post-traumatic stress disorder (PTSD)

Paroxetine extended-release tablet is prescribed to treat the following conditions:

• major depressive disorder 
• panic disorder
• social anxiety disorder
• premenstrual dysphoric disorder (PMDD)

Depression

With depression, you may experience sadness that affects your daily life. Symptoms that last longer than 2 weeks can include:

• feeling sad or anxious
• problems with sleeping, such as insomnia (trouble sleeping) or oversleeping
• decreased energy or fatigue
• loss of interest in hobbies or activities you enjoyed in the past

Panic disorder

With panic disorder, you may experience repeated panic attacks. When you’re not having a panic attack, you may often worry about when the next attack might occur. Symptoms of panic attacks can include:

• increased heart rate
• trouble breathing
• dizziness
• sweating
• nausea

Social anxiety disorder

With social anxiety disorder, you may have symptoms of anxiety due to social interactions you find challenging. One example is meeting new people. Symptoms can include:

• unreasonable fear or panic
• dizziness
• nausea
• trouble breathing
• increased heart rate

PMDD

With PMDD, you may experience changes in mood. These changes tend to occur in the 2 weeks before your period. Symptoms of PMDD can include:

• depression
• panic attacks
• insomnia
• sudden shifts in mood
• anger or irritability

OCD

With OCD, you may have a need for extreme order and tidiness. Other symptoms can include:

• extreme dedication to work despite other relationships being affected
• perfectionism that hinders the ability to finish tasks

Generalized anxiety disorder

With generalized anxiety disorder, you may experience unreasonable, excessive worrying. Other symptoms can include:

• difficulty concentrating
• restless or nervous behavior
• feelings of panic, fear, or doom

PTSD

With PTSD, you may experience mental effects after a traumatic experience. Possible symptoms can include:

• re-experiencing memories
• avoiding people or events
• change in mood
• negative thoughts
• depression

Use for symptoms related to menopause

Doctors may prescribe paroxetine oral capsule for helping prevent certain symptoms of menopause in adults. It’s usually prescribed as a long-term treatment.

During menopause, a person may experience certain symptoms. Examples include:

• hot flashes
• night sweats
• flushing

Doctors may not prescribe paroxetine oral capsule in certain situations, such as treating mental health conditions.

Interactions and warnings for paroxetine

Below, you’ll find information about paroxetine’s possible interactions and warnings.

Interactions of paroxetine

Certain things may affect how a drug works. These include getting vaccines, consuming alcohol or certain foods, or taking the drug with other medications. This effect is called a drug interaction.

Before you take paroxetine, ask your doctor to check for possible interactions. Be sure to tell them about any of the following you take or use:

• prescription or over-the-counter drugs
• vitamins, herbs, or supplements

To learn about drug-condition interactions, see the “Warnings for paroxetine” section below.

Warnings for paroxetine

Some people should not take paroxetine, and others should take it cautiously.

Boxed warning: Risk of suicidal thoughts and behaviors

Paroxetine has a boxed warning about the risk of suicidal thoughts and behaviors in certain people. Boxed warnings are the most serious warnings from the Food and Drug Administration (FDA).

As with other antidepressants, taking paroxetine can increase the risk of suicidal thoughts and behaviors in children and young adults. This risk applies to anyone 24 years and younger. In studies of paroxetine extended-release oral tablet, oral tablet, oral capsule, and oral suspension, this risk was highest during the first few weeks of treatment or after dose increases. Paroxetine is not approved for use in people under age 18 years.

Symptoms that may be a sign of suicidal thoughts and behaviors can include frequent changes in mood or worsening mood, depression, unusual thoughts, or changes in behavior. Talk with your doctor immediately if you experience any of these symptoms.

To learn more, talk with your doctor or pharmacist.

Other warnings

Paroxetine could cause harm to people with certain health conditions. This effect is called a drug-condition interaction. Other factors can also affect whether paroxetine is a safe option for you. These warnings may differ based on the form of paroxetine you take.

Ask your doctor about specific warnings for paroxetine, and be sure to tell your doctor about your:

• current health, including any allergies to medications
• past health conditions or surgeries

Allergic reaction

Paroxetine can cause an allergic reaction in some people. Severe allergic reactions are rare but possible.

If you’ve had an allergic reaction to paroxetine or any of its ingredients, your doctor will likely not prescribe paroxetine. They can tell you about medications that are safer options for you.

A mild allergic reaction may cause the following symptoms:

• skin rash
• itchiness
• flushing (temporary warmth, redness, or deepening of skin color)

A severe allergic reaction may cause the following symptoms:

• swelling under your skin, usually in your hands, feet, eyelids, or lips
• swelling of your mouth, throat, or tongue, which can cause breathing problems

If you have an allergic reaction to paroxetine, call your doctor right away. If you have severe symptoms, call 911 or a local emergency number.

Overdose of paroxetine

If you take paroxetine by mouth, you should not take more paroxetine than your doctor prescribes. For some drugs, doing so may lead to harmful effects or overdose.

If you think you’ve taken too much paroxetine, call your doctor or pharmacist right away. Or you could call 800-222-1222 to speak with someone at America’s Poison Centers. You can also use its online resource. If you have concerning symptoms, call 911 or a local emergency number immediately. You can also go to the closest emergency room.

Pregnancy or breastfeeding and paroxetine

Information about paroxetine and pregnancy and breastfeeding is described below.

Paroxetine and pregnancy

Paroxetine should not be taken during pregnancy. If you’re planning a pregnancy or can become pregnant, talk with your doctor before taking this medication. Your doctor may suggest birth control options to use during treatment with paroxetine.

Paroxetine and breastfeeding

Paroxetine should not be taken while breastfeeding. If you’re currently breastfeeding or planning to do so, talk with your doctor before taking this medication. Your doctor may recommend other ways to feed your child during treatment with paroxetine or recommend a different medication.

What to ask your doctor

Let your doctor know if you have questions about paroxetine or would like more details about it.

Here’s a list of some possible questions you may want to ask your doctor:

• Does paroxetine work better than other treatment options available for my condition?
• What should I do if paroxetine isn’t helping to ease my symptoms?
• What can I do, in addition to taking paroxetine, to help manage my condition?

Resources

• Food and Drug Administration. (2023). Orange Book: Approved drug products with therapeutic equivalence evaluations. https://www.accessdata.fda.gov/scripts/cder/ob/index.cfm
• Paroxetine capsule. (2022). https://nctr-crs.fda.gov/fdalabel/services/spl/set-ids/1383d713-79b9-45bd-bd06-65707f28bc99/spl-doc
• Paroxetine hydrochloride tablet, film coated, extended-release. (2022). https://nctr-crs.fda.gov/fdalabel/services/spl/set-ids/e14c6c14-1cf5-43c3-8f07-cf50b98d12e0/spl-doc.
• Paroxetine suspension. (2022). https://nctr-crs.fda.gov/fdalabel/services/spl/set-ids/134e76f0-45cf-47eb-b6e1-cdb3bb522a0a/spl-doc
• Paroxetine tablet, film coated. (2023). https://nctr-crs.fda.gov/fdalabel/services/spl/set-ids/69699d40-4a64-4337-8664-e4e093437fbf/spl-doc
• Xanax (alprazolam) tablets, for oral use. (2021). https://www.accessdata.fda.gov/drugsatfda_docs/label/2021/018276s055lbl.pdf

Disclaimer: Optum Perks has made every effort to make certain that all information is factually correct, comprehensive, and up to date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or another healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.