Paxil: How the Antidepressant Paroxetine (Seroxat) Works

Paroxetine is the generic name for a popular antidepressant medication, which is most commonly found under the brand names Paxil and Seroxat. The medication is often used to treat all types of depression as well as social anxiety disorder and panic disorder. In some cases, paroxetine is prescribed to treat obsessive-compulsive disorder and post-traumatic stress disorder.

Our guide will explain how paroxetine works, its side effects, and how to get help for yourself or a loved one with co-occurring substance use and mental health disorders.

Who Makes Paroxetine Drugs and How Are They Prescribed?


Paxil, a common brand name for paroxetine, is a medication manufactured by GlaxoSmithKline for the treatment of depression, anxiety disorders, and obsessive-compulsive disorder. Other brand names include Seroxat, Pexeva, or Brisdelle. Paroxetine as a generic drug was approved for prescription use in the US in 2003.

As a selective serotonin reuptake inhibitor (SSRI), paroxetine is one of the many medications that treats mood disorders by preventing some serotonin, a neurotransmitter associated with happiness, from being absorbed by neurons. This enhances neuron-firing.

Paroxetine can be found as a tablet, controlled-release tablet, capsule, and suspension/liquid. The capsules are typically prescribed to be taken twice per day, or every 12 hours; the other formats are usually ingested once per day. Paxil is typically found in tablet doses of 10, 20, 30, and 40 mg. The liquid suspension comes in a dose of 10 mg per 5 mL. Paxil CR is found in doses of 12.5, 25, and 37.5 mg. Pexeva comes in doses of 10, 20, 30, and 40 mg.

Depression and anxiety. People who are prescribed paroxetine to treat major depressive disorder typically receive a prescription for 20 mg once per day, and that dose can be increased over time as needed —  although it should not exceed 50 mg.

Obsessive-compulsive disorder (OCD). Those with OCD also take this medication once per day, but their initial target dose is 40 mg and should not exceed 60 mg per day. People with panic disorder receive a similar dose, while social anxiety disorder is treated more like major depression.

Panic disorder. Individuals with panic disorder should take this medication once per day, and will have similar dosages as those being treated for obsessive-compulsive disorder.

Recently, the Food and Drug Administration (FDA) approved paroxetine to treat hot flashes in menopausal women; this is the first non-hormone medication used in this type of treatment.

Withdrawal from Paroxetine

People who take paroxetine antidepressants may wish at some point to stop taking them. Even if the person takes paroxetine as prescribed, they may experience withdrawal symptoms because their body has developed a dependence on the medication to manage serotonin levels. Withdrawal symptoms include:

  • Vertigo.
  • Dizziness.
  • Confusion.
  • Anxiety.
  • Nausea.
  • Irritability or mood swings.
  • Insomnia.

With the help of a physician, a person can taper their dose of paroxetine until their body is no longer dependent on it. Attempting to stop taking the drug “cold turkey” is more likely to lead to withdrawal symptoms. About 7 percent of people who take paroxetine are likely to experience withdrawal symptoms, so it is important to work with a doctor.

Without a taper schedule, withdrawal symptoms begin between 24 and 48 hours after the final dose and continue for about one week. The majority of symptoms resolve after two or three weeks, although in some rare cases, the person can develop a protracted withdrawal syndrome.

Side Effects of Paxil

Medications containing paroxetine have a black box warning in the United States due to the potential for increased suicidal thinking among those who take this prescription. While paroxetine and its brand names have consistently been effective in treating depression in adults, paroxetine is not effective in treating depression in adolescents and children. Those under the age of 24 may experience an increase in suicidal thinking while not experiencing significant relief from their depression.

There are several side effects associated with paroxetine. These include both psychological and physical side effects.

Physical Side Effects of Paroxetine

  • Headache.
  • Dizziness.
  • Weakness, especially in muscles.
  • Sleepiness, fatigue, or feeling “drugged.”
  • Nausea and vomiting.
  • Diarrhea.
  • Constipation.
  • Stomach pain.
  • Heartburn.
  • Changes in how food tastes.
  • Dry mouth.
  • Excessive sweating.
  • Yawning.
  • Sensitivity to light.
  • Tightness in throat, or feeling a lump in the throat.
  • Pain in muscles, back, or bones.
  • Joint pain and swelling.
  • Flushing.
  • Sore teeth and gums.

Psychological Side Effects of Paxil

  • Trouble concentrating.
  • Nervousness or anxiety.
  • Forgetfulness.
  • Confusion.
  • Difficulty sleeping.
  • Nightmares or strange dreams.

Overdose from Paroxetine

When a doctor monitors an individual’s prescription, it is unlikely that the person will overdose. However, it is possible to take too much paroxetine. Overdose symptoms include:

  • Drowsiness or being unable to stay awake.
  • Uncontrollable shaking or tremors.
  • Changes in heart rate, either faster or slower.
  • Extreme confusion.
  • Nausea and vomiting.
  • Fainting.
  • Blurred vision.
  • Loss of appetite.
  • Unusual bruising or bleeding.
  • Trouble walking, as though one is drunk.
  • Fever.
  • Sweating.
  • Abnormally excited mood.
  • Difficulty urinating.
  • Muscle twitching or jerking.
  • Aggressive or violent behaviors.
  • Yellowing of the skin or eyes (jaundice).
  • Flu-like symptoms.

Paxil Drug Interactions

patient talking to their doctor

Because paroxetine is a potent prescription medication, it can interact with other drugs. One of the most serious interactions is between paroxetine and other antidepressants, including other SSRIs, SNRIs, MAO inhibitors, and tricyclic antidepressants.

Combining these medications, or taking more than the prescribed dose of paroxetine, can lead to serotonin syndrome. This condition involves too much serotonin in the brain, which can lead to agitation, anxiety, rapid and irregular heartbeat, high fever, seizures, and unconsciousness.

Other drugs that paroxetine can interact with include:

  • Blood thinners, especially warfarin.
  • Medications that treat irregular heartbeat.
  • Anti-nausea medications.
  • Anti-seizure drugs.
  • Antihistamines.
  • Aspirin.
  • Diuretic pills.
  • Codeine.
  • Drugs that treat gastrointestinal disorders.
  • Some antibiotics.
  • Atomoxetine, a medication to treat ADHD.
  • Some HIV drugs.
  • Anti-anxiety drugs,
  • Drugs used to treat other mental health issues, such as bipolar disorder or schizophrenia.
  • Anti-fungal medications.
  • Opioid pain medications.
  • Tamoxifen, which is used to treat breast cancer.

Paroxetine’s Interactions with Physical Conditions

If a person taking paroxetine is pregnant or breastfeeding, the antidepressant may affect their child. Taking paroxetine medications throughout pregnancy, especially in the last trimester, has been linked to some heart defects in newborns and to other health problems in infancy during breastfeeding. These issues are rare, but a person who is pregnant or thinking of becoming pregnant while taking paroxetine should consult their doctor about the risks.

Other conditions that may interfere with paroxetine’s effectiveness or that can be made worse by taking paroxetine include:

  • Bipolar disorder.
  • Glaucoma.
  • Seizure disorders, including epilepsy.
  • Kidney disease.
  • Liver disease.
  • People who are allergic to a variety of medications.

Get Help Overcoming Substance Abuse

When a person struggles with depression, anxiety, or another mental health condition, it is important for them to get help. This help often comes in the form of prescription medications and talk therapy. Long-term therapy is the best treatment to manage mood disorders, but in the short-term, prescription medications like paroxetine can help stabilize moods.

Mental health disorder symptoms can be worsened by continued use of substances. Conversely, not addressing underlying mental illness symptoms can exacerbate substance use problems. Because of the complex and often interconnectedness of mental health and substance use disorders, people who struggle with co-occurring substance use and mental health disorders can benefit from an integrated treatment approach that addresses mental illness and addiction simultaneously. These integrated approaches use evidence-based therapies and can include the use of certain medications and adjunct approaches such as mindfulness and meditation.

Choosing the Right Facility

Finding the right New Jersey metro area inpatient drug and alcohol rehab is an important step of the recovery process. Knowing that you will be cared for by a team of addiction treatment professionals who have the expertise and experience to help you or a loved one struggling with addiction will give you peace of mind. Things to look for when choosing addiction treatment in New Jersey include:

Paying for Addiction Treatment

Handling the cost of rehab is a big concern for many people. This is why Sunrise House Treatment Center offers a variety of options to help people access the addiction treatment they need. Contact our knowledgeable and friendly admissions navigators today at to learn more about our treatment center, what to expect in inpatient rehab, and to find out how to start treatment.

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