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Paxil (paroxetine) is a Selective Serotonin Reuptake Inhibitor (SSRI) used to treat depression, anxiety, PTSD, and numerous other mental disorders. It is a very potent medication, and as such care should be taken to use it as directed by a doctor.

Conditions Treated with Paxil

The exact mechanism by which SSRIs work is unclear, but they do provide benefit to patients struggling to control unwanted, anxious, or depressive thoughts. For most people Paxil improves and stabilizes mood while promoting mental clarity and focus. Untreated, individuals suffering from psychiatric disorders often struggle in school, at work, and in relationships with friends and loved ones.

Paxil is commonly used to treat:

  • Major depressive disorder
  • Generalized anxiety disorder
  • Social anxiety disorder
  • Panic disorder
  • Obsessive compulsive disorder
  • Post-traumatic stress disorder
  • Premenstrual dysphoric disorder

Less commonly Paxil is sees off-label use in conditions unrelated to mental disorders; treatment can vary considerably in these cases and a doctor should be consulted for a treatment plan.

Dosage & Administration

Paxil is taken via tablet. Tablets are ideally taken in the morning, but if it causes drowsiness it can be taken in the evening before bed. Tablets may be taken with or without food according to personal preference; if nausea is experienced, taking on a full stomach may help.

The medication is easy to use and treatment is similar in psychiatric applications:

  • Start with 20 mg per day for at least one week.
  • If no improvements are seen, dosage may be increased in 10 mg increments, waiting at least a week between increases.
  • The majority of patients find 40 mg per day to be effective, though some have good results with 20 mg and others require 60 mg per day.
  • Do not exceed 60 mg per day without explicit doctor instruction.

Treatment typically continues for at least several months, and it's not unusual for Paxil to be taken for years at a time. It takes about a month of treatment for full benefit to be felt, though some improvements are usually noticeable after a week or two of taking it. As with any medication, some individuals simply don't respond to treatment; if no significant improvements are seen after a month of taking Paxil, alternative options should be considered.

It's important to note that treatment with Paxil should not end abruptly if it has been taken for more than a few weeks. Ending treatment suddenly can produce severe side effects; they're unlikely to be dangerous but can be very disruptive to daily life. Treatment should be gradually tapered down over the course of several weeks. A doctor can help with a discontinuation plan.

Precautions & Side Effects

Side effects from Paxil are relatively common, but are often transient (stop occurring as the body adjusts to treatment) and are not cause for concern unless severe or persistent:
  • Drowsiness
  • Dry mouth
  • Nausea
  • Weakness
  • Sweating
  • Difficulty sleeping
  • Appetite changes

Rarely Paxil may cause trembling, seizures, severe restlessness, and rapid or irregular heartbeat; these side effects warrant immediate medical attention.

Unfortunately some sexual side effects are relatively common with SSRI use, including loss of libido, vaginal dryness, erectile dysfunction, and delayed ejaculation. There are many products that can alleviate most of these symptoms---such as Viagra or Cialis---but there are no widely-recognized treatments for lost libido. Fortunately sexual side effects nearly always reverse when SSRI treatment stops.

This medication can interact with a range of other drugs. MAOI inhibitors---often prescribed for similar conditions---are of particular concern. Check with a doctor or pharmacist before mixing other medications with paroxetine.

This medication can cause harm to babies if taken while pregnant, particularly during the third trimester. However, as mentioned above, suddenly stopping treatment can also cause problems. If you discover you are pregnant while taking Paxil, speak with a doctor about the best course of action.


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Medicines have benefits and some have risks. Always read the label and use only as directed. If symptoms persist or you have side effects see your health professional.

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