Paxil Review: Pros, Cons & Health Risks

Paxil Review: Pros, Cons & Health Risks

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Disclaimer: None of the information in this article constitutes medical advice, and is just the opinion of the writer(s). We recommend that patients follow their doctor’s guidance in regard to prescription medication.

Paxil is a prescription medication that’s FDA-approved for the treatment of depression along with some other mental conditions like anxiety and panic disorder. It’s one of the oldest prescription antidepressants, having been initially approved in 1992.

The generic version of the drug is called paroxetine, and we’ll use these terms interchangeably throughout this review as they refer to the same active drug ingredient.

But is Paxil proven to be effective for relieving depression? Does it cause any side effects? Is the generic version as effective as the brand-name version? And how do real users rate and describe the effects of Paxil?

In this article we’ll answer all of these questions and more as we review clinical studies on Paxil to determine if it’s effective and what its side effects are. We’ll also explain if the generic version is as effective and share Paxil patient reviews.

Does Paxil Eliminate Depression?

Paxil has been studied in many clinical trials for its effects on depression.

A 2014 medical review compared the efficacy of Paxil and other antidepressant drugs. The study authors concluded that Paxil is the most potent inhibitor of serotonin reuptake, meaning it’s theoretically more powerful than other SSRI drugs.

A meta-study published in the Canadian Medical Association Journal examined data on the effectiveness of Paxil in depressed patients. The researchers analyzed data from over 3,000 patients and reported that Paxil did reduce depression scores compared to placebo pills, but only to a “modest” degree.

A clinical trial on Paxil, published in The Journal of Clinical Psychiatry, tested how much it could reduce depression in patients with major depression. Over 40% of those taking Paxil experienced a “full clinical response,” meaning their depression was effectively eliminated.

We can conclude from the available research that Paxil is effective for treating depression. But does it cause side effects? We’ll answer in the next section.

Does Paxil Cause Side Effects?

Paxil black box warning

Paxil does cause side effects in some patients. The “black box” warning shown above is required by the FDA when a medication has a risk of severe and life-threatening side effects.

In the case of Paxil, the risk that prompts the warning is suicide risk. According to the drug’s label, pediatric and young adult patients are at increased risk of suicidal thoughts and behaviors when taking Paxil.

The more common side effects of Paxil are milder. A medical review on the drug’s side effects reported that gastrointestinal disturbances and nausea are the most common. The review notes that in most patients, the drug is “very well tolerated.”

A review published in the Psychopharmacology Bulletin described Paxil as having “serious side and adverse drug effects” including birth defects, heart abnormalities and some types of cancer.

We recommend that patients speak to their doctor about the risk of these side effects, and young adult patients may wish to speak to their doctor about alternative medications that aren’t associated with increased suicide risk in their demographic.

Real People Try Paxil

A YouTube creator named “717StreetMedia” claims that Paxil improved his life significantly:

A YouTube creator named “BeyondBipolarBlog” claims to have experienced side effects from Paxil:

Can Paxil Treat Anxiety?

Paxil is FDA-approved and indicated for the treatment of generalized anxiety disorder (GAD), social anxiety disorder (SAD) and panic disorder. It’s also been studied for the treatment of all three conditions in clinical trials.

A clinical trial published in The Journal of Clinical Psychiatry found that Paxil significantly reduced anxiety.

A 2000 clinical trial found that Paxil reduced social anxiety scores by around 30% after 12 weeks of treatment.

A medical review on Paxil for the treatment of panic disorder found the drug to be effective, and states that the drug is recommended by the American Psychiatric Association for the treatment of panic.

Based on the available research we conclude that Paxil is effective for treating various types of anxiety. This data suggests that Paxil may be a good option for patients with both depression and anxiety.

Is Generic Paxil As Effective?

As referenced in the intro to this article, the generic version of Paxil is called paroxetine. These medications contain the exact same active ingredient.

We generally recommend that patients speak with their doctor about the generic version of drugs, because they should be equally effective but are often significantly cheaper (especially for those without health insurance).

A 2019 medical review analyzed data from over 3 million patients to compare the safety and efficacy of brand-name versus generic drugs. Generic drugs were found to be equivalent, which suggests that generic paroxetine should be equally effective and safe as Paxil.

Paroxetine costs only $4.50 for 30 pills on Cost Plus Drugs (link), while the average retail price for Paxil is currently $24.56 according to GoodRx.

Does Paxil Cause Withdrawals?

Paxil can cause withdrawals in some patients.

A review published in the Pharmacotherapy journal documents serious adverse effects experienced by three patients who abruptly discontinued use of Paxil. All three patients reported serious sleep disturbances and dizziness.

Paxil’s FDA label reports the following withdrawal symptoms: sadness, irritability, anger, dizziness, sensory disturbances, headache, anxiety, confusion, tiredness and more.

The risk of withdrawals is why it’s so important for patients to work with their doctor if they choose to stop taking Paxil. A doctor can set up a research-backed tapering schedule that gradually reduces intake of the drug, which reduces the risk of side effects and withdrawal symptoms.

Real Patients Review Paxil

Paxil has been reviewed over 900 times on, which is a website that allows patients to publish ratings and share personal reviews of medications they’re taking.

The drug has a score of 6.4 out of 10 for depression, 7.2 out of 10 for anxiety and 7.7 out of 10 for social anxiety.

The top positive review of Paxil for depression is written by a user named “Tyres” who claims the drug relieved many of their symptoms:

"This medication has been very potent to improve my anxiety/depression disorders. No more suicidal thoughts, fear, mood swings, shaking, sweating, anxiety(SAD & GAD), and the list goes on. If you're suffering from severe anxiety and depression, then take the Paxil. I am taking 40mg max dose with no side effects.”

The top negative review of Paxil for depression comes from a user named “Skye” who gives the drug a 1/10 rating and claims it caused side effects and withdrawal symptoms:

“I took it for about 2.5 months and had chronic diarrhea the whole time which only seemed to get worse as time went on. And of course the usual sexual side effects that come with SSRIs…I've never had a problem coming off of any type of medication in my life but this is HORRIBLE. Brain zaps, nightmares, highly increase depression and crying spells. This stuff is freaking poison to my body. I would never recommend this to anyone."

What Should I Avoid While On Paxil?

A YouTube creator named “JJ Medicine” who’s a medical resident has a video on foods and drugs to avoid while taking Paxil (and other SSRIs) due to potential negative interactions. It’s an informative video with over 800,000 views:

Does Paxil Cause Weight Gain?

Patients are often curious about whether Paxil causes weight gain, given that many SSRI meds have this side effect.

A medical review on weight gain and antidepressants reported that Paxil was more likely than other SSRI drugs to cause weight gain. 

Paxil was not shown to cause weight gain when taken at a low dose of 7.5 milligrams (mg), according to a clinical trial published in the Menopause journal. Participants in this trial took the drug for up to 24 weeks.

It appears based on the medical research that Paxil at a low dose does not cause weight gain, but Paxil at a moderate-to-high dose may cause weight gain. In light of this research, we would recommend that overweight and obese individuals speak with their doctor about whether their Paxil dose is likely to cause weight gain.

What Dosage is Paxil Prescribed At?

Paxil is prescribed at a variety of doses according to the severity of the patient’s symptoms, according to a medical review published by StatPearls.

For major depression, adults typically start at 20 mg and may increase dose by 10 mg up to a maximum of 50 mg daily.

Elderly patients have a maximum dose of 40 mg daily.

For anxiety, adults typically start at 20 mg daily and increase to a max of 60 mg daily.

Patients taking Paxil for panic disorder typically start at 10 mg daily and increase to a max of 60 mg daily.

Doctors will typically prescribe a patient Paxil at the lowest dose of the effective range to start, because this can reduce the risk of side effects. If the patient experiences benefits at the lowest dose, they may stay at that dose. If they fail to experience benefit, their doctor may slowly increase their dose.

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Paxil is proven in research studies to effectively treat depression, anxiety, social anxiety and panic disorder.

The medication may increase risk of suicide in children and young adults, so for individuals in these groups it may make sense to consider other options. Paxil can also cause milder side effects like dizziness and nausea in adults.

Paxil can cause withdrawals if stopped abruptly, so it’s important that patients considering quitting Paxil speak with their doctor first to set up a tapering schedule.

For patients considering Paxil, we would recommend speaking with your doctor about the generic paroxetine instead, since it should be equally effective but may be much cheaper.