Table of ContentsView AllTable of ContentsHow It WorksPaxil and GADSide EffectsTaking It Safely
Table of ContentsView All
View All
Table of Contents
How It Works
Paxil and GAD
Side Effects
Taking It Safely
Close
Paxil (paroxetine) is a medication used in the treatment ofgeneralized anxiety disorder(GAD). It belongs to a group of antidepressants known as selective serotonin reuptake inhibitors (SSRIs). SSRIs are first-line drugs used for treating anxiety disorders, along with serotonin-norepinephrine reuptake inhibitors (SNRIs).
In addition to GAD, Paxil is also FDA-approved to treatdepression,social anxiety disorder(SAD),panic disorder(PD),post-traumatic stress disorder(PTSD),obsessive-compulsive disorder(OCD),premenstrual dysphoric disorder(PMDD), and menopause-related hot flashes.
How Paxil Works
Even though SSRIs like Paxil have been widely used since the late 1990s, scientists still don’t know precisely how they work. At first, they thought that simply increasingserotoninlevels reduced symptoms associated with anxiety.
What Is Serotonin?Serotonin is aneurotransmitter, meaning that the brain and nervous system use it to communicate. This naturally occurring chemical plays a role in various processes, including mood regulation and memory function. Low levels of serotonin are associated with depression and anxiety.
What Is Serotonin?
Serotonin is aneurotransmitter, meaning that the brain and nervous system use it to communicate. This naturally occurring chemical plays a role in various processes, including mood regulation and memory function. Low levels of serotonin are associated with depression and anxiety.
But SSRIs correct serotonin imbalances within 24 hours. So, if the increased level of serotonin was solely responsible for anxiety, symptoms would disappear as soon as you took the medication.
Researchers have since learned that higher levels of serotonin boost the brain’s ability to rewire and remodel itself in ways that reduce anxiety symptoms. This restructuring takes time. That’s why it usually takes four to six weeks for the full benefit of the drug to kick in.
SSRIs such as Paxil are typically the first medications tried for treating GAD. If Paxil doesn’t provide relief, another SSRI may be tried. If that doesn’t work, the next step is an SNRI. If the GAD is not responsive to that, atricyclic antidepressantor antipsychotic medication may be prescribed.
In contrast tobenzodiazepines, antidepressants such as Paxil mainly affect the psychic (psychological distress) symptoms of anxiety—including worry, fear, irritability, and concentration difficulties. Research shows that Paxil is effective for reducing anxiety in people with GAD, regardless of gender and race.
Several studies further suggest that using GAD medications such as Paxil for at least six months after remission can help reduce symptom relapse.Engaging in psychotherapy can also help.Cognitive behavioral therapy(CBT) is one option found to not just reduce GAD symptoms, but it can also improve quality of life.
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Side Effects of Paxil
When compared with other SSRIs, paroxetine tends to have a higher incidence of adverse effects.If you are taking Paxil and have bothersome side effects, talk with your healthcare provider. The dosage may need to be adjusted or you might need to switch to a different medication.
Common side effects when taking Paxil include:
Rare side effects of Paxil include bleeding, teeth grinding, and low blood sodium levels. Serious side effects are seizure andserotonin syndrome, which happens when there is too much serotonin in the body and can lead to death. If any of these are experienced, medical attention is required.
Paxil Black Box Warning
Paxil does have an FDA black box warning indicating that children and young adults may have an increased risk of suicidal thoughts and behaviors when taking antidepressant drugs. This drug is not approved for pediatric patients, but if a young adult appears to have worsening depression symptoms, it is important to seek help immediately.
If you or someone you love is having suicidal thoughts, contact theNational Suicide Prevention Lifelineat988for support and assistance from a trained counselor. If you or a loved one are in immediate danger, call 911.For more mental health resources, see ourNational Helpline Database.
If you or someone you love is having suicidal thoughts, contact theNational Suicide Prevention Lifelineat988for support and assistance from a trained counselor. If you or a loved one are in immediate danger, call 911.
For more mental health resources, see ourNational Helpline Database.
Taking Paxil Safely
As with any medication you take, care should be taken to ensure that you use Paxil safely. If you have any questions or concerns about whether this GAD medicine is safe for you, talk with your healthcare provider or pharmacist.
Dosing Information
Your healthcare provider will probably start you on a low dose of Paxil at first, with the recommended starting dose being 20 milligrams (mg) per day. If this doesn’t provide symptom relief, the dosage may be increased in 10 mg increments with a maximum dosage of 50 mg daily.
You can take Paxil with or without food, at any time of the day. If you miss a dose, take it when you remember—unless it’s close to the time to take it again. You don’t want to double your dose.
Precautions
Paxil is generally considered safe and effective when taken as directed, even with long-term use.However, it should not be taken within 14 days of taking amonoamine oxidase inhibitor(MAOI).
Avoid alcohol and drugs while taking Paxil, as they may decrease its benefits. If you are taking other prescription drugs, check with your healthcare provider or pharmacist about potential interactions with these medications.
A Word From Verywell
If you have been prescribed Paxil for generalized anxiety disorder, it’s important to follow the drug’s instructions. It can take some time to figure out the bestGAD treatmentfor you. So, be patient and keep your healthcare provider informed about what is and isn’t working for you.
Additionally, be sure to communicate any issues that arise (such as side effects). This enables your healthcare provider to deal with these effects swiftly, potentially changing your dosage amount or switching you to a different medication.
11 SourcesVerywell Mind uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Bandelow B, Michaelis S, Wedekind D.Treatment of anxiety disorders.Dialogues Clin Neurosci. 2017;19(2):93-107. doi:10.31887/DCNS.2017.19.2/bbandelowStrawn JR, Geracioti L, Rajdev N, Clemenza K, Levine A.Pharmacotherapy for generalized anxiety disorder in adults and pediatric patients: An evidence-based treatment review.Expert Opin Pharmacother. 2018;19(10):1057-1070. doi:10.1080/14656566.2018.1491966Howlett JR, Stein MB, Nemeroff CB.Chapter 12. Paroxetine.Am Psychiatric Assoc Pub Text Psychopharmacol. 2017. doi:10.1176/appi.books.9781615371624.as12Albert PR, Vahid-Ansari F, Luckhart C.Serotonin-prefrontal cortical circuitry in anxiety and depression phenotypes: pivotal role of pre- and post-synaptic 5-HT1A receptor expression.Front Behav Neurosci. 2014;8:199. doi:10.3389/fnbeh.2014.00199Chottekalapanda RU, Kalik S, Gresack J, et al.AP-1 controls the p11-dependent antidepressant response.Mol Psychiatry. 2020;25(7):1364-1381. doi:10.1038/s41380-020-0767-8American Psychiatric Association.Diagnostic and Statistical Manual of Mental Disorders, 5th ed. American Psychiatric Association.Abejuela HR, Osser DN.The Psychopharmacology Algorithm Project at the Harvard South Shore Program: An algorithm for generalized anxiety disorder.Harvard Rev Psychiatry. 2016;24(4):243-256. doi:10.1097/HRP.000000000000098U.S. Food and Drug Administration.Paxil label.Mochcovitch MD, da Rocha Freire RC, Garcia RF, Nardi AE.Can long-term pharmacotherapy prevent relapses in generalized anxiety disorder? A systematic review.Clin Drug Invest. 2017;37:737-743. doi:10.1007/s40261-017-0528-xHealth Quality Ontario.Psychotherapy for major depressive disorder and generalized anxiety disorder: A health technology assessment.Ont Health Technol Assess Ser. 2017;17(15):1-167.Kulenović AD, Serdarević AM, Halilović Z, et al.Observational multicenter study of efficacy of paroxetine film-coated tablet in the treatment of anxiety disorder.Med Glas (Zenica). 2018;15(2):186-191. doi:10.17392/947-18Additional ReadingNational Alliance on Mental Illness.Paroxetine (Paxil).U.S. Food and Drug Administration.Paxil label.
11 Sources
Verywell Mind uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Bandelow B, Michaelis S, Wedekind D.Treatment of anxiety disorders.Dialogues Clin Neurosci. 2017;19(2):93-107. doi:10.31887/DCNS.2017.19.2/bbandelowStrawn JR, Geracioti L, Rajdev N, Clemenza K, Levine A.Pharmacotherapy for generalized anxiety disorder in adults and pediatric patients: An evidence-based treatment review.Expert Opin Pharmacother. 2018;19(10):1057-1070. doi:10.1080/14656566.2018.1491966Howlett JR, Stein MB, Nemeroff CB.Chapter 12. Paroxetine.Am Psychiatric Assoc Pub Text Psychopharmacol. 2017. doi:10.1176/appi.books.9781615371624.as12Albert PR, Vahid-Ansari F, Luckhart C.Serotonin-prefrontal cortical circuitry in anxiety and depression phenotypes: pivotal role of pre- and post-synaptic 5-HT1A receptor expression.Front Behav Neurosci. 2014;8:199. doi:10.3389/fnbeh.2014.00199Chottekalapanda RU, Kalik S, Gresack J, et al.AP-1 controls the p11-dependent antidepressant response.Mol Psychiatry. 2020;25(7):1364-1381. doi:10.1038/s41380-020-0767-8American Psychiatric Association.Diagnostic and Statistical Manual of Mental Disorders, 5th ed. American Psychiatric Association.Abejuela HR, Osser DN.The Psychopharmacology Algorithm Project at the Harvard South Shore Program: An algorithm for generalized anxiety disorder.Harvard Rev Psychiatry. 2016;24(4):243-256. doi:10.1097/HRP.000000000000098U.S. Food and Drug Administration.Paxil label.Mochcovitch MD, da Rocha Freire RC, Garcia RF, Nardi AE.Can long-term pharmacotherapy prevent relapses in generalized anxiety disorder? A systematic review.Clin Drug Invest. 2017;37:737-743. doi:10.1007/s40261-017-0528-xHealth Quality Ontario.Psychotherapy for major depressive disorder and generalized anxiety disorder: A health technology assessment.Ont Health Technol Assess Ser. 2017;17(15):1-167.Kulenović AD, Serdarević AM, Halilović Z, et al.Observational multicenter study of efficacy of paroxetine film-coated tablet in the treatment of anxiety disorder.Med Glas (Zenica). 2018;15(2):186-191. doi:10.17392/947-18Additional ReadingNational Alliance on Mental Illness.Paroxetine (Paxil).U.S. Food and Drug Administration.Paxil label.
Verywell Mind uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
Bandelow B, Michaelis S, Wedekind D.Treatment of anxiety disorders.Dialogues Clin Neurosci. 2017;19(2):93-107. doi:10.31887/DCNS.2017.19.2/bbandelowStrawn JR, Geracioti L, Rajdev N, Clemenza K, Levine A.Pharmacotherapy for generalized anxiety disorder in adults and pediatric patients: An evidence-based treatment review.Expert Opin Pharmacother. 2018;19(10):1057-1070. doi:10.1080/14656566.2018.1491966Howlett JR, Stein MB, Nemeroff CB.Chapter 12. Paroxetine.Am Psychiatric Assoc Pub Text Psychopharmacol. 2017. doi:10.1176/appi.books.9781615371624.as12Albert PR, Vahid-Ansari F, Luckhart C.Serotonin-prefrontal cortical circuitry in anxiety and depression phenotypes: pivotal role of pre- and post-synaptic 5-HT1A receptor expression.Front Behav Neurosci. 2014;8:199. doi:10.3389/fnbeh.2014.00199Chottekalapanda RU, Kalik S, Gresack J, et al.AP-1 controls the p11-dependent antidepressant response.Mol Psychiatry. 2020;25(7):1364-1381. doi:10.1038/s41380-020-0767-8American Psychiatric Association.Diagnostic and Statistical Manual of Mental Disorders, 5th ed. American Psychiatric Association.Abejuela HR, Osser DN.The Psychopharmacology Algorithm Project at the Harvard South Shore Program: An algorithm for generalized anxiety disorder.Harvard Rev Psychiatry. 2016;24(4):243-256. doi:10.1097/HRP.000000000000098U.S. Food and Drug Administration.Paxil label.Mochcovitch MD, da Rocha Freire RC, Garcia RF, Nardi AE.Can long-term pharmacotherapy prevent relapses in generalized anxiety disorder? A systematic review.Clin Drug Invest. 2017;37:737-743. doi:10.1007/s40261-017-0528-xHealth Quality Ontario.Psychotherapy for major depressive disorder and generalized anxiety disorder: A health technology assessment.Ont Health Technol Assess Ser. 2017;17(15):1-167.Kulenović AD, Serdarević AM, Halilović Z, et al.Observational multicenter study of efficacy of paroxetine film-coated tablet in the treatment of anxiety disorder.Med Glas (Zenica). 2018;15(2):186-191. doi:10.17392/947-18
Bandelow B, Michaelis S, Wedekind D.Treatment of anxiety disorders.Dialogues Clin Neurosci. 2017;19(2):93-107. doi:10.31887/DCNS.2017.19.2/bbandelow
Strawn JR, Geracioti L, Rajdev N, Clemenza K, Levine A.Pharmacotherapy for generalized anxiety disorder in adults and pediatric patients: An evidence-based treatment review.Expert Opin Pharmacother. 2018;19(10):1057-1070. doi:10.1080/14656566.2018.1491966
Howlett JR, Stein MB, Nemeroff CB.Chapter 12. Paroxetine.Am Psychiatric Assoc Pub Text Psychopharmacol. 2017. doi:10.1176/appi.books.9781615371624.as12
Albert PR, Vahid-Ansari F, Luckhart C.Serotonin-prefrontal cortical circuitry in anxiety and depression phenotypes: pivotal role of pre- and post-synaptic 5-HT1A receptor expression.Front Behav Neurosci. 2014;8:199. doi:10.3389/fnbeh.2014.00199
Chottekalapanda RU, Kalik S, Gresack J, et al.AP-1 controls the p11-dependent antidepressant response.Mol Psychiatry. 2020;25(7):1364-1381. doi:10.1038/s41380-020-0767-8
American Psychiatric Association.Diagnostic and Statistical Manual of Mental Disorders, 5th ed. American Psychiatric Association.
Abejuela HR, Osser DN.The Psychopharmacology Algorithm Project at the Harvard South Shore Program: An algorithm for generalized anxiety disorder.Harvard Rev Psychiatry. 2016;24(4):243-256. doi:10.1097/HRP.000000000000098
U.S. Food and Drug Administration.Paxil label.
Mochcovitch MD, da Rocha Freire RC, Garcia RF, Nardi AE.Can long-term pharmacotherapy prevent relapses in generalized anxiety disorder? A systematic review.Clin Drug Invest. 2017;37:737-743. doi:10.1007/s40261-017-0528-x
Health Quality Ontario.Psychotherapy for major depressive disorder and generalized anxiety disorder: A health technology assessment.Ont Health Technol Assess Ser. 2017;17(15):1-167.
Kulenović AD, Serdarević AM, Halilović Z, et al.Observational multicenter study of efficacy of paroxetine film-coated tablet in the treatment of anxiety disorder.Med Glas (Zenica). 2018;15(2):186-191. doi:10.17392/947-18
National Alliance on Mental Illness.Paroxetine (Paxil).U.S. Food and Drug Administration.Paxil label.
National Alliance on Mental Illness.Paroxetine (Paxil).
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