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Paxil (paroxetine) is a prescription medication approved by the U.S. Food and Drug Administration (FDA) for treating adults with major depressive disorder (MDD).
These insights are based on 456 comments about Paxil from MyDepressionTeam members. These are the experiences of a small number of individuals and are not meant to be medical advice.
Paxil is a type of medication called a selective serotonin reuptake inhibitor (SSRI) that works by increasing serotonin levels in the brain. The exact way it treats MDD is not fully known.
Doctors prescribe Paxil to adults with major depressive disorder.
Paxil is given as a tablet or liquid taken by mouth, typically once daily in the morning, with or without food. If you are taking Paxil as a liquid, shake the bottle well before taking it.
The recommended starting dose of Paxil for depression is 20 milligrams once daily in the morning.
If needed, a doctor may raise the maintenance dose up to a maximum of 50 milligrams per day.
Some people, such as older adults or those with serious kidney or liver problems, may start at 10 milligrams per day and should not take more than 40 milligrams per day.
When stopping Paxil, the dose should be lowered slowly instead of stopped all at once.
This information is based on the prescribing information, but your healthcare provider may tailor your treatment plan. Always follow their guidance.
These insights are based on 456 comments about Paxil from MyDepressionTeam members.Members who use Paxil often say that patience, close communication with a doctor, and careful attention to side effects matter most. Many also stress that stopping Paxil suddenly can be very hard, and that it helps to notice early if the medication seems to be helping less over time.
Be patient.
Improvement takes more time for some members than others.
“It helped in about a month exactly. It has been six weeks now.”
Talk to your doctor about side effects that feel hard to manage.
“Went up to 40 milligrams last night on my Paxil. So nauseated and lethargic today I can hardly do anything.”
Do not stop Paxil suddenly without a taper plan.
“Please do not ever stop with your meds ever. I had to be without my med, Paxil, for four days and felt sick, physically, and worse with the shakes.”
Keep track of withdrawal symptoms and tell your doctor.
“Some withdrawal symptoms like vertigo and headache. Improves over time.”
Let your doctor know if Paxil seems to stop working.
“I have had depression for over 20 years and started off with Paxil. It worked like a dream and suddenly stopped.”
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In studies of Paxil for MDD in adults, the most common side effects that occurred in greater than 5 percent of people and more often than placebo (an inactive treatment) were:
These side effects occurred in 5 percent to 26 percent of people.
Paxil can cause serious side effects that require immediate medical attention. These include:
Get medical help right away if you think you are having a serious reaction.
Tell your doctor if you have any allergies to paroxetine or any ingredients in Paxil. Do not take Paxil if you have had a serious allergic reaction to paroxetine or any ingredients in Paxil.
Tell your doctor about all medicines you take, including prescription drugs, over-the-counter medicines, and supplements. Paxil and some other medicines may affect each other, causing possible serious side effects.
Do not take Paxil if you take a monoamine oxidase inhibitor (MAOI), linezolid, or IV methylene blue, or have taken one in the last 14 days. Do not take Paxil if you take thioridazine or pimozide.
Before taking Paxil, tell your healthcare provider about all your medical conditions, including if you:
Do not start or stop any other medicines during treatment with Paxil without talking to your healthcare provider first. Stopping Paxil suddenly may cause you to have serious side effects.
If you are pregnant, planning to become pregnant, or breastfeeding while taking Paxil, talk with your doctor about the risks and benefits. Paxil may harm your baby if you are pregnant. Paxil also passes into your breast milk.
Taking Paxil during your first trimester of pregnancy may cause your baby to be at an increased risk of having a heart problem (cardiac malformations) at birth.
Taking Paxil during your third trimester of pregnancy may cause your baby to have breathing, temperature, and feeding problems, low muscle tone, and irritability after birth. It may also cause your baby to be at an increased risk of a serious lung problem at birth.
There is a pregnancy registry for those who are exposed to Paxil during pregnancy. To register with the National Pregnancy Registry for Antidepressants, call 866-961-2388 or visit the registry website.
Paxil is also FDA-approved in adults to treat obsessive-compulsive disorder (OCD), panic disorder (PD), social anxiety disorder (SAD), generalized anxiety disorder (GAD), and post-traumatic stress disorder (PTSD).
These answers are fact-checked by our editorial staff.
How effective is Paxil?
In studies of adults with MDD, Paxil improved depression symptoms more than placebo on standard depression rating measures. In a longer study, Paxil helped lower the chance that depression would come back compared to placebo.
How long does Paxil take to work for depression?
Studies of Paxil for depression lasted about six weeks. It is unknown exactly when symptoms start to improve.
Can Paxil cause sleepiness, insomnia, or tremor when used for depression?
Yes. In adults with MDD, common side effects of Paxil included somnolence, insomnia, and tremor. In studies, sleepiness occurred in 23 percent of people, insomnia in 13 percent, and tremor in 8 percent.
Can Paxil cause problems if I stop taking it suddenly for depression?
Yes. Stopping Paxil abruptly can cause discontinuation syndrome. Reported symptoms include nausea, sweating, dysphoric mood, irritability, agitation, dizziness, sensory disturbances, tremor, anxiety, confusion, headache, lethargy, emotional lability, insomnia, hypomania, tinnitus, and seizures.
The dose should be reduced gradually rather than stopped suddenly whenever possible.
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