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What Is Paxil Used For? Paroxetine Uses And What You Should Know About The Drug

Last Updated: February 14, 2022

Authored by Roger Weiss, MD

Reviewed by Michael Espelin APRN

Paroxetine, commonly referred to by its brand name Paxil, is a selective serotonin reuptake inhibitor (SSRI) antidepressant. As an antidepressant, Paxroxetine uses include the treatment of major depressive disorder (MDD), obsessive-compulsive disorder (OCD), social anxiety disorder (SAD), panic disorder, posttraumatic stress disorder (PTSD), generalized anxiety disorder (GAD), and premenstrual dysphoric disorder (PMDD). This article will attempt to answer the question of what is Paxil used for by discussing the wide spectrum of Paxil uses in the treatment of various mental and psychological conditions. Additionally, optimal use of Paroxetine and several Paroxetine warnings and cautions will be covered.

A woman drinks paxil pills.

What Is Paroxetine Used For?

What is paroxetine and what is Paxil used for? Paxil is a selective serotonin reuptake inhibitor (SSRI) used in various mental health conditions including major depressive disorder (MDD), obsessive-compulsive disorder (OCD), social anxiety disorder (SAD), panic disorder, posttraumatic stress disorder (PTSD), and generalized anxiety disorder (GAD). The aim of Paxil is to improve appetite, sleep, mood, and energy levels in these conditions, as well as to restore a patient’s interest in daily living, decrease anxiety, fear, apprehension, and keep away unwanted thoughts and involuntary behaviors that can have a significant effect on the quality of daily living. Additional medical indications for Paroxetine uses include the use of Paxil for menopause-related vasomotor symptoms such as hot flashes and the use of Paroxetinne for premature ejaculation.

Paxil for Major Depressive Disorder

The primary purpose of Paroxetine is to help and treat people with depression. The efficacy of Paroxetine in the treatment of major depression is similar to other antidepressant drugs. For example, in the comparison of Lexapro vs Paxil, it is shown that both drugs are effective in helping people deal with depression, but Paxil’s side effects and adverse reaction profiles are better. Efficacy of Paroxetine in treatment of major depressive disorder was shown in a study that found that eight-week administration resulted in a noticeable improvement in depressive symptoms and overall mental health manifested by increased calmness, evened temperament, decreased self-consciousness, and increased motivation demonstrated by an eagerness to try new experiences.

Paxil for Generalized Anxiety Disorder (GAD)

One of several of Paroxetine uses includes treatment of patients suffering from generalized anxiety disorder (GAD), which makes sense as it was the second medication approved by the FDA for the treatment of GAD. The use of single daily doses of Paxil varying from 20 mg to 50 mg, has been found to have positive effects on symptoms of general anxiety disorder after eight weeks of treatment. When compared to benzodiazepines, primary medications used in the treatment of GAD for many years, Paroxetine has proved to be more efficient in reducing the anxiety symptoms, such as tension, worry, concentration difficulties, and irritability. It also has a lower risk of side effects, and it is better tolerated.

Paxil for the Premenstrual Dysphoric Disorder (PMDD)

The use of Paxil for menopause-related dysphoria is well established in the medical community. A study analyzing control of symptoms of PMDD with Paroxetine showed that in daily doses varying from 12.5 mg to 25 mg, Paroxetine was efficient in treating the main symptoms of PMDD, such as depressed mood, irritability, affective lability, and difficulty concentrating and tension. Additionally, the use of Paroxetine for hot flashes, headaches, weight gain, bloating, muscle and joint pain, breast tenderness, and other physical symptoms has also been effective. The research participants also showed an improvement in social functioning.

Paroxetine for Hot Flashes Associated with Menopause

Night sweats and hot flashes are symptoms of vasomotor instability which often accompanies menopause. A study on Paroxetine and vasomotor symptoms showed that drug usage led to a reduction of 33% to 67% in the frequency of hot flashes in a treatment period of 6 to 12 weeks. Patients using Paroxetine for hot flashes also reported a reduction in the severity of symptoms of vasomotor instability. The participants in the study experienced mild-to-moderate side effects, and the tolerability was improved by lowering the dose to between 7.5 and 12.5 mg per day.

Paxil for Obsessive-Compulsive Disorder (OCD)

Use of Paxil for OCD, requires higher doses when compared to ones used for depression and also takes longer to achieve symptomatic improvement in OCD. For example, if patients with depression show improvement after 2-6 weeks of treatment, those using Paxil for OCD only showed improvement after 10-12 weeks. Patients using Paxil for OCD, said they had seen a drop in common compulsive behaviors such as excessive double-checking, hoarding, extreme cleaning and washing, tapping, counting, and over-arranging objects. It also made them calmer, happier and helped them keep under control the feeling of fear.

Paxil for Panic Disorder

One of Paxil uses includes successful management of Panic disorder. Participants showed significant improvement after the first four to 12 weeks. Using Paxil for panic attacks is as effective as other treatments such as TCADs, CBT, or benzodiazepines, but it is better tolerated and has minimal side effects. The most effective dose for panic disorder has proven to be 40 mg a day.

Paxil for Posttraumatic Stress Disorder (PTSD)

Paroxetine is one of the two drugs approved by the FDA for the treatment of PTSD. In one study, patients received treatment with Paxil for six months and showed improvement in symptoms from 100% to 64% with a daily dose of 20 mg. Paroxetine for PTSD proved efficient, and the reported side effects were only mild.

Paxil for Social Phobia (Social Anxiety Disorder)

The primary purpose of antidepressant drugs, like Paxil and other SSRIs, is to change the concentration of neurotransmitters in the brain, such as serotonin. This change also accounts for a significant reduction in social phobia symptoms. Studies have shown that using Paxil for social anxiety helped 50% to 80% of the participants see an improvement in their mental health symptoms after 8 to 12 weeks of treatment. The patients reported an improvement in their level of anxiety, fear, and avoidance, and the number of patients who achieved clinical remission with Paroxetine was three times higher when compared to those treated with placebo.

Paxil for Premature Ejaculation

A known sexual side effect of Paroxetine is delayed ejaculation. Some physicians use this effect to treat premature ejaculation in some patients. A study that aimed to evaluate the effectiveness and safety of Paroxetine in the treatment of premature ejaculation found that all 32 patients who were treated with 20mg for a duration of two months had symptomatic improvement and reported a longer interval before ejaculation.

How To Use Paroxetine

The best time of day to take Paxil is in the morning, swallowing the tablet whole, during breakfast to decrease nausea. Some patients might experience sleepiness during the day. In this case, the doctor might recommend taking it in the evening. The dosage depends on the patient’s condition, age, response to treatment, and other medications that the patient takes. For example, taking Paxil and Adderall at the same time can result in Paroxetine drug interactions with adverse effects such as anxiety, racing thoughts, confusion, seizure, fever, increased heart rate, tremor, and hallucinations.

Usually, this medication is prescribed at a lower dose to reduce the risk of side effects. Patients are advised to continue the treatment even if the symptoms improve. Suddenly stopping the treatment might worsen the condition’s symptoms and also lead to headaches, mood swings, tiredness, and sleep changes. Alcohol should be avoided while using the drug. If a dose is missed, it can be taken at a later time, but not too close to the next dose to avoid doubling the quantity of the medication. How long does Paxil stay in the system? The drug’s half-life is between 21 and 24 hours. This means that half of the drug will be eliminated from the system in 24 hours after stopping the usage. Paroxetine will be removed from the system after five days.

A doctor explains to a patient how to take paxil pills.

Paroxetine Warnings and Precautions

As with all medications, Paroxetine uses in various mental health conditions is associated with certain cautions. Below are offered certain cautions and warnings patients should be aware of before starting therapy.

Worsening of Depression and Suicidality Risk

Paxil uses in various conditions may be associated with exacerbation of depression or the emergence of unusual or suicidal behavior or ideation. It is very important to observe those who have just started or have had their dosage adjusted for the first few weeks for symptoms of excessive anxiety, agitation, panic attacks, insomnia, irritability, hostility, aggressiveness, impulsivity, akathisia, hypomania, and/or mania. If these symptoms are seen, the prescribing physician should immediately be contacted for further guidance.

The risk of depression and suicidality is particularly high in children and adolescents with depression, as such Paroxetine should not be used in those younger than 18 years of age.

Serotonin Syndrome

If Paroxetine is used concurrently with other serotonergic drugs such as “triptans”, SNRIs, TCAs, Amphetamines, Lithium, St. John’s wort, or those drugs that impair serotonin metabolism most importantly of which are MAOIs, a potentially life-threatening Serotonin Syndrome can occur. Symptoms and signs of serotonin syndrome include autonomic instability, mental status changes, neuromuscular hyperexcitability, and seizures. If such symptoms and signs are seen all medications should be immediately discontinued and emergency medical help should be sought.

Perinatal and Neonatal Risks

Paxil uses for various mental health conditions in pregnant women may increase the risk of fetal congenital cardiac. Furthermore, exposure to SSRIs during the third trimester has been associated with neonatal need for prolonged hospitalization, respiratory support, and enteral nutrition upon delivery.

Other Warnings

Some other nonspecific Paroxetine-associated warnings and precautions can include increased incidence of seizures; activation of manic or hypomanic episodes in patients with Bipolar disorder; onset of restlessness and agitation; increased risk of gastrointestinal bleeding, especially in the elderly or those who use anticoagulation; and pupillary dilation causing the onset of acute angle-closure glaucoma which is a medical emergency.

Furthermore, in patients with liver or kidney disease, Paroxetine should be used with caution as they are less able to metabolize and excrete it, possibly leading to prolongation of Paxil half-life, accumulation, and toxicity.

Always Consult Your Doctor Before Taking Paxil

Although Paroxetine used for anxiety and depression will start working after about two months of treatment, patients will notice the effects of therapy after the first week. Unfortunately, the first ones to kick in might be the side effects, such as tiredness, lethargy, problems sleeping, or stomach issues. This might be a sign that the doctor will have to lower your dose. The is also a connection between Paxil and weight gain, that is why the APA does not recommend the drug as the first choice for individuals who have type 2 diabetes, are obese, or suffer from constipation or urinary hesitancy.

Paxil is a habit-forming substance with discomforting Paroxetine withdrawal symptoms. In case of any signs of dependence or addiction, contact the professionals from drug rehab centers. They will give confidential and compassionate advice on the treatment approaches to this addiction.

Frequently Asked Questions

How to Tell if Paxil Is Working?

Antidepressants, like Paxil, take a while to work, sometimes even four to eight weeks is needed before the effects of antidepressants take effect. The best way to gauge the effectiveness of antidepressants is to assess your symptomatic improvement by asking yourself questions such as has my interest in various activities improved? Do I have more motivation now than I did before? Do I feel less depressed? Do I have an easier time getting out of bed and doing daily tasks? Has my sleep improved? Do I feel less anxious and worried?

Paxil First Week: What To Expect?

You may not experience any benefit during the first week of treatment, as mentioned antidepressants take several weeks to work. Unfortunately, the side effects of antidepressants do not require nearly as long to appear, thus you may experience common side effects of Paxil such as dizziness, sleepiness, tremors, nausea, constipation, dry mouth, sexual dysfunction, and others during your first week.

Best Time to Take Paroxetine: Morning or Night?

The best time to take Paroxetine is in the morning. Currently recommended guidelines recommend taking this medication once daily in the morning without regard to meals. But, it is suggested that taking this medication with food may decrease adverse gastrointestinal side effects. However, as suggested above, if morning administration is associated with excessive daytime sleepiness it can be taken before bed at night.

Does Paxil Make You Sleepy?

Yes, Paroxetine can make you sleepy. Excessive somnolence sometimes referred to as hypersomnia, is encountered during therapy with this medication and is considered its common side effect. However, this phenomenon has been suggested to be a marker for good clinical response.

Is Paxil Good for Anxiety?

Yes, Paxil is good for anxiety. SSRIs, including Paxil, are first-line drugs of choice in the treatment of anxiety disorders such as General anxiety disorder (GAD), Panic disorder, and Social anxiety disorder (SAD).

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Published on: May 23rd, 2019

Updated on: February 14th, 2022

About Author

Roger Weiss, MD

Dr. Roger Weiss is a practicing mental health specialist at the hospital. Dr. Weiss combines his clinical practice and medical writing career since 2009. Apart from these activities, Dr. Weiss also delivers lectures for youth, former addicts, and everyone interested in topics such as substance abuse and treatment.

Medically Reviewed by

Michael Espelin APRN

8 years of nursing experience in wide variety of behavioral and addition settings that include adult inpatient and outpatient mental health services with substance use disorders, and geriatric long-term care and hospice care.  He has a particular interest in psychopharmacology, nutritional psychiatry, and alternative treatment options involving particular vitamins, dietary supplements, and administering auricular acupuncture.