Paroxetine (Paxil): What It Does and How to Use It Safely
Paroxetine is a commonly prescribed SSRI used for depression, panic disorder, social anxiety, OCD, and PTSD. You’ve probably heard the brand name Paxil—that’s paroxetine. It changes serotonin levels in the brain to help reduce symptoms like low mood, panic attacks, and excessive worry.
How paroxetine is usually taken
Doctors commonly start adults at 10–20 mg once daily and adjust based on response and side effects. For depression many people end up on 20–50 mg; some conditions may require up to 60 mg under close supervision. Older adults or anyone sensitive to meds often start lower. Take it at the same time each day, with or without food, and avoid suddenly stopping the drug.
Common side effects and what to watch for
Expect nausea, drowsiness, dry mouth, constipation, and sometimes weight change or sexual side effects. Most of these ease in a few weeks. Watch for dizziness, sleep changes, or feeling unusually restless—tell your prescriber if those become bothersome.
Stopping paroxetine abruptly can cause withdrawal-type symptoms within days: dizziness, electric‑shock sensations, irritability, and flu-like feelings. Always taper under medical guidance.
There’s a small risk of serotonin syndrome when paroxetine is combined with other serotonergic drugs (like MAO inhibitors, some migraine medicines, or certain supplements). Symptoms include high fever, rapid heartbeat, severe confusion, and muscle stiffness—seek emergency care if they appear.
Paroxetine can interact with blood thinners and NSAIDs, raising bleeding risk. It may also affect how well other drugs work, so give your doctor a full list of medications and supplements before starting.
Pregnancy and breastfeeding need special attention. Paroxetine has been linked to certain newborn complications and may not be the first choice for pregnant women. Discuss risks and alternatives with your provider if you’re pregnant or planning pregnancy.
Mood monitoring matters. Antidepressants can increase suicidal thoughts in people under 25 during the first weeks. Check in with family or caregivers and contact your prescriber right away if mood worsens, new suicidal thoughts appear, or behaviors change suddenly.
Quick practical tips: take the lowest effective dose, give it several weeks to work (often 2–6 weeks), and keep follow-up visits to adjust dose and check side effects. If you miss one dose, take it when you remember unless it's close to the next dose—don’t double up.
Questions to ask your prescriber: Why this med for my diagnosis? What starting dose do you recommend? How long should I expect to try it before deciding it helps? What side effects should prompt a call or a visit? How should we stop it when the time comes?
Paroxetine can help a lot when used correctly. If you have doubts, talk to your doctor or pharmacist — they can personalize the plan and keep you safe while you get better.
