Paxil Index | Brand and Generic Availability ›
Crazy Meds Comprehensive Paxil pages

This is our summary of Paxil. Clicking on a “More…” link will take you to a page with greater detail. The Comprehensive Paxil pages contain the information from all of the “More…” pages.

1.  Brand & Generic Names; Drug Class

US brand name:	Paxil
Generic name:	paroxetine hydrochloride
What is Paxil (paroxetine hydrochloride)?	Paxil (paroxetine hydrochloride) is in the Antidepressants class of drugs.

More about Paxil’s generic availability, worldwide trade names, and more

2.  What is Paxil (paroxetine hydrochloride) used for

2.1  US FDA approved treatment(s)

Both forms: Major Depressive Disorder (MDD), Panic Disorder, & Social Anxiety Disorder. Obsessive-Compulsive Disorder (OCD), Generalized Anxiety Disorder (GAD), & Posttraumatic Stress Disorder (PTSD) (Immed. Rel. only). Premenstrual Dysphoric Disorder (PMDD) (CR only)

2.2  Popular off-label uses

Using the controlled release version (Paxil CR) for OCD, GAD, and PTSD. Headaches. Irritable Bowel Syndrome (IBS). Tourette Syndrome.

More about Paxil’s approved & off-label uses

3.  When will Paxil (paroxetine hydrochloride) start working?

3.1  How long until Paxil starts working

Like all SSRIs two-to-four, sometimes even six weeks.

3.2  Will Paxil really work for what I have?

More about how long until, and how well will Paxil work; and how Paxil compares with other drugs

4.  How to take and stop taking Paxil (paroxetine hydrochloride)

4.1  How to take Paxil

Immediate release - the initial dosage of Paxil is 10mg for Panic Disorder and 20mg for everything else. For GAD, PTSD, and Social Anxiety Disorder 20mg a day is the target dosage. For OCD and Panic Disorder it’s 40mg a day. There is no target dosage for MDD, just a maximum of 50mg a day and that 30mg a day was the average effective dosage in the clinical trials.
The dose is increased 10mg a day per week, until you reach the target dosage and/or something that works. You take it once a day, usually in the morning.
Controlled release - the initial dosage of Paxil CR is 25mg a day for MDD, 12.5mg a day for everything else. The is no target dosage for any condition, which is highly unusual for any crazy med. The maximum dosages are: 62.5mg a day for MDD, 75mg a day for Panic Disorder, 37.5mg a day for Social Anxiety Disorder, and 25mg a day for PMDD.
We at Crazy Meds suggest starting the immediate release at 5–10mg at day for everything, and increasing by 5–10mg a day per week only if you need to. The same goes for Paxil CR, just at 12.5mg a day.
Unless SSRIs usually keep you awake, we suggest you should first try taking Paxil at night.

4.2  How to stop taking Paxil

Very, very slowly and very, very carefully. 5–10mg a day per week for the immediate release form and 12.5mg a day per week for the controlled release (Paxil CR) form.

More about taking and discontinuing Paxil

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5.  Paxil’s (paroxetine hydrochloride’s) pros and cons

5.1  Pros

As the most potent SSRI on the US market, Paxil can be just the thing for severe conditions in the anxiety spectrum.

5.2  Cons

As the most potent SSRI on the US market Paxil has the absolute worst SSRI discontinuation symptoms of any SSRI, and gives the SNRIs a run for their money in discontinuation syndrome suckage. Paxil also has the worst sexual side effects of any SSRI, maybe of any crazy med.

5.3  Interesting stuff your doctor probably didn’t tell you

Paxil one of those meds that if you stop taking it and start up again, it won’t work as well as it used to. For some people that includes stopping for just a couple of days, experiencing the hell of SSRI discontinuation syndrome, and then going back on Paxil. You have to be totally med compliant with Paxil or it could be a pointless waste of time, money and suffering.
Paxil is less likely to work / doesn’t work as well for post-menopausal women. Which just figures, because it’s also pregnancy category D.
More of Paxil’s pros, cons, and interesting stuff

6.  Paxil’s (paroxetine hydrochloride’s) side effects

6.1  Typical side effects

The usual for SSRIs - headache, nausea, dry mouth, sweating, sleepiness or insomnia, constipation (pretty bad for some people, feature and not bug for anyone with IBS), weight gain, and loss of libido. Everyone I’ve read on the subject of how long side effects last (Dr. Stephen Stahl’s Essential Psychopharmacology: The Prescriber’s Guide, Dr. Diamond’s Instant Psychopharmacology, Dr. Drummond’s The Complete Guide to Psychiatric Drugs , Preston et al.’s Consumer’s Guide To Psychiatric Drugs’‘) agrees that everything but the weight gain and loss of libido usually goes away within a couple of weeks. Paxil is notorious for having the worst impact on your libido of all SSRIs.

6.2  Uncommon side effects

Motion sickness/vertigo, food tasting weird, making the symptoms worse.
Because Paxil is so potent the amount of extra serotonin you get, and where you get it, can interfere with dopamine. That can result in a variety of side effects usually associated with antipsychoitics, such as gynecomastia (man boobs), galactorrhea (leaky tits, regardless of gender), akathisia, EPS, TD, and NMS.

6.3  Freaky rare side effects

Enlargement of skin, pathological laughter, and vaginal anaesthesia. You could have quite a career in freaky fetish porn with those.
More about Paxil’s side effects

7.  What Paxil (paroxetine hydrochloride) is best known for

Giving you a libido-ectomy, followed by the SSRI discontinuation syndrome from Hell.
More about Paxil’s black box warnings, noted traits & effects

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8.  Paxil’s (paroxetine hydrochloride’s) half-life & how long until Paxil clears your system

Immediate release: Half-life 21 hours, clearance 4–5 days. Paxil CR: Half-life 15 to 20 hours, clearance 4 days.
Drugs.com’s drug-drug and drug-food interaction checker
More about Paxil’s pharmacokinetics & noted drug-drug & drug-food interactions

9.  How Paxil (paroxetine hydrochloride) works (the best current guess at any rate).

Paxil is a potent SSRI, so it practically floods your brain with serotonin. It may also affect sigma-1 receptors like Zoloft and Luvox do, which would further enhance its anti-anxiety effects. Paxil could also have enough norepinephrine reuptake inhibition properties to make some kind of difference, but it’s probably just enough to be a factor in making the discontinuation syndrome so hellish.
More about how Paxil works. AKA Paxil’s mechanism/method of action, or pharmacodynamics.

10.  Comments

Loved by those for whom it works, loathed by those who had to stop taking it and/or whose sex life vanished, Paxil is one of the top meds people love to hate. Usually better for anxiety than depression. Because Paxil is so potent it shouldn’t be the first med considered unless you’re too anxious to leave your house without being drugged stupid with a benzodiazepine.
More comments As if I didn’t go on long enough here.
Consumer/patient comments about & experiences with Paxil

11.  Discussion board, PI sheet and other allegedly useful links

Crazy Meds’ Paxil discussion board
Paxil’s Full US Prescribing Information / PI Sheet
Allegedly Useful Links. Mostly any official sites we could find for this med and PI sheets from countries other than the US.

Paxil Index | Brand and Generic Availability ›
Crazy Meds Comprehensive Paxil pages

Bibliography

Date created 31 Dec 1969 - 17:00 Page Creator: JerodPoore Last edited by:

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Paxil Basic Overview by JerodPoore is copyright 1969

Page design and explanatory material copyright © 2004 - 2012 Jerod Poore. All rights reserved.

Almost all of the material on this site is copyright © 2004, 2005, 2006, 2007, 2008, 2009, 2010, 2011, and 2012 Jerod Poore. Except, of course, the PI sheets - those are the property of the drug companies who developed the drugs the sheets are about - and any documents that are written by other people which may be posted to this site will remain the property of the original authors. You cannot reproduce this page or any other material on this site outside of the boundaries of fair use copying without the express permission of the copyright holder. That’s usually me, so just ask first. That means if want to print out a few pages to take to your doctor, therapist, counselor, support group, non-understanding family members or something like that - then that’s OK to just do. Go for it! Please. As long as you include this copyright notice and the following disclaimer, I’m usually cool with it.

All rights reserved. No warranty is expressed or implied in this information. Consult one or more doctors and/or pharmacists before taking, or changing how you take any neurological and/or psychiatric medication. Your mileage may vary. What happened to us won’t necessarily happen to you.
The information on Crazy Meds pertains to and is intended for adults. While some information about children and adolescents is occasionally presented (e.g. US FDA approvals), pediatric-specific data such as dosages, side effects, off-label applications, etc. are rarely included in the articles on drugs or discussed on the forum. If you are looking for information regarding meds for children you’ll have to go somewhere else.
Know your sources!
Nobody on this site is a doctor, therapist, or a pharmacist. We don’t portray them either here or on TV. Only doctors can diagnose and treat an illness. Some doctors tend to get pissed off by patients who know too much about medications, so tread lightly when and where appropriate. Diagnosing yourself from a website is like defending yourself in court, you suddenly have a fool for a doctor. Don’t be a cyberchondriac, thinking you have every disease you see a website about, or that you’ll get every side effect from every medication¹. Self-prescribing is as dangerous as buying meds from fraudulent online pharmacies that promise you medications without prescriptions.
All information on this site has been obtained through our personal experience and the experiences family, friends, what people have reported on various reputable sites all over teh intergoogles, the medications’ product information / summary of product characteristic (PI/SPC) sheets, and from sources that are referenced throughout the site. As such the information presented here is not intended as a substitute for real medical advice from your real doctor, just a compliment to it. You should never, ever, replace what a real doctor tells you with something from a website on the Internet. The farthest you should ever take it is getting a second opinion from another real doctor. Educate yourself - always read the PI/SPC sheet or patient information leaflet (PIL) that comes with your medications and never ever throw them away.
Crazy Meds is not responsible for the content of sites we provide links to. We like them, or they’re paid advertisements, or they’re something else we think you should read to help you make an informed decision about a particular med. Sometimes they’re more than one of those things. But what’s on those sites is their business, not ours.
Very little information about visitors to this site is collected or saved. From time to time I look at search terms used and which pages they bring up in an effort to make the information I present more relevant. And the country of origin, just because I’m geeky like that. That’s about it. Depending on how you feel about Schrodinger, our privacy policy should either assuage or exacerbate your paranoia.
All brand names of the drugs listed in this site are the trademarks of the companies named on the PI/SPC sheet associated with the medication, sometimes on the pages about the drugs, even though those companies may have been acquired by other companies who may or may not be listed in this site by the time you read this. Or the rights to the drug were sold to another company. And any or all of the companies involved may have changed their names.
Crazy Meds is optimized for the browser you’re not using on the platform you wish you had. Between you and me, it all looks a lot cleaner using Firefox or Safari, which is what a plurality of visitors use. And I’m running Windows XP3. On a computer that sits on top of my desk. With a 23 inch monitor. Hey, at least you can make the text larger or smaller by clicking on the + or - buttons in the upper right hand corner. If you have Java enabled. Like 99% of the websites on the planet, Crazy Meds is hosted on domain running an open source operating system with a variety of open source applications, including the software used to display what you’ve been reading. As such Crazy Meds is not responsible for whatever weird shit your browser does or does not do when you read this site².
No neurologists, psychiatrists, therapists or pharmacists were harmed in the production of this website. Use only as directed. Void where prohibited. Contains nuts. Certain restrictions may apply. All data are subject to availability. Not available on all mobile devices or in all dimensions of reality.

‘Everything is true, nothing is permitted.’ - Jerod Poore

¹ While there are plenty of books to help you with hypochondria, for some reason there’s not much in the way of websites. Then again, staying off of the Internet is a large part of curing/managing the disorder.

² Have I mentioned how open source operating systems for commercial applications is one of the dumbest ideas in the history of dumb ideas?
[begin rant] I rent a dedicated server for Crazy Meds. It’s sitting on a rack somewhere in Southern California along with a bunch of other servers that other people have rented. The hardware is identical, but no two machines have exactly the same operating systems. I don’t even need to see what is on any of the others to know this. If somebody got their server at the exact same time, with the exact same features as I did, I’m confident that there would be noticeable differences in some aspects of the operating systems. So what does this mean? For one thing it means that no two computers in the same office of a single company have the same operating system, and the techs can spend hours figuring out what the fuck the problem could be based on that alone. It also means that application software like IP board that runs the forum here has to have so many fucking user-configurable bells and whistles that even when I read the manual I can’t find every setting, or every location that every flag needs to be set in order for a feature to run the way I want it to run. And in the real world it means you can get an MBA not only with an emphasis on resource planning, but with an emphasis on using SAP - a piece of software so complex there are now college programs on how to use it. You might think, “But don’t people learn how to use Photoshop or Adobe Illustrator in college?” Sure, in order to create stuff. And in a way you’re creating stuff with SAP. But do you get a Bachelor of Fine Arts degree with an emphasis on Photoshop?
Back in the Big Iron Age the operating systems were proprietary, and every computer that took up an entire room with a raised floor and HVAC system, and had less storage and processing power than an iPhone, had the same operating system as every other one, give or take a release level. But when a company bought application software like SAP, they also got the source code, which was usually documented and written in a way to make it easy to modify the hell out of it. Why? Because accounting principles may be the same the world over, and tax laws the same across each country and state, but no two companies have the same format for their reports, invoices, purchase orders and so forth. Standards existed and were universally ignored. If something went wrong it went wrong the same way for everyone, and was easy to track down. People didn’t need to take a college course to learn how to use a piece of software.
I’m not against the open source concept entirely. Back then all the programmers read the same magazines, so we all had the same homebrew utilities. We even had the forerunner to QR Code to scan the longer source code. Software vendors and computer manufacturers sponsored conventions so we could, among other things, swap recipes for such add-ons and utilities. While those things would make our lives easier, they had nothing to do with critical functions of the operating system. Unless badly implemented they would rarely cause key application software to crash and burn. Whereas today, with open source everything, who the hell knows what could be responsible some part of a system failing. [/end rant]