how long until Paxil starts to work, likelihood Paxil will work for your condition, and Paxil vs. other Antidepressants

> How Long Until Paxil Works


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Comparatively Effective

Two of the most important things to know when deciding on which med is the best for a particular condition1: how likely is it to work and how long will it take.

The odds of a med working for a particular condition and how long it generally takes to work should be fairly easy to nail down, and not need to be summed up by the Internet shorthand YMMV (Your Mileage May Vary). Aside from it being hard enough to get an accurate diagnosis when brain cooties are involved, why is it so difficult to figure out if Paxil (paroxetine) is right for you and how long it will take for you to know that?

  • Because no one is quite sure exactly what causes various conditions.
  • Which is further complicated when everything is a spectrum disorder (e.g. bipolar 1, bipolar 2, all the others they still ignored in DSM-5).
  • And they’re never really sure about how Paxil works in the first place.
  • Plus, if you have more than one condition for which you’re taking one or more medications to treat, things get really complicated.
  • None of which is helped by studies that produce contradictory results and other quirks in The Literature.

Always remember: if your symptoms suddenly get a lot worse, call your doctor immediately. Any drug that makes your symptoms worse is a drug you probably need to stop taking as soon as possible.

We reference a shitload of studies here, so you might want to see our pages on how to deal if a study is legitimate and the tests and methodologies researchers use to measure the efficacy of medications, including during clinical trials to get FDA approval.

How Long Until Paxil (paroxetine) Starts Working

Like all SSRIs two-to-four, sometimes even six weeks. For anxiety spectrum conditions you might start getting benefits within a couple of days.
If you don’t get any positive benefit from Paxil at 20mg a day and/or after six weeks, give up2. As this study shows it’s usually pointless to continue above that dosage/past that time if Paxil hasn’t done you any good.

How Effective Paxil (paroxetine) is for its Approved Uses

Unlike depression it’s usually pretty easy to find the clinical trials for other approved applications.

Generalized Anxiety Disorder (GAD)

For GAD the odds are pretty good Paxil will work.

  • Here the the results of one of the clinical trials for GAD. 61.7% of people taking 20mg 68.0% taking 40mg responded, compared with 45.6% of the placebo patients. Of those, 68% of people taking 20mg and 80% taking 40mg achieved response that made them “essentially indistinguishable from healthy counterparts”; compared with 52% of the people given a placebo.
Or: you have a 60% chance that Paxil will do some good, with about a 35% chance it will make your symptoms disappear.

Social Anxiety Disorder (SAnD)

For Social Anxiety Disorder the odds are also pretty good Paxil will work.

  • Paxil for social anxiety after 36 weeks. This is a follow-up trial GSK ran, testing how well Paxil is at preventing relapse. Not surprisingly those who stayed on Paxil fared a lot better than those who didn’t.

Panic Disorder

Premenstrual Dysphoric Disorder (PMDD)

For PMDD the odds are pretty damned good.

Quote:

71% of patients randomized to 25 mg of paroxetine CR and 67% of patients randomized to 12.5 mg paroxetine CR had a significant response to treatment (defined as ≥50% reduction from baseline VAS-Mood).

  • 85% of women responded to Paxil. This was a follow-up to the clinical trials - so GSK paid for it - and a high efficacy rate is to be expected. They were trying to determine if it made a difference to take Paxil all the time or only during certain phases in one’s cycle; and what, if any, symptoms are helped more than others by Paxil. Irritability seems to be the symptom helped the most. As for taking Paxil all the time or intermittently, that depends on symptoms. As women with other conditions were excluded from the trial there’s not a complete picture, but it makes a big difference for depression. You don’t want to be taking Paxil on and off for depression.

Likelihood Paxil (paroxetine) will Work for Off-Label Applications


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Paxil (paroxetine) versus Other Antidepressants for its Approved Indications

For all Approved Applications

  • Zoloft vs. Paxil vs. Celexa - which is better for medication compliance? Getting people to stay on their meds is essential in getting them to work. That seems obvious, but all the clinical trials in the world don’t mean shit if someone won’t get a refill. This study looks at just that, which med gets the most first refills for approved treatments: depression, social anxiety, and PTSD. The winner: it’s a statistical tie between Zoloft and Celexa, with 54.70% and 54.49% of people taking them getting refills. Given the size of the study - over 14,000 people - Paxil’s first refill rate of 50.99% is significantly poorer, but isn’t overwhelmingly so.
  • Celexa vs. Paxil vs. Zoloft - which med do people stay on longer? This is an indicator of which one generally sucks the most, not which is the most successful, as this is for people who still needed treatment. 14,933 people with depression, PTSD, or social anxiety disorder all taking brand and not generics. The results: Paxil sucks the most, Celexa sucks the least.

Anxiety Spectrum Disorders

  • Paxil vs. Effexor XR vs. placebo for social anxiety. It’s a tie. They work equally well, they’re both better than placebo, and they both suck as much and in similar ways. Even though Wyeth funded this study, having authors who also do work for GSK helped to balance things out. I can’t find what they used for the placebo, because its adverse effects where almost as high as both meds!
  • Paxil vs. Lexapro vs. placebo for generalized anxiety disorder. Five, 10 & 20mg of Lexapro were compared with 20mg of Paxil and a placebo. The winner: 10mg a day of Lexapro. As two of the authors work for Lundbeck, who also sponsored the study and manufacture Lexapro, that’s not a particularly surprising result.
  • Lexapro vs. Paxil for Social Anxiety Disorder (SAnD). SAnD is an off-label use of Lexapro. This Lundbeck-sponsored study isn’t very fair, as it compares 20mg of the older, immediate-release Paxil against 5mg, 10mg, and 20mg of Lexapro. While 20mg of immediate-release Paxil is GSK’s recommendation for SAnD, it’s 25–37.5mg a day for the controlled-release flavor. While 10mg of Lexapro is equal to 10mg of Paxil, 20mg of Lexapro is more like 37.5mg of Paxil CR. So, once again, it’s not all that surprising that 20mg of Lexapro was more effective than 20mg of Paxil.
  • Paxil vs. Seroquel for GAD: Seroquel works better and faster than Paxil. You can take Seroquel and be fat, horny, lazy, and maybe shaky, or take Paxil and wait for it to work, and never want or be able to have sex.

Depression Spectrum Disorders:

  • Zoloft vs. Paxil vs. Prozac for depression. 573 people being treated by primary care physicians (PCPs) are randomly assigned one of the three SSRIs. If it didn’t work or suck too much ove the course of 9 months they got to switch to another med that isn’t one of these. The results: Zoloft wins, but is barely more effective and marginally sucks less. There is absolutely no difference between Paxil and Prozac.
  • Zoloft vs. Paxil vs. Prozac for anxious depression. 108 people with major depression with severe anxiety were randomly given one of the three meds for however long this study lasted. The results: a three-way tie. The only difference was Zoloft and Prozac started working in a week.
  • Zoloft vs. Paxil for depression with personality disorder. 176 people took Zoloft and 177 took Paxil for six months. The results: For one thing, taking SSRIs for six months works a hell of a lot better than taking them for only two or three months. Another useful piece of information (that shows up in other studies): if nothing at all happens in two weeks, you may as well forget whichever one you’re taking. Otherwise Zoloft was somewhat better and sucked noticeably less.
  • Zoloft vs. Paxil for delusional depression. A small, short study - 46 people and six weeks - but Zoloft kicked Paxil’s ass. Zoloft worked for 75% of people taking it, Paxil worked for only 46%, and 41% of people taking Paxil dropped out because of side effects.

How Paxil (paroxetine) Compares with Other Drugs for Off-Label Treatments



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Approved & Off-label Uses | Paxil Index | How to Take and Discontinue


1 Assuming you were correctly diagnosed in the first place.

2 Unless you know for sure you're an ultra-rapid metabolizer of CYP2D6 substrates.


If you have any questions not answered here, please see the Crazymeds Paxil discussion board. We welcome criticisms of the articles, notifications of bad links, site problems, consumer experiences with medications, etc. I’m not always able to write back. Hence I never answer questions about meds via e-mail that are answered by this or other articles. Especially if they have been repeatedly asked on the forum. That’s why we write these damn things. Questions about which meds are best for your condition should also be asked on the forum; because this is a free site, so the price of admission is making things easier for somebody else searching for the same answer. We don’t deal with children on the forum or in private because after doing this for ten years I don’t have the emotional stamina to deal with kids who have brain cooties. How to contact Crazymeds. — Jerod Poore, CME, Publisher Crazymeds (crazymeds.us)


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All information on this site has been obtained from the medications’ product information / summary of product characteristic (PI/SPC) sheets and/or medication guides - which is all you get from sites like WebMD, RxList, NAMBLA NAMI, etc., the sources that are referenced throughout the site, our personal experience and the experiences family, friends, and what people have reported on various reputable sites all over teh intergoogles. 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 medication guide/patient information leaflet (PIL) that comes with your medications and never ever throw them away. OK, you can throw away duplicate copies, but keep at least one, as that’s your proof of purchase of having taken a med in case a doctor doubts your medical history. Plus they take up less space than a bottle, although keeping one inside of a pill bottle is even better.
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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 Remember kids, Microsloth operating systems are like TOS Star Trek movies with in that every other one sucks way, way more. With TOS Star Trek movies you don’t want to bother watching the odd-numbered ones. With Microsloth OS you don’t want to buy and install the even-numbered ones. Anyone who remembers ME and Vista knows what I mean.

3 Have I mentioned how open source operating systems for commercial applications is one of the dumbest ideas in the history of dumb ideas?* I don’t even need my big-ass rant any more. Heartbleed has made my case for me. And that’s just the one that got all the media attention. The very nature of an open source operating system makes security as much of an illusion as anonymity on teh Intergoogles. Before you flip out too much: the domain Crazymeds is hosted on uses a version of SSL that is not affected by the Heartbleed bug. That’s one of the many reasons why I pay a lot of money and keep this site on Lunarpages.

* Yes, I know I’m using open source browsers. I also test the site using the now-defunct IE and Safari browsers. Their popularity - and superiority - killed IE and Safari, so that’s why I rely on the open source browsers. It’s like brand vs. generic meds. Sometimes the generic is better than the brand.

Quote:

71% of patients randomized to 25 mg of paroxetine CR and 67% of patients randomized to 12.5 mg paroxetine CR had a significant response to treatment (defined as ≥50% reduction from baseline VAS-Mood).

  • 85% of women responded to Paxil. This was a follow-up to the clinical trials - so GSK paid for it - and a high efficacy rate is to be expected. They were trying to determine if it made a difference to take Paxil all the time or only during certain phases in one’s cycle; and what, if any, symptoms are helped more than others by Paxil. Irritability seems to be the symptom helped the most. As for taking Paxil all the time or intermittently, that depends on symptoms. As women with other conditions were excluded from the trial there’s not a complete picture, but it makes a big difference for depression. You don’t want to be taking Paxil on and off for depression.

:)

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