Highlighting side effects, warnings, interactions, and more

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US brand name: Paxil
Generic name: paroxetine

Paxil’s Potential Side Effects

Potential Side Effects All Crazy Meds Have

No matter which neurological and/or psychiatric drug you take, you’ll probably get one or more of these side effects. These will usually be gone, or at least will diminish to the point where you barely notice it most of the time, within a week or two.

  • Headache
  • Drowsiness / fatigue - even when taking stimulants in some circumstances.
  • Insomnia, instead of or alternating with the drowsiness.
  • Nausea
  • Assorted other minor GI complaints (constipation, diarrhea, etc.)
  • Generally feeling spacey / out of it
    • Which can all add up to the ever-helpful “flu-like symptoms” listed as an adverse event on the PI sheet of practically every medication on the planet used to treat almost any condition humans and other animals could have.1
  • All crazy meds can, and probably will affect your dreams as well. There is no way of telling if that will be good or bad, let alone if this side effect is permanent or temporary.
  • Any of the above side effects you see listed again below means they’re even more likely to happen and/or stick around longer and/or are worse than most other meds.


Typical Potential Side Effects

The usual for SSRIs - headache, nausea, dry mouth, sweating, sleepiness or insomnia (it’s a coin toss), constipation - pretty bad for some people, feature and not bug for anyone with IBS - weight gain and assorted sexual dysfunctions. 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.

Uncommon Potential Side Effects

Motion sickness/vertigo, food tasting weird (taste perversion), 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 antipsychotics, such as gynecomastia (man boobs), galactorrhea (leaky tits, regardless of gender), and movement disorders such as: akathisia, EPS, TD, and NMS. See the page on drug-induced movement disorders for more information about those scary, but easily fixed (you stop taking the med) side effects.

Freaky Rare Side Effects

Enlargement of skin, pathological laughter, and vaginal anaesthesia. You could have quite a career in freaky fetish porn with those.

Not all side effects have been listed here, just the most likely and most interesting. For all reported side effects, see Paxil’s PI Sheet.



What You Really Need to be Careful About

Taking Paxil every day at the same time. As with Effexor, some people have experienced the beginnings of SSRI/SNRI discontinuation syndrome if they’re even an hour late with their dose.

Pregnancy Category

Paxil’s Noted Drug-Drug, Drug-Food & Drug-Supplement Interactions

Paxil (paroxetine) + tamoxifen = that breast cancer isn’t going anywhere.
Paxil’s interference with tamoxifen’s transformation into its active metabolite is so profound, and well-known, that people taking tamoxifen are often advised to not take any SSRI, or even to not take any antidepressant. Admittedly most, but not all, SSRIs inhibit CYP2D6 to some degree, with Prozac (fluoxetine) being as bad as Paxil (paroxetine). While you’d have to be a poor metabolizer of CYP2D6 to be affected by all the rest of the SSRIs, the no-SSRI rule of thumb is a good one. But to avoid all antidepressants, even those which aren’t even metabolized by CYP2D6, is going a bit too far.

Check for Other Drug-Drug, Drug-Food & Drug-Supplement Interactions Paxil may have at

Drugs.com’s drug-drug and drug-food interaction checker

It’s always a good idea to check for drug-drug interactions yourself. Just because most people in the crazy meds business know about really important interactions (e.g. MAOIs and a lot of stuff, warfarin and everything on the planet) doesn’t mean the person who prescribed your meds told you about them, or the pharmacist has all the meds you take at their fingertips like they’re supposed to. Or they have the time to do their jobs properly when not dealing with complete idiots or playing Angry Farmers on teh Faecesbooks.
Learn more about drug-everything interactions on our page of tips about taking crazy meds.



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1 As well as being an indication of half of said conditions.


Last modified on Wed, 04 May, 2016 at 17:51:42 by JerodPoorePage Author Date created April 08, 2011, at 05:11 PM
“Paxil (paroxetine ) Pharmacology” by Jerod Poore is copyright © 2011 Jerod Poore Published online 2011/04/08

Paxil, and all other drug names on this page and used throughout the site, are the trademarks of someone else. Paxil’s PI Sheet will probably have the name of the manufacturer and trademark owner (they’re not always the same company) at or near the very bottom. Or ask Google who the owner is. The way pharmaceutical companies buy each other and swap products like Monopoly™ real estate, the ownership of the trademark may have changed without my noticing. It may of changed hands by the time you finished reading this article.



Page design and explanatory material by Jerod Poore, copyright © 2003 - 2016. All rights reserved. See the full copyright notice for full copyright details.
Don’t automatically believe everything you read on teh Intergoogles. 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. For more details see the Crazymeds big-ass disclaimer.

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