Paxil, like the earlier antidepressant Prozac, apparently works by enhancing the action of a brain chemical called serotonin. This medication is prescribed to treat major depression, and has been shown to be effective for up to one year. Like Prozac, Paxil is less likely to cause typical side effects associated with older medications.

Tricyclic antidepressants like Elavil, Tofranil, Sinequan and Pamelor often produce dry mouth, dizziness, weight gain, and a sluggish or lethargic feeling. Paxil may not have these effects, and may have a slight stimulant action.

Side Effects and Interactions of Paxil

Side effects associated with this medication include exhaustion, sweating, nausea, decreased appetite, drowsiness, dry mouth, dizziness, insomnia, tremor, problems with ejaculation and anxiety. Less common adverse reactions include headache, palpitations, constipation, diarrhea, blurred vision and decreased libido. A wide range of other reactions have been reported but appear to be uncommon. Report any symptoms to your physician promptly.

It can also interact with a number of other medications. Anyone taking other antidepressants, especially drugs such as Nardil, Marplan or Parnate should stop such a medicine at least two weeks before starting on Paxil. If Paxil is taken first, two weeks should elapse before starting on one of these other medicines. If the amino acid tryptophan ever becomes available in the U.S. again, it should not be taken with Paxil, as it may increase the potential for adverse reactions.

Tricyclic antidepressants like Elavil, Pamelor or Tofranil could in theory have stronger actions and more pronounced toxicity when they are combined with Paxil. This may also occur with certain medications prescribed to regulate heart rhythm. Other compounds that could cause complications in combination with Paxil include Coumadin and possibly Lanoxin.

Tagamet may increase Paxil levels, while phenobarbital or Dilantin can lower them. Interactions between the herb St. John’s wort and Paxil are possible. Switching between antidepressants and herbal treatment calls for medical guidance (physicians can find a suggested protocol for gradual substitution of St. John’s wort in Hyla Cass’s book, St. John’s Wort: Nature’s Blues Buster).

Check with your pharmacist and physician before taking any other medicines or herbs in combination with Paxil.

Special Precautions

Some people may need very close monitoring if the doctor prescribes Paxil. For people who have had an episode of mania, there is a risk that manic symptoms could be triggered by this drug.

Patients who have had seizures also need to followed carefully, since Paxil, like most other antidepressants, may provoke seizures in susceptible individuals. Because it may cause drowsiness or dizziness, people taking this medicine should not drive or use dangerous machines unless an objective evaluation shows they are not impaired.

Older people and those with kidney disease or liver problems may need to start on a reduced dose, as they may eliminate Paxil less efficiently than otherwise healthy people.

Anyone with a history of suicide attempts must also be extremely vigilant. There have been reports that some people may develop a preoccupation with suicide or violence while taking Prozac. It is still not certain whether this is caused by the underlying mental condition or is in some way related to the drug. If Prozac were responsible for any of these incidents, there might also be a risk with Paxil. Family members must help monitor people on Paxil for suicidal thoughts or self-destructive behaviors. The doctor must be notified immediately in such cases.

Taking the Medicine

According to the manufacturer, Paxil should be taken once a day, preferably in the morning. It may be taken either with or without food.

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  1. Mike

    I’ve been on generic Paxil for 20 years. I recently received a bad batch from Solco, and it took a week of feeling crazy and sick until I realized what was happening. I can’t believe how naive I’ve been all this time in believing all this stuff was regulated and that “only the binders and fillers are different.”

    I contacted a Canadian pharmacy and got on Seroxat from the UK. I figured that the real stuff should work. But it’s been 2 months, and I have no energy, and my nights are filled with vivid dreams, insomnia, and acid reflux.

    The generic from Solco actually worked better for me prior to the bad batch. I have to do something, but I’m not sure what. How frustrating and discouraging.

  2. Marcus

    I have taken Paxil since 1998, believe, for anxiety/OCD.

    Twice when I was on the brand name (made by GSK) it was recalled for being super-potent. Both times I had noticed a surge in energy and almost manic-like symptoms before it was recalled.

    For a number of years now I’ve been on the Zydus brand. It has not really helped my anxiety/OCD. But with the most recent batch I got from the pharmacy I noticed the pills looked much sleeker. They are slightly thinner looking. It’s hard to describe because the imprint is the same; the general size is the same; the color is the same, and yet you can see the difference.

    I didn’t think anything of it at the time.

    But I started having symptom after symptom that finally made me question the “new” style of Zydus paroxetine.

    I had symptoms I’ve had in the past of “super potent” Paxil with high blood pressure, hypomanic symptoms, increased temperature, and an agitated feeling in my head. I noticed I had to increase my blood pressure medicine, and even that wasn’t controlling my blood pressure.

    I looked on a website where you can see previous labels, and I saw that they did change their manufacturing site (either in 2017 or 2018 not sure) from Ahmedabad, India to Baddi, India. I would guess this is why the pills look slightly different. I can’t know for sure because my pills come in the pharmacy bottle rather than the manufacturer’s bottle, otherwise I’d know for sure.

    I’m not sure if the previous batch was sub potent and maybe this one is normal, and I’m not responding well to that. Or maybe this batch is super potent.

    I will see my psychiatrist in a couple of days fortunately and take a gamble on another brand.

    • Marcus

      Update: I contacted Zydus.

      Apparently they still manufacture paroxetine in both Baddi and Ahmedabad India.

      However, they said there’s no way for the pharmacy to choose which version they get because it’s dependent on whatever the wholesaler has. They use the same NDC code even though one is ZyGenerics and one is Zydus USA and made in two different factories quite a vast distant away from each other (India is a very large country).

      Also you wouldn’t know which one you’re getting unless you get the manufacturer’s bottle, which is rather unlikely.

  3. Kim

    I have been taking Paxil at 20mg for 15 years with the last 3 years being bumped up to 30 mg. My CVS pharmacy switched to a generic from Solco about 6 months ago and I can really tell a difference in my moods, more anxiety and depression. Has anybody had an issue with generic ‘Solco’ Paxil? Would anyone know if Sandoz still makes there generic? I have tried the local pharms around here and they can not seem to get it.Thanks for your help in advance

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