An Overview of Paxil for Panic Disorder

By

Katharina Star, PhD

Updated on June 12, 2023

Learn more." tabindex="0" data-inline-tooltip="true"> Medically reviewed by

Steven Gans, MD

Paxil pills spilling out of a bottle — Joe Raedle/Getty Images News/Getty Images

What is the most important information I should know about Paxil?

You should not take Paxil if you:

have a hypersensitivity to paroxetine or other ingredients in Paxil; or
have taken an MAOI within the previous 14 days; or
are taking thioridazine or pimozide.

Prescription medication is one of the most common treatment options for panic disorder. Paxil (paroxetine) is one type of medication that is often used to treat panic disorder and other conditions.

Paxil belongs to a category of antidepressants called selective serotonin reuptake inhibitors, or SSRIs. SSRIs first became available in the United States in the 1980s and have continued to remain popular ever since. Compared to other antidepressant medications available at the time, SSRIs were found to have fewer side effects while maintaining effectiveness and safety.

Other common SSRIs include Prozac (fluoxetine), Celexa (citalopram), and Zoloft (sertraline).

Paxil Uses

As the name implies, doctors originally prescribed antidepressants to help reduce the symptoms of depression. However, these medications, including Paxil, are now used to treat mood and anxiety disorders.

Currently, Paxil can be prescribed to treat a variety of conditions, such as:

Aspects of bipolar disorder
Obsessive-compulsive disorder
Social anxiety disorder
Generalized anxiety disorder
Panic disorder (with or without agoraphobia)

SSRI Antidepressants Can Help Panic Disorder

How It Helps With Panic

Serotonin is a naturally-occurring chemical in the brain. As a neurotransmitter, serotonin helps in mood and sleep regulation, as well as other functions. People with mood and anxiety disorders are considered to have a dysregulation in the serotonin system.

Paxil works to balance a person’s level of serotonin by preventing brain cells from quickly absorbing it. Through balancing serotonin levels, Paxil can help enhance mood and reduce anxiety.

Paxil can also help alleviate the symptoms of some common co-occurring conditions, such as depression or sometimes headaches.

How Long Does It Take for Paxil to Work?

Paxil will not work immediately to help reduce your symptoms of panic disorder. Improvements are typically noticed within several days to weeks of starting your prescription, but it can be several months before you experience the full benefits of Paxil.

Side Effects of Paxil

People taking Paxil have the potential to experience some side effects. Typically, the side effects of Paxil gradually subside as your body adjusts to the medication.

If your side effects do not go away or become unmanageable, contact your doctor to discuss options. They might adjust your dose or consider switching you to a different medication.

Common Side Effects

Some of the most common side effects include:

Changes in weight and appetite
Digestive problems
Dizziness and lightheadedness
Drowsiness
Dry mouth
Fatigue
Headaches
Nausea
Sexual side effects
Sleep disturbances

Severe Side Effects

As with all medications, it is possible to have an allergic reaction to Paxil or experience a dangerous drug interaction while taking Paxil with other medications. Be certain that your doctor is aware of all prescribed and over-the-counter medications you are taking.

When to Seek Help

Contact your doctor immediately, or call 911, if you experience any of the following severe side effects.

Confusion
Extreme nervousness, irritability, or anxiety
Rapid heart rate
Signs of an allergic reaction: swelling of the face, mouth, throat, or tongue, hives, rash, difficulty swallowing or breathing
Suicidal thoughts
Vomiting

Missing a Dose

If you miss your dosage of Paxil, try to take it as soon as you remember unless it is at or close to the time for your next dosage. Never take two doses at the same time; instead, take your regular dose and continue following your dosage schedule.

Discontinuing Your Prescription

In some cases, you may decide that you want to stop taking Paxil. Your doctor can help you to gradually reduce your dosage until you are completely off Paxil.

Do not abruptly discontinue your prescription on your own. This can lead to some withdrawal-like symptoms.

Symptoms of Paxil withdrawal can include:

Dizziness
Headaches
Irritability
Worsening anxiety

Precautions and Contraindications

Several precautions and contraindications should be considered when taking Paxil:

Black Box Warning

In 2004, the Food and Drug Administration (FDA) issued an alert, warning that antidepressants such as SSRIs may increase the risk of suicidal thoughts and behaviors. The FDA cautioned that this risk is especially an issue for adolescents and young adults.

Due to these concerns, young people started on SSRIs should be observed for declining mood and suicidal thoughts.

If you are having suicidal thoughts, contact the National Suicide Prevention Lifeline at 988 for support and assistance from a trained counselor. If you or a loved one are in immediate danger, call 911.

Pregnancy/Nursing

It is possible for Paxil to be passed on to a child during pregnancy or while nursing. If you are planning to become pregnant, are currently pregnant, or are nursing, talk to your doctor about the potential risks of Paxil.

Alcohol

Consuming alcohol with Paxil can potentially increase its toxicity or reduce its effectiveness.

Older Adults

When taking Paxil, older adults may be more susceptible to side effects. An adjustment in dosage may be needed to reduce side effects.

The information provided here is meant to be an overview of the use of Paxil for panic disorder. The general information here does not cover all possible scenarios, such as potential adverse side effects, precautions, and contraindications. Always consult your medical provider about any questions and/or concerns you may have about your Paxil prescription.

If you or a loved one are struggling with panic disorder, contact the Substance Abuse and Mental Health Services Administration (SAMHSA) National Helpline at 1-800-662-4357 for information on support and treatment facilities in your area.

For more mental health resources, see our National Helpline Database.

5 Sources

Verywell Mind uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.

U.S. Food and Drug Administration. Prescribing information: Paxil (paroxetine hydrochloride) tablets and oral suspension.
Crocco EA, Jaramillo S, Cruz-Ortiz C, Camfield K. Pharmacological management of anxiety disorders in the elderly. Curr Treat Options Psychiatry. 2017;4(1):33–46. doi:10.1007/s40501-017-0102-4
Lin SH, Lee LT, Yang YK. Serotonin and mental disorders: a concise review on molecular neuroimaging evidence. Clin Psychopharmacol Neurosci. 2014;12(3):196–202. doi:10.9758/cpn.2014.12.3.196
Nevels RM, Gontkovsky ST, Williams BE. Paroxetine-the antidepressant from hell? Probably not, but caution required. Psychopharmacol Bull. 2016;46(1):77-104.
Fornaro M, Anastasia A, Valchera A, et al. The FDA "Black Box" warning on antidepressant suicide risk in young adults: More harm than benefits?. Front Psychiatry. 2019;10:294. doi:10.3389/fpsyt.2019.00294

Additional Reading

Dudley, William. Antidepressants. San Diego, CA: Reference Point Press, 2008.
Silverman, Harold M. The Pill Book. 15th ed. New York, NY: Bantam Books, 2012.

By Katharina Star, PhD
Katharina Star, PhD, is an expert on anxiety and panic disorder. Dr. Star is a professional counselor, and she is trained in creative art therapies and mindfulness.

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