Paxil For Anxiety

Clinically Reviewed by Ami G. Risinger, LPC-MHSP

If you take Paxil for anxiety, its important to understand how the medication works, what benefits it offers, and what types of side effects it may cause.

Contact Time Wellness Centers today to learn more about anxiety treatment in Tennessee.

What Is Paxil?

Paxil is the brand name of a prescription mental health medication that is used to treat a variety of disorders. Its primary active ingredient is paroxetine, which is a selective serotonin reuptake inhibitor (SSRI).

SSRIs are classified as antidepressants, but physicians also prescribe Paxil for anxiety disorders, obsessive-compulsive disorder (OCD), and several other mental health disorders.

According to the medication information website ClinCalc, U.S. pharmacies filled more than 9.5 million prescriptions for Paxil or generic paroxetine in 2023. This represented a 34% increase from 2023, when just over 7.1 million prescriptions were filled, but it was also a 36.2% decrease from 2015, when pharmacies filled more than 15 million Paxil prescriptions.

History of Paxil

Paroxetine was first synthesized in 1975, and Paxil received initial approval from the U.S. Food and Drug Administration (FDA) in 1994.

Paxil was the third SSRI to earn FDA approval, following fluoxetine (Prozac) in 1987 and sertraline (Zoloft) in 1991.

In October 2004, the FDA issued a “black box warning” for Paxil and several other SSRIs to caution consumers of an increased risk of suicidal behaviors among adolescents who took these medications to treat major depressive disorder. 

Uses (What Does Paxil Treat?)

Paxil has been approved by the FDA for use by adults who have:

• Major depressive disorder (MDD)
• Premenstrual dysphoric disorder (PMDD)
• Vasomotor symptoms associated with menopause
• Obsessive-compulsive disorder (OCD)
• Generalized anxiety disorder (GAD)
• Social anxiety disorder (social phobia)
• Panic disorder
• Post-traumatic stress disorder (PTSD)

Physicians also prescribe the medication on an off-label basis to treat several additional mental health conditions, including:

• Separation anxiety disorder
• Persistent depressive disorder (PDD)
• Body dysmorphic disorder
• Postpartum depression

The FDA’s approval of Paxil extends to adults only. The medication is also sometimes used to treat children and adolescents, but all uses for patients under the age of 18 fall into the off-label category.

How Does Paxil Work?

Paxil increases the amount of serotonin in a person’s central nervous system (CNS). Serotonin is a neurotransmitter, or chemical messenger, that regulates several functions, including mood, fear, memory, appetite, and sexual pleasure.

When triggered by the brain, nerve cells release serotonin into the synapses, which are the small gaps that separate cells throughout the CNS. Once the serotonin has crossed the synapse and delivered its message to the receiving nerve cell, a protein transports it back to the originating cell, which absorbs it and stores it for future use.

Paxil disrupts the process of transporting serotonin back to its originating cell, thus preventing it from being reabsorbed. This leads to a buildup of serotonin in the synapses, which has the effect of increasing its influence.

For some people who use Paxil for anxiety, depression, or other mental health reasons, this increase in available serotonin leads to a reduction in symptoms. 

Using Paxil for Anxiety

In the decades since the first SSRIs were introduced, public awareness of serotonin has focused primarily on its impact on depression. 

However, as described in the Handbook of Behavioral Neuroscience, experts have long understood that serotonin is also closely associated with fear, panic, and other anxiety-related symptoms.

FDA Approval

With researchers documenting the potential benefits of Paxil for people with anxiety disorders, the FDA expanded its list of approved uses of the medication to include panic disorder in 1996 and generalized anxiety disorder in 2001. 

When these decisions were made, Paxil became the first SSRI to be authorized by the FDA to treat these conditions.

Today, the FDA’s approval for Paxil includes three anxiety disorders:

• Generalized anxiety disorder (GAD)
• Social anxiety disorder (social phobia)
• Panic disorder

Also, treating separation anxiety disorder is one of the more common off-label uses of Paxil.

Adverse Effects 

Though Paxil has proved effective at treating various anxiety disorders, its use has been linked with a variety of adverse effects. And, as indicated by its FDA-mandated black box warning, some of Paxil’s side effects can be particularly severe.

Among the more common side effects of Paxil use are:

• Dizziness
• Headache
• Fatigue
• Excessive perspiration 
• Nausea
• Appetite loss
• Restlessness
• Constipation
• Diarrhea
• Insomnia

In many cases, these side effects subside within a few weeks after a person begins to take the medication, as their body adapts to the presence of the drug. 

Less common, but potentially much more serious, side effects include:

• Thoughts of suicide
• Suicidal behaviors
• Manic episodes
• Increased bleeding risk
• Drop in sodium levels
• Sexual dysfunction

Paxil use can also cause serotonin syndrome, a potentially fatal condition with symptoms that include confusion, agitation, racing heart rate, elevated body temperature and blood pressure, vomiting, and muscle rigidity.

If you experience any concerning symptoms after taking Paxil, consult with your doctor or seek immediate medical attention.

Paxil Withdrawal

People who use Paxil for an extended period may also develop several distressing withdrawal symptoms if they abruptly stop taking it.

Often referred to as antidepressant discontinuation syndrome, Paxil withdrawal can involve:

• Onset or return of anxiety symptoms
• Mood swings
• “Brain zaps,” or the sensation of brief electric pulses in your head
• Intense nightmares
• Paresthesia (numbness, burning, or tingling in extremities)
• Various flu-like symptoms

To minimize your risk of Paxil withdrawal or reduce the intensity of your symptoms, you should consult with the doctor who prescribed the medication to you before stopping. Your doctor can set up a tapering schedule, which will allow your body to slowly adapt to diminishing amounts of Paxil.

Find Anxiety Treatment in Tennessee

Time Wellness is a trusted source of comprehensive, personalized services for adults who have been living with anxiety disorders, other mental health conditions, and co-occurring addictions. 

Treatment options at our center in Chattanooga, TN, include residential/inpatient care, a partial hospitalization program (PHP), and an intensive outpatient program (IOP). For outpatient clients who need additional support while in treatment, we also partner with closely vetted supportive housing providers and sober living homes in the area.

To learn more about how we can help you or a loved one, or to schedule a free assessment, please visit our Admissions page or call us today.