What’s the Difference? — Talkspace

Differences Between Paxil vs. Zoloft

To compare Paxil and Zoloft, it’s necessary to assess the differences between these drugs. Both SSRI antidepressant medications affect neurotransmitters in the brain to help maintain balance. Still, they work slightly differently, and which is best will depend on several factors. 

Conditions they treat

While both drugs are antidepressants and treat some of the same conditions, there are also  some differences in others Paxil versus Zoloft can treat.

Paxil is FDA-approved to address symptoms of: 

Paxil off-label uses include:

Zoloft is approved by the FDA to treat: 

• Major depressive disorder (MDD)
• Obsessive-compulsive disorder (OCD)
• Panic disorder
• Post-traumatic stress disorder (PTSD)
• Social anxiety disorder
• Premenstrual dysphoric disorder (PMDD)

Zoloft off-label uses include:

• Autism
• Disordered eating
• Generalized anxiety disorder (GAD)
• Personality disorders

Note that off-label uses for any drug have been seen as effective, but they’re not FDA approved. 

Dosage amount

Dosage can vary between Paxil and Zoloft, and it’s important to take either drug exactly as prescribed. 

Paxil is available in either immediate or controlled release forms:

• Immediate-release — Start with 10 – 20 mg, increased by 10 mg weekly if needed, only as advised by a doctor; maximum of 50 mg daily.  
• Controlled release: Start with 12.5 – 25 mg, increased by 12.5 mg weekly if needed, only as advised by a doctor; maximum of 62.5 mg per day. 

Zoloft is available in the following dosages and forms:

• Tablets — 25, 50, or 100 mgs
• Capsule — 150 – 200 mg
• Liquid — 20 mg/mL

Side effects

When we compare Paxil and Zoloft, we need to look at each drug’s side effects. While some reactions can be the same, the drugs can affect everyone differently.

Common side effects of Paxil:

• Nausea
• Weakness
• Drowsiness 
• Sexual dysfunction
• Risk of bleeding
• Weight gain  

Common side effects of Zoloft:

• Nausea or vomiting
• Diarrhea
• Dry mouth
• Headache
• Dizziness or lightheadedness
• Sexual side effects
• Weight change

Does Paxil have less side effects than Zoloft?

Before deciding if Zoloft is better than Paxil, or vice versa, remember that Individual responses can vary. Factors like health conditions, age, and concurrent use of other medications can all impact how a drug affects someone. 

Some research suggests Zoloft may be tolerated better in certain people, but knowing which drug is best for you will ultimately be decided by you and your doctor.

Does Paxil or Zoloft make you gain weight?

• Paxil: Not everyone will experience weight gain on Paxil, but it’s important to note that about 1% of people in clinical trials did see weight gain related to taking the drug. Some research suggests that weight gain is more likely with Paxil than with other SSRIs.  

• Zoloft: Significant research shows that Zoloft weight gain is temporary and moderate. While it can be expected for people on antidepressants to see weight gain as a side effect, studies show that Zoloft may have less risk of causing significant weight gain than other antidepressants.