Which is Right For You? — Talkspace

Overview of Paxil 

Paxil (paroxetine) is an SSRI antidepressant that works by increasing levels of the neurotransmitter serotonin in the brain to improve mood and emotion. 

“This selective serotonin reuptake inhibitor (SSRI) stops the breakdown and uptake of serotonin in the neural synapse, so the amount of serotonin keeps on increasing, helping the synapse to keep on working and resolving symptoms.”

– Talkspace psychiatrist Dr. Muhammad Munir

By blocking serotonin reuptake, Paxil can increase levels to restore balance effectively for your mental health. It is often used to treat conditions like major depressive disorder, generalized anxiety disorder (GAD), panic disorder, premenstrual dysphoric disorder (PMDD), and social anxiety disorder.

Like any drug, there are potential side effects of Paxil that range from nausea and drowsiness to sexual issues. That said, Paxil is generally well-tolerated by most users. It’s not uncommon for people to not experience any severe adverse reactions while taking this drug.

Overview of Prozac  

Like Paxil, Prozac (fluoxetine) is an SSRI that alters serotonin levels in the brain to stabilize mood and improve your mental health condition. Prozac is slightly different in what it treats when compared to Paxil, though. While both drugs are common in treating depression and some types of anxiety disorders, Prozac is also prescribed to treat bulimia. 

“Prozac has been the parent medication for the new era of antidepressants”

– Talkspace psychiatrist Dr. Muhammad Munir

Brand Name	Paxil	Prozac
Generic Name	Paroxetine	Fluoxetine
Class	Selective serotonin reuptake inhibitor (SSRI)	Selective serotonin reuptake inhibitor (SSRI)
Uses — FDA Approved	Major depressive disorder   Obsessive-compulsive disorder Premenstrual dysphoric disorder Panic disorder Post-traumatic stress disorder Social anxiety disorder Generalized anxiety disorder	Major depressive disorder Obsessive-compulsive disorder Premenstrual dysphoric disorder Panic disorder  Bulimia nervosa
Off-label Uses	OCD in children  Postpartum depression Irritable bowel syndrome (IBS)  Postmenopausal symptoms Premature ejaculation	Generalized anxiety disorder Neuropathy or nerve pain caused by long-term diabetes  Fibromyalgia  Migraine  Premature ejaculation
Side Effects	Dry mouth  Headache  Changes in vision  Increased anxiety Nervousness  Sexual dysfunction Weight gain from Paxil	Headache  Insomnia  Difficulty falling asleep  Drowsiness or fatigue  Diarrhea or constipation Changes in appetite
Dosage Forms/Strengths	Tablet: Immediate release in 10, 20, 30, 40 mg  Extended-release tablet: 12.5, 25, 37.5 mg Oral solution: 10mg/5mL Capsule: 7.5 mg	Tablet: 10, 20, 60 mg Generic extended-release capsule: 90 mg Oral solution: 20 mg/5mL Capsule: 10, 20, 40 mg
Safety Precautions	Risk of withdrawal syndrome Serotonin syndrome Increase in suicidal thoughts (more in adolescents and people younger than 24) Change in blood pressure	Risk of withdrawal syndrome Serotonin syndrome Increase in suicidal thoughts (more in adolescents and people younger than 24) Increased risk in elderly population for falls, blood pressure issues, and electrolyte imbalance

Key Similarities Between Paxil & Prozac

Because Paxil and Prozac are in the same class of drugs, they work in the same way by increasing the brain’s serotonin level. With both drugs, the increased serotonin helps with mood regulation. Because they work similarly, Paxil is one of the more common alternatives to Prozac and vice versa.

Efficacy in treating depression and anxiety

Paxil and Prozac have both proven effective for treating depression and anxiety disorders. They help balance your emotions by enhancing serotonin’s effects, which often results in reduced symptoms. 

Is Paxil or Prozac better for anxiety?

Both medications are FDA-approved to treat various types of anxiety disorders — although Paxil is also FDA-approved to treat general anxiety disorder (GAD). In clinical trials, both drugs were found effective in treating major depression that included high levels of anxiety. How well one or the other works for you will depend on several factors.

People can react very differently to the same medication. Body chemistry, symptoms, other medications being taken, comorbid conditions, and dosage can all come into play when trying to determine the efficacy of a drug.

Is Paxil or Prozac better for depression?

Both Paxil and Prozac are effective for treating symptoms of depression. They are both considered first-line treatments for major depressive disorder (MDD).

However, while they are recommended for and can be beneficial in treating depression, the outcome may differ from person to person depending on factors like intensity of symptoms and general health. Clinical trials found no significant difference between Paxil and Prozac in the efficacy of treating major depression.

Shared side effects

Some of the shared common side effects of Paxil and Prozac include:

• Headache
• Insomnia
• Dry mouth
• Sexual dysfunction
• Upset stomach
• Change in appetite

Drug interactions

Like any medication, certain drug interactions are important to be aware of before taking Paxil vs Prozac. Most drugs can have interactions with numerous medications, both prescription and over-the-counter. Make sure your doctor knows if you’re taking any of the following:

• NSAIDs
• St. John’s Wort
• Monoamine oxidase inhibitor (MAOI)
• Thiazide diuretics 
• Opioids 
• Blood thinning medications, including Warfarin and aspirin
• Anti-nausea medications, including Zofran 
• Any other medications that increase serotonin levels — including ADHD medications like Adderall, TCAs, Buspar, and some migraine medications

Key Differences Between Paxil & Prozac

Although there are many similarities between Paxil and Prozac, there are some key differences, too. Even though the drugs can be used to treat depression, Paxil has a wider range of FDA-approved uses. Another major difference is that there may be fewer side effects of Prozac than Paxil.

Mechanism of action

Both medications belong to the SSRI class of drugs, but they have different mechanisms of action. Prozac blocks the reuptake transporter protein in the presynaptic terminal to effectively block the reuptake of serotonin into the presynaptic serotonin neurons. 

Paxil works slightly differently — it increases the synaptic serotonin concentration by blocking the serotonin reuptake transporter. 

Approved uses

FDA-approved drugs have gone through rigorous testing and are recommended to treat certain conditions. The FDA has approved both Paxil and Prozac for treating depression, but Paxil is also approved for the treatment of generalized anxiety disorder and social phobia, while Prozac is approved for treating bulimia.

Specific side effects

Because people can react differently to medications, not everyone will experience every side effect of a drug. That said, there are some specific reactions that might be more common with one drug vs. the other.

• More unique to Paxil: Paxil might cause more drowsiness in some people than Prozac. Reduced libido and weight gain from Prozac are two side effects that may also be lower than Paxil.
• More unique to Prozac: Prozac can cause insomnia due to its stimulating effect.

Choosing Between Paxil and Prozac

Deciding on medication is never a one-size-fits-all exercise. Making the choice between Paxil and Prozac depends on your body chemistry, your condition and symptoms, your medical history, and how well you tolerate each drug’s side effects and potential withdrawal symptoms.

Your doctor or psychiatrist will play a significant role in helping you decide on the best course of treatment to effectively reduce or eliminate your symptoms. They will consider all the variables at play before making any recommendations. 

It’s also essential to remember that the first drug you try may not be the last. Effective treatment plans can take time to finalize. Stay in contact with your doctor, and let them know if you’re having any unusual or uncomfortable side effects. They might adjust the dose or decide that a new medication should be tried.  

Get a Professional Evaluation with Talkspace

Talkspace makes getting a professional evaluation and deciding on a treatment plan simple, affordable, and accessible. You don’t have to face the challenge of determining which medication is right. Talkspace will connect you with a licensed psychiatrist who will assess your symptoms and condition and provide a treatment they think will best help you.

An accurate diagnosis is a critical first step in deciding on a medication or drug. From there, ongoing and open communication about how well your treatment plan works will ensure optimal results.

Reach out to Talkspace today to learn more about how you can get a treatment plan in place so you can overcome your symptoms and get back to living.