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Paroxetine (Paxil) Side Effects

Katelyn Hagerty

Reviewed by Katelyn Hagerty, FNP

Written by Geoffrey C. Whittaker

Published 07/22/2020

Updated 08/12/2023

If you have depression, you already know it’s taking a toll on your life. From making it harder to manage your responsibilities to dampening your enthusiasm for enjoying meaningful experiences, depression can make life pretty hard. 

Unfortunately, sometimes the medications used to treat depression can cause problems too — even if they’re providing a net improvement to the way you feel.

Paxil® is one such treatment — an antidepressant that comes with a risk of side effects. 

Look, you may already know this, just as you may already know that when a mental health disorder has you feeling down and out, the risk of mild side effects may be a risk worth taking.

But we’re also pretty sure that knowing the potential side effects ahead of time is not just a curiosity — it’s a necessity.

Below, we’ve explained the typical paroxetine adverse effects people may see, the interactions with other medications you should be aware of and some important precautions to take to make sure this medication works the way it’s supposed to — without any danger to your health.

Googling around for the side effects of Paxil can lead to some scary search results. A lot of people wonder how common the dangerous side effects are or how dangerous the common side effects are. Others just want to know what to expect. 

For those of you just learning about this medication for the first time, Paxil is a brand-name antidepressant drug, also available under the generic name paroxetine, for the treatment of depression and anxiety

Paxil is a member of the class of drugs known as selective serotonin reuptake inhibitors, or SSRIs, which work to increase the amount of the neurotransmitter (brain chemical) serotonin in the brain.

Although paroxetine is an antidepressant, depression may not be the only reason you end up with a prescription for paroxetine, Paxil or Paxil CR (another form of this medication. In addition to major depressive disorder, this medication is sometimes prescribed for the treatment of hot flashes associated with menopause, as well as several mental health conditions, including:

To understand risks that come with the relief from these conditions that antidepressants can bring, let’s first talk timeline. Usually, people notice paroxetine side effects within the first week they start taking this medication, because it takes Paxil and similar SSRIs more than one dose to build up in your system.

The most common side effects of paroxetine, according to the Food and Drug Administration (FDA), include: 

  • Nausea

  • Sleepiness and yawning

  • Headache

  • Tiredness or drowsiness

  • Weakness

  • Dizziness

  • Anxiety 

  • Trouble sleeping 

  • Sexual dysfunction, including anorgasmia in women and ejaculation problems for men

  • Tremors

  • Blurred vision

  • Sweating

  • Changes in appetite 

  • Dry mouth

  • Infection

  • Constipation

But here’s the good news about this list of potentially miserable problems: they’re typically short-term ones. Over time, many of these side effects can go away or lessen. But if they’re disruptive to your life or do not go away, tell your healthcare provider — there may be an alternative medication better suited for you.

Serious side effects of paroxetine are fairly rare, but can include serotonin syndrome (more on that in a moment), as well as glaucoma.

To learn more about potential side effects, check out our articles on Paxil and alcohol effects and Paxil and weight gain.

There’s another potential source of risk associated with paroxetine besides the medication itself — how you’re taking it, and specifically, what you’re taking with it.

We’ve broken these considerations into four categories:

  • Medication interactions

  • Overdose and serotonin syndrome

  • Withdrawal symptoms

  • Miscellaneous warnings

Let’s take a look at the details.

Medication Interactions

Paroxetine may interact negatively with some medicines, so it’s important to prevent such adverse effects whenever possible. 

A few of the medications known to cause drug interactions with Paxil include blood thinners, other antidepressant medications, non-steroidal anti-inflammatory medications (NSAIDs) such as ibuprofen, antihistamines, St. John’s wort and more. 

If you’re considering getting a prescription for paroxetine online, tell your healthcare provider about all other medications you’re on, including over-the-counter drugs and supplements. 

It’s especially important to talk to your healthcare provider if you’re taking:

  • Thioridazine

  • Pimozide

  • Warfarin

  • Methylene blue

  • Desipramine

  • Isocarboxazid

  • Phenelzine

  • Risperidone

  • Selegiline

  • Venlafaxine

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Overdose and Serotonin Syndrome

There’s one category of medications that may be the most dangerous to take with paroxetine: other antidepressants. Don’t take this antidepressant alongside other antidepressants unless specifically told to by a healthcare provider. 

That means no paroxetine if you’re currently on monoamine oxidase inhibitors (MAOIs), serotonin-norepinephrine reuptake inhibitors (SNRIs) like duloxetine, tricyclic antidepressants or SSRIs like citalopram, fluoxetine or sertraline.

Too much antidepressant medication — whether it’s from taking two antidepressants or just too much paroxetine — can lead to a serious side effect called serotonin syndrome. 

Serotonin syndrome is relatively rare, but possible when taking Paxil. It’s a serious condition — in fact it could be life-threatening in extremes. 

This is one reason it’s important to only take the antidepressant dosage that your doctor prescribes. And it’s why the experts always advise that you just wait until it’s time for the next dose if you skip a dose of your medication — you don’t want too much in your system at once. 

If you experience the following symptoms, seek medical attention: 

  • Shivering

  • Abrupt changes in blood pressure

  • Diarrhea

  • Confusion

  • Muscle tension

  • Seizures

  • Fever

Withdrawal Symptoms

One of the other major worries for people who take antidepressants like paroxetine is what happens when you want to stop taking it — whether withdrawal can happen. While SSRIs are not habit-forming, stopping Paxil abruptly can result in symptoms of withdrawal (also called discontinuation syndrome), so tell your healthcare provider if you want to be taken off of the medication. 

Potential withdrawal symptoms include: 

  • Nausea

  • Vomiting

  • Dizziness

  • Headache

  • Nightmares

  • Irritability

  • Electric shock sensations

  • Feeling pins and needles on the skin 

  • Suicidal thoughts and an increased risk of suicide

Luckily, most of these can be avoided (or at least reduced) by coming off of Paxil gradually, over time, which your healthcare provider can help with. Going cold turkey, meanwhile, will lead to worsening of these effects.

Other Precautions When Taking Paroxetine

If you’ve looked at all this information so far and feel prepared to use or continue using paroxetine, great. However, there are a few final things to be aware of when it comes to the potential adverse effects of paroxetine:

  • Drinking alcohol. Generally speaking, Paxil and alcohol don’t mix. If you’re concerned about your drinking, talk to a healthcare professional about support.

  • Bipolar disorder. Paroxetine should not be used in the treatment of bipolar disorder.

  • Allergic reaction. While rare, an allergic reaction can occur – let your provider immediately know if you get any hives, swelling, rash or difficulty breathing. 

  • Pregnancy. Inform your healthcare provider if you’re trying to become pregnant or if you become pregnant — they will want to talk to you about the risks and benefits of taking Paxil while pregnant.

  • Breastfeeding. Because paroxetine can make its way into your breastmilk, it’s generally advised that you talk with your provider about using paroxetine while breastfeeding.

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For some people, living with depression is merely existing. And sometimes the sheer effort it takes to go through the daily motions of life leaves no energy for seeking help. 

If you’re one of these people, know that you’re not alone, you’re loved and you have options, including paroxetine.

If you decide to give it a try, here’s what to remember about potential risks:

  • Every individual needs different support for depression and anxiety. Your healthcare provider can determine whether your symptoms may be helped by an antidepressant such as paroxetine. 

  • The determination about whether you could benefit safely from paroxetine is based on, among other things, your diagnosis, medical history and the medications you’re currently on.  

  • When deciding whether to take paroxetine, it’s important to balance the potential risks with the potential benefits. 

  • Your healthcare professional can help you make an educated decision on whether it’s the right drug for you. 

Want to know more? We’ve got you covered. In addition to offering paroxetine online, we also offer online psychiatry and virtual mental health services to help you get moving in the direction you want with your mental health. 

We can also answer your further questions about antidepressants, including more about SSRIs and other common antidepressants.

There’s always more to learn, and there are always more options. Learn more about yours today.

3 Sources

Hims & Hers has strict sourcing guidelines to ensure our content is accurate and current. We rely on peer-reviewed studies, academic research institutions, and medical associations. We strive to use primary sources and refrain from using tertiary references.

  1. HIGHLIGHTS OF PRESCRIBING INFORMATION: PAXIL CR (paroxetine) extended-release tablets, for oral use . (n.d.-f). https://www.accessdata.fda.gov/drugsatfda_docs/label/2019/020936s047lbl.pdf.
  2. Chu A, Wadhwa R. Selective Serotonin Reuptake Inhibitors. [Updated 2023 May 1]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK554406/.
  3. Shrestha P, Fariba KA, Abdijadid S. Paroxetine. [Updated 2022 Jul 19]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK526022/.

This article is for informational purposes only and does not constitute medical advice. The information contained herein is not a substitute for and should never be relied upon for professional medical advice. Always talk to your doctor about the risks and benefits of any treatment. Learn more about our editorial standards here.

Katelyn Hagerty, FNP

Kate Hagerty is a board-certified Family Nurse Practitioner with over a decade of healthcare experience. She has worked in critical care, community health, and as a retail health provider.

She received her undergraduate degree in nursing from the University of Delaware and her master's degree from Thomas Jefferson University. You can find Katelyn on Doximity for more information.

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