Medically reviewed by Vicky Davis, FNP
Written by Our Editorial Team
Last updated 7/17/2022
The Paxil® vs Prozac® question is a popular one these days — they’re both popular medications, with similar functions, and they can both deliver relief from mood swings and other mood disorder symptoms.
But what makes Prozac or Paxil better or worse isn’t necessarily something universal, and depending on your personal needs one or the other might be better suited to help you with treatment for depression or another mood disorder.
To understand the differences between these two medications (and which one you might benefit most from), let’s start with some background information.
These two medications have a lot in common (nearly everything, actually), so let’s clarify what’s what.
Prozac (generic name fluoxetine), is a selective serotonin reuptake inhibitor (SSRI) approved by the Food and Drug Administration (FDA) to treat a variety of mood disorders.
Paxil (generic name paroxetine) is also an SSRI and is also approved by the FDA to treat a variety of mood disorders.
SSRIs generally “work” to treat mood disorders by balancing a neurotransmitter in your brain called serotonin — your serotonin levels can affect your mood, so SSRIs sort of trick your brain into keeping higher levels of serotonin on standby to help regulate your mood. More serotonin means fewer lows, which in turn, reduces the severity and frequency of depressive episodes.
Generally, SSRIs are considered among the most well-tolerated antidepressant drugs, so both of these medications are at least in the right company.
But sharing a category doesn’t mean they’re identical.
One of the main reasons to explore the differences between these medications is that not every antidepressant works the same for every person. Antidepressants are neither good nor bad — they’re about what works and what doesn’t work for you.
What works for you may depend on what you need treated, your tolerance for individual medications and your tolerance to side effects. Let’s look at how they compare.
Prozac is also used to treat major depressive disorder, obsessive-compulsive disorder, panic disorder, premenstrual dysphoric disorder and bipolar depression, but is also used in the treatment of bulimia, binge eating disorder and has been used effectively off-label for anxiety treatment and the treatment of borderline personality disorder.
Paxil is specifically recommended in the treatment of major depressive disorder, post-traumatic stress disorder, generalized anxiety disorder, social anxiety disorder, panic disorder, obsessive-compulsive disorder and premenstrual dysphoric disorder.
It can also be used to treat hot flashes and night sweats associated with menopause for some women.
In addition to its use in treating mood disorders, Paxil is also occasionally prescribed off-label for premature ejaculation.
That may seem random, but, believe it or not, it’s not the only mood disorder medication used to treat these conditions.
Both Paxil and Prozac can be prescribed both as a time-release tablet, as well as in liquid form, and both should be taken orally.
With regards to dosage, the two medications do vary slightly.
Paxil maxes out at a top safe dose of around 50mg per day (depending on what it’s being used to treat), while someone can safely take up to 80mg of Prozac per day without negative effects.
Generally, Paxil has the smaller recommended minimum dose at 10mg per day, while Prozac will typically be started at 20mg per day.
The side effects of Paxil may include dry mouth, reduced sex drive, sexual function side effects, loss of appetite, insomnia, sweating, drowsiness, nausea, vomiting, headache, fever, chills, anxiety, irritability, dizziness and others.
Prozac causes the same issues, but additionally may cause panic attacks, bruising, bleeding, decreased vaginal lubrication, headache, yawning and mania.
Both Paxil and Prozac are effective medications for the treatment of mental disorders, and both have proven themselves through a number of clinical trials.
Both medications likewise have adverse effects to be wary of. The key difference isn’t really something you’re going to find on paper.
What we’re saying is that we can’t really tell you which medication you should take — no one can without understanding your unique circumstances.
And even then, a tailored treatment for your symptoms of depression may still require trying more than one antidepressant medication before you achieve success.
Generally, studies show that SSRIs can be effective for treating depression. Other medications may help you treat your depression without causing unintended consequences like weight loss or weight gain, or without causing undesired drug interactions with medications like blood thinners.
When treating depression, not only do you have to worry about the complications we just mentioned, you also have to worry about the big picture of what else might be needed to really make a difference in your treatment.
While medications are proven safe and effective when used as directed, the fact is that not every case of depression requires medication. It’s also not always the case that medication for depression is adequate treatment on its own.
This could be the case for many reasons, from variations in the types of depression you’re trying to treat, to individual brain chemistry and biology.
Suffice it to say that every person’s mental health journey is different, and every treatment type should likewise be different and tailored to every individual’s needs.
So whether you’re dealing with major depression, clinical depression, generalized anxiety disorder, panic disorder, bipolar disorder, social anxiety disorder or another type of disorder, the right depression treatment for you is what matters.
Your depression treatment may include health and lifestyle improvements. For instance, it may also include therapy.
Modern therapeutic techniques like cognitive behavioral therapy (CBT) work. CBT’s goal is to help patients recognize the signs and symptoms of their mood disorder and begin to correct and control those behaviors, overcome negative thoughts and escape that depressive spiral — and return to it less often.
Lest you think some couch time with a mental health professional and a handful of pills are going to be the whole picture, you may be surprised to find that your lifestyle can play a huge part in your mental health.
Who would have thought that smoking, drinking, eating poorly, avoiding exercise, taking recreational drugs, neglecting your sleep and generally bailing on your health could cause problems?
If you’re not taking care of yourself, putting some care and attention into your daily routine can go a long way for both your mental and physical health — and studies show a little exercise can be just as beneficial as medication in some instances.
Getting your mental health in check is worth it, and that can mean a lengthy treatment process that involves trial and error, patience, time and tact.
Getting on the right antidepressant drug for your needs is not always an overnight process. While Paxil and Prozac are both in the same family of medications (SSRIs), they’re two drugs, used for different purposes and each has their own side effects. Though they’re similar, they are different.
And what works for someone else may not work for you.
If you’re unhappy with your current medication, a healthcare professional will be able to help you determine the best course of action for treating your depressive disorder, or whatever else you’re currently struggling with.
Alongside that pharmacological treatment, however, you may also want to consider therapy to support your mental health journey. If you’re not sure where to start, consider hers’ support system. Our online therapy resources are available right now.