Paxil Vs. Zoloft: Drug Comparison

Paxil^® (paroxetine) is a selective serotonin reuptake inhibitor (SSRI) used to treat mood disorders by increasing available serotonin levels in the brain, which helps regulate mood and reduce anxiety. Its FDA-approved indications include major depressive disorder (MDD), generalized anxiety disorder (GAD), panic disorder, obsessive-compulsive disorder (OCD), social anxiety disorder, and post-traumatic stress disorder (PTSD). Paxil is available in tablet, extended-release tablet, and oral suspension forms. Common side effects include nausea, drowsiness, and sexual dysfunction, and it carries a boxed warning for an increased risk of suicidal thoughts and behaviors in children, adolescents, and young adults, especially during the initial treatment period.

Zoloft^® (sertraline) is a selective serotonin reuptake inhibitor (SSRI) used to treat mood disorders by increasing available serotonin levels in the brain, which helps improve mood and reduce symptoms of anxiety and depression. Its FDA-approved indications include the treatment of major depressive disorder (MDD), obsessive-compulsive disorder (OCD), panic disorder (PD), post-traumatic stress disorder (PTSD), social anxiety disorder (SAD), and premenstrual dysphoric disorder (PMDD). Off-label uses may include the treatment of eating disorders and generalized anxiety disorder (GAD). Zoloft is available in tablet and oral solution forms, typically taken once daily. Common side effects include nausea, dizziness, insomnia, and sexual dysfunction, and it carries a boxed warning for an increased risk of suicidal thoughts and behaviors in children, adolescents, and young adults, particularly during the initial treatment period.

Selective serotonin reuptake inhibitor (SSRI)

Selective serotonin reuptake inhibitor (SSRI)

Paxil (paroxetine hydrochloride) is indicated in adults for the treatment of:

• Major depressive disorder (MDD)

• Obsessive compulsive disorder (OCD)

• Panic disorder (PD)

• Social anxiety disorder (SAD)

• Generalized anxiety disorder (GAD)

• Posttraumatic stress disorder (PTSD)

Zoloft (sertraline hydrochloride) is indicated for the treatment of:

• Major depressive disorder (MDD)

• Obsessive-compulsive disorder (OCD)

• Panic disorder (PD)

• Posttraumatic stress disorder (PTSD)

• Social anxiety disorder (SAD)

• Premenstrual dysphoric disorder (PMDD)

• Typically taken orally once daily

• Comes in 10 mg (score), 20 mg (scored), 30 mg, and 40 mg extended-release tablets

• Typically taken orally once daily

• Comes in 25 mg, 50 mg, and 100 mg tablets and 20 mg/mL oral solution

Most common adverse reactions (≥5% and at least twice placebo) are:

• Abnormal ejaculation

• Weakness

• Constipation

• Decreased appetite

• Diarrhea

• Dizziness

• Dry mouth

• Female genital disorder

• Impotence

• Infection

• Insomnia

• Libido decreased

• Male genital disorder

• Nausea

• Nervousness

• Sleepiness

• Sweating

• Tremor

• Yawn

Most common adverse reactions (≥5% and twice placebo) in pooled placebo-controlled MDD, OCD, PD, PTSD, SAD and PMDD clinical trials were:

• Nausea

• Diarrhea/Loose stool

• Tremor

• Indigestion

• Decreased appetite

• Excessive sweating

• Ejaculation failure

• Decreased libido

• Concomitant use of monoamine oxidase inhibitors (MAOIs) or use within 14 days of discontinuing a MAOI

• Concomitant use of pimozide or thioridazine

• Known hypersensitivity to paroxetine or to any of the inactive ingredients in Paxil

• Drug interactions: drugs highly bound to plasma protein, drugs metabolized by CYP2D6, tamoxifen

• Concomitant use of monoamine oxidase inhibitors (MAOIs), or use within 14 days of stopping MAOIs

• Concomitant use of pimozide

• Known hypersensitivity to sertraline or excipients

• Zoloft oral solution only: Concomitant use of disulfiram

• Drug interactions: protein-bound drugs, CYP2D6 substrates

• Serotonin syndrome

• Embryofetal and neonatal toxicity

• Increased risk of bleeding

• Activation of mania/Hhypomania

• Seizures

• Angle-closure glaucoma

• Sexual dysfunction

• Serotonin syndrome

• Increased risk of bleeding

• Activation of mania/hypomania

• Seizures

• Angle closure glaucoma

• QTc prolongation

• Sexual dysfunction

• Pregnancy: Third trimester use may increase risk for persistent pulmonary hypertension and withdrawal in the neonate

WARNING: SUICIDAL THOUGHTS AND BEHAVIORS

Increased risk of suicidal thoughts and behavior in pediatric and young adult patients taking antidepressants. Closely monitor all antidepressant treated patients for clinical worsening and emergence of suicidal thoughts and behaviors. Paxil is not approved for use in pediatric patients.

WARNING: SUICIDAL THOUGHTS AND BEHAVIORS

Antidepressants increased the risk of suicidal thoughts and behaviors in pediatric and young adult patients.

Closely monitor for clinical worsening and emergence of suicidal thoughts and behaviors.

*This information is from the label for brand name Paxil^®. See the Full Prescribing Information for more complete information. Paroxetine, the active ingredient in Paxil, may also be the active ingredient in other medications, and this information may not be accurate for all medications that include the active ingredient paroxetine.

*This information is from the label for brand name Zoloft^®. See the Full Prescribing Information for more complete information. Sertraline, the active ingredient in Zoloft, may also be the active ingredient in other medications, and this information may not be accurate for all medications that include the active ingredient sertraline.