Using Paxil for Generalized Anxiety Disorder

Stressed woman rubbing her forehead at laptop

JGI / Jamie Grill / Getty Images

Paxil (paroxetine) is an antidepressant medication approved for the treatment of generalized anxiety disorder (GAD). It belongs to the group of antidepressants known as selective serotonin reuptake inhibitors (SSRIs).

In addition to GAD, Paxil is also FDA-approved to treat depression and social anxiety disorder (SAD). Additionally, it can also be used to treat panic disorder, post-traumatic stress disorder (PTSD), premenstrual dysphoric disorder (PMDD), and obsessive-compulsive disorder (OCD).

Currently, Lexapro (escitalopram) and Paxil are the only SSRIs approved by U.S. Food and Drug Administration (FDA) for treating GAD.

How Paxil Works

Even though SSRIs like Paxil have been widely used since the late 1990s, scientists still don't know precisely how they work. At first, they thought that simply increasing serotonin levels reduced symptoms associated with anxiety. 

What Is Serotonin?

Serotonin is a neurotransmitter, meaning that the brain and nervous system use it to communicate. This naturally occurring chemical plays a role in various processes, including mood regulation and memory function. Low levels of serotonin are associated with depression and anxiety.

But SSRIs correct serotonin imbalances within 24 hours. So if the increased level of serotonin were solely responsible for your anxiety, your symptoms would disappear as soon as you took the medication. 

Instead, researchers have found that over time, higher levels of serotonin boost the brain's ability to rewire and remodel itself in ways that reduce anxiety symptoms. And this restructuring takes time. That’s why it usually takes four to six weeks for the full benefit of the drugs to kick in.

Paxil and GAD

GAD is characterized by persistent and excessive worry about a number of different topics. Most people worry about things like health, money, or work difficulties from time to time. But people with GAD are unable to stop worrying about these things. Quite often their worries or fears are out of proportion to the situation.

Just the thought of getting through the day may provoke anxiety.

In contrast to benzodiazepines, antidepressants such as Paxil, mainly affect the psychic (psychological distress) symptoms of anxiety, such as worry, fears, irritability, and concentration difficulties. 

GAD is usually treated with psychotherapy, medication, or a combination of the two. It can take some time to figure out the best combination for you, so be patient and keep your doctor informed about what is and isn't working for you.

Generalized Anxiety Disorder Discussion Guide

Get our printable guide to help you ask the right questions at your next doctor's appointment.

Mind Doc Guide

Taking Paxil Safely

As with any medication you take, be aware of how and when to take Paxil. If you have any questions or concerns, talk with your doctor or pharmacist. It's important to know that:

  • You can take Paxil with or without food, at any time of the day.
  • If you miss a dose, take it when you remember, unless it's close to the time to take it again. Don't double your dose.
  • You should avoid alcohol and drugs while taking Paxil, as they may decrease the benefits.
  • Your doctor will probably start you on a low dose to begin with and increase it if needed.
  • Paxil is safe and effective when taken as directed. There are no known risks from long-term use.
  • You should check with your doctor or pharmacist about potential interactions with other medications.
  • Paxil is not approved for use by children.

Side Effects of Paxil

Common side effects of Paxil include:

  • Constipation
  • Diarrhea
  • Dizziness
  • Dry mouth
  • Fatigue
  • Increased sweating
  • Headache
  • Nausea
  • Nervousness
  • Restlessness
  • Sexual dysfunction
  • Sleep difficulties (either too much or too little)

Typically, these side effects will go away within a couple of weeks of taking the medication.

Rare side effects include bleeding, teeth grinding, and low sodium blood levels. Serious side effects are seizure and serotonin syndrome, which happens when there is too much serotonin in the body and can lead to death.

Compared with other SSRIs, a higher incidence of adverse effects was indicated for paroxetine treatment, including sedation, constipation, sexual dysfunction, discontinuation syndrome, weight gain, and congenital malformations

A Word From Verywell

If you have been prescribed Paxil for generalized anxiety disorder, it's important to follow your doctor's instructions. Be sure to communicate any issues that arise (such as side effects) so that they can be dealt with swiftly.

Was this page helpful?
4 Sources
Verywell Mind uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
  1. U.S. Food and Drug Administration. Paxil label.

  2. Albert PR, Vahid-Ansari F, Luckhart C. Serotonin-prefrontal cortical circuitry in anxiety and depression phenotypes: pivotal role of pre- and post-synaptic 5-HT1A receptor expression. Front Behav Neurosci. 2014;8:199. doi:10.3389/fnbeh.2014.00199

  3. Chottekalapanda RU, Kalik S, Gresack J, et al. AP-1 controls the p11-dependent antidepressant response. Mol Psychiatry. 2020;25(7):1364-1381. doi:10.1038/s41380-020-0767-8

  4. American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders. 5th ed. American Psychiatric Association; 2013

Additional Reading
  • National Alliance on Mental Illness and College of Psychiatric and Neurologic Pharmacists. Paroxetine (Paxil).