Paxil CR as a Treatment for Social Anxiety Disorder

Prozac, Paxil and Zoloft anti-depressant tablets, close-up

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Paxil is the brand name of the generic medication paroxetine hydrochloride. Paxil is a prescription medication used to treat depression, anxiety disorders, and other serious mental health problems.

Manufactured by GlaxoSmithKline, Paxil was the first medication approved for the treatment of social anxiety disorder (SAD).

Paxil CR is the longer-acting, controlled-release version of Paxil. A selective serotonin re-uptake inhibitor (SSRI), Paxil slows reabsorption of the chemical serotonin in the brain. Serotonin is believed to play a role in the regulation of mood and anxiety.


Paxil comes in tablet form and must be swallowed whole—not chewed or crushed. It is generally taken once per day in the morning, with or without food. If you forget to take a daily dose, take it when you remember. However, if it is close to the time of your next dose, it is better to skip the missed dose altogether.

It is important to continue taking Paxil as long as your doctor instructs, even if you begin to feel better. If you abruptly stop taking Paxil, you may experience withdrawal symptoms such as dizziness, abnormal dreams, and tingly sensations. To avoid these symptoms, your doctor will slowly taper your dosage when you stop taking Paxil.


For people with SAD, a typical dosage of Paxil CR starts at 12.5 mg, with increases of 12.5 mg weekly, although there can be variability in these doses and increases. In general, elderly people will be given a lower dose.


Paxil should be used with caution if you:

  • Have impaired liver or kidney function
  • Have a history of seizures
  • Have a history of mania
  • Pregnant or planning to become pregnant
  • Breastfeeding

The effectiveness of Paxil in children and adolescents has not been studied and the medication has not been approved for people under 18 years of age. There is some evidence to suggest an increased risk of suicidal thoughts and behaviors in children taking Paxil.


Paxil should not be taken in combination with, or within weeks of taking monoamine oxidase inhibitors (MAOIs), thioridazine, or pimozide. The result of such combinations can be fatal.

Caution should be used when taking a number of other medications in combination with Paxil, such as anticoagulants and anti-inflammatories. Consumption of alcohol is also not advised while taking Paxil. In general, you should inform your doctor of any prescription or over-the-counter medications, or any other substances that you are taking or plan to take.

Side Effects

Side effects of Paxil generally appear early in the initiation of the drug, can often improve with time, and may include the following:

  • Nausea
  • Drowsiness
  • Insomnia
  • Sweating
  • Tremors
  • Weakness/loss of strength
  • Dizziness
  • Dry mouth
  • Sexual dysfunction
  • Constipation
  • Diarrhea
  • Gas
  • Nervousness
  • Decreased appetite
  • Weight gain

When first starting Paxil or when changing the dosage, watch for more serious side effects such as agitation, hostility, panic, extreme hyperactivity, and suicidal thoughts and behaviors. If you experience any of these symptoms, it is important to report these to your doctor immediately.

For some people, Paxil may interfere with judgment, thinking, and motor skills. It is important not to operate dangerous machinery or participate in hazardous activities unless you are sure that Paxil is not affecting you in this way.


The risk of a fatal overdose of Paxil is very low. Symptoms of an overdose may include the following:

  • Dizziness
  • Drowsiness
  • Facial flushing
  • Nausea
  • Sweating
  • Vomiting
  • Coma

When combined with some medications, there is a risk of serotonin syndrome, a potentially fatal condition. Symptoms of Serotonin Syndrome include the following:

  • Agitation
  • Confusion
  • Sweating
  • Hallucinations
  • Abnormal reflexes
  • Muscle spasms 
  • Rapid heartbeat

If you've been prescribed Paxil, you may be worried and wondering what to expect. Take a deep breath, and know that your doctor has chosen this SSRI as the best form of treatment for your social anxiety.

If you are still concerned or have further questions, don't feel embarrassed to ask them or have a family member ask. The more informed you are about your medication treatment, the better of an experience it will be.

Below is a list of other related anxiety medications that you could be prescribed.

Other Anxiety Medications

If you or a loved one are struggling with social anxiety disorder, contact the Substance Abuse and Mental Health Services Administration (SAMHSA) National Helpline at 1-800-662-4357 for information on support and treatment facilities in your area.

For more mental health resources, see our National Helpline Database.

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.
  • Food and Drug Administration. Paxil Prescribing Information.

  • Bezchlibnyk-Butler KZ, Jeffries, JJ, eds. Clinical Handbook of Psychotropic Drugs. Toronto, Canada: Hogrefe & Huber; 2003.

By Arlin Cuncic
Arlin Cuncic, MA, is the author of "Therapy in Focus: What to Expect from CBT for Social Anxiety Disorder" and "7 Weeks to Reduce Anxiety."