An Overview of Paxil for Panic Disorder

Paxil pills spilling out of a bottle
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Prescription medication is one of the most common treatment options for panic disorder. Paxil (paroxetine) is one type of medication that is often used to treat panic disorder and other conditions.

Background Information

Paxil belongs to a category of antidepressants called selective serotonin reuptake inhibitors, or SSRIs. SSRIs first became available in the United States in the 1980s and have continued to remain popular ever since. Compared to other antidepressant medications available at the time, SSRIs were found to have fewer side effects while maintaining effectiveness and safety. Other common SSRIs include Prozac (fluoxetine), Celexa (citalopram), and Zoloft (sertraline).

As the name implies, doctors originally prescribed antidepressants to help reduce the symptoms of depression. However, these medications, including Paxil, are now used to treat both mood and anxiety disorders. Currently, Paxil can be prescribed to treat a variety of conditions, such as aspects of bipolar disorder, obsessive-compulsive disorder, social anxiety disorder, generalized anxiety disorder, and panic disorder (with or without agoraphobia).

How It Helps With Panic

Serotonin is a naturally-occurring chemical in the brain. As a neurotransmitter, serotonin helps in mood and sleep regulation, as well as other functions. People with mood and anxiety disorders are considered to have a dysregulation in the serotonin system.

Paxil works to balance a person’s level of serotonin by preventing brain cells from quickly absorbing it. Through balancing serotonin levels, Paxil can help enhance mood and reduce anxiety.

Paxil can also help alleviate the symptoms of some common co-occurring conditions, such as depression or sometimes headaches.

Side Effects

Paxil will not work immediately to help reduce your symptoms of panic disorder. Improvements are typically noticed within several days to weeks of starting your prescription, but it can be several months before you experience the full benefits of Paxil.

People taking Paxil have the potential to experience some side effects.

Common Side Effects

Typically, the side effects of Paxil gradually subside, but if they do not go away or become unmanageable, then contact your doctor to discuss options.

  • Changes in weight and appetite
  • Digestive problems
  • Dizziness and lightheadedness
  • Drowsiness
  • Dry mouth
  • Fatigue
  • Headaches
  • Nausea
  • Sexual side effects
  • Sleep disturbances

Severe Side Effects

As with all medications, it is possible to have an allergic reaction to Paxil or experience a dangerous drug interaction while taking Paxil with other medications. Be certain that your doctor is aware of all prescribed and over-the-counter medications you are taking.

When to Seek Help

Contact your doctor immediately, or call 911, if you experience any of the following severe side effects.

  • Confusion
  • Extreme nervousness, irritability, or anxiety
  • Rapid heart rate
  • Signs of an allergic reaction: swelling of the face, mouth, throat, or tongue, hives, rash, difficulty swallowing or breathing
  • Suicidal thoughts
  • Vomiting

Missing a Dose

If you miss your dosage of Paxil, try to take it as soon as you remember unless it is at or close to the time for your next dosage. Never take two doses at the same time; instead, take your regular dose and continue following your dosage schedule.

Discontinuing Your Prescription

Your doctor can help you to gradually reduce your dosage until you are completely off Paxil. Do not abruptly discontinue your prescription on your own, as this can possibly lead to some withdrawal-like symptoms, including:

  • Dizziness
  • Headaches
  • Irritability
  • Worsening anxiety

Precautions and Contraindications

Several precautions and contraindications should be considered when taking Paxil:

Black Box Warning

In 2004, the Food and Drug Administration (FDA) issued an alert, warning that antidepressants such as SSRIs may increase the risk of suicidal thoughts and behaviors. The FDA cautioned that this risk is especially an issue for adolescents and young adults. Due to these concerns, young people started on SSRIs should be observed for declining mood and suicidal thoughts.


It is possible for Paxil to be passed on to a child during pregnancy or while nursing. If you are planning to become pregnant, are currently pregnant, or are nursing, talk to your doctor about the potential risks of Paxil.


Consuming alcohol with Paxil can potentially increase its toxicity or reduce its effectiveness.

Older Adults

When taking Paxil, older adults may be more susceptible to side effects. An adjustment in dosage may be needed to reduce side effects.

The information provided here is meant to be an overview of the use of Paxil for panic disorder. The general information here does not cover all possible scenarios, such as potential adverse side effects, precautions, and contraindications. Always consult your medical provider about any questions and/or concerns you may have about your Paxil prescription.

If you or a loved one are struggling with panic 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.

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. FDA. Paxil.

  2. Crocco EA, Jaramillo S, Cruz-Ortiz C, Camfield K. Pharmacological management of anxiety disorders in the elderlyCurr Treat Options Psychiatry. 2017;4(1):33–46. doi:10.1007/s40501-017-0102-4

  3. Lin SH, Lee LT, Yang YK. Serotonin and mental disorders: a concise review on molecular neuroimaging evidenceClin Psychopharmacol Neurosci. 2014;12(3):196–202. doi:10.9758/cpn.2014.12.3.196

  4. Fornaro M, Anastasia A, Valchera A, et al. The FDA "Black Box" warning on antidepressant suicide risk in young adults: More harm than benefits?Front Psychiatry. 2019;10:294. doi:10.3389/fpsyt.2019.00294

Additional Reading
  • Dudley, William. Antidepressants. San Diego, CA: Reference Point Press, 2008.

  • Silverman, Harold M. The Pill Book. 15th ed. New York, NY: Bantam Books, 2012.

By Katharina Star, PhD
Katharina Star, PhD, is an expert on anxiety and panic disorder. Dr. Star is a professional counselor, and she is trained in creative art therapies and mindfulness.