Panic Disorder Treatment An Overview of Paxil for Panic Disorder By Katharina Star, PhD facebook linkedin 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. Learn about our editorial process Katharina Star, PhD Medically reviewed by Medically reviewed by Steven Gans, MD on October 22, 2020 Steven Gans, MD is board-certified in psychiatry and is an active supervisor, teacher, and mentor at Massachusetts General Hospital. Learn about our Review Board Steven Gans, MD Updated on November 11, 2020 Print Joe Raedle/Getty Images News/Getty Images Table of Contents View All Table of Contents Background Information How It Helps With Panic Side Effects Missing a Dose Ending Your Prescription Precautions and Contraindications 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). SSRI Antidepressants Can Help Panic Disorder 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 Paxil Side Effects and Precautions 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 Understanding SSRI Discontinuation Syndrome 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. Pregnancy/Nursing 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. Alcohol 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. Was this page helpful? Thanks for your feedback! Learn the best ways to manage stress and negativity in your life. Sign Up You're in! Thank you, {{form.email}}, for signing up. There was an error. Please try again. What are your concerns? Other Inaccurate Hard to Understand Submit Article 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. FDA. Paxil. Updated June 2014. Crocco EA, Jaramillo S, Cruz-Ortiz C, Camfield K. Pharmacological management of anxiety disorders in the elderly. Curr Treat Options Psychiatry. 2017;4(1):33–46. doi:10.1007/s40501-017-0102-4 Lin SH, Lee LT, Yang YK. Serotonin and mental disorders: a concise review on molecular neuroimaging evidence. Clin Psychopharmacol Neurosci. 2014;12(3):196–202. doi:10.9758/cpn.2014.12.3.196 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.