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, some of 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 insufficient serotonin levels.

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 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.

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

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.

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

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

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:

  • Worsening anxiety
  • Headaches
  • Dizziness
  • Irritability

Precautions and Contraindications

Several precautions and contraindications should be considered when taking Paxil:

  • Black box warning: In 2007, the Food and Drug Administration (FDA) issued an alert, warning that SSRI usage may increase the risk of suicidal thoughts and behaviors. The FDA cautioned that this risk is especially an issue for adolescents and young adults who are taking SSRIs. Due to these concerns, young people 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: You should avoid drinking alcohol while taking Paxil. Consuming alcohol can potentially increase the toxicity of Paxil 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.

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Article Sources

  • Dudley, William. Antidepressants. San Diego, CA: Reference Point Press, 2008.
  • Silverman, Harold M. The Pill Book. 15th ed. New York, NY: Bantam Books, 2012.