Paxil vs. Viibryd: Which One Should I Take?

When you’re looking for treatment for your depression or anxiety, you may feel confused and overwhelmed by the wide variety of antidepressants available, which can make choosing one difficult.  

This medication guide compares two common selective serotonin reuptake inhibitors (SSRIs)—Paxil and Viibryd—to help you better understand the benefits and downsides of each and have a more informed conversation with your healthcare provider before starting treatment.

If you need a reliable, affordable healthcare provider to prescribe an SSRI like Paxil or Viibryd, Klarity can help. We’ll connect you with a licensed medical professional so you can get treatment, which could include prescription medication.

Schedule an appointment, and we’ll match you with an experienced healthcare provider for your first telehealth appointment within 48 hours. 

This article discusses suicide, suicidal ideation, and self-harm. If you or someone you know is experiencing suicidal thoughts or is in crisis, contact the Suicide Prevention Lifeline immediately at 800-273-8255.

What is Paxil?

Paxil is the brand name for the antidepressant medication paroxetine, a selective serotonin reuptake inhibitor (SSRI). SSRIs alleviate the symptoms of major depressive disorder by blocking receptors in the brain from reabsorbing serotonin. 

This process increases serotonin levels in the brain, which helps to stabilize fluctuating moods, improve sleep cycles, regulate appetite, and increase alertness and energy levels.  

Common Doses and Forms of Paxil

Paxil is available in three forms: 

• Immediate-Release (IR) Tablets
• Extended-Release (ER) tablets
• Liquid suspension

The biggest difference between the IR tablets and ER tablets is that IR tablets may require multiple doses per day, while you can take just one ER tablet daily. The one you choose depends on your schedule and specific needs. For instance, someone with depression-related brain fog and forgetfulness may benefit from the convenience of an extended-release tablet.

All tablets are scored and printed with the dosage amount on one side and Paxil on the other. They’re also color-coded by dosage, as follows: 

• 10 mg yellow
• 20 mg pink
• 30 mg blue 
• 40 mg green 

The suspension works well for those who have trouble swallowing pills. It’s orange in color with orange flavoring added to improve the taste. Each 5 mL of liquid contains 10mg of Paxil. Regardless of which version you decide to take, most people are prescribed an initial dose of 20 mg, which can be gradually increased to a maximum dosage of 50 mg daily. 

Conditions Paxil Treats

Paxil effectively treats a wide range of mental health problems, the most common being depression and anxiety. 

Some of the other conditions Paxil treats include: 

• Obsessive-compulsive disorder (OCD)
• Menopausal symptoms
• Premenstrual dysphoric disorder (PMDD) 
• Panic disorder

Paxil Can Treat Symptoms of Depression

Of the listed disorders, Paxil is only FDA-approved to treat depression, though it’s considered safe to prescribe for other uses. These uses simply haven’t gone through the FDA approval process yet. 

SSRIs are among the most commonly prescribed medications to treat anxiety and depression because these conditions often stem from a chemical imbalance in the brain. Increased serotonin levels help alleviate the fatigue, nervousness, brain fog, and sleep disturbances associated with anxiety, depression, and related disorders such as panic disorder.

Off-Label Uses for Paxil

Medical professionals frequently prescribe Paxil off-label to treat conditions related to mood and body chemistry, such as: 

• Obsessive-compulsive disorder 
• Menopausal symptoms
• Premenstrual dysphoric disorder (PMDD) 
• Anxiety and panic disorder

Increased serotonin helps individuals feel calmer and more focused so that they can manage these conditions more easily. 

Paxil Costs

A 30-day supply of brand-name Paxil can cost up to $300, while the same amount of the generic formula, paroxetine, costs between $16 and $40, on average. The price could be lower or higher, depending on your coverage and the pharmacy you use. 

Paxil Side Effects

Because they affect your brain chemistry, most SSRIs cause mild to moderate side effects. Some may fade completely in a few weeks, while others may be intermittent. 

A few of the most common side effects include: 

• Changes in vision
• Weakness, drowsiness, or dizziness
• Sweating, anxiety, or shaking
• Insomnia
• Reduced appetite
• Nausea, vomiting, diarrhea, or constipation
• Dry mouth
• Headaches
• Sexual dysfunction 

The following side effects are rare but may indicate a serious medical issue called serotonin syndrome. This condition occurs when the brain becomes flooded with too much serotonin. It can affect anyone taking SSRIs or other serotonin-affecting medications and can be fatal if left untreated.

If you experience any of the following, seek medical attention immediately: 

• Racing thoughts, requiring less sleep, manic euphoria
• Blurred or tunnel vision 
• Eye pain, swelling, or seeing halos around lights
• Bone pain or tenderness
• Swelling or easy bruising
• Unusual changes in weight or appetite
• Unusual bleeding from the nose, mouth, vagina, or rectum
• Coughing up blood;
• Rigid muscles, high fever, sweating
• Confusion, racing heart or arrhythmia, tremors, or fainting
• Severe headache, slurred speech 
• Severe weakness and reduced coordination

Paxil Warnings

It’s important to speak with your healthcare provider before starting Paxil to determine if it’s the right medication for you, especially if you have preexisting conditions. Those with the following conditions or symptoms should consider an alternative to Paxil: 

• Heart disease or stroke
• High blood pressure
• Liver or kidney disease
• Bleeding disorders
• Epilepsy 
• Bipolar disorder 
• Sexual dysfunction
• Glaucoma
• Low blood sodium levels

Paxil Drug Interactions

Those taking the following medications should avoid taking Paxil: 

• Monoamine oxidase inhibitors (MAOIs)
• Pimozide or other Tourettes syndrome medications
• Thioridazine or other antipsychotic medications
• Stimulant medications, like Adderall
• Opioid-based painkillers
• Herbal supplements, such as St. John’s Wort
• Tryptophan

If you take MAOIs and want to try Paxil, stop taking the MAOIs for at least 14 days before starting Paxil. Additionally, those with a history of substance misuse should consider alternatives to Paxil. 

You should take Paxil exactly as prescribed, and should not stop abruptly, as it can result in withdrawal symptoms. If you’d like to discontinue use, consult with your healthcare provider for ways to safely taper off the medication. 

What is Viibryd?

Viibryd is the brand name for the SSRI medication vilazodone. Like Paxil, it increases serotonin levels in the brain by preventing receptors from absorbing it into the bloodstream. This gives the brain more serotonin to regulate moods, improve concentration and energy levels, and make sleep easier.  

Common Doses and Forms of Viibryd

Viibryd only comes in tablet form and should be taken with food. Most individuals start with an initial dosage of 10mg daily, gradually increasing to a maximum dose of 40mg daily. 

Each Viibryd tablet is oval-shaped and printed with the dosage. They’re also color-coded by dose, as follows: 

• 10 mg red
• 20 mg yellow
• 40 mg blue

Conditions Viibryd Treats

Since Viibryd is a more potent SSRI than Paxil, it’s usually only prescribed to treat depression and depression-related conditions. However, it’s also proven effective in an off-label capacity for treating anxiety and obsessive-compulsive disorder. 

Viibryd Can Treat Symptoms of Depression

Like Paxil, Viibryd addresses the symptoms of depression by regulating serotonin production in the brain. It makes more serotonin available to help alleviate symptoms like: 

• Chronic fatigue
• Panic attacks
• Insomnia
• Lack of appetite
• Lack of interest
• Chronic nervousness

Off-Label Uses for Viibryd

So far, Viibryd has only been FDA-approved to treat depression. FDA approval requires rigorous testing and significant resources, so not all medications can be approved for every use. However, it’s considered safe and effective to prescribe off-label for the following conditions: 

• Obsessive-compulsive disorder
• Generalized anxiety disorder 
• Panic disorder

Viibryd Costs

A month’s worth of brand-name Viibryd can cost up to $341. Its generic counterpart, vilazodone, has recently been FDA-approved for prescription and costs around $15 for a 30-day supply. As with any medication, these prices may fluctuate based on your pharmacy and insurance coverage.

Viibryd Side Effects

Viibryd has fewer common side effects than Paxil, which should subside within a few weeks as your body acclimates to the medication. These side effects include: 

• Nausea
• Vomiting
• Diarrhea
• Insomnia
• Sexual dysfunction

The following severe side effects may be symptoms of a potentially fatal condition called serotonin syndrome. If you experience any of the following severe side effects, seek medical attention immediately: 

• Seizures
• Blurred or tunnel vision
• Eye pain, swelling, or seeing halos around lights
• Easy bruising or unusual bleeding
• Racing thoughts or unusual risk-taking behavior
• Decreased inhibitions, euphoria, or extreme sadness
• Headache or severe weakness
• Confusion or slurred speech
• Loss of coordination or feeling unsteady

Viibryd Warnings

SSRIs can adversely affect or exacerbate certain conditions. If you have any of the following conditions — including family history — you may want to seek alternatives to Viibryd: 

• Liver or kidney disease
• Bleeding or blood clotting disorders
• Narrow-angle glaucoma
• Epilepsy
• Bipolar disorder
• Sexual function issues
• A history of drug addiction
• Suicidal thoughts

Viibryd Drug Interactions

Viibryd may interact poorly with certain medications and cause serious health problems. If you take any of the following medications, you may need to find an alternative antidepressant: 

• Monoamine oxidase inhibitors (MAOIs)
• Pimozide or other Tourettes syndrome medications
• Thioridazine or other antipsychotic medications
• Stimulant medications, like Adderall
• Opioid-based painkillers
• Herbal supplements, such as St. John’s Wort
• Tryptophan

Get Anxiety and Depression Treatment With Klarity

Do you need help managing your anxiety or depression but don’t know which medication is right for you? Klarity can help. We have connected thousands of people with licensed and certified healthcare professionals to help them manage their depression and anxiety right from home — and we can help you do the same. 

With Klarity, you skip the waiting room in favor of remote telehealth appointments and receive an SSRI like Paxil or Viibryd as part of your personalized treatment plan (if applicable). Find a provider in your state who can evaluate your symptoms and determine the right treatment for you. 

Frequently Asked Questions About Paxil and Viibryd

Does Paxil Make You Gain Weight? Does Viibryd?

Many SSRIs cause a small to moderate amount of weight gain, including Paxil. This is more likely to happen if you’re taking a higher dose. 

Viibryd is less likely to cause weight gain, but it may still happen, especially if you regain a lost appetite and begin eating regularly. 

Is Paxil or Viibryd Better for Anxiety?

Paxil is more effective at treating anxiety, but it’s not tolerated as well as Viibryd. Individuals worried about significant side effects may find Viibryd is better for treating their anxiety. 

Can I Replace Paxil with Viibryd?

Yes, it’s generally considered safe to replace one SSRI with another. To avoid withdrawal symptoms, your healthcare provider will have you taper off of Paxil and start on a low dose of Viibryd, either while you’re tapering down or after you’ve stopped taking Paxil. 

Is Paxil Energizing or Sedating? What About Viibryd?

Daytime drowsiness is a possible side effect of both of these antidepressant medications. However, whether they energize or calm you will depend on the condition you have and the symptoms you’re experiencing. 

For instance, if you have major depression accompanied by listlessness, the increased serotonin will likely energize you. Conversely, if you have anxiety and racing thoughts, they’ll probably help calm you down. 

Does Paxil Cause Brain Fog? Does Viibryd?

Since both of these medications can cause daytime sleepiness, you may experience some brain fog as a result. 

Can I Drink Alcohol On Paxil? On Viibryd?

No, it can be dangerous to drink alcohol while taking SSRIs. Alcohol and SSRIs amplify each other, which could place your health at serious risk. 

Can I Drink Caffeine When I’m on Paxil? How About Viibryd?

Caffeine doesn’t interact or interfere with SSRI antidepressants, so you can continue enjoying your morning coffee. However, you may want to limit caffeine intake to help manage side effects like nervousness and insomnia. 

What Is Better For Depression—Paxil or Viibryd?

Both of these medications treat depression in similar ways. Which one is better for you depends on your medical history, other medications you’re taking, and how well you tolerate them without serious side effects. A healthcare provider on Klarity can review your medical history and help you choose the best one for you.