Prozac vs. Paxil: Which One Should I Take?

If you struggle with anxiety or depression, you have most likely heard of Prozac or Paxil. These two medications belong to a larger class of medications called selective serotonin reuptake inhibitors (SSRIs). SSRIs are the most commonly prescribed drugs used in the treatment of anxiety and depression. 

Although both medications are quite similar, there are important differences between Prozac vs. Paxil that should be considered when discussing treatment options with your healthcare provider. In this article, we provide a comparison guide of Prozac and Paxil, so you can be better informed on your treatment options and determine which medication is best for you.

If you are struggling with anxiety or depression, an SSRI like Prozac or Paxil could relieve your symptoms. Klarity connects patients with licensed healthcare providers in their state for effective, convenient, and affordable online anxiety and depression treatment. To speak to a medical professional about alleviating your symptoms with a personalized treatment plan, schedule an appointment on Klarity today. 

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 Prozac?

Prozac is one of the most commonly prescribed SSRI antidepressant medications and has been safely used to treat anxiety and depression for decades. Like other SSRIs, Prozac increases serotonin levels in the brain and helps to restore the neurochemical balance that is disrupted by anxiety or depression. 

Common doses and forms of Prozac

Prozac, also known as fluoxetine in its generic form, is available as an oral solution, capsule and tablet forms. The medication is typically started at a dose of 20 mg, which is then titrated up until an effective dose is found.

The oral solution is the least commonly prescribed formulary, and it is typically reserved for the pediatric population. It is available in one dosage form of 20 mg/5 mL. 

Capsules are available in 10, 20, and 40 mg formulations, as well as a generic 90 mg extended-release formulation. The tablets are available in 10, 20, and 60 mg dosage forms. 

Conditions Prozac treats

Prozac is one of the most effective SSRI medications for treating many different anxiety and depressive disorders. 

Prozac is FDA-approved for: 

• Major depressive disorder (MDD) 
• Obsessive-compulsive disorder (OCD) 
• Eating disorders, such as Bulimia nervosa 
• Panic disorder 
• Premenstrual dysphoric disorder (PMDD)

When used in combination with Zyprexa, Prozac is useful in the treatment of: 

• Acute depressive disorders in patients with bipolar I disorder 
• Treatment-resistant depression 

Prozac can treat symptoms of Anxiety and Depression

Prozac is known to improve and stabilize mood, increase energy levels, and reduce feelings of helplessness and hopelessness, which are all common symptoms of depression. 

In addition, Prozac helps treat symptoms of anxiety, such as decreasing feelings of nervousness, worry, and intrusive thoughts. 

Off-label uses for Prozac

Like many medications, there are several “off-label” uses for Prozac. A certain medication may not be FDA-approved for a specific condition due to the large amount of funding and resources required to get FDA approval, as well as the time the medication has been on the market. In short, although a medication is not FDA-approved for a certain condition, this does not mean that the medication is not effective or safe. 

Some off-label uses for Prozac include: 

• Generalized anxiety disorder 
• Migraine headaches 
• Fibromyalgia 
• Neuropathy or nerve pain caused by long-term diabetes 
• Premature ejaculation 

Prozac Costs

Prozac, in its name-brand or generic versions of the medication, is typically covered by most commercial health insurance plans. Without the use of insurance, a 30-day supply of name-brand medication can run up to $1000 per month. 

This cost can be significantly reduced with the use of coupon codes and generic formularies, with an average cost of a 30-day supply averaging around $10 per month.  

Prozac side effects

Prozac is associated with a number of mild side effects and a few rare yet serious adverse effects. It is important to keep these in mind when starting a new medication and to tell your healthcare provider if you begin to experience any of the following side effects. 

Some of the most common side effects associated with Prozac include: 

• Difficulty falling asleep or insomnia 
• Drowsiness or fatigue 
• Changes in bowel movements, including diarrhea or constipation
• Changes in appetite
• Headache 
• Increased anxiety or nervousness 
• Tremor 
• Dry mouth 
• Sexual dysfunction, including lack of desire and orgasm 

Prozac warnings

As with most SSRIs, there are a few rare side effects associated with Prozac that can be potentially fatal. Therefore, it is important to take Prozac as prescribed and under close supervision from your healthcare provider. Some serious side effects and warnings include: 

Increased suicidal thoughts and behaviors: typically seen in adolescents and young adults under 24 years of age. If you begin to experience thoughts of self-harm, contact your healthcare provider immediately or seek urgent medical care at the nearest ER. The Suicide and Crisis Lifeline is available 24/7 at 988. 

Serotonin Syndrome: a serious and potentially life-threatening condition that occurs with increased levels of serotonin in the body. 

Common signs and symptoms include: 

• Fever 
• Elevated blood pressure and heart rate 
• Increased anxiety, agitation or restlessness
• Dilated pupils 
• Muscle stiffness, spasms, or loss of coordination

Caution with use in the elderly population: can result in dangerous changes in blood pressure and electrolyte imbalances, increasing the risk for injury, such as falls 

Withdrawal or discontinuation syndrome: typically seen when abruptly discontinuing Prozac or decreasing the dose of medication. It is important to discuss medication changes with your healthcare provider so that you can safely taper off the medication.  

Common withdrawal symptoms include: 

• Headache 
• Dizziness, vertigo, or visual disturbances 
• Tremor 
• Increased anxiety, agitation, or restlessness
• Confusion or irritability
• Insomnia or difficulty sleeping 

Prozac drug interactions

As with all SSRI medications, there are several medications that should be avoided while taking Prozac. It is important to discuss all medications that you are currently taking with your healthcare provider, including over-the-counter medications and supplements. 

Some of the most common medications to avoid while taking Prozac include: 

• Monoamines oxidase inhibitors
• NSAIDs
• Blood thinning medications, including Warfarin and aspirin
• Opioids 
• Anti-nausea medications, including Zofran 
• Thiazide diuretics 
• Medications that increase serotonin levels: ADHD medications including Adderall, TCAs, Buspar, antipsychotics, Lithium, migraine medications, over-the-counter supplements such as St. John’s Wort and recreational drugs like MDMA 

What is Paxil?

Like Prozac, Paxil is another SSRI medication commonly prescribed for the treatment of several depressive and anxiety conditions. As with other SSRI drugs, Paxil works by increasing the levels of serotonin in the brain to restore the neurochemical balance that is often disrupted in those with anxiety and depression. 

Common doses and forms of Paxil 

Paxil is available in both name-brand and generic formulations, known as paroxetine. Similar to Prozac, Paxil is available in oral liquid suspension, tablets, and capsules. The typical dose is started at 10 mg per day and titrated up to the lowest effective dose on a weekly basis. The maximum dose of Paxil typically does not exceed 50 mg. 

The oral solution is available in one concentration of 10 mg/5mL and is mostly used in the pediatric population. 

Tablets are available in both immediate and extended-release formulations: 

• Immediate release: 10, 20, 30, 40 mg 
• Extended-release: 12.5, 25, and 37.5 mg 

The capsule formulary is available in one dosage of 7.5 mg. 

Conditions Paxil treats

Paxil is used to treat a number of different anxiety and depressive conditions. Some of the most common uses for Paxil include: 

• Major depressive disorder (MDD) 

• Generalized anxiety disorder (GAD)
• Post-traumatic stress disorder (PTSD)
• Obsessive-compulsive disorder (OCD)
• Premenstrual dysphoric disorder (PMDD)
• Panic disorder
• Social anxiety disorder (SAD)

Paxil can treat symptoms of Anxiety and Depression

Paxil helps treat depressive symptoms by improving mood and allowing you to enjoy activities you may have lost interest in, as well as improve feelings of worthlessness, helplessness, and hopelessness. 

Paxil can have an impact on physical symptoms, such as: 

• Changes in appetite
• Reduced fatigue
• Help with concentration
• Improve sleep quality 

In addition, the medication can help reduce anxiety, intrusive thoughts, and feelings of panic or impending doom. 

Off label uses for Paxil

Paxil has a few off-label uses, such as: 

• Postpartum depression
• Post-menopausal symptoms
• Irritable bowel syndrome (IBS) 
• OCD in children 
• Premature ejaculation 

Paxil Costs

Paxil is typically covered by most commercial health insurance plans. If you are uninsured, the use of generic medication and coupon codes significantly cuts the cost of a 30-day supply of medication between $4-$20. 

Paxil side effects

As with any medication, Paxil is associated with the risk of developing side effects. It is important to note that everyone reacts differently to medication and if you develop any adverse effects while on Paxil, notify your healthcare provider immediately. 

Some of the most common side effects associated with Paxil include: 

• Headache 
• Changes in vision 
• Increased anxiety, nervousness, restlessness
• Insomnia 
• Dry mouth 
• Sexual dysfunction, including impotence, lack of desire, or orgasm 
• GI upset, loss of appetite, nausea, or constipation 
• Weight loss or gain 
• Dizziness, fatigue 

Contact your healthcare provider if you begin to experience severe side effects, including:

• Mania: decreased need for sleep, increased risk-taking behaviors, pressured speech, racing thoughts
• Blurred or tunnel vision, eye pain, or extreme changes in vision
• Bone pain, tenderness, or swelling
• Easy bruising or signs of bleeding, such as dark stool or blood in the rectum
• Muscle spasms or involuntary contractions 
• Confusion or loss of consciousness
• Slurred speech
• Elevated or irregular heartbeat
• Severe weakness or loss of coordination 

Paxil warnings

Similar to Prozac, there are a number of more serious adverse reactions to the medication and, therefore, should be aware of before starting Paxil. If you begin to experience any serious side effects after starting Paxil, it is important to contact your healthcare provider immediately or seek medical attention. 

As mentioned above with Prozac, some serious side effects include: 

• Increased suicidal thoughts and behaviors: typically seen in adolescents and young adults under 24 years of age. If you begin to experience thoughts of self-harm, contact your healthcare provider immediately or seek urgent medical care at the nearest ER. The Suicide and Crisis Lifeline is available 24/7 at 988. 
• Serotonin syndrome 
• Dangerous changes in blood pressure and electrolyte imbalances in older individuals 
• Withdrawal or discontinuation syndrome 

Paxil drug interactions

As mentioned prior, before starting any new medication, it is important to discuss all medications that you are currently taking with your healthcare provider, including over-the-counter medications and supplements. 

Some of the most common medications to avoid while taking Paxil include: 

• Monoamines oxidase inhibitors (MAOI)
• NSAIDs
• Blood thinning medications, including Warfarin and aspirin
• Opioids 
• Anti-nausea medications, including Zofran 
• Thiazide diuretics 
• Medications that increase serotonin levels: ADHD medications including Adderall, TCAs, Buspar, antipsychotics, Lithium, migraine medications, over-the-counter supplements such as St. John’s Wort and recreational drugs like MDMA 

Key Differences Between Paxil vs. Prozac

Prozac and Paxil both belong to the SSRI class of medications, but have distinct characteristics that set them apart. Understanding the key differences between Paxil and Prozac can help individuals make informed decisions about which mental health medication is right for them.

While both medications are prescribed for depression, Prozac has a broader range of approved uses. It is commonly used to treat MDD, panic disorder, OCD, and PMDD. On the other hand, Paxil is approved for MDD, panic disorder, social anxiety disorder, GAD, PTSD, and OCD. 

While Prozac and Paxil can both cause common side effects associated with SSRIs, Paxil is generally associated with a higher incidence of certain side effects. These may include drowsiness, weight gain, and more pronounced sexual dysfunction. However, it’s important to note that individual responses to medications can vary, and some individuals may have a different experience. 

Another notable difference lies in the dosing schedule. Prozac has a longer half-life compared to Paxil, which means it stays in the body for a longer duration. This allows for a once-daily dosing regimen, which can be convenient for individuals who prefer simplicity and consistency. Conversely, Paxil typically requires twice-daily dosing. 

Ultimately, consulting with a healthcare professional is crucial in determining the most appropriate medication for your specific condition and needs. They will take into account your individual circumstances to guide you toward the option that aligns best with your treatment goals.

Paxil or Prozac: Which One is Right for You?

Both Paxil and Prozac are effective in the treatment of major depression and anxiety disorders. When comparing the two medications, Prozac is more commonly prescribed than Paxil due to its lighter side effect profile. 

As always, it is important to note that everyone reacts to medications differently. One medication that is highly effective with limited side effects for one person may not be right for another. For this reason, you should never attempt to self-medicate your symptoms, and should always consult with a medical professional to receive a prescription.

For people with anxiety or depression who are seeking a safe and reliable way to access medication, Klarity can help. We connect patients with licensed healthcare providers in their state for affordable and convenient online anxiety and depression treatment. Your provider will evaluate, diagnose, and determine if Paxil, Prozac, or another medication is right for you. 

Schedule an appointment through Klarity to get started. This will help us understand your symptoms and match you with a provider who specializes in treating anxiety or depression.

Frequently Asked Questions About Prozac and Paxil

We went over a lot of new information in this article, so we have answered some of the most commonly asked questions about Prozac and Paxil:

Will Prozac or Paxil Make You Gain Weight? 

With any SSRI medication, there is a possibility of weight gain when starting the medication. Although when comparing Prozac vs. Paxil, Prozac is associated with less weight gain and can even cause weight loss in some individuals. 

In one study, Paxil caused 6% of participants to gain up to 3.6% weight gain, making it one of the SSRIs with the most chance for weight gain.

Is Prozac or Paxil Better for Anxiety?

Both Prozac and Paxil are equally effective in the treatment of anxiety and related conditions. Out of the two medications, Prozac is more commonly prescribed due to fewer associated side effects. As noted above, everyone reacts to medications differently, and therefore, some individuals may find Paxil to be more effective than Prozac and vice versa.

Can I Replace Prozac with Paxil?

Prozac and Paxil are two SSRI medications and work in a similar fashion. Therefore they can replace each other. But, there are different dosing of the two medications, which means you should be monitored under the close supervision of your healthcare provider while you taper off one of the medications. 

Is Prozac Energizing or Sedating? What About Paxil?

Prozac is considered to be an energizing antidepressant and is, therefore, typically taken in the morning. Paxil, on the other hand, is considered to be a more sedating SSRI medication and is commonly recommended for nighttime dosing. 

Can I Drink Alcohol On Paxil? On Prozac?

Generally, it is not recommended to drink alcohol while taking any SSRI medication. Drinking while on Paxil or Prozac can increase the risk of adverse effects of the medication and can enhance the effect of alcohol, which can lead to dangerous outcomes. 

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

Overall, it is considered safe to drink caffeine while taking Prozac or Paxil. It is important to remember that caffeine is a drug in itself and can cause adverse effects, especially if consumed in large quantities. Be sure to monitor for any adverse effects while consuming caffeine, such as increased anxiety, restlessness, or agitation.