Paxil vs. Zoloft: What’s the Difference & Which One Should I Take?

If you suffer from anxiety or depression, you may have heard of Paxil and Zoloft. They are two commonly-prescribed medications used to treat a number of depression and anxiety disorders. 

Both Paxil and Zoloft are selective serotonin reuptake inhibitors (SSRIs), meaning they work by increasing the amount of serotonin in the brain, which is linked to regulating mood, sleep cycles, wound healing, sexual function, and more. A lack of serotonin disrupts these functions and can cause major depressive disorder (MDD), anxiety disorders, panic disorders, and other mood disorders. 

This article will discuss the differences between Zoloft and Paxil to help you make a more educated decision alongside your healthcare provider. Despite being similar medications, Paxil and Zoloft can affect people differently, so you should always work with a medical professional who can evaluate your symptoms and medical history and prescribe the safest antidepressant for you.

If you suffer from anxiety or depression and are interested in managing your symptoms with SSRIs like Paxil or Zoloft, Klarity can help. We’ll connect you with a licensed healthcare provider in your state for affordable and simple telehealth appointments to determine which medication, if any, is right for you. 

Schedule an appointment, and we’ll match you with a depression or anxiety specialist within 48 hours to begin personalized treatment. 

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 paroxetine, an FDA-approved SSRI to treat depression, anxiety, and other disorders in adults 18 years and older. It is not approved or recommended for children under the age of 18. 

Both the brand name and generic form are available via prescription. It’s considered safe for long-term use under the supervision of a healthcare provider. 

Paxil Forms and Doses

Paxil is available in pill and liquid forms. The pills are typically lozenge-shaped, scored down the center, and embossed with the dosage. They’re also color-coded by dosage as follows: 

• Pink: 20 mg
• Blue: 30 mg
• Green: 40 mg

The liquid suspension is orange in color and orange flavored to improve the taste. Every 5 mL of the suspension contains a 10 mg dose of Paxil or paroxetine. 

The recommended daily dosage for healthy adults is between 20 and 60 mg. Seniors, particularly those with kidney issues, usually receive between 10 and 40 mg daily. 

Conditions Paxil Treats

Paxil is FDA-approved to treat the following conditions:

• Depression, or major depressive disorder
• Anxiety
• Obsessive-compulsive disorder (OCD)
• Panic disorder
• Post-traumatic stress (PTS)
• Hot flashes
• Premenstrual dysphoric disorder (PMDD)

Symptoms of Anxiety Paxil Can Treat

When prescribed to treat anxiety, Paxil can help alleviate the following: 

• Restlessness
• Difficulty concentrating
• Irritability and mood shifts
• Muscle tension
• Irregular sleep patterns

Symptoms of Depression Paxil Can Treat

As a prescription treatment for depression, Paxil can help alleviate the following: 

• Chronic sadness
• Feelings of worthlessness or guilt
• Feelings of hopelessness and helplessness
• Diminished interest in daily activities
• Irregular eating patterns
• Low energy or trouble focusing
• Suicidal thoughts
• Nervous energy or lethargy

Off-Label Uses For Paxil

In some cases, healthcare providers may prescribe Paxil off-label for the following conditions:

• Separation anxiety
• Dysthymia (persistent depressive disorder)
• Body dysmorphia
• Postpartum depression
• Premature ejaculation

Paxil Costs

Without insurance, a 30-day supply of brand-name Paxil pills or liquid suspension can cost between $250 and $435. The generic form of Paxil—paroxetine—in tablet form costs between $20 and $31 for 30 pills. Paroxetine liquid suspension costs approximately $345 for a 250 mL bottle. 

Brand-name Paxil is not covered by Medicare and is rarely covered by other types of insurance. However, the generic version is typically wholly or partially covered. 

Paxil Side Effects

The most common side effects of Paxil include:

• Headache or dizziness
• Nausea, constipation, or diarrhea
• Dry mouth
• Excessive sweating
• Nervousness and restlessness
• Fatigue and drowsiness
• Insomnia

Rare but more serious side effects of Paxil include: 

• Racing thoughts and excessive talking
• Euphoria or deep sadness
• Seeming decreased need for sleep
• Unusual risk-taking behavior
• Blurred or tunnel vision
• Eye pain, swelling, or seeing halos around lights
• Bone pain, tenderness, swelling, or bruising
• Changes in weight or appetite
• Easily bruised
• Unusual bleeding from the eyes, nose, mouth, rectum, or vagina
• Coughing up blood
• Stiff, rigid muscles
• High fever and sweating
• Confusion or slurred speech
• Irregular heartbeat
• Tremors, fainting, or headache
• Weakness or loss of coordination

Contact your healthcare provider immediately if you experience severe or prolonged side effects. 

Paxil Warnings For Use

The following medical conditions are contraindicated for Paxil: 

• Liver or kidney problems
• Broken bones
• Bipolar disorder
• Glaucoma
• Seizure disorders
• Conditions with increased risk of bleeding

Those who are pregnant or may become pregnant should consult a healthcare provider before taking Paxil. They will discuss your medical history and current status with you before prescribing medication.

Paxil Drug Interactions

The following medications should not be taken with Paxil: 

• Cold and allergy medicine
• Sedatives, sleeping pills, and muscle relaxers
• Seizure medication
• Nonsteroidal anti-inflammatory drugs (NSAIDs)
• Blood thinners
• Tryptophan
• Opioid-based painkillers
• Certain heart medications
• St. John’s wort

What Is Zoloft?

Zoloft is the brand name for the SSRI medication sertraline. It’s FDA-approved to treat depression and OCD in adults and OCD in children and adolescents aged 6 to 17. It’s not approved for children under six years of age. 

Zoloft Forms and Doses

Patients may take Zoloft in either tablet or liquid form. The liquid solution is usually administered to children, while Zoloft tablets are given to people aged 13 and older. However, adults who have trouble swallowing pills may ask for a liquid prescription. 

Liquid Zoloft is a clear, peppermint-flavored suspension that contains 20 mg of sertraline per dose. Each bottle contains 60 mL of fluid which must be diluted before you take it. Dilution instructions come with the bottle.

The tablets are oval, scored in the center, and embossed with the dosage amount. Dosages vary and are color-coded to avoid confusion: 

• Green: 25 mg
• Blue: 50 mg
• Salmon pink: 100 mg

When starting Zoloft, children are given 25 mg while adults receive 50 mg. Both starting doses may be gradually increased to 50 and 200 mg as a standard daily dose.

Conditions Zoloft Treats

Zoloft is FDA-approved to treat the following conditions: 

• Major depression
• Obsessive-compulsive disorder (OCD)
• Panic disorder
• Post-traumatic stress (PTS)
• Premenstrual dysphoric disorder (PMDD)
• Social anxiety disorder

Symptoms of Depression Zoloft Can Treat

Zoloft is most often prescribed as an antidepressant because it has been found to be effective in relieving the following symptoms: 

• Depressed, irritable, or fluctuating moods
• Disturbed sleep
• Irregular appetite cycles
• Low energy levels
• Disinterest in daily life

Symptoms of Anxiety Zoloft Can Treat

Zoloft can be prescribed to treat several anxiety-related disorders, including generalized anxiety disorder, social anxiety, and panic disorder.  

When administered for anxiety, Zoloft can help alleviate the following:

• Unwanted or intrusive thoughts
• Intense fear
• Panic attacks 
• Chronic feelings of anxiety

Off-Label Uses For Zoloft

Zoloft may be prescribed off-label for many conditions, including:

• Alcoholism
• Eating disorders
• Diabetic neuropathy
• Dementia
• Hot flashes
• Fibromyalgia
• Migraines
• Personality disorders
• Tourette syndrome
• Premature ejaculation

Zoloft Cost

If you’re planning to take brand-name Zoloft, be prepared to pay between $215 and $315 for a 30-day supply. Its generic form, sertraline, is much less expensive, costing only $4 to $25 for the same number of tablets.

Most insurance companies don’t cover brand-name Zoloft but will cover sertraline. Sertraline may be partially or completely covered, depending on your insurance, and is 100% covered by Medicare.

Zoloft Side Effects

Zoloft has common side effects that may subside or diminish over time. They include: 

• Nausea or indigestion
• Diarrhea or loose stool
• Tremors or twitching
• Decreased appetite and weight loss
• Bruising and muscle aches
• Decreased libido/trouble orgasming
• Excessive sweating
• Anxiety

The following side effects are rarer but more serious. If you experience any of the following symptoms, contact your healthcare provider immediately:

• Heart arrhythmia
• Bleeding and liver injury
• Confusion and seizures
• Suicidal thoughts
• Changes in behavior

If you are having suicidal thoughts, immediately call the Suicide and Crisis Lifeline at 988.

Zoloft Warnings for Use

Zoloft is contraindicated for those with a history of the following conditions: 

• Liver problems
• Epilepsy and seizure disorders 
• Glaucoma
• Bipolar disorder
• Thyroid disease

Pregnant or breastfeeding individuals should talk to their healthcare provider before starting Zoloft or any other SSRI medication.

Zoloft Drug Interactions

If you’re taking Zoloft, you should avoid using certain medications and substances, including:

• Monoamine oxidase inhibitors (MAOIs)
• Blood thinners
• Antipsychotic and antiseizure medications
• Alcohol—recreational and alcohol-based medications

Paxil or Zoloft: Which One is Right For You?

Paxil and Zoloft are both SSRI antidepressants used to treat anxiety and depression. Despite their many similarities, the different side effects, dosage levels, and contraindications may make one medication safe and the other dangerous.

For this reason, you should always consult with a medical professional before starting Paxil, Zoloft, or any other SSRI. Self-medicating could lead to several dangerous and potentially deadly side effects. 

If you need an affordable way to get a prescription for anxiety or depression medication, Klarity is here for you. At Klarity, we combine convenient telehealth services with flat, fair pricing. No more time-consuming doctor’s appointments, no rearranging your schedule, and no insurance needed. 

In just 48 hours, your provider can determine if Paxil, Zoloft, or another SSRI is right for you, and send a prescription directly to your local pharmacy to be picked up at your convenience. Schedule an appointment today, and we’ll match you with a licensed healthcare provider for straightforward, cost-effective online depression and anxiety treatment. 

Frequently Asked Questions About Paxil and Zoloft

Does Paxil Have More Side Effects Than Zoloft?

Paxil’s list of side effects is longer than Zoloft’s. However, roughly the same percentage of patients experience similar side effects from each drug.

How Do I Shift From Zoloft to Paxil?

If you need to shift from one SSRI drug to another, there are a few methods your healthcare provider may recommend, including cross-tapering and direct-switch. 

To cross-taper from Zoloft to Paxil, you’ll begin taking lower doses of Zoloft while simultaneously taking a low dose of Paxil. You’ll continue decreasing the Zoloft and increasing the Paxil until you’re only taking Paxil. 

For the direct-switch method, you’ll simply stop taking Zoloft and begin taking Paxil at a low dose. Your healthcare provider can discuss your options and help you decide which way is safest and most effective for you.

Is Paxil the Strongest SSRI?

According to the National Library of Medicine, paroxetine—the generic form of Paxil— is the most potent serotonin reuptake inhibitor among available SSRIs.

Does Paxil or Zoloft Make You Gain Weight?

Weight gain is a possible side effect of most SSRI medications, including Paxil and Zoloft. Raising the serotonin levels in the brain may increase your appetite or affect your metabolism. However, this side effect isn’t necessarily permanent. 

Is Paxil the Best Medication for Anxiety?

Paxil is one of the most potent SSRIs, and it’s FDA-approved to treat anxiety disorders. However, some of its side effects—such as nervousness, restlessness, and racing thoughts—could cancel out its benefits for those with anxiety-related conditions. 

Your healthcare provider will discuss all possible side effects and work with you to prescribe the best medication to treat your anxiety.

Can I Take Paxil for Life? How About Zoloft?

Some patients take Paxil or Zoloft for years at a time with no adverse effects. However, the longer you take either medication, the higher your chances of experiencing withdrawal symptoms if you stop taking the medication, especially Paxil. 

Talk to your healthcare provider about the safest, most effective way to take SSRI antidepressants long-term.  

Does Paxil Make You Lazy? Does Zoloft?

Paxil and Zoloft both have insomnia and drowsiness as potential side effects, and Paxil may make it difficult to concentrate. Experiencing these side effects could lower your energy and make it hard to complete daily tasks, giving the appearance of laziness.

Your psychiatric healthcare provider will work with you to prescribe the best medication for your anxiety or depression. Book an appointment with a licensed practitioner on Klarity today to determine whether Paxil, Zoloft, or another drug will work best for you.