Paxil (paroxetine) and Zoloft (sertraline) both belong to a class of antidepressants and mood stabilizers known as SSRIs (selective serotonin reuptake inhibitors). An SSRI works by increasing serotonin (a chemical messenger, called a neurotransmitter) levels in the brain, which aids in relieving the symptoms of depression and other mental disorders.
Despite the fact that both Paxil and Zoloft have the same treatment goal and belong to the same class of drugs, they both have some key differences and similarities that are important to know.
Table of Contents
- What is Paxil?
- What is Zoloft?
- Paxil Versus Zoloft
- Can You Take Paxil and Zoloft Together?
- Which Is Better, Paxil or Zoloft?
- When Should You Consult a Doctor?
- Key Takeaways
What is Paxil?
Paxil (paroxetine HCl) is a prescription-only selective serotonin reuptake inhibitor (SSRI).
The Food and Drug Administration (FDA) has licensed it to treat diseases such as depression, post-traumatic stress disorder (PTSD), anxiety, and other similar problems.
Paxil Uses
Paxil is approved by the FDA to treat the following conditions:
- Social anxiety disorder
- Panic disorder
- Generalized anxiety disorder
- Major depressive disorder
- Post-traumatic stress disorder
- Obsessive-compulsive disorder
Mechanism of Action of Paxil
Paxil regulates serotonin levels by preventing brain cells from readily absorbing it. By controlling serotonin levels, Paxil can help enhance mood and lessen anxiety.
Paxil can also help with symptoms of common co-occurring conditions like depression and headaches.
Side Effects of Paxil
Paxil will not immediately relieve your panic disorder symptoms. Improvements are usually noticeable within a few days to weeks of starting your prescription, but it may take many months to reap the full benefits of Paxil. People who take Paxil may encounter some side effects.
Common Side Effects
The side effects of Paxil usually fade over time, but if they persist or become unbearable, contact your doctor to discuss your 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
Paxil, like all drugs, might cause an allergic reaction or cause a serious drug interaction when combined with other medications. Make sure your doctor is aware of all prescription and over-the-counter medications you are using.
If you encounter any of the following serious side effects, get medical treatment right away:
- Changes in mood, anxiety, or behavior
- Eye problems, such as eye pain, changes in vision, swelling, or redness in or around your eyes
- Abnormal bleeding
- Seizures or convulsions
- Manic episodes.
- Weight loss or Weight gain
- Low sodium levels
What is Zoloft?
Zoloft (sertraline) is a selective serotonin reuptake inhibitor (SSRI). It is most typically used to treat depression, but it is also used to treat obsessive-compulsive disorder (OCD), panic disorder, and post-traumatic stress disorder (PTSD). Zoloft is occasionally recommended to treat social anxiety disorder and other phobias.
Zoloft Uses
Zoloft is approved by the FDA to treat the following conditions:
- Social anxiety disorder
- Panic disorder
- Major depressive disorder
- Post-traumatic stress disorder
- Obsessive-compulsive disorder
- Premenstrual dysphoric disorder (PMDD)
Zoloft Mechanism of Action
Serotonin is a chemical neurotransmitter that facilitates the transmission of electrical impulses from one neuron to the next. Normally, serotonin is immediately reabsorbed; however, an SSRI such as Zoloft permits serotonin to remain in the synaptic gap between neurons for a longer period of time. This allows the chemical to send more messages to the receiving neuron, which may improve mood.
Side effects of Zoloft
Zoloft, like all medications, has the potential for adverse effects. Inform your doctor right away if you encounter any discomfort or problems while taking this medicine.
Common Side Effects
Adults and children experience varied side effects when using Zoloft. Some side effects, however, are known to affect both populations equally. Among these adverse effects are:
- Diarrhea
- Indigestion
- Loss of appetite
- Nausea
- Fatigue and drowsiness
- Changes in sleep habits
- Agitation
- Shaking or tremors
- Increased sweating
- Sexual problems, including reduced sex drive and ejaculation failure
Other side effects related to Zoloft use in children include:
- Slowed growth rate
- Weight gain or weight loss
- Aggressiveness
- Frequent urination
- Nose bleeds
- Abnormal increase in muscle movement or agitation
Severe Side Effects
Zoloft has the potential to induce serious side effects and symptoms that necessitate rapid medical intervention. The following are serious Zoloft adverse effects:
- Suicidal thoughts and behaviors
- Severe allergic reactions with signs and symptoms such as swelling of the face, tongue, eyes, or mouth, Severe rash, Trouble breathing
- Seizures
- Abnormal bleeding
- Manic episodes.
- Glaucoma
Paxil Versus Zoloft
How Are Paxil and Zoloft Different?
Paxil and Zoloft have many similarities, but they are not the same drug and are not used interchangeably.
They are different in the conditions they are indicated for. The Food and Drug Administration (FDA) has approved Paxil and Zoloft for social anxiety disorder, panic disorder, major depressive disorder, post-traumatic stress disorder, obsessive-compulsive disorder, and premenstrual dysphoric disorder (PMDD).
The FDA has also approved Paxil to treat generalized anxiety disorder (GAD) and vasomotor symptoms of menopause.
Paxil is not FDA-authorized for children, whereas Zoloft is only allowed for children and adolescents to treat OCD.
At the discretion of health care providers, these medications may be used for off-label uses.
Paxil off-label usage may include:
- Separation anxiety
- Postpartum depression
- Body dysmorphic disorder
- OCD in children and adolescents
- Premature ejaculation
- Dysthymia
While the off-label uses of Zoloft include:
- Bulimia nervosa
- Binge eating disorder
- Generalized anxiety disorder (GAD)
- Premature ejaculation
- Body dysmorphic disorder
How Are Paxil and Zoloft Similar?
Since Paxil and Zoloft belong to the same class of drugs, they have many similarities with each other
Both of these drugs:
- Are SSRI antidepressants
- Helpful in maintaining regulated serotonin levels in the brain
- Have comparable side effects
- Both are available in liquid and tablet form
- Are taken once a day
- Are FDA-approved to treat depression, PTSD, OCD, and other mental and mood-related disorders.
Paxil vs Zoloft: Side Effects
Paxil’s most common side effects are nausea, sleepiness, headache, dry mouth, and weakness. The most common Zoloft side effects are nausea, dry mouth, diarrhea, and insomnia. Both medicines have a similar set of side effects, with differing percentages of people experiencing them.
Paxil is more likely than other antidepressants to reduce sexual appetite and delay or prevent ejaculation.
When used in children and teenagers, Paxil (paroxetine), like most antidepressants, has a high risk of suicidal thoughts and behavior.
If you are elderly or have dementia, it may not be a suitable medication for you.
Zoloft, on the other hand, is more likely to cause diarrhea compared to other antidepressants.
It can also cause a decrease in sexual desire, inability to orgasm or ejaculate, and modest weight gain.
Dosage of Paxil and Zoloft
The doses of Paxil and Zoloft differ. Because they are distinct medications, the dosages are not directly similar.
Paxil Dosage
Paxil is available in tablet and liquid form. It can be consumed with or without meals.
It comes in both immediate-release and controlled-release forms.
- Immediate-release: Doses start at 20 mg and increase in 10 mg weekly increments up to a maximum of 50 mg per day. For elderly patients, the initial dose is 10 mg, with a maximum daily dose of 40 mg.
- Controlled Release: Doses start at 25 mg and increase in 12.5 mg weekly increments up to a maximum of 62.5 mg per day. For elderly patients, the starting dose is 12.5 mg, with a maximum daily dose of 25 mg.
Zoloft Dosage
Zoloft comes in tablet, capsule, and liquid solution forms. When taken with food, absorption is enhanced.
- Oral tablets: Available in three dosages of 25 mg, 50 mg, or 100 mg
- Oral capsules: Available in two dosages of 150 mg and 200 mg
- Liquid solution: Available in the dosage of 20 mg per milliliter
Dosages for depression begin at 50 mg per day for adults and are raised in 50 mg per day increments at weekly intervals as needed, up to a maximum dosage of 200 mg per day.
Warnings of Paxil and Zoloft
All antidepressants, including Paxil and Zoloft, come with a black boxed warning, which is the strongest warning required by the FDA. Patients of any age who take antidepressants should be closely monitored for signs of changes in behavior, and suicidality, especially during the first few months of treatment and if any changes in dose occur.
Antidepressants increase the risk of suicidal thoughts and behavior in children, adolescents, and young adults. Depression and other psychological disorders also increase the risk of suicide.
Families and caregivers should also monitor the patient, and notify the prescriber of any issues.
Paxil Warnings
Paxil, like other antidepressants, carries a black box warning.
This risk is greatest in children, teenagers, and young adults, although it can impact anyone of any age.
Inform your healthcare practitioner if you see signs of increasing agitation, impulsiveness, panic attacks, severe irritability, worsened anxiety, or manic behavior. Your healthcare provider should weigh the risks and rewards before continuing on the prescription.
However, Paxil should not be prescribed to those patients who have certain medical issues or who are taking certain drugs.
If you have any of the following conditions, Paxil may not be a viable prescription choice for you.
- If you take or have taken MAOIs in the last 14 days
- If you’re on a Thioridazine prescription.
- If Pimozide is prescribed to you.
- If you’re allergic to any of the components in Paxil
Zoloft Warnings
Zoloft also comes with a black box warning.
If you see any of the following warning signals, contact your doctor straight away:
- Suicidal thoughts or discussion (this risk is greater in children, adolescents, and young adults, but can affect any age.)
- Worsening anxiety
- Manic behavior
- Unusual changes in behavior
- Irritability
- Restlessness
- Panic attacks
- Agitation, aggression, or hostility
- Insomnia
Zoloft should not be prescribed to those patients who have certain medical issues or who are taking certain drugs.
If you have any of the following conditions, your doctor should not prescribe you Zoloft:
- If you take or have taken MAOIs in the last 14 days
- If you’re on a Thioridazine prescription.
- If Pimozide is prescribed to you.
- If you’re allergic to Sertraline or any of the components in Zoloft
- If you’ve used Disulfiram (this only applies to liquid dosage of Zoloft)
- If you’ve any kind of liver damage or cirrhosis
Drug interactions with Paxil and Zoloft
- MAO inhibitors (monoamine oxidase inhibitor antidepressants) can be extremely hazardous and potentially lethal when used with Paxil or Zoloft. All MAO inhibitors should be used 14 days apart from SSRIs.
- Combining Paxil or Zoloft with other serotonin-boosting medicines, as well as other SSRIs, SNRIs, or tricyclic antidepressants can raise the risk of serotonin syndrome.
- Aspirin and other nonsteroidal anti-inflammatory drugs (NSAIDs) should not be combined with Paxil or Zoloft since they can increase the risk of bleeding.
Paxil and Zoloft may interact with a variety of different medications. These include;
Sedatives, narcotics, sleeping pills, the amino acid L-tryptophan, medicines for seizures or anxiety, other antidepressants, cold or allergy medicines, blood thinners, medicines to treat migraines, tramadol, muscle relaxers, or cimetidine.
Can You Take Paxil and Zoloft Together?
Simultaneous use of two or more serotonergic medications, such as serotonin reuptake inhibitors like Paxil and Zoloft, may increase the risk of serotonin syndrome, which is a rare but dangerous and sometimes fatal condition.
Symptoms of the serotonin syndrome may include:
- Mental status changes such as irritation, confusion, hallucination, altered consciousness, and coma
- Neuromuscular abnormalities such as tremor, myoclonus, rigidity, hyperreflexia, and ataxia;
- Gastrointestinal symptoms such as diarrhea, vomiting, nausea, and abdominal cramping.
- Autonomic dysfunction, such as hyperthermia, tachycardia, diaphoresis, blood pressure changes, shivering, and mydriasis.
Which Is Better, Paxil or Zoloft?
Paxil and Zoloft are in the same pharmacological class, however, they operate slightly differently.
Although Zoloft is only approved for depression, many doctors also prescribe it for anxiety.
Whether one or the other works better for you is determined by your personal response to the drug, your health conditions, your age, and any other medications you may be taking.
Consult your doctor to see if one of these medications is good for you.
When Should You Consult a Doctor?
If you are experiencing any of the symptoms of depression, such as chronic melancholy, a lack of desire, or indifference towards activities that used to interest you, you should consult a doctor.
Although your doctor may not always recommend an antidepressant, they will be able to assist you in finding a treatment plan that works for you and improves your quality of life.
In addition, your doctor will be able to discuss the treatment options available to you, as well as the risks and benefits of each.
How Can DrHouse Help You?
If you have depression or anxiety and are seeking prescription drugs such as Paxil or Zoloft, consulting with a doctor online is the most convenient approach for you to discuss your treatment options.
DrHouse, an online healthcare service, can connect you with a doctor in as little as 15 minutes. Using the virtual interface, you can voice your concerns regarding symptoms and explore treatment choices. A prescription for your problem can be written by any DrHouse online doctor.
Key Takeaways
- Paxil and Zoloft are both SSRIs and work to increase the serotonin levels in the brain
- Paxil is available in tablet and liquid form while Zoloft is available in tablet, capsule, and liquid solution form.
- The most common side effects of Paxil include nausea, sleepiness, headache, dry mouth, and weakness. The most common Zoloft side effects are nausea, dry mouth, diarrhea, and insomnia.
- Paxil and Zoloft should not be taken together or with other serotonergic medications as they can lead to serotonin syndrome.
Sources:
- PRESCRIBING INFORMATION PAXIL ® (paroxetine hydrochloride). (n.d.). Retrieved from https://www.accessdata.fda.gov/drugsatfda_docs/label/2017/020031s074lbl.pdf
- McRae, A. L., & Brady, K. T. (2001). Review of sertraline and its clinical applications in psychiatric disorders. Expert Opinion on Pharmacotherapy, 2(5), 883–892. https://doi.org/10.1517/14656566.2.5.883
- Swanson, J. (n.d.). Unraveling the Mystery of How Antidepression Drugs Work. Retrieved from Scientific American website: https://www.scientificamerican.com/article/unraveling-the-mystery-of-ssris-depression/
- Shihabuddin, L., & Rapport, D. (1994). Sertraline and extrapyramidal side effects. The American Journal of Psychiatry. Retrieved from: https://psycnet.apa.org/record/1994-26746-001
- Keltner, N. (1994). Serotonin syndrome: a case of fatal SSRI/MAOI interaction. Perspectives in Psychiatric Care, 30(4), 26-31.Retrieved from: https://onlinelibrary.wiley.com/doi/abs/10.1111/j.1744-6163.1994.tb00446.x
- Sanchez, C., Reines, E. H., & Montgomery, S. A. (2014). A comparative review of escitalopram, paroxetine, and sertraline. International Clinical Psychopharmacology, 29(4), 185–196. https://doi.org/10.1097/yic.0000000000000023
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