Can Paxil Hurt Your Heart? (9+ Risk Factors)

This article will discuss the potential impact of Paxil on the heart. It explores what research suggests about Paxil’s heart-related effects and highlights the potential benefits of Paxil for the heart.

Furthermore, the article explains factors that can influence Paxil’s effect on the heart. It concludes by providing recommendations for individuals experiencing heart-related issues while taking Paxil.

Can Paxil hurt your heart?

Paxil may hurt one’s heart or cause cardiac damage. However, this risk is very rare and is more likely to occur in individuals with pre-existing heart conditions or those taking other medications that can also affect the heart.  It’s worth mentioning that the benefits of taking Paxil usually outweigh the potential risks.

Paroxetine was found to have cardio-protective properties. However, it is essential to monitor any changes in your heart rate or symptoms while taking Paxil. If you experience chest pain, irregular heartbeat, or shortness of breath while on Paxil, seek medical attention and report to your doctor.

How can Paxil affect the heart?

The mechanism by which most antidepressants like Paxil can affect the heart is through their interaction with neurotransmitters in the brain. Most antidepressants work by increasing serotonin levels and possibly other neurotransmitters like dopamine and noradrenaline.

Unfortunately, increased levels of serotonin and other neurotransmitters can also impact the heart. To illustrate, some antidepressants, especially citalopram, can prolong a specific electrical signal in the heart known as the QT interval. This can increase the risk of a dangerous arrhythmia called torsades de pointes [1].

SSRIs like paroxetine, however, are generally considered safer for the heart, as they have a more selective action on serotonin reuptake and do not significantly affect other neurotransmitters or receptors that may be involved in cardiac function.

What does research suggest?

Overall, the research suggests that selective serotonin reuptake inhibitors (SSRIs) like paroxetine can have cardio-protective qualities and benefit the heart, rather than harm it.

For example, one study explored the use of SSRIs (like Paxil) in depressed patients who experienced an acute myocardial infarction (MI).

SSRIs have been found to reduce the risk of death and the risk of recurrent MI by 43%, suggesting that their use in depressed patients with MI may help reduce subsequent cardiovascular morbidity and mortality [2].

Another study investigated the cardiovascular effects of paroxetine compared to amitriptyline. Amitriptyline significantly increased heart rate and the QTc interval and weakened cardiac muscles, while paroxetine did not alter any of the cardiovascular parameters measured [3].

A meta-analysis of nine studies found that first-trimester exposure to paroxetine did not increase cardiac malformations, with rates of cardiac malformations similar between the paroxetine-taking group and the control group (1.1% vs 1.1%). This indicates that using Paxil in pregnancy does not harm the heart [4].

Another investigation found that therapeutic doses of paroxetine did not have hemodynamic or electrophysiological effects. To illustrate, in healthy men receiving single doses, paroxetine did not affect heart rate, blood pressure, or the electrocardiogram [5].

One study found that paroxetine has antihypertensive properties during psychological stress in psychiatrically healthy individuals with CAD. To illustrate, while on paroxetine,  blood pressure was 10-15% lower during the stressor compared to placebo [6].

Another investigation found that co-treatment with paroxetine in rats treated with doxorubicin preserved left ventricular morphology and contractility, suggesting that Paxil may offer cardioprotection in the presence of doxorubicin-induced cardiomyopathy [7].

What factors may influence Paxil’s effect on the heart?

Some factors can increase the likelihood of experiencing cardiac side effects while taking Paxil. Some of these factors are mentioned below:

  • Taking very high doses of Paxil or abruptly escalating the dose without proper titration can potentially increase the risk of heart issues.
  • Pre-existing cardiovascular conditions such as heart attacks, strokes, or heart rhythm abnormalities put people at higher risk of experiencing heart-related effects while taking Paxil.
  • Combining Paxil with certain medications, such as monoamine oxidase inhibitors (MAOIs), other antidepressants, or drugs that affect the cardiovascular system, could potentially have an impact on the heart and increase the risk of cardiac adverse effects.
  • Individuals with other pre-existing medical conditions, such as hypertension (high blood pressure), diabetes, or obesity, may have an increased risk of heart issues when taking Paxil.
  • Advanced age may be a contributing factor in the risk of heart-related effects. Older adults may be more susceptible to cardiovascular complications.
  • Tobacco smoking is known to increase the risk of heart disease. When combined with Paxil use, it may further compound the risk of heart-related issues.
  • Having a family history of cardiovascular disease can also be a relevant factor in assessing the risk of heart issues while taking Paxil.
  • Individual sensitivity: each person may have their unique sensitivity and response to medications, including Paxil. Some individuals may be inherently more at risk for experiencing heart-related effects.
  • Substance abuse: concurrent use of alcohol or illicit drugs in combination with Paxil may potentiate the risk of heart issues.
  • General health status, including factors like poor physical fitness, obesity, or a sedentary lifestyle, can contribute to the risk of heart-related effects when taking Paxil.

What to do if Paxil harms your heart?

If you experience any potential heart-related issues while taking Paxil, it is crucial to seek immediate medical attention. Moreover, here are some possible approaches that may be considered:

Undergo a thorough examination by a qualified healthcare provider

To assess your heart function, you may need to conduct some tests. Depending on the severity of the symptoms, it may be necessary to monitor your heart function using tests like electrocardiograms (ECGs) to evaluate cardiac rhythm and detect any abnormalities.

Moreover, review all medications, including over-the-counter drugs and supplements, with your doctor to ensure there are no potential interactions or contraindications that could worsen cardiac issues.

Schedule follow-up appointments with your healthcare provider to monitor your cardiac health, discuss any concerns, and review the ongoing need for Paxil or any adjustments in treatment.

Dose adjustment

Discuss with your healthcare provider the possibility of adjusting the dosage of Paxil. Your doctor may consider gradually reducing the dose.

You must carefully follow your healthcare provider’s guidance regarding the use of Paxil. This includes adhering to prescribed dosages, avoiding sudden discontinuation without medical supervision, and promptly reporting any new or worsening symptoms.

Adopt heart-healthy lifestyle practices

Maintain a balanced diet, engage in regular exercise, quit tobacco smoking, and limit alcohol consumption. These measures can help improve cardiovascular health and reduce the risk of heart-related complications.

Switch to an alternative antidepressant

If Paxil-induced heart issues are persistent, your doctor may consider switching to another antidepressant.

Based on my research, I found that while there is a rare risk of Paxil affecting the heart, this is more likely to occur in individuals with pre-existing heart conditions or those taking other medications that can also impact the heart.

Studies suggest that SSRIs like Paxil may have cardioprotective properties and can benefit the heart. From my perspective, however, it is essential to monitor any changes in heart rate or symptoms while on Paxil and seek medical attention if experiencing chest pain, irregular heartbeat, or shortness of breath.

Factors that may influence Paxil’s effect on the heart include dosage, pre-existing cardiovascular conditions, medication interactions, other health conditions, advanced age, smoking, family history, individual sensitivity, substance abuse, and general health status.

If Paxil does harm the heart, I recommend seeking medical attention, adjusting the dosage, monitoring heart function, reviewing medications, adopting a heart-healthy lifestyle, and following the doctor’s guidance are possible approaches.

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Al-Radideh O, Chan KH, Gupta S, Slim J, Bellary S. Concurrent Serotonin Syndrome and Prolong QT Interval Induced by Paroxetine Overdose With Isotretinoin. Cureus. 2021 Apr 15;13(4):e14497. doi: 10.7759/cureus.14497. PMID: 34007750; PMCID: PMC8121124.


Taylor CB, Youngblood ME, Catellier D, Veith RC, Carney RM, Burg MM, Kaufmann PG, Shuster J, Mellman T, Blumenthal JA, Krishnan R, Jaffe AS; ENRICHD Investigators. Effects of antidepressant medication on morbidity and mortality in depressed patients after myocardial infarction. Arch Gen Psychiatry. 2005 Jul;62(7):792-8. doi: 10.1001/archpsyc.62.7.792. PMID: 15997021.


Kuhs H, Rudolf GA. Cardiovascular effects of paroxetine. Psychopharmacology (Berl). 1990;102(3):379-82. doi: 10.1007/BF02244107. PMID: 2147517.


O’Brien L, Einarson TR, Sarkar M, Einarson A, Koren G. Does paroxetine cause cardiac malformations? J Obstet Gynaecol Can. 2008 Aug;30(8):696-701. doi: 10.1016/S1701-2163(16)32918-8. PMID: 18786292.


Warrington SJ, Lewis Y. Cardiovascular effects of antidepressants: studies of paroxetine in healthy men and depressed patients. Int Clin Psychopharmacol. 1992 Jun;6 Suppl 4:59-64. PMID: 1431013.,single%2020%2D40%20mg%20doses.


Golding M, Kotlyar M, Carson SW, Hoyler S, Lazarus C, Davidson C, Guzzo J, Sontz E, Garbutt JC. Effects of paroxetine on cardiovascular response to mental stress in subjects with a history of coronary artery disease and no psychiatric diagnoses. Psychopharmacology (Berl). 2005 Nov;182(3):321-6. doi: 10.1007/s00213-005-0075-7. Epub 2005 Oct 19. PMID: 16001113.


Kosić M, Nešić Z, Glumac S, Vasić M, Pajović V, Savić B, Japundžić-Žigon N. Paroxetine mitigates cardiac remodelling by doxorubicin and increases survival. Biomed Pharmacother. 2022 Jan;145:112411. doi: 10.1016/j.biopha.2021.112411. Epub 2021 Nov 12. PMID: 34781149.

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