Does Paxil affect Xanax? (+3 interactions)

This article will discuss the query, “Does Paxil affect Xanax?” We will also discuss the appropriate use of Paxil and Xanax together, the potential interactions between Paxil and Xanax, and how to manage those side effects.

Does Paxil affect Xanax? 

Yes, Paxil does affect Xanax. Taking Paxil and Xanax together can amplify the shared side effects such as sedation, and dizziness, and increase the risk of serotonin syndrome. 

Paxil (Paroxetine) is a well-known SSRI (Selective Serotonin Reuptake Inhibitor). It is an FDA-approved drug for disorders like major depressive disorder and social anxiety disorder. (1)

Xanax (Alprazolam) is a psychoactive medication and belongs to the class of benzodiazepines. It is an FDA-approved drug to manage anxiety disorders and panic disorders. (2)

When Paxil and Xanax can be taken together? 

Your doctor may prescribe you Paxil and Xanax together if you have anxiety, depression, or both. Xanax is given at a small dosage at the beginning of the treatment because it is a fast-acting benzodiazepine and provides rapid symptom relief which helps you to adhere to the medications. The dose of Xanax is reduced gradually once Paxil starts to work. This combined therapy approach is safe to use and known to improve overall outcomes (3). 

When Paxil and Xanax should not be taken together? 

Paxil and Xanax are not safe to be used together in the elderly population. Paxil and Xanax are associated with the side effects of dizziness and drowsiness that increase the risk of falls in the elderly. The combination of benzodiazepines and SSRI is known to increase the risk of hip fracture in older people (4). 

Paxil and Xanax should not be used with other CNS depressants like antihistamines and muscle relaxants to avoid the potential additive effect (2). Simultaneous use of monoamine oxidase inhibitors (MAOIs) with Paxil and Xanax is contraindicated due to the risk of serotonin syndrome (1). 

What are the side effects of taking Xanax and Paxil together? 

Your doctor may prescribe you Xanax and Paxil together if you are diagnosed with anxiety or depression. Here are some side effects you may experience while taking Xanax and Paxil together. 

Increased Sedation: 

Sedation is a common side effect of SSRIs like Paxil and Lexapro and these drugs make you sleepy. Paxil is known to induce greater sedation as compared to other SSRIs (5). Xanax is a CNS depressant and has a calming effect on the nervous system which mediates sedation (2). Thus, taking Paxil and Xanax together can increase the sedation and make you feel drowsy, which is a commonly reported side effect of both drugs (1,2). 


Paxil and Xanax are both associated with the side effects of dizziness (1,2). These drugs work on the central nervous system and influence the neurotransmitters which have various effects on our body. As a result, these drugs can cause dizziness as a side effect. Thus, taking Paxil and Xanax together can make you feel dizzy. 

Serotonin Syndrome: 

Paxil increases the level of serotonin in the brain (1). Xanax is also associated with an increase in the level of neurotransmitters like dopamine and serotonin (6). Thus, taking Paxil and Xanax together increases your risk of serotonin syndrome. 

Serotonin syndrome is a life-threatening condition that occurs due to the buildup of excessive serotonin in the body. It can be identified by the following signs and symptoms (7)

  • restlessness 
  • increased heart rate 
  • muscle rigidity 
  • dilated pupils
  • nausea
  • vomiting 

How to manage the side effects of Paxil and Xanax together? 

Taking Paxil and Xanax together is considered safe and their side effects can be managed. A study conducted on the concomitant use of antidepressants and benzodiazepines found that people in combination therapy were less likely to leave the treatment due to side effects than those receiving antidepressants alone (8). Therefore the side effects are well tolerated if the medications are used properly. 

Remember the following recommendations while taking both medications: 

  • Communicate openly with your healthcare provider during the treatment. Discuss your concerns with the doctor and receive proper guidance on the appropriate use of medications. 
  • Strictly adhere to the prescribed dosage. Do not change or increase the doses unless guided by your healthcare provider. 
  • Due to the increased risk of sedation, avoid driving and operating dangerous machinery if you feel drowsy. 
  • Keep an eye on the potential side effects. Immediately inform your doctor if you are having suicidal thoughts, confusion, anxiety, severe dizziness, or memory impairment (2). 


In my view, if your provider has prescribed Xanax and Paxil together, it is safe to use and will produce positive health outcomes due to the additive effect. However, some shared side effects like drowsiness and dizziness can be increased which are moderate and manageable. You must learn about the appropriate use of these medications from your healthcare provider to avoid serious side effects and manage your health. 

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Shrestha P, Fariba KA, Abdijadid S. Paroxetine. [Updated 2023 Jul 17]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jan-. Available from:


George TT, Tripp J. Alprazolam. [Updated 2023 Apr 24]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jan-. Available from:


Dunlop BW, Davis PG. Combination treatment with benzodiazepines and SSRIs for comorbid anxiety and depression: a review. Prim Care Companion J Clin Psychiatry. 2008;10(3):222-8. doi: 10.4088/pcc.v10n0307. PMID: 18615162; PMCID: PMC2446479.


Westaway K, Blacker N, Shute R, Allin R, Elgebaly Z, Frank O, Pratt N, Roughead E. Combination psychotropic medicine use in older adults and risk of hip fracture. Aust Prescr. 2019 Jun;42(3):93-96. doi: 10.18773/austprescr.2019.011. Epub 2019 Jun 3. PMID: 31363307; PMCID: PMC6594851.


Marken PA, Munro JS. Selecting a Selective Serotonin Reuptake Inhibitor: Clinically Important Distinguishing Features. Prim Care Companion J Clin Psychiatry. 2000 Dec;2(6):205-210. doi: 10.4088/pcc.v02n0602. PMID: 15014630; PMCID: PMC181142.


Ait-Daoud N, Hamby AS, Sharma S, Blevins D. A Review of Alprazolam Use, Misuse, and Withdrawal. J Addict Med. 2018 Jan/Feb;12(1):4-10. doi: 10.1097/ADM.0000000000000350. PMID: 28777203; PMCID: PMC5846112.


Simon LV, Keenaghan M. Serotonin Syndrome. [Updated 2023 Jul 17]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jan-. Available from:


Furukawa TA, Streiner DL, Young LT. Antidepressant plus benzodiazepine for major depression. Cochrane Database Syst Rev. 2001;(2):CD001026. doi: 10.1002/14651858.CD001026. PMID: 11405972.

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