Does Paxil cause anxiety at first? (+3 tips)

In this article, we will discuss whether or not Paxil causes anxiety at the start of treatment, research studies supporting this claim, factors contributing to increased anxiety due to Paxil, what to do if you are experiencing anxiety while taking Paxil, and techniques and self-care practices to reduce anxiety.

Does Paxil cause anxiety at first?

Yes, Paxil may cause anxiety at the beginning of your treatment. Paxil is the brand name of the medication paroxetine, an antidepressant that belongs to the class of drugs known as SSRIs (Selective Serotonin Reuptake Inhibitors). Paxil enhances serotonin (natural neurotransmitter) levels in the brain. (1)

In the first few weeks of taking Paxil, it can occasionally make you feel more anxious. This is because your body needs time to adjust and get used to the new serotonin levels in your brain and for the drug to start taking effect.

As your body adjusts to the medication and you continue to take it, the initial rise in anxiety usually subsides. (2)

What does research suggest?

Clinical investigations indicate that anxiety was observed in several individuals following the start of antidepressants, including paroxetine (Paxil), sertraline, fluoxetine, citalopram (Celexa), venlafaxine, mirtazapine, and bupropion (Wellbutrin).

According to the study’s findings, 12.4% of patients experienced anxiety when they started taking paroxetine.

The study concluded that the early stages of antidepressant treatment in patients diagnosed with depression have been linked to elevated levels of anxiety, agitation, and restlessness. The mechanism of action of antidepressants in causing anxiety at the beginning of treatment is not fully understood. (3)

What factors contribute to Paxil-induced anxiety?

Several factors may contribute to Paxil-induced anxiety such as : (3), (4), (5)

Dosage: High Paxil doses increase the likelihood of experiencing elevated anxiety. 

Age: Younger populations (aged less than 45 years) are associated with higher risks of anxiety at the beginning of Paxil treatment.

Underlying medical conditions: Certain medical conditions such as heart diseases, thyroid problems, respiratory disorders such as asthma, and IBS (Irritable Bowel Syndrome) can all induce anxiety while taking Paxil.

Concurrent medications: Certain medications such as corticosteroids, thyroid medications, asthma medications, ADHD (Attention Deficit Hyperactivity Disorder) medications, and Parkinson’s disease medications can induce anxiety while taking Paxil.

Stress: Chronic stress can increase anxiety symptoms while taking Paxil.

Gender and race: Females are more prone to anxiety symptoms at the beginning of Paxil treatment than males. Also, white races are associated with anxiety symptoms more than the black race population.

Lifestyle factors: Alcohol, caffeine, and nicotine can all induce anxiety while taking Paxil.

What to do if you are experiencing anxiety while taking Paxil?

If you are experiencing anxiety while taking Paxil, consult your healthcare provider or psychiatrist. If you are new to the medication, you can experience anxiety in the first few weeks of taking Paxil. This side effect will probably fade away after that.

If your anxiety persists, your psychiatrist may reduce your medication dose or switch you to antidepressant alternatives with fewer adverse effects such as: (3)

Mirtazapine: It is an atypical antidepressant that belongs to the class of drugs known as TeCA (Tetra-Cyclic Antidepressants) and is sold under the brand name Remeron. It was proven effective in treating depression with fewer anxiety-related symptoms

Venlafaxine: It is an SNRI (Serotonin and Norepinephrine Reuptake Inhibitors) antidepressant medication that is sold under the brand name Effexor. It can be used instead of Paxil and has fewer anxiety-related symptoms.

Bupropion: It is an atypical antidepressant that is sold under the brand name Wellbutrin. According to certain research, bupropion was shown effective in treating depression and can cause fewer anxiety-related symptoms when compared to Paxil.

If your anxiety is severe and persistent, your healthcare provider might prescribe anti-anxiety medications such as benzodiazepines like alprazolam, diazepam, or buspirone (Buspar) to reduce your anxiety symptoms. (6)

What techniques and self-care practices can be used to reduce anxiety?

There are several techniques and self-care practices that can be used to reduce anxiety, some of which include: (7)

Exercising: Daily regular exercises such as walking, swimming, and aerobics can help in reducing anxiety symptoms.

Meditation: Meditation and spending your time in nature can help relieve stress and relax your mind.

Breathing Exercises: Deep and slow breaths can help relax your mind and reduce anxiety symptoms.

CBT (Cognitive Behavioral Therapy): This kind of psychotherapy can help in relieving anxiety and stress by organizing and changing your thoughts.


Based on my knowledge and research, Paxil can cause anxiety at the beginning of treatment. However, this side effect probably fades away after a few weeks of starting the medication.

Consult your healthcare provider if your anxiety symptoms persist. They might reduce your dose or switch you to an alternative with fewer adverse effects.






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Mayo Clinic. Antidepressants: Get tips to cope with side effects [Internet]. Mayo Clinic. 2019. Available from:


Li Z, Pfeiffer PN, Hoggatt KJ, Zivin K, Downing K, Ganoczy D, et al. Emergent Anxiety after Antidepressant Initiation: A Retrospective Cohort Study of Veterans Affairs Health System Patients With Depression. Clinical Therapeutics. 2011 Dec;33(12):1985-1992.e1. Available from:


Mayo Clinic. Anxiety disorders [Internet]. Mayo Clinic. Mayo Foundation for Medical Education and Research; 2018. Available from:


Ellis RR. What Meds Might Cause Anxiety? [Internet]. WebMD. 2021. Available from: 


Understanding Generalized Anxiety Disorder — Treatment [Internet]. WebMD. 2023. Available from:


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