Does Paxil Work Like Xanax? (3+ differences)

This article discusses the differences between Paxil and Xanax, two medications commonly used to treat anxiety disorders. It explores their mechanisms of action, therapeutic uses, side effects, withdrawal symptoms, and factors to consider when choosing between the two.

It’s important to consult with a healthcare professional to determine the most appropriate treatment for individual needs.

Does Paxil work like Xanax?

Paxil does not work like Xanax. Paxil (paroxetine) and Xanax (alprazolam) are both medications used to treat different conditions, and they work in different ways.

Paxil is a selective serotonin reuptake inhibitor (SSRI) antidepressant used in treating depression, anxiety disorders, obsessive-compulsive disorder (OCD), and post-traumatic stress disorder (PTSD). On the other hand, Xanax is a benzodiazepine, and it is mainly prescribed for anxiety disorders and panic disorders [1,2].

While they both can be used to treat anxiety disorders, they have different mechanisms of action and potential side effects. It’s important to note that medication effectiveness can vary from person to person, so it’s crucial to consult with a doctor who can prescribe the most appropriate treatment for you.

What are the differences between Xanax and Paxil?

The differences between Xanax and Paxil are mentioned below 

Mechanism of action

Xanax, a benzodiazepine, is known for its anti-anxiety properties. It binds to GABA-A receptors in the brain, enhancing the activity of gamma-aminobutyric acid (GABA), an inhibitory neurotransmitter. This leads to reduced anxiety levels, muscle relaxation, and sedation by increasing GABA’s inhibitory effects [2].

On the other hand, Paxil inhibits serotonin’s reuptake at nerve terminals in the brain, thereby increasing its levels between nerve cells. By maintaining higher levels of serotonin, Paxil can help in mood stabilization and improve symptoms of depression, anxiety disorders, and other conditions [1].

Therapeutic uses

Xanax is approved for managing anxiety, including generalized anxiety disorder, panic disorder, and social anxiety disorder. It may also be used for the short-term management of anxiety-related insomnia and as an adjunctive treatment for depression-related anxiety. Xanax can also be used in the treatment of acute alcohol withdrawal symptoms [3,4].

It may occasionally be prescribed off-label for other conditions, such as certain phobias, or as a short-term intervention for severe stress or situational anxiety. However, off-label use should only be prescribed by a healthcare professional after considering the risks and benefits [2].

Paxil is approved for several conditions, including major depressive disorder (MDD), generalized anxiety disorder (GAD) panic disorder, social anxiety disorder (SAD), and obsessive-compulsive disorder (OCD). It is also indicated for post-traumatic stress disorder (PTSD) [5]. 

Similar to Xanax, Paxil may also have off-label uses based on clinical judgment and individual patient needs. Examples of off-label uses may include body dysmorphic disorder, postpartum depression, premenstrual dysphoric disorder (PMDD), certain phobias, and treatment-resistant depression [1].

Side effects

The most commonly reported side effects of Xanax include [2]:

  • Drowsiness
  • Dizziness
  • Lightheadedness
  • Fatigue
  • Impaired coordination
  • Memory problems
  • Confusion
  • Difficulty concentrating
  • Headache
  • Dry mouth
  • Nausea
  • Constipation
  • Changes in appetite
  • Weight gain or weight loss
  • Decreased sex drive or erectile dysfunction 

Common side effects associated with Paxil may include [1]:

  • Nightmares
  • Dizziness
  • Tiredness
  • Headache
  • Dry mouth
  • Sweating
  • Blurred vision
  • Tremors
  • Changes in appetite or weight
  • Nausea
  • Diarrhea or constipation
  • sexual dysfunction or decreased sexual desire
  • Sleep disturbances (such as insomnia or vivid dreams).

The side effects mentioned above are not exhaustive, and some individuals may experience different or additional side effects. Additionally, the severity and frequency of side effects can vary from person to person. It’s crucial to discuss any concerns or noticeable side effects with a doctor.

Withdrawal symptoms

When discontinuing Paxil, some withdrawal symptoms may include dizziness, fatigue, flu-like symptoms, gastrointestinal disturbances, insomnia, irritability, nightmares, and sensory disturbances, among others. These symptoms can vary in intensity and duration, but they typically resolve within a few weeks [1]. 

Benzodiazepine withdrawal, including Xanax, can be more severe than SSRIs, causing anxiety, restlessness, irritability, insomnia, tremors, sweating, muscle pain, and seizures in severe cases. It is recommended to taper off the medication under medical supervision for safe management [2]. 

How to choose between taking Xanax or Paxil?

When considering the choice between taking Xanax or Paxil, several factors may come into play. The decision is typically made based on a range of considerations, including the patient’s specific disease, symptoms, medical history, and the advice and guidance of a healthcare professional.

The intensity of symptoms can also influence the choice. Xanax has a quick onset and short duration of action, providing immediate relief for acute symptoms. However, its effectiveness in managing long-term symptoms may be limited due to potential tolerance and dependence issues.

Paxil may take several weeks to reach its full effect in alleviating symptoms, which makes it a better option for managing chronic or persistent symptoms.

Moreover, Xanax should be used with caution in individuals with a history of substance abuse or addiction, as it carries a higher risk of dependence. Any potential drug interactions or contraindications with other medications should also be considered when making a decision.

Ultimately, the decision between Xanax and Paxil should be made in consultation with a doctor. They can consider the person’s condition, and weigh the potential benefits, risks, and side effects associated with each medication, to determine the suitable drug.


In conclusion, Paxil and Xanax are two medications with different mechanisms of action and therapeutic uses. Paxil is an SSRI prescribed for depression, anxiety disorders, OCD, and PTSD, while Xanax is a benzodiazepine primarily used for anxiety disorders and panic disorders.

While they both may be used for anxiety, they have different mechanisms of action, potential side effects, and withdrawal symptoms. It is important to Consult a healthcare professional to determine the best treatment option based on your needs, medical history, and symptom intensity and duration.

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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-.


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


Highlights of Prescribing Information. XANAX (alprazolam) tablets, for oral use, CIV.


Kattimani S, Bharadwaj B. Clinical management of alcohol withdrawal: A systematic review. Ind Psychiatry J. 2013 Jul;22(2):100-8. doi: 10.4103/0972-6748.132914. PMID: 25013309; PMCID: PMC4085800.


Highlights of Prescribing Information. Paxil (paroxetine) tablets, for oral use. Paxil (paroxetine) oral suspension.

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