Does Paxil work right away for anxiety? (3+ factors)

In this article, we will discuss whether Paxil works right away for anxiety. Furthermore, we will talk about how Paxil works, what the research suggests, contributing factors, and what to do if Paxil does not work for you. 

Does Paxil work right away for anxiety?

Paxil does not work right away for anxiety. Patients start feeling improvements in their sleep patterns, appetite, and mood in the early phase of treatment with Paxil. However, Paxil may take up to 6-8 weeks to show its therapeutic benefits for anxiety (1). 

Paxil, also known as Paroxetine, is a selective serotonin reuptake inhibitor (SSRI) antidepressant that is FDA-approved to treat generalized anxiety disorder (GAD), social anxiety disorder (SAD), depression, obsessive-compulsive disorder (OCD), and related mental conditions (2). 

How does Paxil work for anxiety?

Paxil works for anxiety by blocking the reuptake of a neurotransmitter, serotonin, in the brain cells. Reuptake is a process where serotonin is reabsorbed in the nerve cells. By this mechanism of action, Paxil and other SSRIs such as Celexa, increase the concentration levels of serotonin in the synaptic region, where it remains for a longer period.

The prolonged presence of serotonin increases the neurotransmission between brain cells. Serotonin regulates the mood, sleep, appetite, and the body’s stress response, thereby reducing the symptoms of anxiety (2). 

How long does Paxil take to work for anxiety?

Paxil may start working for anxiety within the first week of treatment. Patients may observe improvements in their anxiety symptoms when given 20mg to 50mg of Paxil once daily. These doses of Paxil are found to be effective in the treatment of generalized anxiety disorder (GAD). 

However, the complete therapeutic effects of Paxil may be shown after 8 weeks of antidepressant treatment. You may observe some mild side effects in the initial phase of Paxil treatment, which may disappear once your body adjusts to the medication (1).

What does research suggest about Paxil and anxiety?

According to a research study on Paxil and anxiety, it was suggested that Paxil is safe and effective in patients with social anxiety disorder (SAD) who also have an alcohol use disorder. The study also indicated that the presence of alcohol use disorder does not interfere with the effectiveness of Paxil (3).

Another research study indicated that Paxil is safe to use among elderly patients aged between 65 to 75 for anxiety disorders. However, elderly patients may have higher levels of Paxil in their blood and may take more time to eliminate from the system (4). 

What factors affect Paxil’s immediate effectiveness for anxiety?

The factors affecting Paxil’s immediate effectiveness for anxiety may include dose, dosage form, and the patient’s gender. These factors affect the metabolism of Paxil in the body. The drug clearance from the body may decrease when the dose of Paxil is increased, and the dosage form affects the distribution of the drug in the bloodstream.

The gender of the patients may also affect the availability of medicine in the body, as females were found to have higher levels of Paxil. Other factors, such as individual sensitivity, underlying medical conditions, or family history, may also impact the immediate effectiveness of Paxil for anxiety (4). 

What to do if Paxil is not helping your anxiety?

If you think that Paxil is not helping your symptoms of anxiety, please wait for at least 8 weeks before making any decision about continuing the medicine, as Paxil may take some time to show its complete therapeutic effects. However, the response to the medication may vary among patients based on individual factors. 

If your anxiety symptoms persist even after 8 weeks of treatment with Paxil, please reach out to your healthcare provider. They may evaluate your current symptoms and family or medical history, monitoring your response throughout the treatment. Your doctor may adjust the dosage of Paxil to achieve the desired therapeutic response.

Alternative treatments can be considered by your healthcare provider, if your response to Paxil is unsatisfactory or you do not respond at all. Your doctor may discontinue Paxil over a few weeks by tapering down the dose and switching you to alternative treatments for anxiety. 

Your doctor may prescribe Benzodiazepines such as Xanax, Rivotril, or Ativan if a quick onset of action is required for anxiety. Other medications such as serotonin-norepinephrine reuptake inhibitors (SNRIs) and GABA modulators can also be prescribed by your doctor (6). 


Based on my research analysis, I conclude that Paxil does not work immediately for anxiety, as it may take up to 6 to 8 weeks before showing its complete therapeutic effects. However, the onset of action may depend on individual factors and variations among individuals. 

If Paxil does not help with anxiety, do not stop taking it on your own. Always consult your healthcare provider because discontinuing Paxil suddenly may cause withdrawal symptoms. 

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