Does Paxil work well? (3+ signs)

In this article, we will answer the question “Does Paxil work well?’. We will also discuss signs to know whether Paxil is working for you, and what to do if you feel that this medication isn’t helping your condition.

Does Paxil work well?

Yes, Paxil (Paroxetine) works effectively in treating various depressive disorders. Paxil is a selective serotonin reuptake inhibitor (SSRI), recommended by the FDA to treat disorders like generalized anxiety disorder (GAD), social anxiety disorder (SAD), panic disorder (PD), post-traumatic stress disorder (PTSD), major depressive disorder (MDD), and obsessive-compulsive disorder (OCD).

Paxil has been found to work effectively for the treatment of these disorders, but it may not work for everyone taking the medication. The efficacy of Paxil can vary from person to person depending on how your body reacts to the medication.

For what other cases can Paxil work?

Paxil has been used by healthcare professionals for the treatment of many other disorders as well. Some off-label uses of paroxetine are premenstrual dysphoric disorder (PMDD), persistent depressive disorder, postpartum depression, body dysmorphic disorder, separation anxiety and chronic headache.

Delayed or inhibited release is a side effect experienced by many individuals on Paroxetine therapy. Clinicians have found this side effect can help treat patients with sexual dysfunction, especially premature release.

Diabetic neuropathy has been treated with many different medications but no medicine has shown to be completely effective. Normally, tricyclic antidepressants are well-tolerated and somewhat effective in patients with symptoms of diabetic neuropathy but if they do not work healthcare professionals prescribe Paroxetine for equivalent efficacy. Paroxetine and imipramine have shown comparable efficacy for diabetic neuropathy.

Neurocardiogenic syncope (also known as vasovagal or reflex syncope) does not have a definitive treatment protocol but Paroxetine has been found to help patients with this condition. Symptoms of vasovagal syncope are known to significantly reduce with the long-term use of Paroxetine.

What does research suggest?

Many research studies have been conducted on the efficacy of Paroxetine and all of them show varying results. Paroxetine seems to work well in most people if used for the right conditions and in the right dosages.

A research study has reported that Paroxetine was effective and well-tolerated when used as a long-term treatment in individuals with MDD. The effectiveness of Paroxetine was assessed over one year. It has been shown to work well as maintenance therapy. On the Hamilton rating scale for depression (HRSD) the patients’ scores improved by 17% to 96% (1).

Another research found that Paroxetine works well for individuals with GAD when used once daily in doses from 20mg to 50mg. The results were declared after an 8-week treatment duration. Paroxetine was found to be well-tolerated and the adverse effects observed were not of much significance. A greater proportion of patients given Paroxetine had an improvement of 50% or more in their depression symptoms (2,3).

A review article, assessing the safety and efficacy of Paroxetine in different mood disorders and comparing the results with other medications, stated that Paroxetine worked well in most patients. It showed comparable efficacy to tricyclic antidepressants (TCAs) in the treatment of depression. Individuals treated with Paroxetine showed more than 50% reduction in depressive symptoms. When used for MDD, it also showed equivalent efficacy to Nefazodone (4).

Comparison with other antidepressants: How does Paxil perform?

Paxil works as well as many other antidepressants used for the same conditions. A study reviewing and comparing its efficacy with other antidepressants has reported the following (4):

  • Paroxetine has been compared to Clomipramine for the treatment of OCD. Both medications have shown similar efficacy. Paroxetine also has been successfully used for one year, as long-term therapy in patients with OCD to prevent relapse.
  • Paroxetine has been found to be more effective than Clomipramine in the treatment of PD. A long-term trial has shown fewer relapse cases when treated with Paroxetine.
  • Paroxetine is associated with fewer withdrawals due to adverse events as compared to TCAs.
  • Paroxetine has shown greater efficacy than Fluoxetine in some cases.
  • Nefazodone and Paroxetine are comparable in terms of efficacy when used for MDD.

How long does it typically take for Paxil to show results?

Paxil, like other SSRIs and antidepressants, take almost 4-6 weeks to show full effect. You may not feel much difference in your mood and condition until 6 weeks of therapy with Paxil.

The timeline for Paxil’s efficacy and when you might start to see improvements in your symptoms depends on individual factors and the type of disorder that needs treatment. To see positive changes in your condition, please make sure you are persistent with the medication.

If you do not see any improvement in your condition even after continuous therapy with Paxil for 6 weeks, you should consult your healthcare provider so that any underlying problem can be ruled out.

When does Paxil start to not work well?

Paxil therapy is sometimes shown to have adverse effects when used in the long term. Some common effects seen with long-term use of Paxil are constipation, increased heart rate, sedation, insomnia, irritability, agitation and weight gain. These side effects can sometimes cause compliance issues and the individual may withdraw from treatment.

In addition to these common issues, some individuals experience very rare side effects when using Paxil for a longer duration. Some of the rare side effects are tremors, bleeding, mania, seizures, unusual dreams, cardiovascular events, liver disease and kidney problems. In these cases, Paxil does more harm than good and any such side effect should receive immediate medical attention.

Paxil has been known to cause dependence in individuals taking therapy. If the medication is abruptly stopped after dependence has developed then the individual may start showing withdrawal symptoms. Some withdrawal symptoms include panic attacks, aggression, diarrhoea, forgetfulness, sweating, headaches, insomnia and shock-like sensations in the brain.

Long-term use and increased incidence of side effects can have an impact on Paxil’s efficacy. Moreover, dependence on the medication can also affect the efficacy of Paxil in many individuals. If you experience any of the above side effects or have been using Paxil for a long duration, it is better to consult a doctor so the efficacy of your medication can be checked

What factors can affect Paxil’s efficacy?

Some factors that can affect the efficacy of Paxil are:

Lifestyle factors

Lifestyle factors can have an impact on the efficacy of any medication and Paxil is no exception. Making changes in your lifestyle by improving your diet, regulating your sleep cycle and getting a healthy amount of daily exercise can improve its efficacy.


The effectiveness of Paxil may change with dosage adjustments and different doses may be more suitable for different individuals. If Paxil is causing side effects or is not working for you, then your dosage may be higher or lower than required.

You will need to talk to a healthcare professional regarding your concerns. Your doctor may increase or decrease the dose of Paxil, to better suit your condition.


Sometimes age, gender, genetics or other demographic factors can play a role in how well Paxil might work in any individual. All these factors vary from person to person so your body may not react to the medication as intended. Renal and hepatic impairment in the elderly can be a cause of decreased efficacy or increased side effects of Paxil.

Severity of condition

Sometimes depressive disorders become so severe that they require more than one medication for treatment. In that case, monotherapy with Paxil will not be as effective. your doctor may give you a higher dose of Paxil, give adjunctive therapy or may prescribe you a more potent antidepressant for your condition.

It is essential to consult your doctor if any change in prescription is required. Do not make changes to your medications or dosages without the guidance of a doctor.

What are the potential side effects of Paxil?

Paxil has been known to cause side effects at the start of therapy. Some common side effects include (5):

  • Constipation
  • Nausea
  • Diarrhoea
  • Decreased appetite
  • Insomnia
  • Sweating
  • Tremors
  • Decreased sex drive

Some rare side effects include:

How to know if Paxil is working?

There are some signs and symptoms which can tell you if Paxil is working for your condition:

  • You feel increased energy and motivation
  • You feel more focused and have better concentration
  • You have a more improved mood
  • You do not feel as sad or hopeless as before
  • You take more interest in daily activities
  • You have an improved decision-making ability
  • You feel more like yourself again
  • Your diet and eating patterns are going back to normal
  • Your sleep schedule has improved
  • You have a more positive mindset towards life

What to do if Paxil is not working for you?

Paxil is overall a good antidepressant, but may not be the best one for you. If Paxil is not working for you, it is advised to consult a healthcare provider who will assess your condition and adjust your prescription accordingly.

Make sure you are taking the medication as prescribed, at the correct time and in the correct dosage. However, if you still fail to notice any difference in your condition you should seek guidance from a healthcare professional.

If your doctor finds that Paxil is not working for you he may increase the dose or switch you to another antidepressant altogether. Do not stop using Paxil without consulting your doctor because abrupt cessation of therapy can cause withdrawal symptoms in some individuals.


In this article, we answered the question “Does Paxil work well?”. We also discussed how to tell if Paxil is working for you and what to do if Paxil does not improve your condition. To summarize, Paxil does work well in many depressive disorders, but if it does not help your condition there are many other options available.

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Mauri MC, Laini V, Bitetto A, Boscati L, Scalvini M, Mapelli L, Rudelli R. Long term efficacy of paroxetine in major depression: a study with plasma levels. International Journal of Psychiatry in Clinical Practice. 1999 Jan 1;3(2):115-9.


Pollack MH, Zaninelli R, Goddard A, McCafferty JP, Bellew KM, Burnham DB, Iyengar MK. Paroxetine in the treatment of generalized anxiety disorder: results of a placebo-controlled, flexible-dosage trial. Journal of Clinical Psychiatry. 2001 May 1;62(5):350-7.


Barbui C, Furukawa TA, Cipriani A. Effectiveness of paroxetine in the treatment of acute major depression in adults: a systematic re-examination of published and unpublished data from randomized trials. Cmaj. 2008 Jan 29;178(3):296-305.


Gunasekara NS, Noble S, Benfield P. Paroxetine: an update of its pharmacology and therapeutic use in depression and a review of its use in other disorders. Drugs. 1998 Jan;55:85-120.


The Food and Drug Administration (FDA). HIGHLIGHTS OF PRESCRIBING INFORMATION. PAXIL (paroxetine) tablets, for oral use. Available from:

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