Is Paxil CR better than Paxil? (5 factors)

In this article, we will explore whether Paxil CR is better than Paxil. Furthermore, we will also discuss how Paxil CR is superior to Paxil, examining differences in onset and duration of action, and exploring factors influencing the choice between these two dosage forms. 

Is Paxil CR better than Paxil?

Yes, Paxil CR is better than Paxil. Paxil CR is a controlled-release formulation, whereas Paxil is an immediate-release formulation. Paxil is available in both tablet and liquid forms. 

Paxil, also known as Paroxetine, is a selective serotonin reuptake inhibitor (SSRI) approved by the FDA to treat anxiety, depression, panic disorders, and other related mental health conditions.

Paxil works by inhibiting the reuptake of serotonin in the brain cells. Serotonin is a chemical neurotransmitter that regulates the sleep, mood, appetite, and stress response of the body (1). 

How is Paxil CR better than Paxil?

Paxil CR is better than Paxil in the following ways:

Low medical costs

A 6-month research study comparing the total expenses of Paxil CR and Paxil revealed that Paxil’s immediate-release formulation was more expensive. Paxil CR proved to be more cost-effective for all the diagnoses for which Paxil is prescribed (2). 

Lower risk of side effects 

Paxil CR is safer than Paxil, associated with fewer adverse drug reactions. The controlled-release formulation of Paxil causes a lower risk of side effects, especially gastrointestinal effects.

This is because the controlled-release formulation releases the drug into the bloodstream slowly, therefore blood levels do not fluctuate suddenly. Approximately 70% of patients reported satisfaction with Paxil CR, with only a few patients experiencing common side effects, such as nausea, dry mouth, dizziness, tiredness, or insomnia (3,4). 

More efficacy 

Paxil CR is effective in patients who do not respond well to the immediate-release formulation of Paxil. Patients reported improved symptoms of anxiety and depression while taking Paxil CR compared to Paxil, particularly for major depressive disorder (MDD) and social anxiety disorder (SAD) (3). 

Lower rate of dropouts 

During comparative studies, the dropout rate of patients was higher with Paxil immediate-release compared to Paxil controlled-release. Patients withdrew from the treatment with Paxil IR due to the incidence of bothersome side effects. 

Paxil CR demonstrated effectiveness even in the early phase of treatment, with a milder onset of nausea in the first week. This led to higher patient adherence to Paxil CR compared to Paxil IR (4). 

Elderly people may show increased adherence to Paxil CR compared to Paxil IR due to factors such as slower metabolism, individual sensitivity, and other health-related issues (5). 

What are the differences between Paxil and Paxil CR?

Paxil CR and Paxil differ from each other in terms of onset and duration of action. Paxil’s immediate-release formulation releases the drug immediately into the bloodstream, causing rapid fluctuations in blood levels. Paxil IR is beneficial for patients requiring quick relief from anxiety and depression symptoms with a short duration of action. 

Paxil controlled-release, on the other hand, releases the drug slowly into the bloodstream, leading to gradual increases in blood levels and a lower incidence of side effects. Paxil CR has a longer duration of action compared to Paxil IR, providing prolonged therapeutic effects (4).

What factors influence the choice between Paxil CR and Paxil?

The factors which may impact the choice between Paxil CR and Paxil IR are as follows:

  • If quick relief is necessary, Paxil IR may be prescribed. 
  • For consistent and prolonged therapeutic effects, Paxil CR is preferred. 
  • In case you experience bothersome side effects, Paxil CR, with a lower risk of side effects, is more beneficial. 
  • Elderly patients, with slower metabolism and other health conditions, may prefer Paxil CR. 
  • The once-daily dosing of Paxil CR enhances patient adherence to antidepressant therapy (4,6). 


As per my analysis, Paxil CR is better than Paxil IR due to various reasons. Paxil CR has sustained therapeutic effects, cost-effectiveness, and a lower risk of side effects.

However, the decision to choose the appropriate dosage form either Paxil IR or Paxil CR is the responsibility of your healthcare provider. Do not take or stop taking any antidepressant without consulting your healthcare provider. 

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