Published on 28 June 2022

Paxil For PTSD: Is It The Best Medication?

Paroxetine (Paxil) ptsd
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Post-traumatic stress disorder (PTSD) is a mental condition that causes persistent mental and emotional distress following a traumatic or terrifying event. Have you ever imagined panicking up in the middle of the night and experiencing such a scary event?

Although half of the adults in the US will experience at least one traumatic experience in their lifetime, most people will not go on to develop PTSD. It is estimated that more than 3% of American adults currently have PTSD, with people assigned female at birth and transgender people being more likely to develop PTSD than people assigned male at birth.

This article will discuss the different treatments available for PTSD and the most effective medications for this condition.

What Is Post-traumatic Stress Disorder (PTSD)? 

It is a psychiatric disorder that may occur to someone who has experienced or witnessed a past traumatic event similar to a terrorist act, a natural disaster, a severe accident, war/combat, or who has been through life-threatening events or sexual violence or severe injury is a post-traumatic stress disorder (PTSD).

Previous to this, it was also known by the name of 'shell shock' during world war I and as 'combat fatigue' during the phase of World War II, but it doesn't need to occur to someone from war veterans only.

PTSD can occur to anyone with any traumatic background. Many people face the PTSD problem with a set of any ethnicity, nationality, or culture at any age. Approx. 3.5 percent of US adults are affected. An estimated one in 11 Americans is targeted for PTSD. This number doubles in women.

  • US Latinos, 
  • African Americans, 
  • American Indians – are the three ethnic groups that are disproportionately affected and have increased rates of PTSD than non-Latino whites.

The First-choice Treatment For PTSD

The current evidence base for the psychopharmacology of PTSD is most via all SSRIs, i.e., selective serotonin reuptake inhibitors such as Sertraline, Fluoxetine, and Paroxetine, as well as for SNRI,i.e., selective serotonin-norepinephrine reuptake inhibitor such as Venlafaxine. 

Only Paroxetine (Paxil) and Sertraline (Zoloft) are approved by the FDA for PTSD. 
Most doctors recommend SSRIs and SNRIs as first-choice medications for people with PTSD. 

What Is Paxil?

Paroxetine is sold under the brand name Paxil. It is a commonly prescribed generic drug for anxiety and depression approved by the Food and Drug Administration (FDA). Paxil treats various conditions, including social anxiety disorder, panic disorder, OCD, PTSD, GAD, and PMDD. Another condition that is used is Paxil for PE (premature ejaculation).

It's important to note that Paxil is not available over the counter and requires a prescription to be purchased from a certified online pharmacy or local drug store, as stated by Smith in 2005.

How Does Paxil Work?

Paxil is the best SSRI medicine available on the market—paxil works by raising serotonin levels in the brain. Serotonin is a chemical signal used for communication within the brain and nerves throughout the body.

People with PTSD may have changes in these chemical signals that contribute to PTSD symptoms. Twelve weeks is the pre-estimated time for these medicine takes to work. 

Paxil For PTSD

Paxil is FDA-approved for treating PTSD and is one of the most common medications. In studies, Paxil effectively reduced PTSD symptoms in over 50% of those taking it and was well-tolerated. Studies show that over 54 % to 62% of patients get the best results from Paxil. 

Paxil is not available over the counter in the US. It is only available with a prescription. Any person with PTSD cannot buy Paxil online as it is a US-controlled substance.

Other Uses

Efficacy Of Paxil

According to the observations from the clinical study, Paxil is comparatively more effective than the placebo drug, as only a few patients of the Paroxetine group did not experience any improvement in symptoms of at least 50% (99% CI 0.77–0.90, Random effect RR 0.83).

Significantly, more patients from the paroxetine group left their studies because of side effects than in the placebo group (95% CI 1.44–2.18, Random effect RR 1.77) or experienced suicidal tendencies (95% CI 1.17–5.54, Odds ratio 2.55). 

Success Rate Of Paxil To Treat PTSD

Every medication that the FDA approves to treat a specific condition has a success rate according to the people's usage and working effectively on the condition. In terms of Paxil used for PTSD, It is observed that 12 weeks of treatment resulted in - remission rates were 61.2% and 44.0% for placebo, 72.9% and 52.5% for paroxetine IR, and 73.7% and 56.2% for paroxetine CR, respectively. 

Possible Side Effects Of Paxil

Any medication has its side effects. It also depends on who is consuming and various other aspects of the person's health. It deals with two different types of side effects. If you are suffering from severe effects, contact your doctor. 

Common Side Effects

Severe Side Effects


Worsened depression


Suicidal thoughts

Delayed ejaculation



Dangerous impulses


Worsened anxiety




Aggressive behavior

Frequently Asked Questions

All SSRIs can cause sedation, and Paxil is one of the most sedating SSRI drugs. These are better tolerated if taken at night.
SSRIs increase the serotonin level in the brain. Paxil usually takes four to six weeks to start showing its positive effects.
You should stay on Paxil for at least 4 or 5 months after your symptoms of the first depression episode stop.

Dosages for Post-Traumatic Stress Disorder: 


  • Per your doctor's recommendations, start with 20 milligrams (20 mg) or better, even with 10mgs. 
  • Your doctor may feel to adjust your dosage. However, the dose should not be more than 50 mg to 25 ml per day. 
  1. Older adults - For older adults, start with 20 milligrams of the 10 MLS of this specific medicine, which usually should be taken in the morning. It should not exceed more than 40 mg or 20 ml per day. 
  2. Children- For children, every dose should be prescribed by the accosted doctor.  

What If You Miss A Dose?

If you miss any dose, take it as soon as you remind of it. However, if you exceed the time and it is almost time for another next dose, do not double the doses. Rather skip the missed dose and return to your regular dosing schedule. 

Where Should You Store The Medicine?

  • Keep medicines out of the reach and sight of children.
  • Store medicine at room temperature in a closed container, away from moisture, heat, and direct light. 
  • Do not keep expired medicine or drugs that are no longer needed.
  • Consult your healthcare professional about how you should dispose of any medicine you do not use.

Warnings Of Paxil

FDA Warnings

  • Antidepressant medications may increase suicidal thoughts and behaviors. Especially within the first few months of treatments or the dose is changed. 
  • Paroxetine is not approved for use in children.
  1. Serotonin syndrome warning - This drug can cause potentially life-threatening conditions called serotonin syndrome. Many medications can cause this type of syndrome. The syndrome's symptoms are agitation, hallucinations, confusion, and trouble thinking. 
  2. Worsened depression warning - In some cases, Paxil can worsen your depression if you experience unusual behavior changes, especially during the first few months of the treatment.
  3. Stopping treatment warning - If you are stopping treatment of this drug, it needs to be done gradually. Don't stop taking drugs abruptly. You may face some withdrawal symptoms. 
  4. Sexual problems warning - This drug can cause sexual dysfunction. Symptoms may include decreased sex drive, delayed orgasm, or an inability to orgasm. 
  5. Increased bleeding warning - This medicine may increase your risk of bleeding and bruising, especially if taken with aspirin. 

Alternative Treatment For PTSD

Medications help manage PTSD in some individuals. However, treatment should also include counseling and psychotherapy. Psychotherapy (Talk therapy) is a highly recommended treatment for people with PTSD as it helps them manage PTSD by positively changing how they process and perceive traumatic events.

People may respond better to specific treatments, whether it is different types of psychotherapy or medications. Therefore, you should thoroughly discuss these options with your provider to determine your best option.

Alternative Options For PTSD 

Medications help manage PTSD in some individuals. However, treatment should also include counseling and psychotherapy. Psychotherapy (Talk therapy) is a highly recommended treatment for people with PTSD as it helps them manage PTSD by positively changing how they process and perceive traumatic events.

People may respond better to specific treatments, whether it is different types of psychotherapy or medications. Therefore, you should thoroughly discuss these options with your provider to determine your best option.

What Happens If PTSD Is Left Untreated?

PTSD can adversely impact an individual's lifestyle, including work, family, friends, and overall quality of life. 
If left untreated, PTSD can have serious long-term consequences, including:

  • Breathing problems, such as asthma
  • Heart disease (including high blood pressure and higher stroke risk)
  • Sleep problems
  • Neurologic disorders (including migraines and dementia)
  • Chronic pain (including muscle pain)
  • Other mental health conditions (including depression, anxiety, and SUD)
  • Diabetes
  • Gastrointestinal problems (including irritable bowel syndrome, acid reflux, and heartburn)
  • Higher risk for autoimmune diseases (including rheumatoid arthritis, lupus, and multiple sclerosis) 

Symptoms of PTSD can become overwhelming, especially if left untreated. Research suggests that there is a strong connection between PTSD and suicide. One study found that suicide rates were 4 to 7 times higher for people with PTSD than those without it.

What Medications Should Be Avoided In PTSD?

During PTSD, medicines should be taken after consultation with the medical practitioner, with all precautions. Certain medications might worsen symptoms or raise the risk of substance use disorder (SUD).

Benzodiazepines are used to treat anxiety conditions and panic attacks. However, some benzodiazepines are prescribed for people with PTSD. These include Diazepam (Valium), Alprazolam (Xanax), Lorazepam (Ativan), and Clonazepam (Klonopin). However, research suggests that these drugs can worsen PTSD symptoms.

Apart from Benzodiazepines, Stimulant drugs should also be avoided in people with PTSD. CNS stimulants enhance activity and communication between brain cells to treat attention-deficit hyperactivity disorder (ADHD). However, stimulants such as amphetamine salts (Adderall) can be risky in people with PTSD, as they are 14 times more likely than those without PTSD to develop SUD.

Bottom Line from Practical Anxiety Solutions

PTSD is a mental health condition, which if left untreated, can lead to long-term health complications. Behavioral therapy, psychotherapy, and medications can help treat PTSD symptoms.

Paxil (Paroxetine), belonging to the class of Antidepressants, SSRI, is used for treating depression and related conditions. It is highly efficacious and the first choice of drug for Post-traumatic stress disorder (PTSD). It is a well-tolerated drug that has significantly reduced all three PTSD symptom clusters, i.e., re-experiencing, avoidance, and hyperarousal.

However, people may respond differently to different therapies. Do not forget to discuss these options with your provider so you can find the best PTSD treatment for you.

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