Published on 02 February 2023

Paxil Vs Zoloft: Find Right Option For You?

Paroxetine (Paxil) PAXIL-VS-ZOLOFT
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If you are looking for a comparison between Paxil and Zoloft, chances are you're unaware of the antidepressant that works best for your pain. Let's break it down for you.

Paxil and Zoloft are two different and effective antidepressants available today. Here, the term "antidepressant" is a bit misleading as these medications are not only used to treat depression but also treat a wide range of mental health conditions. In 2022, a new study found that nearly 10% of Americans suffer from depression, with mood disorders increasing fastest among teens and young adults.

Continue reading this blog to learn about the similarities and dissimilarities between Paxil and Zoloft and other pharmacological properties that will help you choose the best-suited pain medication.

What Is Paxil?

Paxil (Generic name- Paroxetine) is an antidepressant for treating depression and other psychological conditions. The FDA approved it in 1992 to treat anxiety, depression, post-traumatic stress disorder, and others. It is a Selective serotonin reuptake inhibitor (SSRI) that is available by prescription only. Paroxetine is a prescription medicine; if you want to buy Paroxetine online, you will require legit prescription from a doctor.

Paxil comes in two forms: an oral tablet and an oral liquid suspension. It is also known as Paxil CR, a controlled-release tablet designed to release its active ingredient slowly throughout the day. Both formulations are taken once a day. The following table lists the various dosages and strengths of Paxil.

The FDA-approved uses of Paxil in adults include:

  • Panic disorder
  • Social Anxiety disorder
  • Major depressive disorder (MDD)
  • Obsessive-compulsive disorder (OCD)
  • Generalized Anxiety disorder (GAD)
  • Premenstrual dysphoric disorder (PMDD) for Paxil CR
  • Post-traumatic stress disorder

Off-label uses for Paxil include:

  • Separation Anxiety
  • Premature ejaculation
  • Cancer-related itching
  • Persistent depressive disorder (dysthymia)
  • Postpartum depression
  • Body dysmorphic disorder
  • Postpartum depression

Paxil is not FDA-approved for use in children or adolescents under age 18. It is sometimes prescribed off-label in this group for OCD and Social Anxiety disorder.

What Is Zoloft?

Zoloft (Generic name- Sertraline). The FDA approved it in 1991 to treat depression and other mood disorders. It is a Selective serotonin reuptake inhibitor (SSRI). To get Sertraline online you need to have the prescription. Zoloft comes in two forms: an oral tablet (25 mg, 50 mg, 100 mg) and an oral liquid solution (20 mg/mL). It is usually taken once a day. The FDA-approved uses of Zoloft in adults (and children when age is specified) include:

  • Panic disorder
  • Social Anxiety disorder
  • Major depressive disorder (MDD)
  • Obsessive-compulsive disorder (OCD) (>= six years)
  • Premenstrual dysphoric disorder (PMDD) 
  • Post-traumatic stress disorder

Off-label uses for Zoloft include:

  • Generalized Anxiety disorder (GAD)
  • Bulimia nervosa
  • Body dysmorphic disorder
  • Binge eating disorder

How Does Paxil Work?

Paxil is a selective serotonin reuptake inhibitor (SSRI) that helps to balance neurotransmitters in the brain. Specifically, it helps decrease serotonin reuptake, leading to more balanced levels and supporting better mood, feelings of calmness, and overall perception of well-being. Serotonin is a "feel good" hormone that produces feelings of relaxation and happiness.

How Does Zoloft Work?

Zoloft is another selective serotonin reuptake inhibitor (SSRI), like Paxil. It has mood-stabilizing effects and can reduce anxiety, depression, and other mood-related symptoms. This drug works by maintaining high serotonin levels in the brain. Serotonin is a neurotransmitter that is a chemical messenger to pass messages between brain cells. The body usually reabsorbs, or reuptakes, neurotransmitters once the chemical messengers have done their job; SSRIs inhibit the reuptake of serotonin, which leaves more of the mood-boosting hormone in the brain.

Paxil VS Zoloft: What Are Similarities?

Paxil and Zoloft have unique characteristics and properties that make them more efficient drugs than one another. Both drugs vary in pharmacology, morphology, pharmacokinetic or pharmacodynamic properties. Let us find out about the similarities between these drugs.

  Paxil Zoloft
Drug class Selective serotonin reuptake inhibitor (SSRI) Antidepressant Selective serotonin reuptake inhibitor (SSRI) Antidepressant
FDA Approval FDA approved FDA approved
Indications Major depression, panic disorder, obsessive-compulsive disorder (OCD), social Anxiety disorder, premenstrual dysphoric disorder (PMDD), and post-traumatic stress disorder (PTSD) Major depression, panic disorder, obsessive-compulsive disorder (OCD), social Anxiety disorder, premenstrual dysphoric disorder (PMDD), and post-traumatic stress disorder (PTSD)
Withdrawal symptoms Yes Yes
Legal status Not a controlled drug Not a controlled drug

Paxil VS Zoloft: What Are The Difference?

  Paxil Zoloft
Generic Name Paroxetine Sertraline
Indications Treats mental health conditions in adults only Treats Obsessive-compulsive disorder in children as young as six years old
Dosage the daily dose is 10-60 mg, depending on the indication and response to treatment. The daily dose is 50-200 mg, depending on the indication and response to treatment.
Dosage Form Available in tablets,
Extended-release tablets and Suspension
Available in tablets and solution/liquid form
Metabolism Extensive, Metabolized via Liver (CYP2D6-mediated) Liver-mediated (primarily N-demethylation mainly by CYP2B6; also metabolism by CYP2C19, others)
Pregnancy category Category D Category C
Elimination half-life 21 hours 26 hours
Excretion Renal (64 %) and fecal (36 %) Urine (40-45 %) and Feces (40-45 %)

Paxil VS Zoloft: Which Is More Effective?

Several clinical trials and studies have been conducted that compare the effectiveness of Paxil and Zoloft. One of the studies conducted in 2000 and the other in 2004 found that both drugs were equally effective in treating major depressive and panic disorders.  

However, Zoloft was found to be slightly better tolerated than Paxil and cause fewer side effects in patients. While most individuals will experience similar relief in symptoms while taking the medications, some may let one drug be better.

Frequently Asked Questions

Avoid taking Alcohol with Zoloft, Paxil, or other antidepressant medications, as alcohol can exacerbate the side effects of these drugs.
Most antidepressants cause weight gain, but the risk of weight gain is comparatively higher with some SSRIs.
It is best to take Paxil or Zoloft at the same time every day to experience the full benefits of either medication. Your healthcare provider determines the best medicine for your anxiety or depression.

What Are the Possible Side Effects?

Like many medications, Paxil or Zoloft also cause side effects. Because of this reason, your medical practitioner may recommend starting with the lowest possible dose of Paxil or Zoloft for the first 7 to 10 days of treatment. 

Side effects of Paxil Side effects of Zoloft
Dizziness Indigestion
Increased sweating Nausea
Decreased appetite Tremor
Insomnia/ Sleepiness Diarrhea or loose stool
Nervousness Reduced appetite
Weakness Increased sweating
Tremor Sexual problems 
Sexual problems Drowsiness

These are the side effects most frequently reported in clinical studies of each drug. These lists do not include all side effects; not everyone taking Paxil or Zoloft experiences side effects. If you're experiencing sexual side effects, you must talk about it with your healthcare provider.

Paxil Precautions:

Precautions should be taken while taking SSRIs such as Paxil or Zoloft to avoid adverse effects.

  • Paxil comes with a boxed warning from the FDA stating that it can increase the risk of suicidal thoughts or actions.
    If an individual thinks of self-harm or experiences suicidal ideation, seek medical attention immediately. This risk can affect anyone at any age but is most increased in children, adolescents, and young adults.
  • Paxil is unsafe for people with certain health conditions or who take specific medications.
  • If the signs of increased panic attacks, agitation, worsening anxiety, impulsiveness, extreme irritability, or manic behavior occur, inform your healthcare provider.
  • Aspirin and other NSAIDs should not be used with Paxil as they can increase the risk of bleeding. 
  • The serotonin syndrome risk increases if you use Paxil with other medications that affect serotonin levels (Antidepressants, triptans for migraines, St. John's wort)
  • Paxil can worsen your eye condition if you have narrow-angle glaucoma.
  • Paroxetine (Paxil) may cause harm to your unborn baby if you're pregnant. If you are planning to conceive or are pregnant, speak with your provider to understand the risks and benefits of continuing this medication.
  • Very rarely, paroxetine (Paxil) can reduce sodium levels in the blood. You might need regular blood tests while taking paroxetine (Paxil) to ensure the sodium in your blood stays normal.

Zoloft Precautions:

Zoloft comes with a boxed warning as well. If an individual thinks of self-harm or experiences suicidal ideation, seek medical attention immediately. This risk can affect anyone at any age but is most increased in children, adolescents, and young adults.
If the signs of increased panic attacks, agitation, worsening anxiety, impulsiveness, restlessness, extreme irritability, or manic behavior occur, inform your healthcare provider.

  • Zoloft is unsafe for people with certain health conditions or who take specific medications.
  • Aspirin and other NSAIDs should not be used with Zoloft because of the increased risk of bleeding. 
  • The serotonin syndrome risk increases if you use Paxil with other medications that affect serotonin levels (Antidepressants, triptans for migraines, St. John's wort)
  • Zoloft (sertraline) can affect your heart's natural rhythm and cause it to beat abnormally. If you've had heart problems, talk to your healthcare provider first to ensure Zoloft is safe for you to take.
  • Zoloft can cause deficient sodium levels in your blood. Tell your provider immediately about your weakness, confusion, difficulty concentrating, headache, or memory problems.

Are Zoloft, Paxil, And Other Ssris The Same Drug?

SSRIs like Paxil and Zoloft have the same effect on the human body, i.e., increasing the level of serotonin, but they are not entirely the same. Each SSRI has a slightly different molecular structure, which means they have unique active ingredients and pharmacological properties. These molecular structures explain why various SSRIs vary slightly in side effects, dosage recommendations, contraindications, and reactions to other medications.

Do All Drugs Interact With Paxil and Zoloft?

Several medications can interact with SSRIs. Drug interactions can lead to harmful effects. Because of this, it's important to always check with your pharmacist or healthcare provider before starting any new medications, including over-the-counter drugs or dietary supplements.

The most effective medication for you should only be determined by your healthcare provider, who can consider your medical conditions, history, and other drugs that could interact with Paxil or Zoloft.

Paxil Interaction:

  • MAO inhibitors (monoamine oxidase inhibitor antidepressants) in combination with Paxil can be very dangerous or potentially fatal. The use of MAO inhibitors should be separated from SSRIs by 14 days. 
  • Using Paxil in combination with other drugs that increase serotonin and other SNRIs, SSRIs, or tricyclic antidepressants can increase the risk of serotonin syndrome. 
  • Aspirin and other NSAIDs should be avoided with Paxil, as they can increase the risk of bleeding. 
  • Avoid taking Paxil with Thioridazine as it can cause QT prolongation, which can be life-threatening. 
  • Paxil may lower the effectiveness of Tamoxifen, a medication used to treat breast cancer. 
  • Always inform your medical practitioner of OTC drugs, other prescriptions, herbs, or supplements to avoid potentially serious side effects and interactions, like serotonin syndrome, gastrointestinal bleeding, and heart arrhythmias, all of which can be life-threatening.

Zoloft Interaction:

Zoloft is contraindicated in individuals with certain health conditions or who take specific medications.

  • If any of the following apply, your doctor will not prescribe Zoloft:
    • Individual taking Pimozide, Clopidogrel, Warfarin
    • Taking MAOIs or has within the past 14 days
    • Taking disulfiram (for liquid Zoloft only)
    • Taking Antihistamines or sleep aids
    • Liver disorder or cirrhosis 
    • Opiate-based painkillers or cough suppressants
    • Is sensitive to sertraline or any ingredients in Zoloft
  • Contraindicated supplements include Tryptophan and St. John's wort.
  • Taking Zoloft in combination with other drugs that increase serotonin and other SNRIs, SSRIs, or tricyclic antidepressants might increase the risk of serotonin syndrome. 
  • Aspirin and other NSAIDs should be avoided with Zoloft or sertraline, as they can increase the risk of bleeding.
  • Always inform your medical practitioner of OTC drugs, other prescriptions, herbs, or supplements to avoid potentially serious side effects and interactions, like serotonin syndrome, gastrointestinal bleeding, and heart arrhythmias, all of which can be life-threatening.

Bottom Line From Practical Anxiety Solutions

Paxil and Zoloft are prescription antidepressants equally effective in treating depression and other common mental health conditions like Anxiety disorders.

However, Zoloft can treat obsessive-compulsive disorder (OCD) in children as young as six. The medicines cause similar side effects, but studies show that Zoloft was slightly better tolerated than Paxil. However, the best medication depends on the individual's medical history, genetics, medicines, and your healthcare provider's recommendations.

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