Paxil vs Effexor

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For patients with major depressive disorder (MDD) or other types of depression, certain drugs that modify the levels of neurotransmitters in the brain linked to mood can aid in stabilizing depressive lows and managing symptoms. Paxil and Effexor are two such medications commonly prescribed for these conditions. Each drug affects different neurotransmitters in the brain, but both serve to stabilize moods in patients battling depression. Paxil is classified as a selective serotonin reuptake inhibitor (SSRI), primarily affecting serotonin levels. On the contrary, Effexor falls under the category of serotonin-norepinephrine reuptake inhibitors (SNRIs), influencing both serotonin and norepinephrine levels.

What is Paxil?

Paroxetine (the generic name for Paxil) is an antidepressant belonging to the Selective Serotonin Reuptake Inhibitors (SSRIs) class. It was approved by the FDA in 1992. Paxil works by increasing levels of free serotonin in the brain, preventing its reabsorption and thus allowing it to linger longer than usual. This medication is often prescribed for various forms of depression, obsessive-compulsive disorder (OCD), panic disorders, and anxiety disorders.

On the other hand, Venlafaxine (known as Effexor) falls under a slightly different class known as serotonin-norepinephrine reuptake inhibitors (SNRIs). Approved by FDA in 1993, Effexor not only increases levels of serotonin but also boosts norepinephrine levels too.

While both can be effective at managing symptoms of depression and anxiety-related conditions, their influence on these neurotransmitters differs significantly: Paxil selectively influences serotonin with minor effects on dopamine and norepinephrine. Conversely, Effexor impacts both serotonin and norepinephrine more equally. This difference could lead to varying side-effects profiles between these two medications.

What conditions is Paxil approved to treat?

Paxil is approved for the treatment of a range of mental health disorders, which include:

  • Major depressive disorder (MDD)
  • Panic disorder with or without agoraphobia
  • Social anxiety disorder
  • Generalized anxiety disorder (GAD)
  • Post-traumatic stress disorder (PTSD)
  • Obsessive-compulsive disorder (OCD)

How does Paxil help with these illnesses?

Paxil acts as a selective serotonin reuptake inhibitor (SSRI), which is designed to manage depression by enhancing the quantity of serotonin in the synapses of the brain. Paxil blocks it from being reabsorbed by neurons, allowing for higher levels to be maintained over more extended periods. Serotonin is a neurotransmitter that functions as a messenger within the brain and across various parts of the body, contributing significantly to mood regulation, cognition, memory, sleep patterns, hunger response and body temperature regulation among other things. The belief is that individuals with depression have relatively lower serotonin levels. Hence Paxil's ability to increase these levels can help mitigate depressive symptoms and aid patients in managing their condition.

On the other hand, Effexor works somewhat differently than Paxil; it’s known as a serotonin-norepinephrine reuptake inhibitor (SNRI). This means it not only increases amounts of available serotonin but also enhances norepinephrine concentrations — another important neurotransmitter responsible for alertness and energy — thus offering an additional avenue for battling depression symptoms.

What is Effexor?

Effexor is a brand name for venlafaxine, an antidepressant that falls into the category of serotonin-norepinephrine reuptake inhibitors (SNRIs). This means it increases levels of both serotonin and norepinephrine in the brain by reducing their reabsorption. It also has a minor inhibitory effect on dopamine reuptake. Venlafaxine received FDA approval in 1993. Since Effexor operates differently from selective serotonin reuptake inhibitor (SSRI) drugs like Paxil, its side-effect profile varies as well; it does not typically induce drowsiness and is less likely to contribute to weight gain or sexual dysfunction—common issues associated with SSRIs such as Paxil. The influence on both serotonin and norepinephrine may prove beneficial in treating depression, particularly in patients who have not responded favorably to traditional SSRI antidepressants like Paxil.

What conditions is Effexor approved to treat?

Effexor is a medication that has been approved by the FDA for treating conditions such as:

  • Major depressive disorder (MDD)
  • Generalized anxiety disorder (GAD)
  • Social anxiety disorder (SAD)
  • Panic disorder

It's important to note that Effexor is one of few antidepressants also used in managing symptoms of hot flashes associated with menopause. Always consult your healthcare provider before starting on any new medication regimen.

How does Effexor help with these illnesses?

Norepinephrine, a neurotransmitter that also functions as a hormone, plays significant roles in many bodily processes such as maintaining alertness, fostering memory recall and concentration. It is highly involved in the body's "fight or flight" response under stress. Much like serotonin, diminished levels of norepinephrine have been linked to depression. Effexor functions by increasing the quantities of both serotonin and norepinephrine available in the brain which helps alleviate some symptoms associated with depression. Its dual-action on these two key neurotransmitters makes it stand out from other medications like Paxil which primarily focus on regulating serotonin levels only. Therefore, Effexor can be prescribed when a patient does not respond well to typical SSRI antidepressants (such as Paxil), or it may be combined with them if needed.

How effective are both Paxil and Effexor?

Both paroxetine (Paxil) and venlafaxine (Effexor) have proven to be effective in treating depression and were approved by the FDA within a few years of each other. They act on different neurotransmitters, so they may be prescribed under varying circumstances. The effectiveness of Paxil and Effexor in managing depression was directly studied in a 1997 double-blind clinical trial; both drugs exhibited comparable efficacy in alleviating depressive symptoms along with similar safety profiles. None of the measures used to gauge effectiveness differed significantly between patients receiving paroxetine or venlafaxine.

A 2002 meta-analysis showed that paroxetine is effective from the first week of treatment, has a side effect profile comparable to many other antidepressants, and is generally well-tolerated even among elderly individuals or pregnant women. This study also stated that paroxetine had become one of the most widely prescribed selective serotonin reuptake inhibitors globally due largely to its established track record for effectively handling depression. The optimal dosage thought to display maximum efficacy is believed to be around 20-40 mg/day.

Meanwhile, a review conducted in 2018 suggested that venlafaxine appears more potent than placebo at mitigating depressive symptoms, maintaining an efficacy level akin to common antidepressants when it comes down to treating moderate-to-severe major depressive disorder (MDD). Furthermore, while evidence supporting venlafaxine's ability as standalone therapy isn't quite as extensive compared with SSRIs like Paxil given its unique dual-action mechanism — simultaneously inhibiting reuptake of serotonin & norepinephrine— it might serve as an ideal choice for patients who haven't responded adequately well with SSRIs alone or are concerned about minimizing certain SSRI-associated adverse effects such as sexual dysfunction.

abstract image of a researcher studying a bottle of drug.

At what dose is Paxil typically prescribed?

Oral dosages of Paxil for adults generally range from 20-50 mg/day, but research suggests that a 20 mg/day dosage is often sufficient for treating major depressive disorder in the majority of patients. For adolescents under the age of 18, starting doses are typically lower at around 10 mg/day. Dosage adjustments may be made after several weeks if there is no response. However, it's important not to exceed a maximum daily dose of 60mg/day for any individual. Effexor, on the other hand, has an initial recommended dosage of 75mg taken in two or three divided doses across the day with meals for adults suffering from depression and anxiety disorders; this can be gradually increased over time based upon patient response up to a maximum daily limit of about 375mg.

At what dose is Effexor typically prescribed?

Effexor treatment usually begins with a dosage of 37.5-75 mg/day, which can then be gradually increased to an average dose of 150 mg/day, divided into two or three doses spaced evenly throughout the day. The maximum recommended dose is 375 mg/day (though some patients may require higher doses), divided into three doses and spaced at regular intervals throughout the day. If after several weeks there's no response to treatment at the initial dosage levels, your healthcare provider may consider increasing it.

What are the most common side effects for Paxil?

Common side effects of Paxil and Effexor include:

  • Anxiety
  • Nervousness
  • Insomnia or unusual dreams
  • Drowsiness, fatigue
  • Tremors or shaking
  • Loss of appetite (anorexia)
  • Nausea, stomach upset, constipation or diarrhea
  • Dry mouth
  • Sexual problems including decreased libido, abnormal ejaculation, impotence in men and difficulty having an orgasm in women.
  • Sweating more than usual -In some rare cases experiencing symptoms similar to the flu (flu syndrome) -Throat discomfort due to pharyngitis and sinusitis.

Always consult your healthcare provider if you experience any adverse reactions while taking these medications.

abstract image of a patient experiencing side effect

Are there any potential serious side effects for Paxil?

In the rare event of severe side effects, Effexor can induce:

  • Thoughts about suicide or self-harm
  • Signs of allergic reaction: hives, difficulty breathing, swelling in face or throat
  • Eye problems: blurred vision, tunnel vision, eye pain or swelling
  • Cardiovascular issues: rapid heart rate, chest fluttering shortness of breath and sudden dizziness
  • Low sodium levels - headache confusion slurred speech severe weakness vomiting loss of coordination feeling unsteady
  • Severe nervous system reaction - very stiff (rigid) muscles high fever sweating confusion fast or uneven heartbeats tremors feeling like you might pass out.
  • Symptoms indicative of serotonin syndrome such as agitation hallucinations fever sweating shivering fast heart rate muscle stiffness twitching loss of coordination nausea vomiting and diarrhea

If any such adverse reactions occur while on Effexor therapy it is important to seek immediate medical attention.

What are the most common side effects for Effexor?

Effexor, also known as venlafaxine, may have a range of side effects including:

  • Nausea or vomiting and loss of appetite
  • Dry mouth or throat
  • Sleep problems such as insomnia or abnormal dreams
  • Sweating and sometimes nervousness or anxiety
  • Abnormal heartbeat rate which might be faster than usual
  • Blurred vision in some cases
  • Constipation issues can occur
  • Headache and dizziness aren't uncommon
  • A rash could develop in rare instances
    The drug may lead to increased urination too. It can occasionally cause confusion, agitation, even hostility. Some people experience muscle pain or joint pain while using this medication. In contrast to some other antidepressants like Paxil (paroxetine), weight loss rather than gain often occurs. As always, it is crucial that these potential side effects are discussed with your healthcare provider before beginning treatment.

Are there any potential serious side effects for Effexor?

Effexor, although beneficial for many, can on occasion lead to severe side effects. These may include:

  • Signs of an allergic reaction: hives; difficulty breathing; swelling in your face or throat.
  • Evidence of a skin reaction: fever, sore throat, burning eyes, skin pain, red or purple skin rash with blistering and peeling.
  • Changes in mood or behavior: aggressiveness, agitation, panic attacks, insomnia.
  • Vision changes such as blurred vision or eye redness/pain/swelling.
  • Heart issues like fast/irregular heartbeats and chest pain.
  • Neurological problems like seizures (convulsions), headaches along with dizziness/fainting.

If any of these become apparent when taking Effexor it is vital that you seek immediate medical attention.

Contraindications for Paxil and Effexor?

Both Paxil and Effexor, like many other antidepressant medications, may exacerbate symptoms of depression in some individuals. If you notice your depression worsening, or an increase in suicidal thoughts or behavior after starting these medications, it is paramount to seek immediate medical help.

Neither Paxil nor Effexor should be taken if you are currently taking or have recently stopped taking monoamine oxidase (MAO) inhibitors. It's important to inform your healthcare professional about all the medications you're using; MAOIs will require a period of approximately two weeks to clear from the system before starting Paxil or Effexor to prevent potentially harmful interactions.

How much do Paxil and Effexor cost?

For the brand name versions of these drugs:

  • The price of 60 tablets of Paxil (20 mg) averages around $230, which works out to $3.80–$7.60/day, depending on your dose.
  • The price of 30 capsules of Effexor XR (75 mg) averages is about $200, working out to approximately $6.67/day.

Thus, if you are in the higher dosage range for Paxil (i.e., 40 mg/day or higher), then brand-name Effexor can be less expensive on a per-day treatment basis. Please note that cost should not be a primary consideration in determining which drug is right for you.

For the generic versions of Paxil (paroxetine) and Effexor (venlafaxine), costs are significantly lower:

  • Paroxetine (20 mg tablets) is available in packs of 30 tablets and above, with approximate costs starting from as low as $0.10 up to around $1 per day based on dosages varying between 10mg and upwards to 50mg daily.

  • Venlafaxine comes usually in extended-release capsules from doses ranging between ~37.5mg -150mg with costs averaging about $.15-.70 cents a day depending upon the required daily dose.

Remember prices may vary due to location or insurance coverage status among other factors so always consider consulting with a healthcare provider when making decisions regarding prescription medication options.

Popularity of Paxil and Effexor

Paroxetine, also known by the brand name Paxil, was prescribed to approximately 4.8 million people in the USA in 2020. It accounted for around 10% of Selective Serotonin Reuptake Inhibitor (SSRI) prescriptions and about 5% of total antidepressant prescriptions. Paroxetine is a popular choice due to its effectiveness against depression as well as anxiety disorders, obsessive-compulsive disorder, and panic attacks. The prevalence of paroxetine has remained relatively stable over the past decade.

Venlafaxine, commonly marketed under the brand name Effexor, was prescribed to an estimated 6.7 million people in the US during that same year. Venlafaxine falls into a different class called Serotonin-Norepinephrine Reuptake Inhibitors (SNRIs), accounting for roughly one-fourth of all SNRI prescriptions and just over 7% of overall antidepressant prescriptions in America last year alone. This particular drug's popularity has been on a steady rise since its introduction due it being an effective treatment option for major depressive disorder along with generalized anxiety disorder and social phobia.


Both Paxil (paroxetine) and Effexor (venlafaxine) have well-established records of usage in patients with depression, supported by numerous clinical studies indicating their effectiveness over placebo treatments. They can sometimes be used together, but this requires careful consideration by a physician as they may interact with each other. The different mechanisms of action between the two - Paxil primarily affects serotonin while Effexor affects both serotonin and norepinephrine - result in them being prescribed under different circumstances. While Paxil is often seen as a first-line treatment option for conditions such as major depressive disorder, panic disorder, social anxiety disorder among others, Effexor might be considered an adjuvant therapy to Paxil or an alternative for patients who did not respond well to SSRIs like Paxil.

Both drugs are available in generic form which provides significant cost savings especially for those paying out-of-pocket. Both medications may require an adjustment period; effects may not be immediately noticeable.

The side effect profiles are similar between the two drugs and generally well-tolerated although there are some differences; sexual dysfunction is more common with Paxil than with Effexor. Patients must closely monitor changes in mood when starting these medications and should seek immediate medical help if they notice worsening depression or start having suicidal thoughts or thoughts about self-harm.