Paxil for OCD: uses, effectiveness, and side effects

Paxil (paroxetine) is a medication widely prescribed to treat obsessive-compulsive disorder (OCD). It’s also used to treat other mental health conditions, including major depressive disorder (MDD). It’s a selective serotonin reuptake inhibitor (SSRI) that works on the brain chemical serotonin, which has an integral role in regulating mood and behavior. Keep reading to learn more about Paxil for OCD. 

Start your journey to better mental health today. Find a provider on Klarity to see if Paxil or another medication is right for you.

What is Paxil (paroxetine)?

Paxil (paroxetine) is an antidepressant medication. It’s an SSRI commonly used to treat a variety of mental health conditions affected by serotonin levels in the brain. Paxil is approved by the U.S. Food and Drug Administration (FDA) to treat the following conditions:

• OCD 
• Major depressive disorder (MDD)
• Generalized anxiety disorder (GAD)
• Social anxiety disorder (SAD)
• Panic disorder 
• Premenstrual dysphoric disorder (PMDD)
• Vasomotor symptoms associated with menopause
• Post-traumatic stress disorder (PTSD) 

Paxil works by regulating serotonin, a brain chemical essential for improving mood and reducing anxiety.  

Providers often prescribe Paxil off-label to help manage other mental health and medical conditions. It may be used for migraines, certain types of pain management, or premenstrual dysphoric disorder (PMDD). 

Your provider uses their best clinical judgment when they prescribe something off-label. Don’t hesitate to ask them to share more about their thought process, including why they think a medication might work for you. 

Available doses of Paxil

Paxil comes in the following doses and forms: 

• Standard release tablets: typically taken once daily, and are available in 10, 20, 30, and 40 milligram doses.
• Extended-release tablets (Paxil CR): designed to release the drug into the body over a longer period to maintain a steadier level of medication in the bloodstream. These doses are available in 12.5, 25, and 37.5 milligram doses. 
• Oral suspension: a liquid form of Paxil sometimes prescribed as an alternative for people who have trouble swallowing pills. 

Work with your provider to determine which form of Paxil and what dose is best for you. 

What is OCD?

OCD can be a chronic and disabling mental health condition. It’s characterized by recurring intrusive thoughts (obsessions) and ritualistic behaviors (compulsions). A person may feel the urge to repeat compulsive behaviors over and over to combat distress associated with the intrusive thoughts. OCD can interfere with your daily functioning, causing issues at home, work, school, and relationships. 

OCD usually centers around themes, including but not limited to: 

• Fear of germs
• Thoughts of hurting yourself or others 
• Arranging items in a specific way 

Treatment typically involves a combination of medications, like Paxil or other antidepressants, and exposure therapy to help people gain control of their symptoms and improve their quality of life. 

How is OCD treated with Paxil?

Paxil for OCD works by preventing the reuptake of serotonin in the brain. This increases serotonin’s availability in the brain, which can help regulate mood, decrease anxiety, and reduce compulsive behaviors. 

It’s not uncommon if you have OCD to also experience depression. The constant distress and interruption to your daily life can cause OCD to get worse, which leads to low mood and other symptoms. 

The good news is Paxil is shown to effectively treat depression and anxiety, as well as OCD. If you notice symptoms of depression that may be tied to intrusive thoughts and compulsions, talk to your provider about how to tackle depression, intrusive thoughts, and compulsions with Paxil or another OCD treatment option.

Is Paxil good for OCD?

Paxil is a well-studied medication and is effective for treating OCD. Research shows that it can significantly reduce OCD symptoms by acting on serotonin levels. A 2019 systematic review of peer-reviewed studies focusing on medications used to treat OCD found that doses between 20 and 60 milligrams of Paxil were effective in reducing anxiety and improving quality of life. 

At time of publication, Paxil is rated 7.4 out of 10 on drugs.com. Ratings come from reviews by real people who take Paxil for OCD. Almost 70% of reviewers shared positive experiences with the medication. Many shared that it helped them break years-long cycles of intrusive thoughts and compulsive behaviors. 

How long does it take Paxil to work for OCD?

The time it takes to start seeing progress with Paxil varies from person to person. Clinical studies suggest that some improvement is noticed as early as 2 to 4 weeks after starting the medication. It could take up to 8 to 12 weeks to experience the full benefits. A 2017 randomized, double-blind trial compared placebo, Anafranil, and Paxil for OCD. The results showed that after just 4 weeks, patients taking Paxil saw significant decreases in their Yale-Brown obsessive-compulsive scale (Y-Bocs) scores, a measure used to rate the severity of OCD symptoms.

The important thing is to be patient and compassionate with yourself. Take Paxil consistently and as prescribed, so it can build up in your system. Maintaining regular and open communication with your provider is essential, so they can monitor your progress and adjust your dose as necessary. 

The ideal dose of Paxil for OCD varies for everyone. The starting dose is often 20 milligrams a day. Your provider may increase your dose to 60 milligrams over time, depending on your symptoms, how you respond, and your side effects, if any. They’ll consider a few things when determining your dose, like your medical history, the severity of your symptoms, and how you respond to Paxil.  Your provider will also talk with you about when and how to take the medication to maximize your benefits. 

What side effects does Paxil have?

Before starting a new medication, talk to your provider about side effects. Paxil, like other SSRIs, can cause side effects that usually resolve as your body adjusts to the medication. 

Common side effects of Paxil

Common side effects of Paxil include:

• Headache
• Dizziness
• Weakness
• Difficulty concentrating
• Nervousness
• Forgetfulness
• Confusion
• Sleepiness
• Nausea
• Vomiting
• Diarrhea
• Constipation
• Gas
• Stomach pain
• Heartburn
• Changes in the ability to taste food
• Decreased appetite
• Weight loss or gain
• Sexual dysfunction
• Dry mouth
• Sweating
• Yawning
• Pain 
• Tenderness or swelling of the joints 

Serious side effects of Paxil

In some cases, a person can experience serious side effects from Paxil, such as:

• Hallucinations
• Fainting
• Rapid, pounding, or irregular heartbeat
• Chest pain
• Difficulty breathing
• Seizures
• Abnormal bleeding or bruising
• Small red spots that appear under the skin
• Peeling or blistering of the skin
• Sore throat, fever, chills, cough
• Uncontrollable shaking
• Unsteady walking that can lead to falling
• Numbness or tingling in the hands, feet, arms, or legs
• Painful erection
• Sudden nausea or vomiting
• Hives, rash, or itching
• Swelling of the face, hands, feet, or lower legs
• Black and tarry stool or blood in the stool
• Bloody vomit or vomit that looks like coffee grounds
• Bone pain or fracture

If you experience any serious side effects, seek medical care as quickly as possible. Paxil can also lead to suicidal thoughts and behaviors. Get immediate help if you experience a crisis. After receiving emergency care, call your provider to schedule a follow-up appointment to discuss your care plan. 

What to know when considering Paxil

If you’re thinking about starting Paxil for OCD or any other condition, be aware of the potential side effects, adverse reactions, and its boxed warning. 

Paxil carries a boxed warning, which is the FDA’s strongest warning for a medication. Paxil can increase the risk of suicidal thoughts and behaviors in children, adolescents, and young adults. This risk may be higher at the beginning of treatment. Keep your appointments and communicate openly with your provider about how you’re feeling, so they can help you manage potential safety issues. 

What to avoid when taking Paxil

To reduce unwanted side effects, there are things you want to avoid if you taking Paxil, including:

• Other antidepressants: Let your provider know if you take other antidepressants, such as SSRIs, serotonin and norepinephrine reuptake inhibitors (SNRIs), or monoamine oxidase inhibitors (MAOI). These medications also influence serotonin levels in the brain. Avoid taking more than 1 of these medications at the same time to prevent serotonin syndrome. 
• Non-steroidal anti-inflammatory drugs (NSAIDs) and blood thinners: There’s a risk for increased bleeding when taking these medications with Paxil. Don’t take NSAIDs or blood thinners with Paxil unless your provider approves you doing so.
• Alcohol: Paxil may have a sedative effect. Taking Paxil with alcohol can increase the risk of drowsiness and other side effects. 

Who shouldn’t take Paxil?

You shouldn’t take Paxil if you: 

• Have a history of severe allergic reactions to paroxetine or any other ingredient in Paxil. 
• Are taking MAOIs, or have taken them within the last 14 days. Be sure to tell your provider about all medications you currently take and any you’ve recently taken. 
• Have a cardiovascular or neurological disorder that may be exacerbated by Paxil’s side effects. Share your full medical history with your provider before starting Paxil for OCD. 

Interactions with other drugs can be a concern when taking Paxil. If you have a condition that requires treatment with antipsychotics, certain antibiotics, or antifungal agents, talk to your provider about alternatives. 

Stopping Paxil can cause withdrawal-like symptoms

Abruptly stopping Paxil can cause withdrawal-like symptoms, such as mood changes, dizziness, confusion, nausea, sweating, sleep disturbances, irritability, and anxiety. To avoid these symptoms, never discontinue Paxil without talking to your provider first. Instead, work with your provider to gradually taper off the medication while they monitor your progress. 

How much does Paxil cost?

The cost of Paxil varies depending on different factors, including: 

• Dosage
• Quantity  
• Brand-name (Paxil) or generic (paroxetine)
• Pharmacy 
• Insurance coverage
• Coupons and discounts

According to drugs.com, the retail cost of a 30-day supply of 10-milligram Paxil tablets is more than $290 without insurance. 

There are a few things you can do to reduce the cost of your prescription, such as:

• Ask your provider to prescribe the generic version.
  Check for coupons from local pharmacies.
• Check for coupons from the drug manufacturer (GlaxoSmithKline).
• Check for prescription discounts from websites like SingleCareRx, drugs.com, or GoodRx.
• Talk to your provider or pharmacist to see if they’re aware of any prescription assistance programs you’re eligible for. 

Paxil vs other OCD medications 

When comparing Paxil to other medications used to treat OCD, it’s important to talk with your provider and consider your needs, potential side effects, and the effectiveness of the medication. 

The table below provides information about the class, side effects, and effectiveness of some of the common medications for OCD. 

How to get a prescription for Paxil

The first step to get a prescription for Paxil is to get a qualifying diagnosis from a licensed mental health provider. This involves meeting with a provider via telehealth or in person so they can evaluate your symptoms. Your provider will ask about your medical history and current symptoms, and discuss the treatment options available to you. 

When considering medication as part of your treatment plan, your provider may refer you to a psychiatrist. If you and your care team decide that Paxil is the right choice for you, your provider will discuss how to take it and the side effects with you before giving you a prescription. 

Platforms, like Klarity, make it fast and easy to find healthcare providers who specialize in OCD. 

Key takeaway

Paxil (paroxetine) is a well-established medication for the treatment of OCD. As an SSRI, it works by acting on serotonin levels in your brain, which helps regulate mood and reduce compulsive behaviors. While taking the medication on its own may help, Paxil works best as part of a care plan that includes therapy. Talk to a mental health provider to develop the best treatment plan for you. 

Find a telehealth provider for an OCD prescription online

If you think you have OCD and are ready to take the next step with diagnosis and treatment, it’s time to find a mental health provider. Klarity lets you easily find and connect with a qualified provider who can assess your symptoms and prescribe the right medication. Find a provider today. 

FAQs about Paxil

What is the downside of Paxil?

Paxil has the potential to cause side effects, like nausea, drowsiness, sexual dysfunction, and weight gain. It may also increase the risk of suicidal thoughts and behaviors in adolescents and young adults. When taking Paxil, it’s important to keep appointments with your provider as they monitor how you respond to the medication. 

Why is Paxil rarely prescribed?

Paxil is prescribed less frequently for OCD than other SSRIs. This is primarily because of side effects and adverse events, like weight gain and suicidal thoughts and behaviors. Some providers are more cautious about prescribing this medication and opt instead to use other SSRIs to treat OCD. 

What is the best antidepressant for OCD?

The best antidepressants for OCD are those in the selective serotonin reuptake inhibitor (SSRI) class. SSRIs include medications like Zoloft (sertraline), Prozac (fluoxetine), and Luvox (fluvoxamine). Research shows that each of these medications are effective in reducing the symptoms of OCD. Work closely with your qualified mental health provider to determine which antidepressant is best for you based on your symptoms and how you respond to medications. 

Sources

Current Neuropharmacology, Psychopharmacological Treatment of Obsessive-Compulsive Disorder (OCD), Aug. 2019, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7059159/ 

Drugs.com, Paxil Prices, Coupons, and Patient Assistance Programs, https://www.drugs.com/price-guide/paxil 

Drugs.com, Paxil User Reviews and Ratings, https://www.drugs.com/comments/paroxetine/paxil.html 

European Psychiatry, Paroxetine concentrations in obsessive-compulsive disorder: support for therapeutic interval, Apr. 2017, https://www.sciencedirect.com/science/article/abs/pii/S0924933817325166 

Frontiers in Psychiatry, Duty to Warn: Antidepressant Black Box Suicidality Warning is Empirically Justified., Feb. 202, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7031767/ 

Frontiers in Psychiatry, Optimal Dose of Serotonin Reuptake Inhibitors for Obsessive-Compulsive Disorder in Adults: A Systematic Review and Dose-Response Meta-Analysis, Sept. 2021, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8495022/ 

Medline Plus, Paroxetine, https://medlineplus.gov/druginfo/meds/a698032.html 

Psychopharmacology Bulletin, Paroxetine- The Antidepressant from Hell? Probably Not, But Caution Required, Mar. 2016,  https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5044489/ 

StatPearls Publishing, Obsessive-Compulsive Disorder, Jan. 2024, https://pubmed.ncbi.nlm.nih.gov/31985955/ 

StatPearls Publishing, Paroxetine, Jul. 2023, https://www.ncbi.nlm.nih.gov/books/NBK526022/ 

StatPearls Publishing, Selective Serotonin Reuptake Inhibitors, May 2023, https://www.ncbi.nlm.nih.gov/books/NBK554406/ 

StatPearls Publishing, Serotonin Syndrome, Jul. 2023, https://www.ncbi.nlm.nih.gov/books/NBK482377/ 

U.S. Food and Drug Administration, Paxil Prescribing Information, https://www.accessdata.fda.gov/drugsatfda_docs/label/2012/020031s067%2C020710s031.pdf 

The information provided in this article is for educational purposes only and should not be construed as medical advice. Always seek the guidance of a qualified healthcare professional with any questions or concerns you have regarding your health.

If you’re having a mental health crisis or experiencing a psychiatric emergency, it’s crucial to seek immediate help from a mental healthcare professional, such as a psychiatrist, psychologist, or therapist. You can also call your local emergency services, visit your nearest emergency room, or contact a crisis hotline, such as the National Suicide Prevention Lifeline, by calling or texting 988 or dialing the Lifeline’s previous phone number, 1-800-273-TALK (1-800-273-8255) in the U.S.

How we reviewed this article: This article goes through rigorous fact-checking by a team of medical reviewers. Reviewers are trained medical professionals who ensure each article contains the most up-to-date information, and that medical details have been correctly interpreted by the author.