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Paxil Side Effects

Generic name: paroxetine

Medically reviewed by Drugs.com. Last updated on Apr 4, 2025.

Note: This document provides detailed information about Paxil Side Effects associated with paroxetine. Some dosage forms listed on this page may not apply specifically to the brand name Paxil.

Applies to paroxetine: oral capsule, oral suspension, oral tablet, oral tablet extended release.

Important warnings This medicine can cause some serious health issues

Oral route (capsule)

Antidepressants, including selective serotonin reuptake inhibitors (SSRIs), have been shown to increase the risk of suicidal thoughts and behavior in pediatric and young adult patients when used to treat major depressive disorder and other psychiatric disorders.

Because paroxetine mesylate is an SSRI, monitor patients closely for worsening and for emergence of suicidal thoughts and behaviors.

Advise families and caregivers of the need for close observation and communication with the prescriber.

Oral route (tablet)

Warning: Suicidal Thoughts and Behaviors. Antidepressants increased the risk of suicidal thoughts and behaviors in pediatric and young adult patients taking antidepressants in short-term studies.

Closely monitor all antidepressant-treated patients for clinical worsening and for emergence of suicidal thoughts and behaviors.

Paroxetine mesylate is not approved for use in pediatric patients.

Oral route (tablet; tablet, extended release; suspension)

Antidepressants increased the risk of suicidal thoughts and behaviors in pediatric and young adult patients in short-term studies.

Closely monitor all antidepressant-treated patients for clinical worsening, and for emergence of suicidal thoughts and behaviors.

Paroxetine hydrochloride is not approved for use in pediatric patients.

Precautions

It is very important that your doctor check your progress at regular visits to make sure this medicine is working properly. Blood tests may be needed to check for unwanted effects.

Using this medicine while you are pregnant can harm your unborn baby. Use an effective form of birth control to keep from getting pregnant. If you think you have become pregnant while using the medicine, tell your doctor right away.

Do not take paroxetine (the active ingredient contained in Paxil) with a monoamine oxidase (MAO) inhibitor (eg, isocarboxazid [Marplan®], linezolid [Zyvox®], methylene blue injection, phenelzine [Nardil®], selegiline [Eldepryl®], tranylcypromine [Parnate®]). Do not start taking paroxetine during the 2 weeks after you stop a MAO inhibitor and wait 2 weeks after stopping paroxetine before you start taking a MAO inhibitor. If you take them together or do not wait 2 weeks, you may develop confusion, agitation, restlessness, stomach or intestinal symptoms, a sudden high body temperature, an extremely high blood pressure, or severe convulsions.

Do not take pimozide (Orap®) or thioridazine (Mellaril®) while you are taking this medicine. Using these medicines together can cause very serious heart problems.

Paroxetine may cause a serious condition called serotonin syndrome if taken together with some medicines. Do not use paroxetine with buspirone (Buspar®), fentanyl (Abstral®, Duragesic®), lithium (Eskalith®, Lithobid®), tryptophan, St. John's wort, amphetamines, or some pain or migraine medicines (eg, meperidine, methadone, rizatriptan, sumatriptan, tramadol, Demerol®, Frova®, Imitrex®, Maxalt®, Methadose®, Relpax®, Ultram®, Zomig®). Check with your doctor first before taking any other medicines with paroxetine.

This medicine may decrease the amount of sperm men make and affect their ability to have children. If you plan to have children, talk with your doctor before using this medicine.

Paroxetine may cause some teenagers and young adults to be agitated, irritable, or display other abnormal behaviors. It may also cause some people to have suicidal thoughts and tendencies or to become more depressed. Some people may have trouble sleeping, get upset easily, have a big increase in energy, or start to act reckless. If you or your caregiver notice any of these unwanted effects, tell your doctor right away. Let the doctor know if you or anyone in your family has bipolar disorder (manic-depressive) or has tried to commit suicide.

Do not suddenly Stop taking paroxetine without checking first with your doctor. Your doctor may want you to gradually reduce the amount you are using before stopping it completely. This will decrease the chance of having withdrawal symptoms such as agitation, breathing problems, chest pain, confusion, diarrhea, dizziness or lightheadedness, fast heartbeat, headache, increased sweating, muscle pain, nausea, restlessness, runny nose, trouble in sleeping, trembling or shaking, unusual tiredness or weakness, vision changes, or vomiting.

Check with your doctor right away if you develop the following symptoms during the first few weeks of treatment with paroxetine: inability to sit still, need to keep moving, or restlessness.

The use of alcohol is not recommended in patients who are taking paroxetine.

Paroxetine may cause some people to become drowsy or have blurred vision. Make sure you know how you react to this medicine before you drive, use machines, or do anything else that could be dangerous if you are not alert or able to see clearly.

Hyponatremia (low sodium in the blood) may occur with this medicine. Check with your doctor right away if you have confusion, difficulty concentrating, headaches, memory problems, weakness, and unsteadiness.

This medicine may increase your risk for bleeding problems. Make sure your doctor knows if you are also taking other medicines that thin the blood, including NSAIDs (eg, aspirin, diclofenac, ibuprofen, naproxen, Advil®, Aleve®, Celebrex®, Voltaren®), or warfarin (Coumadin®, Jantoven®).

This medicine may increase the risk of bone fractures. Tell your doctor if you have unexplained bone pain, tenderness, swelling, or bruising. Also, ask your doctor about ways to keep your bones strong to help prevent fractures.

Check with your doctor right away if you have decreased interest in sexual intercourse, delayed or inability to have an orgasm in women, inability to have or keep an erection in men, or loss in sexual ability, desire, drive, or performance. These could be symptoms of sexual dysfunction.

Do not take other medicines unless they have been discussed with your doctor. This includes prescription or nonprescription (over-the-counter [OTC]) medicines and herbal (eg, St. John's wort) or vitamin supplements.

Common side effects of Paxil

Some side effects of paroxetine may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects.

Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:

More common side effects

  • acid or sour stomach
  • belching
  • decreased appetite
  • heartburn
  • pain or tenderness around the eyes and cheekbones
  • passing gas
  • problems with urinating
  • runny or stuffy nose
  • sleepiness or unusual drowsiness
  • stomach discomfort or upset
  • trouble sleeping

Less common side effects

  • abnormal dreams
  • change in sense of taste
  • congestion
  • discouragement, feeling sad, or empty
  • drugged feeling
  • fast or irregular breathing
  • feeling of unreality
  • headache, severe and throbbing
  • increased appetite
  • itching of the vagina or genital area
  • itching, pain, redness, or swelling of the eye or eyelid
  • lack of emotion
  • loss of interest or pleasure
  • lump in the throat
  • menstrual changes
  • pain during sexual intercourse
  • problems with memory
  • sense of detachment from self or body
  • sneezing
  • thick, white vaginal discharge with no odor or with a mild odor
  • tightness in the throat
  • tingling, burning, or prickling sensations
  • trouble concentrating
  • voice changes
  • watering of the eyes
  • weight loss
  • yawn

Incidence not known

  • decrease in smell
  • loss of sense of smell

Serious side effects of Paxil

Along with its needed effects, paroxetine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

Check with your doctor immediately if any of the following side effects occur while taking paroxetine:

Less common side effects

  • agitation
  • chest pain or tightness
  • chills
  • cold sweats
  • confusion
  • difficulty with breathing
  • dizziness, faintness, or lightheadedness when getting up from a lying or sitting position
  • fast, pounding, or irregular heartbeat or pulse
  • muscle pain or weakness
  • skin rash

Rare side effects

  • absence of or decrease in body movements
  • bigger, dilated, or enlarged pupils (black part of the eye)
  • difficulty with speaking
  • dry mouth
  • fever
  • inability to move the eyes
  • incomplete, sudden, or unusual body or facial movements
  • increased sensitivity of the eyes to light
  • poor coordination
  • red or purple patches on the skin
  • restlessness
  • seizures
  • shivering
  • sweating
  • talking, feeling, and acting with excitement and activity you cannot control
  • trembling or shaking, or twitching

Incidence not known

  • back, leg, or stomach pains
  • blindness
  • blistering, peeling, or loosening of the skin
  • blue-yellow color blindness
  • blurred vision
  • constipation
  • cough or hoarseness
  • dark urine
  • decreased frequency or amount of urine
  • decreased vision
  • difficulty with swallowing
  • electric shock sensations
  • eye pain
  • fainting
  • general body swelling
  • headache
  • high fever
  • hives or itching skin
  • inability to move the arms and legs
  • inability to sit still
  • increased thirst
  • incremental or ratchet-like movement of the muscle
  • joint pain
  • light-colored stools
  • lockjaw
  • loss of appetite
  • loss of bladder control
  • lower back or side pain
  • muscle spasm, especially of the neck and back
  • muscle tension or tightness
  • need to keep moving
  • painful or difficult urination
  • painful or prolonged erection of the penis
  • pale skin
  • puffiness or swelling of the eyelids or around the eyes, face, lips, or tongue
  • raised red swellings on the skin, the buttocks, legs, or ankles
  • red, irritated eyes
  • sensitivity to the sun
  • skin redness or soreness
  • slow heart rate
  • sores, ulcers, or white spots on the lips or in the mouth
  • spasms of the throat
  • stiff muscles
  • stomach pain
  • sudden numbness and weakness in the arms and legs
  • swelling of the breasts
  • swelling of the face, fingers, or lower legs
  • swollen or painful glands
  • tightness in the chest
  • unexpected or excess milk flow from the breasts
  • unusual bleeding or bruising
  • unusual tiredness or weakness
  • vomiting
  • weight gain
  • yellowing of the eyes or skin
  • decreased interest in sexual intercourse
  • delayed or inability to have an orgasm
  • inability to have or keep an erection
  • loss in sexual ability, desire, drive, or performance

For healthcare professionals

Applies to paroxetine: oral capsule, oral suspension, oral tablet, oral tablet extended release.

General adverse events

HYDROCHLORIDE IR/MESYLATE TABLET FORMULATIONS: The most commonly reported side effects included nausea, ejaculation disturbance/abnormal ejaculation, somnolence, and asthenia.

HYDROCHLORIDE CR FORMULATIONS: The most commonly reported side effects included headache, ejaculation disturbance, nausea, and somnolence.

MESYLATE CAPSULES: The most commonly reported side effects included headache, fatigue, lethargy, and malaise.[Ref]

Gastrointestinal

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Nervous system

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Extrapyramidal symptoms such as akathisia, bradykinesia, cogwheel rigidity, dystonia, hypertonia, and oculogyric crisis have been associated with concomitant pimozide therapy.

Potentially life-threatening serotonin syndrome has been reported with SSRIs as monotherapy, but particularly with concomitant use of other serotonergic drugs and drugs that impair the metabolism of serotonin. Signs and symptoms associated with serotonin syndrome or neuroleptic malignant syndrome included agitation, confusion, diaphoresis, diarrhea, fever, hypertension, rigidity, and tachycardia, and were in some cases associated with concomitant use of serotonergic drugs.[Ref]

Genitourinary

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There are several reports of priapism associated with use.[Ref]

Psychiatric

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Other

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Cardiovascular

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Respiratory

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Musculoskeletal

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Patients 50 years or older receiving selective serotonin reuptake inhibitors (SSRIs) have shown an increased risk of bone fractures.[Ref]

Ocular

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Immunologic

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Hepatic

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Hematologic

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Hypersensitivity

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Renal

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See also:

References

1. (2001) "Product Information. Paxil (paroxetine)." GlaxoSmithKline

2. (2001) "Product Information. Paxil CR (paroxetine)." SmithKline Beecham

3. Cerner Multum, Inc. "UK Summary of Product Characteristics."

4. Cerner Multum, Inc. "Australian Product Information."

5. (2014) "Product Information. Brisdelle (paroxetine)." Noven Pharmaceuticals, Inc.

6. (2014) "Product Information. Pexeva (paroxetine)." Synthon Pharmaceuticals Ltd

Frequently asked questions

Further information

Paxil side effects can vary depending on the individual. Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.

Note: Medication side effects may be underreported. If you are experiencing side effects that are not listed, submit a report to the FDA by following this guide.