Comprehensive medication guide to Paxil including estimated pricing, availability information, side effects, and how to find it in stock at your local pharmacy.
Estimated Insurance Pricing
$0–$10 copay for generic paroxetine on most commercial plans (Tier 1); Medicare Part D typically covers generic at minimal cost. Brand-name Paxil is Tier 3–5 and may require prior authorization.
Estimated Cash Pricing
$4–$87 retail for generic paroxetine IR (30 tablets at 20 mg); as low as $4 with GoodRx or SingleCare coupon at Walmart or comparable pharmacy. Paxil CR (25 mg, 30 tablets) costs $15–$50 with discount card.
Medfinder Findability Score
80/100
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Paxil is the brand name for paroxetine hydrochloride, a selective serotonin reuptake inhibitor (SSRI) antidepressant. Originally approved by the FDA in 1992 and developed by GlaxoSmithKline, Paxil is now primarily dispensed as generic paroxetine. It is used to treat a wide range of psychiatric conditions including depression, anxiety disorders, OCD, PTSD, PMDD, and menopausal symptoms.
Available formulations include immediate-release (IR) tablets in 10 mg, 20 mg, 30 mg, and 40 mg strengths; controlled-release (CR) tablets in 12.5 mg, 25 mg, and 37.5 mg; oral suspension (10 mg/5 mL); and Brisdelle capsules (7.5 mg paroxetine mesylate) for menopausal hot flashes.
Paroxetine is not a controlled substance and can be prescribed by any licensed provider including primary care physicians, psychiatrists, nurse practitioners, and telehealth providers.
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Paroxetine works by blocking the serotonin reuptake transporter (SERT) — a protein that normally recycles serotonin back into nerve cells after it has been released. By blocking SERT, paroxetine increases the amount of serotonin available in the spaces between nerve cells (synapses), enhancing serotonergic signaling in the brain.
Unlike most other SSRIs, paroxetine also has significant anticholinergic activity (muscarinic receptor blockade), which contributes to side effects like dry mouth, constipation, and sedation. It is also one of the most potent inhibitors of the CYP2D6 liver enzyme, which has important implications for drug interactions with many commonly used medications.
Paroxetine has a short half-life of approximately 21 hours with no active metabolites, and it inhibits its own CYP2D6-mediated metabolism. These pharmacokinetic properties mean that paroxetine has the highest discontinuation syndrome risk among SSRIs — doses should never be stopped abruptly.
10 mg — Immediate-release tablet
Starting dose for elderly patients and for panic disorder titration
20 mg — Immediate-release tablet
Standard starting and maintenance dose for most conditions
30 mg — Immediate-release tablet
Intermediate maintenance dose
40 mg — Immediate-release tablet
Recommended maintenance dose for OCD and panic disorder
12.5 mg — Controlled-release tablet (Paxil CR)
Starting CR dose; also PMDD dose
25 mg — Controlled-release tablet (Paxil CR)
Standard CR maintenance dose
37.5 mg — Controlled-release tablet (Paxil CR)
CR dose for anxiety and depression
10 mg/5 mL — Oral suspension
Liquid form for patients unable to swallow tablets
7.5 mg — Capsule (Brisdelle)
Low-dose paroxetine mesylate for menopausal hot flashes
As of 2026, paroxetine is not on the FDA's active drug shortage list. Generic immediate-release tablets are produced by multiple manufacturers — including Apotex, Mylan, Teva, Zydus, and Aurobindo — and are generally widely available at most pharmacies. The 10 mg and 20 mg IR strengths are particularly easy to find.
However, Paxil CR (controlled-release) and the oral suspension are more vulnerable to spot shortages due to fewer manufacturers. Brand-name Paxil is rarely stocked proactively. Patients on higher IR strengths (30 mg, 40 mg) may occasionally encounter a pharmacy that does not routinely stock those doses. If you're having trouble finding your formulation, try an independent pharmacy or warehouse club pharmacy.
If you're having difficulty finding paroxetine in stock at your local pharmacy, medfinder calls pharmacies near you to check which ones can fill your specific prescription — saving you hours of calling around yourself.
Paroxetine is not a controlled substance, which means any licensed prescriber can write a prescription without DEA registration requirements. This greatly broadens who can prescribe it and makes it accessible through telehealth in all 50 states.
Psychiatrists — specialists in complex depression, anxiety, OCD, and PTSD management
Primary care physicians (PCPs) — family medicine and internal medicine MDs and DOs
Nurse practitioners (NPs) and physician assistants (PAs) — full prescribing authority in most states
OB/GYNs — for PMDD and menopausal hot flash indications (Brisdelle)
Telehealth providers — widely available; paroxetine can be prescribed via telemedicine without DEA restrictions
Telehealth platforms such as Teladoc, Hims/Hers, and Talkspace Psychiatry can prescribe paroxetine after a remote evaluation. This is particularly convenient for patients in areas with limited mental health specialist availability, or for those managing depression or anxiety symptoms that make it difficult to leave home.
No. Paxil (paroxetine) is not a controlled substance and has no DEA schedule. It can be prescribed by any licensed provider — including primary care physicians, nurse practitioners, physician assistants, and telehealth providers — without DEA-specific restrictions.
Because it is not controlled, paroxetine can be prescribed in any quantity with unlimited refills, e-prescribed or faxed like any standard medication, and dispensed without additional pharmacy verification steps. This also means it is easily accessible via telehealth platforms for patients in all 50 states.
The most common side effects of paroxetine include:
Nausea (especially in the first 1-2 weeks)
Drowsiness and fatigue
Dry mouth
Sweating (including night sweats)
Sexual dysfunction (reduced libido, delayed orgasm, erectile dysfunction) — very common long-term
Weight gain (more than other SSRIs)
Constipation, dizziness, insomnia, headache
Serious side effects requiring medical attention:
Serotonin syndrome (agitation, high fever, muscle rigidity, rapid heart rate) — seek emergency care
Increased suicidal thoughts in patients under 25 (FDA black box warning)
Hyponatremia (low sodium) — confusion, headache, weakness, seizures
Mania or hypomania in patients with undiagnosed bipolar disorder
Discontinuation syndrome (brain zaps, dizziness, nausea, anxiety) — do NOT stop abruptly
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Sertraline (Zoloft)
SSRI approved for MDD, OCD, PTSD, SAD, panic disorder, and PMDD. More versatile than paroxetine with less sexual dysfunction and weight gain. Generic from $4-$10/month.
Escitalopram (Lexapro)
SSRI approved for MDD and GAD. Considered the best-tolerated SSRI with fewest drug interactions. Good choice for patients on complex regimens. Generic from $5-$20/month.
Fluoxetine (Prozac)
SSRI with very long half-life — best for reducing discontinuation syndrome risk. Approved for MDD, OCD, panic disorder, bulimia, and PMDD. Generic from $4-$15/month.
Venlafaxine (Effexor XR)
SNRI approved for MDD, GAD, SAD, and panic disorder. May be more effective for anxious depression or treatment-resistant cases. Does not inhibit CYP2D6. Generic from $15-$40/month.
Prefer Paxil? We can find it.
MAO Inhibitors (phenelzine, tranylcypromine, linezolid, methylene blue)
majorAbsolutely contraindicated — can cause fatal serotonin syndrome. 14-day washout required before switching.
Tamoxifen
majorParoxetine inhibits CYP2D6 conversion of tamoxifen to endoxifen (active metabolite), reducing tamoxifen efficacy by up to 65%. Avoid combination; use sertraline or venlafaxine instead.
Thioridazine and Pimozide
majorContraindicated — paroxetine raises levels via CYP2D6 inhibition, risking QTc prolongation and fatal arrhythmias.
Triptans (sumatriptan, rizatriptan)
moderateIncreased serotonin syndrome risk. Use with caution; monitor for agitation, tachycardia, and elevated temperature.
Tramadol
moderateSerotonin syndrome risk; paroxetine also inhibits CYP2D6 conversion of tramadol to active analgesic metabolite, reducing pain relief.
Warfarin and anticoagulants
moderateParoxetine impairs platelet serotonin, increasing bleeding risk. Monitor INR closely when used with warfarin.
NSAIDs (ibuprofen, naproxen, aspirin)
moderateIncreased GI bleeding risk due to combined antiplatelet effect. Use acetaminophen for pain relief when possible.
Tricyclic antidepressants (nortriptyline, amitriptyline)
moderateParoxetine inhibits CYP2D6 metabolism of TCAs, raising TCA plasma levels significantly. Dose reduction and monitoring required.
Metoprolol and carvedilol (beta-blockers)
moderateParoxetine raises metoprolol levels via CYP2D6 inhibition; may cause excessive bradycardia or hypotension.
Alcohol
minorIncreased CNS depression; may worsen depression and anxiety symptoms being treated.
Paxil (paroxetine) is a highly effective SSRI with FDA approval for more indications than most other antidepressants. For patients with depression, anxiety disorders, PTSD, OCD, or PMDD, it remains a commonly prescribed and clinically validated option. Its unique pharmacological profile — anticholinergic activity, strong CYP2D6 inhibition, and short half-life — requires attention to drug interactions and careful tapering when discontinuing.
The good news on cost: generic paroxetine IR is one of the most affordable medications in its class, available for as little as $4/month. Paxil CR costs more but remains accessible. Brand-name Paxil is rarely medically necessary given the therapeutic equivalence of generics. Patients should explore discount programs like GoodRx and SingleCare if cost is a concern.
For patients struggling to fill their paroxetine prescription due to local pharmacy stock issues, medfinder can call pharmacies near you to find which ones have your medication in stock — helping you avoid the dangerous situation of running out of paroxetine without warning.
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