Prozac vs Paxil: Choosing an SSRI for Depression and Anxiety
speciality medications
Selective serotonin reuptake inhibitors, or SSRIs, are the first-line choice – usually – for treating depression and anxiety.
They’ve been prescribed for decades, are generally well tolerated, and can make a life-changing difference for people struggling with mood disorders.
While there are many, many different meds that fit neatly into the SSRI category, there are two that are very commonly prescribed and are so recognizable that even people who don’t take them tend to be aware of what they do.
These are Prozac (fluoxetine) and Paxil (paroxetine).
Both are effective, both are available as generics, and both are commonly prescribed worldwide.
Of course, this availability doesn’t always translate to accessibility – or ease of getting started.
When patients first get prescribed an SSRI and are working with their doctors to determine their best treatment plan, they tend to wonder:
- Which one – Prozac or Paxil – works better for anxiety?
- Which one causes fewer side effects?
- Is Prozac or Paxil better for depression?
- How do costs compare now that both are available as generics?
We’re here to help answer these questions (and others!).
Let’s break down the similarities and differences between Prozac and Paxil so you or your loved one can make informed decisions about your health.
What Are SSRIs, and How Do They Work?
Before we do a head-to-head comparison of Prozac and Paxil, let’s talk for a moment about what SSRIs actually do for patients with anxiety and/or depression.
Selective serotonin reuptake inhibitors work by increasing serotonin levels in the brain. Serotonin is a neurotransmitter that plays a key role in regulating a person’s mood, sleep, and appetite.
When the human body’s serotonin levels are too low, that can result in poor sleep, appetite declines, and adverse effects on a person’s overall mood. If this continues, it can result in symptoms of more chronic or severe depression and anxiety.
SSRIs help boost a person’s overall levels of serotonin by blocking the brain from reabsorbing serotonin too quickly.
(Hence the name – reuptake inhibitor).
When SSRIs work well for a person, they should have more serotonin available in their brain to help their nerve cells communicate better. The end result should look like improved mood and reduced anxiety.
Prozac and Paxil are both SSRIs, but their differences in metabolism, half-life, and side effect profiles can influence which one is the better fit for a given patient.
Prozac (Fluoxetine): Overview and Common Uses
There’s a reason that Prozac is so well known and trusted, by doctors and patients alike.
Prozac was the very first SSRI to be introduced to the U.S. market.
It was approved for use in 1987.
Its generic name is fluoxetine, and today it is available at a fraction of its original brand-name price.
Here’s What Prozac Is Used For
Prozac is approved for:
- Major depressive disorder
- Obsessive-compulsive disorder (OCD)
- Panic disorder
- Bulimia nervosa
- Premenstrual dysphoric disorder (PMDD)
And those are just its official indications.
Depending on your symptoms, your doctor may consider prescribing Prozac to you off-label, or for conditions outside of that specific approved list.
This tends to happen for conditions like post-traumatic stress disorder (PTSD) and social anxiety disorder.
Why Is Prozac So Effective?
There are a few reasons why Prozac is so widely used (and why it works so well for so many conditions and for so many people!).
These reasons include:
Its surprisingly long half-life. A substance’s half-life is a measure of how long that substance takes to decay. Since Prozac has a long half-life, it takes longer to decay – which means Prozac stays in the body longer than most SSRIs.
This means missing a dose is less likely to cause immediate withdrawal symptoms. (This is not permission to skip doses, as that won’t be good for you or your mental health, but if accidents do happen, Prozac can be more forgiving than other alternatives.)
Its helpful activating effect. Many patients find Prozac slightly energizing, which can be helpful for depression associated with fatigue, low motivation, or “slowed down” feelings.
Its flexible dosing schedule and administration. Prozac is available in capsules, tablets, and liquid form. This can make it easier for patients to find a Prozac treatment regimen that works for them and their schedule.
Paxil (Paroxetine): Overview and Common Uses
After Prozac came Paxil.
Paxil is another popular SSRI, and it’s been in use ever since it was approved in 1992.
Here’s What Paxil Is Used For
Paxil is used for a wide variety of indications.
It has one of the widest ranges of approved indications, actually, which means that there’s a very good chance that Paxil could be helpful for you – almost regardless of the mental health condition you’re seeking help for.
Paxil’s approved indications include:
- Major depressive disorder
- Generalized anxiety disorder (GAD)
- Panic disorder
- Obsessive-compulsive disorder (OCD)
- Post-traumatic stress disorder (PTSD)
- Premenstrual dysphoric disorder (PMDD)
- Social anxiety disorder
As you scrolled down that list, you might have noticed that Paxil is approved to treat several anxiety-related conditions.
Since this is the case, often, doctors will prescribe Paxil when patients are struggling with anxiety, instead of presenting with stricter depression-related symptoms.
What Makes Paxil Unique?
If you’re choosing between Prozac and Paxil, what are some of the reasons you might opt for Paxil over Prozac?
Here are a few of the reasons the two meds differ:
Paxil has a shorter half-life. A shorter half-life means that the substance degrades more quickly, so, unlike Prozac, Paxil leaves the body relatively fast.
While this means it works sooner, it also makes missed doses more noticeable. Many patients report withdrawal symptoms if they forget to take their daily pill.
Paxil does have a sedating effect. Paxil tends to be more calming and sedating compared to Prozac (and its energizing effect), which some patients with anxiety find helpful.
On the other hand, this can make daytime drowsiness a little more of an issue – which may mean that you will need to consider your dosing schedule quite strategically.
Paxil can come with a higher risk of weight gain. Among SSRIs, Paxil is one of the most likely to cause weight changes. This may be a deciding factor for some patients.
Prozac vs. Paxil for Depression
We’ve talked a little about how Prozac and Paxil can help treat anxiety.
Do they work well for treating depression?
The quick answer is – yes.
Both Prozac and Paxil are highly effective for treating major depressive disorder.
Let’s break that down, since the specific way each of these SSRIs and the way they might affect you can differ, even if slightly:
- Prozac may be a better choice for patients whose depression includes fatigue, low energy, or lack of motivation, since it has a more activating profile.
- Paxil may be more suitable for patients whose depression is accompanied by severe anxiety, restlessness, or insomnia, thanks to its calming effect.
Paxil vs Prozac for Anxiety
What about how these SSRIs treat anxiety? Are there any considerations there you should be aware of?
Yes, there are.
As you might recall, Paxil has some inherent relaxing and sedating effects, along with approval for a wide range of different anxiety conditions (including but not limited to GAD, social anxiety disorder, panic disorder, PTSD, and OCD).
There’s also the possibility that your doctor may prescribe Paxil to you off-label for symptoms related to anxiety even if you don’t have a specific anxiety disorder – e.g., if you experience high levels of nervous energy, restlessness, or insomnia.
While Prozac can help some patients with anxiety, especially if they’ve tried Paxil and have determined they need to seek an alternative, it’s usually a second-line option.
(This is not least because of Prozac’s activating effect, which can feel a bit jarring if a patient is already undergoing overwhelming anxiety).
Prozac vs Paxil: Side Effects
Like all powerful medications, these two SSRIs do come with the potential to cause some side effects. Some of these side effects are common to both: If you start taking either Paxil or Prozac, you might need to watch out for nausea, dizziness, sexual dysfunction, headaches, and changes in sleep.
But, of course, there are some specific considerations to keep in mind as you’re choosing an SSRI for depression or anxiety.
What Are Prozac’s Side Effects?
Prozac is:
- More likely to cause insomnia or restlessness. This is especially true at the beginning of treatment, when your body’s still getting used to the drug.
- More likely to result in jitteriness or a potentially over-energized feeling, due to that activating effect.
- Less likely to result in weight gain for most people when compared to Paxil.
- Less likely to result in withdrawal symptoms if a patient misses any doses.
What Are Paxil’s Side Effects?
Paxil is:
- More likely to cause sedation, fatigue, or drowsiness, due to its inherent sedative effect, which some patients find helpful for anxiety-related insomnia but others find limiting.
- More likely to cause weight gain for some patients, when compared to Prozac, especially with long-term use.
- More likely to cause withdrawal symptoms when a patient accidentally misses doses, or if a patient decides (with the help and oversight of a healthcare professional!) to taper their doses.
Prozac vs Paxil: Which One Costs Less?
Once you’ve made a decision about whether you’re going to take Prozac or Paxil, a very important and extremely logistical decision comes next.
Which of these medications is more financially accessible to you?
Fortunately, both Prozac and Paxil have been in use for a long time – decades. That means the patents on brand-name medications have long expired, and both Paxil and Prozac are available as low-cost generics (fluoxetine and paroxetine).
In most cases, this means that either medication should be very affordable, and price itself will rarely need to be your deciding factor.
Here, through NorthWestPharmacy.com, you can buy the brand and generic versions of both medications.
- You can buy brand Prozac for about $3.50 per tab, and generic fluoxetine for about $0.20 per tab.
- You can buy brand Paxil for about $2.00 per tab, and generic paroxetine for about $0.60 per tab.
How to Work With Your Doctor to Choose the Right SSRI
If taking an SSRI for your anxiety and depression is new for you, it can be difficult to know how to get started – especially if figuring out which one is best for you is a decision that, itself, is causing you anxiety.
We understand, and we’re here to help.
Here’s a quick step-by-step guide that you can follow to approach this decision.
Track your symptoms carefully. Start a new note on your phone or stick a piece of paper and a pencil on a central table in your home, then just start writing down whether your depression is marked by fatigue, restlessness, insomnia, or other patterns.
These details may feel insignificant in the moment, but, especially as they aggregate, they will both help you notice your symptoms more and help you identify patterns.
Be open about any side effects you’re worried about. If weight gain, drowsiness, or insomnia are particular concerns, let your provider know before you start your treatment.
Discuss your medical history openly. As your doctor helps you figure out whether Paxil or Prozac is your best option, they should ask you about your medical history.
Don’t hold back, this is important information! Seniors, people with heart disease, or those taking multiple medications may respond differently to each SSRI.
Be realistic about medication adherence. If you sometimes forget doses, Prozac’s long half-life may be a better fit.
If you’re consistent and need fast relief from anxiety, Paxil could be more effective.
Prozac vs Paxil — Finding the Right Fit for You!
Both Prozac (fluoxetine) and Paxil (paroxetine) are proven, effective SSRIs for treating depression and anxiety.
The choice between them usually comes down to individual factors:
- Prozac tends to be more activating and better tolerated in terms of weight gain.
- Paxil is often more sedating and may be better for patients with significant anxiety or insomnia, though it carries a higher risk of weight gain and withdrawal effects.
- Both medications are affordable in generic form, making cost less of a deciding factor than symptom profile and side effect preferences.
The bottom line is simple – There’s no one-size-fits-all answer as to whether Paxil vs Prozac is best for you, uniquely!
The best approach is to work closely with your doctor, describe your symptoms and concerns openly, and explore safe, affordable options for filling your prescription.
When you’re ready to buy reliably authentic, high-quality, and low-cost Paxil or Prozac, the entire team here at NorthWestPharmacy.com is ready to support you and your healthcare journey.
