Compare Paxil vs. Lexapro

Head-to-head comparisons of medication uses, side effects, ratings, and more.

Paxil
(Paroxetine)

Lexapro
(Escitalopram)

Improves mood and helps you relax. Paxil (Paroxetine) is good for treating depression and anxiety but it causes more weight gain, sleepiness, and withdrawal symptoms than other antidepressants.Improves mood and helps you relax. Lexapro (Escitalopram) is good for treating depression and anxiety. Might be less likely to cause side effects than some antidepressants, but not the best choice for people with heart or liver problems.
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Reviews & ratings
Filter group. All currently selected
Filter group. All currently selected
4.516587677725118Paxil
Reviews for Paxil (Paroxetine)
52%
of people (All ages) say Paxil (Paroxetine) is worth it
39%
say it works well
23%
say it's a big hassle
633 reviews
Have you used Paxil (Paroxetine)?
Worth itNot sureNot worth it
Reviews for Lexapro (Escitalopram)
59%
+7% vs. Paxil (Paroxetine)
46%
+7% vs. Paxil (Paroxetine)
15%
+8% vs. Paxil (Paroxetine)
958 reviews
Have you used Lexapro (Escitalopram)?
Worth itNot sureNot worth it
Side effects
PaxilLexapro
  • Abnormal ejaculation† 27%
  • Ejaculatory disturbance 26%
  • Nausea 22%
  • Dry mouth 19%
  • Drowsiness 17%
  • Lower sex drive 11%
  • Diarrhea 11%
  • Sleep difficulty 11%
  • Constipation 10%
  • Decreased libido 10%
More Paxil side effects »
  • Ejaculation disorder 12%
  • Ejaculation disorder (primarily ejaculatory delay) 11%
  • Sleep difficulty 10%
  • Nausea 10%
  • Diarrhea 9%
  • Headache 7%
  • Drowsiness 6%
  • Fatigue 6%
  • Dizziness 5%
  • Lower sex drive 5%
More Lexapro side effects »
How it works
PaxilLexapro
Paxil (Paroxetine) is a selective serotonin reuptake inhibitor (SSRI) antidepressant. It increases serotonin activity in the brain, which regulates mood.Lexapro (Escitalopram) is a selective serotonin reuptake inhibitor (SSRI) antidepressant. It increases serotonin activity in the brain, which regulates mood.
Type of medication
PaxilLexapro
Antidepressant
Selective serotonin reuptake inhibitor (SSRI)
Prescription only
Antidepressant
Selective serotonin reuptake inhibitor (SSRI)
Prescription only
Available as
PaxilLexapro
  • Pill
  • Extended release tablet
  • Liquid
  • Pill
  • Liquid
Used for (click to learn more)
PaxilLexapro
Risk factors for serious side effects
PaxilLexapro
  • Age 24 years or younger
  • Using other medications that affect serotonin
  • Stopping Paxil (Paroxetine) suddenly
  • Taking other blood-thinning drugs
    • History of bipolar disorder
    • At risk for bipolar disorder
      Detailed Paxil (Paroxetine) risks & warnings »
      • Age 24 years or younger
      • Using other medications that affect serotonin
      • Stopping Lexapro (Escitalopram) suddenly
      • Higher dose
      • History of heart problems
      • History of liver problems
      • Taking other blood-thinning drugs
        • History of bipolar disorder
        • At risk for bipolar disorder
        Detailed Lexapro (Escitalopram) risks & warnings »
        Pregnancy

        Research studies with real people found harmful effects on unborn babies, but the benefits might outweigh the risks even if you’re pregnant. Talk with your doctor.

        Research studies with animals found harmful effects on unborn babies. It hasn’t been properly studied in humans. The benefits might outweigh the risks even if you’re pregnant. Talk with your doctor.

        Food
        PaxilLexapro
        • Take with food to avoid upset stomach.
        • Take with food to avoid upset stomach.
        Kidneys and liver
        PaxilLexapro
        No kidneys and liver related info.
        • Not a good option for you if you have heart or liver problems.
        Sex
        PaxilLexapro
        No sex related info.
        • Can cause sexual side effects like low libido and an inability to orgasm or ejaculate.
        Sleep
        PaxilLexapro
        • It causes drowsiness, so it's good for people who have trouble sleeping.
        No sleep related info.
        Weight
        PaxilLexapro
        • Can cause weight gain, which can be helpful if you've recently lost weight or have a low appetite.
        • More likely to cause minor weight gain (1 to 5 pounds) or make you feel sick if you miss a dose than other antidepressants.
        • More likely to cause minor weight gain (1 to 5 pounds) than other antidepressants.
        Upsides and benefits
        PaxilLexapro
        • Lowers relapse rates of depression and anxiety disorders, including OCD, panic disorder, social anxiety disorder, and generalized anxiety disorder.
        • It causes drowsiness, so it's good for people who have trouble sleeping.
        • Can cause weight gain, which can be helpful if you've recently lost weight or have a low appetite.
        • Effective at relieving depression and anxiety symptoms.
        • Six out of ten people who use an antidepressant for the first time find that it works for them.
        • Lowers relapse rates of depression.
        • Causes less sleepiness than some other antidepressants.
        • Effective at relieving depression and anxiety symptoms.
        • Six out of ten people who use an antidepressant for the first time find that it works for them.
        Downsides and risks
        PaxilLexapro
        • Can cause more sexual side effects like low libido and an inability to orgasm or ejaculate than most antidepressants.
        • More likely to cause minor weight gain (1 to 5 pounds) or make you feel sick if you miss a dose than other antidepressants.
        • Can harm an unborn child, so you can't take it if you're pregnant.
        • Like most antidepressants, it can cause a higher risk of suicidal thoughts and behavior for people younger than age 24.
        • The first antidepressant you try doesn't always work or it can cause side effects you really don't like. You might need to try a few different medications until you find one that works for you.
        • Can cause sexual side effects like low libido and an inability to orgasm or ejaculate.
        • More likely to cause minor weight gain (1 to 5 pounds) than other antidepressants.
        • Can cause an irregular heartbeat if you take a high dose (20 mg a day, or more).
        • Not a good option for you if you have heart or liver problems.
        • Like most antidepressants, it can cause a higher risk of suicidal thoughts and behavior for people younger than 24.
        • The first antidepressant you try doesn't always work, and might have side effects you really don't like. You might need to try a few different medicines until you find one that works for you and that you can tolerate.
        Tips from our pharmacists for people taking the medication
        PaxilLexapro
        • The controlled-release (CR) tablet can cause less nausea than other forms.
        • Don’t crush, break, or chew the Paxil (Paroxetine) controlled-release tablet or the Pexeva film-coated tablets.
        • It’s best to take Paxil (Paroxetine) in the morning, except Brisdelle, which can be taken at bedtime.
        • Take with food to avoid upset stomach.
        • Takes about 8 to 12 weeks to see the medication's full effects on your mood.
        • Stop taking it slowly to avoid getting withdrawal symptoms.
        • Tell your doctor if you notice sudden mood changes or unusual thoughts.
        • Take with food to avoid upset stomach.
        • Takes about 8 to 12 weeks to see the medication's full effects on your mood.
        • Stop taking it slowly to avoid getting withdrawal symptoms.
        • Tell your doctor if you notice sudden mood changes or unusual thoughts.
        Learn more
        More about PaxilSide effectsReviews & ratingsAlternativesFDA package insert
        Have you used Paxil (Paroxetine)?
        Worth itNot sureNot worth it
        More about LexaproSide effectsReviews & ratingsAlternativesFDA package insert
        Have you used Lexapro (Escitalopram)?
        Worth itNot sureNot worth it