Compare Paxil vs. Pristiq

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

Paxil
(paroxetine)

Pristiq
(desvenlafaxine)

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. Pristiq (Desvenlafaxine) is basically the same medication as Effexor, which is cheaper because it's available as a generic.
Reviews & ratings
Filter group. All currently selected
Filter group. All currently selected
4.53Paxil
Reviews for Paxil
52%
of people (All ages) say Paxil is worth it
39%
say it works well
24%
say it's a big hassle
694 reviews
Have you used Paxil (paroxetine)?
Worth itNot sureNot worth it
Reviews for Pristiq
53%
-1% worse vs. Paxil
49%
-10% worse vs. Paxil
23%
-1% worse vs. Paxil
196 reviews
Have you used Pristiq (desvenlafaxine)?
Worth itNot sureNot worth it
Side effects
PaxilPristiq
  • Nausea 17%
  • Drowsiness 14%
  • Dry mouth 6%
  • Headache 1%
  • Muscle weakness 9%
  • Constipation 5%
  • Sleep difficulty 7%
  • Ejaculatory disturbance‡§ 13%
  • Dizziness 7%
  • Diarrhea 4%
More Paxil side effects »
  • Nausea 16%
  • Dry mouth 8%
  • Sleep difficulty 6%
  • Excessive sweating 7%
  • Dizziness 5%
  • Drowsiness 5%
  • Constipation 5%
  • Decreased appetite 6%
  • Fatigue 3%
  • Anxiety 3%
More Pristiq side effects »
How it works
PaxilPristiq
Paxil (Paroxetine) is a selective serotonin reuptake inhibitor (SSRI) antidepressant. It increases serotonin activity in the brain, which regulates mood.Pristiq (Desvenlafaxine) is a serotonin and norepinephrine reuptake inhibitor (SNRI) antidepressant. It increases serotonin and norepinephrine activity in the brain, which regulates mood.
Type of medication
PaxilPristiq
Prescription onlyPrescription only
Available as
PaxilPristiq
  • Pill
  • Extended release tablet
  • Liquid
  • Extended release
Used for
PaxilPristiq
Risk factors for serious side effects
PaxilPristiq
  • Age 24 years or younger
  • Using other medications that affect serotonin
  • Stopping Paxil (Paroxetine) suddenly
  • Taking other blood-thinning drugs
  • History of bipolar disorder
Detailed Paxil (paroxetine) risks & warnings »
  • Age 24 years or younger
  • Using other medications that affect serotonin
  • Stopping Pristiq (Desvenlafaxine) suddenly
  • History of high blood pressure
  • Taking other blood-thinning drugs
Detailed Pristiq (desvenlafaxine) 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
PaxilPristiq
  • Take with food to avoid upset stomach.
No food related info.
Sleep
PaxilPristiq
  • It causes drowsiness, so it's good for people who have trouble sleeping.
No sleep related info.
Weight
PaxilPristiq
  • 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.
No weight related info.
Upsides and benefits
PaxilPristiq
  • Effective at relieving depression and anxiety symptoms.
  • 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.
  • Six out of ten people who use an antidepressant for the first time find that it works for them.
  • Effective at relieving symptoms and lowering relapse rates for depression.
  • Six out of ten people who use an antidepressant for the first time find that it works for them.
Downsides and risks
PaxilPristiq
  • 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.
  • Similar to Effexor, without any extra benefits in clinical studies.
  • Can cause sexual side effects (usually low libido or the inability to have an orgasm or ejaculate).
  • Not available in generic form, so it's more expensive.
  • Like most antidepressants, can cause higher risk of suicidal thoughts and behavior for people age 24 and younger.
  • 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.
Tips from our pharmacists for people taking the medication
PaxilPristiq
  • 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.
  • 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.
  • Takes 8 to 12 weeks to see full effects on mood.
  • Can cause sweating and high blood pressure.
  • Stop taking slowly to avoid 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 PristiqSide effectsReviews & ratingsAlternativesFDA package insert
Have you used Pristiq (desvenlafaxine)?
Worth itNot sureNot worth it