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.
Find lowest prices
Powered by GoodRxSave on your next prescription. Be sure you’re getting the lowest price for your medication, even if you have insurance.
Reviews & ratings
Button Group. All currently active
Button Group. All currently active
4.516587677725118Paxil
Reviews for Paxil (Paroxetine)
52%
of people say Paxil (Paroxetine) is worth it
39%
say it works well
23%
say it's a big hassle
Reviews for Pristiq (Desvenlafaxine)
48%
4% vs. Paxil (Paroxetine)
45%
+6% vs. Paxil (Paroxetine)
25%
2% vs. Paxil (Paroxetine)
Side effects
PaxilPristiq
  • 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 »
  • Nausea 31%
  • Excessive sweating 17%
  • Dry mouth 16%
  • Dizziness 11%
  • Constipation 10%
  • Impotence 10%
  • Sleep difficulty 9%
  • Decreased appetite 8%
  • Drowsiness 8%
  • Fatigue 7%
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
Antidepressant
Selective serotonin reuptake inhibitor (SSRI)
Prescription only
Antidepressant
Serotonin-norepinephrine reuptake inhibitor (SNRI)
Prescription only
Available as
PaxilPristiq
  • Pill
  • Extended release tablet
  • Liquid
  • Extended release
Used for (click to learn more)
PaxilPristiq
How well it works for depression
The free Iodine Start program helps people track how well they are improving, and find the right antidepressant faster.

After 4 weeks using Start and Paxil (Paroxetine), here’s how much better people feel.

After 4 weeks using Start and Pristiq (Desvenlafaxine), here’s how much better people feel.

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
    • At risk for 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
        • History of bipolar disorder
        • At risk for bipolar disorder
        Detailed Pristiq (Desvenlafaxine) risks & warnings »
        Pregnancy category
        PaxilPristiq
        DFDA pregnancy category (Weigh risks vs. benefits)

        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.

        See the FDA package insert
        CFDA pregnancy category (Weigh risks vs. benefits)

        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.

        See the FDA package insert
        Alcohol
        No specific alcohol-related info.No specific alcohol-related info.
        Food
        • Take with food to avoid upset stomach.
        No specific food-related info.
        Kidneys and liver
        No specific kidneys and liver-related info.No specific kidneys and liver-related info.
        Sex
        • Can cause more sexual side effects like low libido and an inability to orgasm or ejaculate than most antidepressants.
        • Paxil (Paroxetine) can cause lower sex drive or difficulty having an orgasm. If the problem persists after the first 2 to 3 months, you can talk to your doctor about alternative antidepressants or performance-enhancing medications.
        • Can cause sexual side effects (usually low libido or the inability to have an orgasm or ejaculate).
        • Pristiq (Desvenlafaxine) can cause lower sex drive or difficulty having an orgasm. If the problem persists after the first 2 to 3 months, you can talk to your doctor about alternative antidepressants or performance-enhancing medications.
        Sleep
        • It causes drowsiness, so it's good for people who have trouble sleeping.
        • Stopping Paxil (Paroxetine) suddenly may cause withdrawal symptoms such as nausea, anxiety, agitation, flu-like symptoms, trouble sleeping, and dizziness. Withdrawal symptoms usually occur within 3 days of stopping the medication, and go away within 1 to 2 weeks. Work with your doctor to gradually reduce your dose.
        • Stopping Pristiq (Desvenlafaxine) suddenly may cause withdrawal symptoms such as nausea, anxiety, agitation, flu-like symptoms, trouble sleeping, and dizziness. Withdrawal symptoms usually occur within 3 days of stopping the medication, and go away within 1 to 2 weeks. Work with your doctor to gradually reduce your dose.
        Weight
        • 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 cause weight gain, which can be helpful if you've recently lost weight or have a low appetite.
        No specific 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.
        • 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.
        • Tell your doctor if you notice sudden mood changes or unusual thoughts.
        • 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
        More about PristiqSide effectsReviews & ratingsAlternativesFDA package insert