Compare Prozac vs. Paxil

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

Prozac
(Fluoxetine)

Paxil
(Paroxetine)

Improves mood and helps you relax. Prozac (Fluoxetine) is good for treating depression and anxiety. It's more energizing than other antidepressants, but may not be the best choice for people who have trouble sleeping.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.
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Reviews & ratings
Button Group. All currently active
Button Group. All currently active
4.7375Prozac
Reviews for Prozac (Fluoxetine)
61%
of people say Prozac (Fluoxetine) is worth it
40%
say it works well
16%
say it's a big hassle
Reviews for Paxil (Paroxetine)
52%
9% vs. Prozac (Fluoxetine)
39%
1% vs. Prozac (Fluoxetine)
23%
7% vs. Prozac (Fluoxetine)
Side effects
ProzacPaxil
  • Rash 57%
  • Sleep difficulty 20%
  • Nausea 18%
  • Muscle weakness 12%
  • Drowsiness 10%
  • Tremor 9%
  • Dry mouth 9%
  • Lower sex drive 9%
  • Loss of appetite 7%
  • Anxiety 7%
More Prozac side effects »
  • 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 »
How it works
ProzacPaxil
Prozac (Fluoxetine) is a selective serotonin reuptake inhibitor (SSRI) antidepressant. It increases serotonin activity in the brain, which regulates mood.Paxil (Paroxetine) is a selective serotonin reuptake inhibitor (SSRI) antidepressant. It increases serotonin activity in the brain, which regulates mood.
Type of medication
ProzacPaxil
Antidepressant
Selective serotonin reuptake inhibitor (SSRI)
Prescription only
Antidepressant
Selective serotonin reuptake inhibitor (SSRI)
Prescription only
Available as
ProzacPaxil
  • Pill
  • Delayed release capsule
  • Liquid
  • Pill
  • Extended release tablet
  • Liquid
Used for (click to learn more)
ProzacPaxil
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 Prozac (Fluoxetine), here’s how much better people feel.

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

Risk factors for serious side effects
ProzacPaxil
  • Age 24 years or younger
  • Using other medications that affect serotonin
  • Stopping Prozac (Fluoxetine) suddenly
  • History of heart problems
  • History of liver problems
  • Drug interactions
  • Taking other blood-thinning drugs
    • History of bipolar disorder
    • At risk for bipolar disorder
    Detailed Prozac (Fluoxetine) risks & warnings »
    • 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 »
        Pregnancy category
        ProzacPaxil
        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
        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
        Alcohol
        No specific alcohol-related info.No specific alcohol-related info.
        Food
        • Take in the morning with food to avoid side effects.
        • Take with food to avoid upset stomach.
        Kidneys and liver
        No specific kidneys and liver-related info.No specific kidneys and liver-related info.
        Sex
        • Can cause sexual side effects like low libido and an inability to orgasm or ejaculate.
        • Prozac (Fluoxetine) 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 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.
        Sleep
        • Stopping Prozac (Fluoxetine) 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.
        • 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.
        Weight
        No specific weight-related info.
        • 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.
        Upsides and benefits
        ProzacPaxil
        • Lowers relapse rates of depression and bulimia nervosa.
        • Causes less sleepiness than other antidepressants.
        • It's more energizing than other antidepressants, so it's good for people who have low energy.
        • It has been used to treat depression for a long time, so there's a lot of information available about how it works and how safe it is.
        • 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 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.
        Downsides and risks
        ProzacPaxil
        • Can cause sexual side effects like low libido and an inability to orgasm or ejaculate.
        • Can increase feelings of anxiety or cause headaches during the first few weeks of taking it. These effects should go away over time.
        • More likely than other antidepressants to interact with other medications you're taking.
        • 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 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 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.
        Tips from our pharmacists for people taking the medication
        ProzacPaxil
        • Take in the morning with food to avoid side effects.
        • 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.
        • 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 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 ProzacSide effectsReviews & ratingsAlternativesFDA package insert
        More about PaxilSide effectsReviews & ratingsAlternativesFDA package insert