Paxil vs. Luvox

See how Paxil and Luvox compare on approved uses, dosing, side effects, and cost.

Key Takeaways

  • Paxil is FDA-approved for six conditions including depression and several anxiety disorders, while Luvox is approved only for OCD.

  • Both carry a boxed warning for increased suicidal thoughts in young people and interact with many other drugs, but through different liver enzymes.

  • Luvox typically costs far less out of pocket than Paxil, though Paxil offers more dosing form options.

Paxil vs. Luvox Drug Summary

Paxil

Paxil (paroxetine) is a selective serotonin reuptake inhibitor (SSRI) used to treat depression, anxiety disorders, panic disorder, PTSD, and OCD. It comes as an immediate-release tablet, extended-release tablet, or oral suspension, usually taken once daily.

Luvox

Luvox (fluvoxamine) is an SSRI that's FDA-approved specifically for obsessive-compulsive disorder in adults and children ages 8 and up. It's taken as an oral tablet once or twice daily depending on dose, and is sometimes used off-label for depression and anxiety.

Paxil vs. Luvox Side Effects

Paxil

Most common
nausea (up to 26%)
somnolence (up to 23%)
dry mouth (up to 18%)
asthenia (up to 15%)

Luvox

Most common
nausea (up to 40%)
somnolence (up to 27%)
headache (up to 35%)
insomnia (up to 35%)

Paxil vs. Luvox Dosage

Paxil

Dosage
Dosage Table
STAGE DOSE WHEN
Starting dose 20 mg once daily At the start
Maximum dose 50 mg once daily If needed
Dose changes 3 increases As tolerated

Luvox

Dosage
Dosage Table
STAGE DOSE WHEN
Starting dose 25 mg once daily At the start
Maximum dose 300 mg/day If needed
Dose changes 4 increases As tolerated

Paxil vs. Luvox Indications

Paxil

Paxil is FDA-approved to treat major depressive disorder, obsessive-compulsive disorder, panic disorder, social anxiety disorder, generalized anxiety disorder, and PTSD. It is not approved for use in children.

  • Major depressive disorder

  • Obsessive-compulsive disorder

  • Panic disorder

  • Social anxiety disorder

  • Generalized anxiety disorder and PTSD

Luvox

Luvox is FDA-approved only for obsessive-compulsive disorder, in both adults and children ages 8 to 17. Doctors sometimes prescribe it off-label for depression, social anxiety, or panic disorder, though these uses aren't FDA-approved.

  • OCD in adults (FDA-approved)

  • OCD in children ages 8-17 (FDA-approved)

  • Off-label for depression

  • Off-label for social anxiety disorder

  • Off-label for panic disorder

Paxil vs. Luvox Pros and Cons

Paxil

Paxil has one of the broadest FDA-approved indication lists among SSRIs, covering depression and several anxiety disorders. Its strong CYP2D6 inhibition means it can raise levels of many other medications, and its short half-life can make stopping it harder than other SSRIs.

Pros

  • FDA-approved for six different conditions

  • Available as tablet, extended-release, or liquid

  • Long history of use since 1992

Cons

  • Strong CYP2D6 inhibitor, affects many other drugs

  • Short half-life linked to harder discontinuation

  • Not approved for pediatric patients

  • Higher list price, roughly $300 to $310 per month without insurance

Luvox

Luvox's FDA approval is narrower, limited to OCD in adults and children, though it's often used off-label for depression and anxiety. It strongly inhibits CYP1A2 instead of CYP2D6, which changes which other drugs it interacts with, most notably caffeine.

Pros

  • FDA-approved for pediatric OCD starting at age 8

  • Available only as lower-cost generic

  • Substantially lower list price, roughly $15 to $170 per month without insurance

Cons

  • FDA-approved for only one condition, OCD

  • Potent CYP1A2 inhibitor, interacts with caffeine

  • Higher maintenance doses require twice-daily dosing

  • Brand-name product discontinued, generic only

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