Paxil vs. Sertraline
See how Paxil and Sertraline compare on approved uses, dosing, side effects, and cost.
Key Takeaways
Paxil and sertraline are both SSRIs approved for major depressive disorder, OCD, panic disorder, and social anxiety disorder, but only Paxil covers generalized anxiety disorder and only sertraline covers PMDD.
Paxil has a shorter half-life than sertraline, which is linked to more noticeable withdrawal symptoms if a dose is missed or the drug is stopped abruptly.
Sertraline is widely available as a low-cost generic, while brand-name Paxil carries a much higher monthly list price.
Paxil vs. Sertraline Drug Summary
Paxil
Paxil (paroxetine) is a selective serotonin reuptake inhibitor (SSRI) used to treat major depressive disorder, obsessive-compulsive disorder, panic disorder, social anxiety disorder, generalized anxiety disorder, and post-traumatic stress disorder. It comes as an immediate-release tablet, an extended-release tablet (Paxil CR), and an oral suspension, all taken once daily. Paxil has been FDA-approved since 1992.
Sertraline
Sertraline is a selective serotonin reuptake inhibitor (SSRI) used to treat major depressive disorder, obsessive-compulsive disorder, panic disorder, post-traumatic stress disorder, social anxiety disorder, and premenstrual dysphoric disorder. It comes as a tablet, capsule, or oral solution, taken once daily. Sertraline is the generic form of Zoloft and has been sold as a generic since 2006.
Paxil vs. Sertraline Side Effects
Paxil
Sertraline
Paxil vs. Sertraline Dosage
Paxil
Sertraline
| 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 |
| STAGE | DOSE | WHEN |
| Starting dose | 50 mg once daily | At the start |
| Maximum dose | 200 mg once daily | If needed |
| Dose changes | 3 increases | As tolerated |
Paxil
| 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 |
Sertraline
| STAGE | DOSE | WHEN |
| Starting dose | 50 mg once daily | At the start |
| Maximum dose | 200 mg once daily | If needed |
| Dose changes | 3 increases | As tolerated |
Paxil vs. Sertraline Indications
Paxil
Paxil is approved for major depressive disorder, OCD, panic disorder, social anxiety disorder, generalized anxiety disorder, and PTSD. It is the only drug of this pair with an FDA approval for generalized anxiety disorder. Paxil is not approved for use in children or teens.
Major depressive disorder
Obsessive-compulsive disorder
Panic disorder
Social anxiety disorder
Generalized anxiety disorder
Sertraline
Sertraline covers most of the same conditions as Paxil, plus premenstrual dysphoric disorder, which Paxil does not carry as an indication. It does not have an FDA approval for generalized anxiety disorder. Sertraline's OCD approval also extends to children ages 6 and up.
Major depressive disorder
Obsessive-compulsive disorder
Panic disorder
Post-traumatic stress disorder
Premenstrual dysphoric disorder
Paxil vs. Sertraline Pros and Cons
Paxil
Paxil offers coverage for generalized anxiety disorder that sertraline lacks, plus extended-release and liquid options for dosing flexibility. Its strong effect on the CYP2D6 liver enzyme means it interacts with many other medications, and stopping it abruptly can trigger more noticeable withdrawal symptoms than some other SSRIs.
Pros
Only SSRI here approved for generalized anxiety disorder
Available as extended-release tablet or oral suspension
Long track record dating back to 1992 approval
Cons
Strong CYP2D6 inhibitor, more drug interactions
Short half-life makes withdrawal symptoms more likely
Not approved for use in anyone under 18
Sertraline
Sertraline treats PMDD, an indication Paxil does not carry, and has pediatric approval for OCD starting at age 6. It carries less drug-interaction risk than Paxil and tends to be easier to stop, though sexual side effects and diarrhea show up more often on its label.
Pros
Only SSRI here approved for PMDD
Pediatric OCD approval starting at age 6
Weaker CYP2D6 inhibition means fewer drug interactions
Cons
Not approved for generalized anxiety disorder
Diarrhea more common than with Paxil
Sexual side effects, including ejaculation failure, common in men
Common Symptoms and Related Diseases You Can Explore
Explore a range of common symptoms the Doctronic Symptom Checker can help you understand.