Paxil vs Pexeva: Which Paroxetine Antidepressant Is Better?

Roni Shye
Roni Shye, PharmD BCGP BCACP, is a licensed pharmacist in the states of Florida, Ohio, and Pennsylvania.
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You or someone you know may suffer from anxiety, depression, or both. Anxiety and depression can be extremely debilitating with potential for negatively impacting a person’s daily life, but there are treatments that can help, including therapy and SSRI (selective serotonin reuptake inhibitor) medications like Paxil (paroxetine hydrochloride) and Pexeva (paroxetine mesylate).

What are Paxil and Pexeva prescribed to treat?
Pexeva is used to treat generalize anxiety disorder (GAD), major depressive disorder (MDD), obsessive compulsive disorder (OCD), and panic disorder (PD). Paxil is used for the same conditions, with the addition of post-traumatic stress disorder (PTSD) and social anxiety disorder.

How are Paxil and Pexeva available?
Pexeva is available as an immediate-release tablet in 10 mg, 20 mg, 30 mg, and 40 mg strengths.

Paxil is also available as an immediate-release tablet in 10 mg, 20 mg, 30 mg and 40 mg strengths—but it has additional options, including 12.5 mg 25 mg, and 37.5 mg extended-release tablets, and a 10 mg/5 mL oral liquid.

Is there a generic version?
Paxil immediate- and extended-release tablets are availalble as generic paroxetine. There is no generic equivalent for Pexeva.

So, what’s the difference? Are there any advantages to using Pexeva?

Not really. Pexeva first became available in the early 2000s as an alternative to Paxil, which at the time, did not have a generic and still cost a pretty penny. Although the active ingredients are slightly different forms of paroxetine, both drugs work in the same way.

Pexeva was introduced to offer a 30% savings over Paxil, so initially, Pexeva would have offered a lower-cost option for anyone taking Paxil or any of the other brand-only SSRIs.

Now though, generic Paxil is significantly less expensive and there is no generic for Pexeva—rendering Pexeva almost obsolete.

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