Paxil vs. Pexeva for Depression: Which Is Best?
Key takeaways:
Paxil and Pexeva are two brand names for the antidepressant paroxetine. They have similar effectiveness, side effects, and interactions.
Paxil and Pexeva are both available as immediate-release oral tablets. Paxil also comes as an oral liquid and an extended-release tablet.
Paxil and Pexeva are both available as brand-name medications. But you can also find Paxil as a lower-cost generic. GoodRx can help make your prescription more affordable.
Table of contents
If you’re living with depression, you may be taking an antidepressant. Often, selective serotonin reuptake inhibitors (SSRIs) are a first-choice medication for treating depression. Paroxetine is a commonly prescribed SSRI. But there are two brand names for this medication that can treat depression: Paxil and Pexeva.
When a medication has multiple brand names, you may wonder if one is better or has more side effects. If these questions have been on your mind, we’ve got you covered.
Let’s dive in and discuss the differences between Paxil and Pexeva.
Search and compare options
What is Paxil?
Paxil (paroxetine hydrochloride) is an SSRI. It was the original brand name for paroxetine and was first FDA-approved in 1992. It’s available as an immediate-release (IR) oral tablet and liquid. It also comes as an extended-release (ER) tablet called Paxil CR.
What conditions is Paxil approved to treat?
Paxil is FDA-approved for a number of health conditions. But its approved uses vary depending on the form.
The IR tablet and liquid are FDA-approved to treat:
Major depressive disorder (MDD, or “depression”)
Panic disorder (PD)
Social anxiety disorder (SAD)
Obsessive compulsive disorder (OCD)
Generalized anxiety disorder (GAD, or “anxiety”)
Post-traumatic stress disorder (PTSD)
Paxil CR is FDA-approved to treat:
MDD
PD
SAD
Premenstrual dysphoric disorder (PMDD)
What is Pexeva?
Pexeva (paroxetine mesylate) is also an SSRI. It contains a slightly different form of paroxetine than Paxil. But there’s no evidence that this chemical difference affects how the medication works in the body. Pexeva was FDA-approved in 2003. It only comes as an IR tablet.
Read more like this
Explore these related articles, suggested for readers like you.
What conditions is Pexeva approved to treat?
Pexeva is FDA-approved to treat the following mental health conditions:
MDD
OCD
PD
GAD
How do Paxil and Pexeva work for depression?
As mentioned above, Paxil and Pexeva are SSRIs that treat depression and other mental health conditions. This group of medications boosts levels of serotonin in the brain. Serotonin is a chemical messenger that’s believed to help regulate mood. Raising serotonin in the body is thought to help relieve symptoms of depression.
SSRIs are some of the safest and most effective depression medications. But they can take a few weeks to start relieving depression symptoms. So remember to be patient if you’re just starting Paxil or Pexeva.
How are Paxil and Pexeva taken?
Regardless of whether you’re taking Paxil or Pexeva, the dosage instructions are generally the same. It’s recommended to take your dose once a day in the morning. You can take it with or without food.
The available dosages vary depending on which form you’re taking. Paxil IR tablets and Pexeva are available in the following doses:
10 mg
20 mg
30 mg
40 mg
The liquid version of Paxil comes as a 10 mg/5 mL dosage. Paxil CR comes as 12.5 mg, 25 mg, and 37.5 mg tablets.
How effective are Paxil and Pexeva for depression?
Paxil and Pexeva are similarly effective for depression. There’s no evidence that one works better than the other.
In clinical trials, people taking paroxetine experienced significant improvement in depression symptoms compared to those taking a placebo (a pill with no medication in it).
Studies also showed long-term benefits of taking paroxetine. People who took the medication for an extended period of time (1 year) were less likely than those taking a placebo to have their symptoms worsen or return.
What are the known side effects of Paxil and Pexeva?
Regardless of whether you take Paxil or Pexeva, the possible side effects are the same. Compared to other SSRIs, they tend to cause more side effects overall.
Common side effects of Paxil and Pexeva include:
Nausea
Drowsiness
Trouble sleeping
Sexual side effects, like low libido or delayed ejaculation
Weakness
What are the serious side effects of Paxil and Pexeva?
All SSRIs are linked to more serious side effects, but they’re rare. It’s important to discuss these with your healthcare provider when first starting Paxil or Pexeva. They can let you know if your unique risks are higher, and ways to help catch these problems early.
Serious side effects of Paxil and Pexeva include:
Arrhythmias (abnormal heart rhythms)
A higher risk of bleeding, especially if you take blood thinners or nonsteroidal anti-inflammatory drugs (NSAIDs)
Serotonin syndrome (a condition caused by too much serotonin in the brain)
Suicidal thoughts or behaviors — the risk is higher for people younger than 25 years old
If you or someone you know is having thoughts of suicide, you’re not alone, and help is available. Call the National Suicide Prevention Lifeline at 988, or text HOME to 741-741 to reach the Crisis Text Line.
What interactions do Paxil and Pexeva have?
Because Paxil and Pexeva both contain paroxetine, they interact with the same medications and substances. Some of the most notable interactions include:
Monoamine oxidase inhibitors (MAOIs), such as selegiline (Zelapar, Emsam) and linezolid (Zyvox)
Serotonin and norepinephrine reuptake inhibitors (SNRIs), such as duloxetine (Cymbalta)
Triptan migraine medications, such as sumatriptan (Imitrex)
Opioids, such as tramadol (Ultram)
St. John’s wort, an over-the-counter herbal medication
Thioridazine
Pimozide
This isn’t a list of all possible interactions. Be sure to share a medication list with your healthcare provider and pharmacist. This can help them catch interactions before they happen.
How to save on Paxil and Pexeva
Paxil and Pexeva are available as brand-name medications. But you can also find Paxil as a lower-cost generic. GoodRx can help you navigate the many ways to save on your prescription.
Save with GoodRx. GoodRx can help you save over 80% off the average retail price of the generic version of Paxil. Generic Paxil’s price at certain pharmacies is as low as $10.00 with a free GoodRx discount.
Save with patient assistance programs. If you’re uninsured or underinsured, you may be eligible for Pexeva’s patient assistance program, which offers the medication at no charge. Patient assistance programs are also available for both brand-name and generic Paxil.
Can you take Paxil and Pexeva together for depression?
No. Both Paxil and Pexeva contain paroxetine. So taking both medications would be like taking a double dose of one of them. You should never take more paroxetine than what’s been prescribed for you. Taking more than what’s recommended can raise your risk of excessive or serious side effects.
The bottom line
Paxil and Pexeva are two different forms of the SSRI paroxetine. Both have similar effectiveness, side effects, and interactions. They’re also both taken once daily in the morning.
The biggest difference between Paxil and Pexeva lies in the dosage forms available. Both medications come as IR tablets. But Paxil also comes as an oral liquid and an ER tablet. Regardless of which form of paroxetine you take, you can expect similar results. Discuss whether Paxil or Pexeva is better for you with your healthcare provider.
Why trust our experts?
References
Apotex Corp. (2021). Paxil [package insert].
Apotex Corp. (2021). Paxil CR [package insert].
ClinCalc. (2020). Paroxetine.
Sebela Pharmaceuticals Inc. (2021). Pexeva [package insert].
U.S. Food and Drug Administration. (n.d.). FDA approved drugs: Apotex.
U.S. Food and Drug Administration. (n.d.). FDA approved drugs: Sebela Ireland LTD.
