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Paxil vs. Lexapro

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

Key takeaways

Paroxetine (Paxil) and escitalopram (Lexapro) are both selective serotonin reuptake inhibitors (SSRIs) used to treat depression and anxiety. However, they have some important differences. Paroxetine is available in both immediate-release and extended-release forms and is also approved for panic disorder, social anxiety disorder, obsessive-compulsive disorder, post-traumatic stress disorder, and premenstrual dysphoric disorder. Escitalopram, on the other hand, is specifically approved for depression and generalized anxiety disorder (GAD), but may be used off-label for other mental health conditions. Paroxetine can cause weight gain and sexual problems more frequently than escitalopram, which is generally considered to have fewer side effects than many other antidepressants. Both medications can cause withdrawal symptoms if stopped suddenly. Both medications are available as a brand and a lower-cost generic.

Paroxetine

(Paxil)

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Escitalopram

(Lexapro)

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Summary for Paxil

Prescription only

Paroxetine (also known by it's brand name Paxil) is a selective serotonin reuptake inhibitor (SSRI), used for different types of anxiety problems and depression. It's available as a brand name and generic version, and it comes as an immediate-release tablet, an oral suspension, and an extended-release tablet. Possible side effects include nausea, sexual side effects, and weight gain. It can also cause withdrawal symptoms (e.g., headache, trouble sleeping, anxiety) if you suddenly stop taking it.

Indications for Paxil

Pros and Cons for Paxil

Pros

  • Only needs to be taken once daily
  • Available as a tablet and oral liquid
  • Can be taken with or without food
  • Can be used for many different mental health conditions
  • Can be helpful for people who have both anxiety and depression

Cons

Common Side Effects for Paxil

  • Abnormal ejaculation (up to 28%)
  • Nausea (up to 25%)
  • Weakness (up to 22%)
  • Sleepiness or trouble sleeping (up to 24%)
  • Dry mouth (up to 18%)
  • Constipation (up to 16%)
  • Sweating (up to 14%)
  • Dizziness (up to 14%)
  • Diarrhea (up to 12%)
  • Low libido (up to 12%)
  • Shakiness (up to 11%)

Warnings for Paxil

  • Worsening depression, suicidal thoughts, and unusual behavior
  • Serotonin syndrome
  • Risk of harm to unborn babies
  • Sexual problems
  • Withdrawal
  • Risk of bleeding
  • Not for use alone in bipolar disorder
  • Glaucoma
  • Low blood sodium levels
  • Seizures
  • Risk of abnormal heart rhythm from interactions

Summary for Lexapro

Prescription only

Escitalopram, also known by its brand name, Lexapro, is a selective serotonin reuptake inhibitor (SSRI). It's a first-choice antidepressant to treat depression and anxiety in adults and children. The medication is available as a tablet and oral solution, in both brand and generic forms. A dose is typically taken by mouth once per day. Some common side effects include nausea, trouble sleeping (insomnia), and dizziness.

Indications for Lexapro

Pros and Cons for Lexapro

Pros

  • First-choice medication for anxiety and depression
  • Only need to take it once a day
  • Generally has fewer side effects compared to other antidepressants
  • Can be taken with or without food

Cons

  • Can take up to 2 months before you feel the the full benefits
  • Risk of certain sexual problems
  • Can raise your risk for bleeds
  • Can cause withdrawal symptoms if you suddenly stop taking it

Common Side Effects for Lexapro

  • Headache (24%)
  • Nausea (15-18%)
  • Ejaculation problems (9-14%)
  • Sleepiness (6-13%)
  • Trouble sleeping (9-12%)
  • Dry mouth (6-9%)
  • Diarrhea (8%)
  • Tiredness (5-8%)

Warnings for Lexapro

  • Worsening depression, suicidal thoughts, and unusual behavior
  • Serotonin syndrome
  • Stopping escitalopram (Lexapro) too suddenly
  • Risk of bleeding
  • Not for use alone in bipolar disorder
  • Glaucoma
  • Life-threatening abnormal heart rhythm (QT prolongation)
  • Low blood sodium levels
  • Sexual problems

Prices with our coupons for Paxil vs. Lexapro

Price Card Drug Icon
Paroxetine90 tablets / 20mg
$10.00$10.00
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Escitalopram30 tablets / 10mg
$9.51$17.33
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