Paxil vs Xanax: Which Is The Better Anxiolytic?

Anxiety is an issue everyone deals with at some point in their lives. You can have anxiety before taking an exam or before going for an interview.

However, anxiety becomes a worrying issue when you are always feeling uncomfortable, disturbed, and on the edge; carrying out daily chores without worry seems like an impossible task. This is when anti-anxiety pills play their role and you start comparing Paxil vs Xanax. Let me explain why.

Nevertheless, anxiolytic medicines come with many side effects which makes it all the more important to choose the right medicine to treat your symptoms. Paxil and Xanax are the most commonly prescribed drugs- two drug choices that can be very confusing. Read further to clear your idea and choose what’s best to alleviate your symptoms.

How do Paxil and Xanax act?

Paxil or paroxetine is a long-acting drug and a selective serotonin reuptake inhibitor. It increases the amount of the hormone serotonin in the body. Serotonin is also known as the “feel-good hormone” because it is responsible for controlling our mood swings and keeping us happy. It is also a precursor for a neurotransmitter called melatonin which regulates the body’s sleep-wake cycle.

On the other hand, Xanax or alprazolam is a benzodiazepine that increases the amount of a neurotransmitter called gamma-aminobutyric acid(GABA) in the brain producing a calming effect. Xanax has the quickest onset of action (5-10minutes) amongst the benzodiazepines. It is a fast-acting drug with a relatively short duration of action (2-3hrs).

What is good about Paxil?

Paxil reduces the uptake of serotonin in the body and increases the level of serotonin in the body, it helps in improving your mood, appetite, energy level and overall helps restore daily lifestyle. It also helps in re-establishing your messed-up sleep routine. Paxil also decreases fear and the number of panic attacks; all of which are major problems when you’re dealing with anxiety.

paxil vs xanax

Since Paxil is a long-acting drug, it can take several weeks to be effective. This gives Paxil an added advantage of having a reduced risk of developing drug dependency.

What is good about Xanax?

Xanax slows down the nervous system which brings tranquility and relaxes your body. The relaxing feeling helps people sleep peacefully which is a rising concern for people suffering from chronic anxiety. It is more effective if it’s taken between 45 minutes to 2 hours before sleeping. Xanax also helps you pay attention, focus, and concentrate.

paxil vs xanax

Treatment specifications

Paxil is used in the primary treatment of depression and anxiety as an element of depressive disorders. Paxil is also used to treat social anxiety, post-traumatic stress disorders, obsessive-compulsive disorders(OCD), and chronic panic attacks. However, Paxil’s use is not focused on treating anxiety particularly but anxiety associated with depression.

OCD and HOCD Are Not The Same. Want To Know How?

However, Xanax is used to treat anxiety and chronic anxiety disorders such as general anxiety disorders(GAD) and insomnia. Xanax is particularly handy in acute situations and gives short-term relief in crises. It can help you get through that job interview that’s making your heart pound or the plane flight you’ve been fearing.

Paxil vs Xanax: Which One is Better?

The main disadvantage of taking Paxil is that it takes a long time to act and after a few weeks of waiting for the drug to act, you might realize that the drug is not going to be effective. While you’re waiting for the drug to work, side effects like a disturbance in the sleep-wake cycle resulting in both too much sleep or too little sleep will kick in.

This in turn results in fatigue, restlessness, nausea, and headaches. It can also cause weight gain which will put a toll on your mental health. More severe side effects include having sexual problems like low sex drive and even impotency.

It can also make you have suicidal thoughts. In most cases, the side effects go away a few weeks after taking the medication properly. However, please seek help or consult your doctor to change your medications if you’re experiencing any of the severe side effects.

Serotonin syndrome

Serotonin syndrome is a serious complication that can occur often when you’re taking Paxil for a long time increasing the level of serotonin in the body to a toxic level. It can cause shivering, confusion, twitching of muscles, hypertension, tremor, etc. Discontinuing Paxil or any other offending agents will eventually solve the problem.

However, sometimes it’s difficult to realize the cause behind your symptoms which can cause more severe symptoms like high fever, slurred speech, agitation, and abnormal bowel sounds. Severe symptoms as such is a hospital emergency so if you’re experiencing any of the above, please contact the nearest hospital and discontinue any medications you’re taking.

Xanax, on the other hand, is cheaper than Paxil and causes less severe side effects like drowsiness, tiredness, memory problems, headache, nausea, vomiting. It gives an almost immediate effect which is required when you’re anxious about something. I mean, what’s the point of taking a drug if it’s not going to make you feel better when you need it to.

That being said, because Xanax results in such an immediate calming effect, there’s a high chance of drug abuse and hence, addiction. Consuming Xanax over a long period also causes the body to develop a tolerance for the drug which will make you take the drug in an increasingly higher dose every day.

Thus, leading to addiction. Xanax addiction causes severe effects and is very likely to bring back the anxiety it helped you deal with so effectively in the first place. Let’s consider the medication addiction before comparing Paxil vs Xanax.

Xanax addiction

Xanax addiction is a very common but alarming condition. You might be taking Xanax just as prescribed and still get addicted by developing tolerance. Signs and symptoms include delirium, cognitive impairment, drowsiness, impaired coordination, etc. It can also cause withdrawal symptoms like dizziness, uncontrollable vomiting, rapid heart rate, and a state of constant panic.

Ways to avoid addiction-

Conjugate Xanax intake with therapy

Xanax intake without therapy has a high risk of developing an addiction. Anxiety can be decreased drastically by sharing your fears and thoughts with a counselor. So, don’t hesitate to talk to someone.

Take Xanax on an “as needed” basis

Take the pill only as prescribed or when there’s no way to avoid taking the drug. Consult your doctor as soon as the medicine is over to change the drug. Don’t take any extra pills.

Taper off when done

Don’t stop taking the medicine abruptly. Decrease the dose with time and stop gradually. This way, you won’t experience any of the withdrawal symptoms and extra urge for going back to taking the drug.

Use generic or extended-release Xanax

Many psychiatrists suggest that neither Paxil nor Xanax has a take on anxiety. Generic or slow-release Xanax increases the duration of action reducing the constant requirement of the drug. Thus, reducing the chance of abuse or addiction.

Don’t stop taking the drug when you feel good

Continue taking the drug just because you feel good and relieved of anxiety. Complete the dosing schedule as prescribed but don’t take any extra pills either.

Don’t miss any dose

This is something you have to be careful with no matter which antidepressants or anti-anxiety medicine but particularly with Xanax since it’s a highly addictive drug.

When you miss a dose, there’s a high chance that you’re going to feel more anxious than you usually do and end up taking a higher dose than required. This will lead to tolerance and hence, addiction.

Dangers of Xanax

Xanax can also cause adverse drug reactions when not taken with precautions. Before you compare Paxil vs Xanax consider the things to avoid when taking Xanax-

Avoid alcohol consumption with Xanax

Even a little bit of alcohol consumption can cause major drug reactions as alcohol causes central nervous system depression and so does Xanax. It can cause severe symptoms and even coma.

avoid alcohol while comparing Paxil vs Xanax

Avoid drinking grapefruit drinks

Grapefruit juice or grape-containing drinks affects liver enzymes reducing Xanax metabolism and hence increasing the duration of action of stay of Xanax in the body.

Don’t take Xanax during pregnancy

Avoid taking the drug during the second and third trimester of pregnancy as it will cause withdrawal symptoms in the baby.

Avoid smoking or drugs like marijuana

The cause behind the effect hasn’t been identified yet but some harmful effects have been recorded when they are mixed in high doses.

Avoid caffeinated drinks

This causes a very mild reaction but if you’re taking Xanax to help you sleep then it’s best to avoid coffee or caffeinated drinks as caffeine will oppose the purpose of taking Xanax.

How effective is combining the two drugs?

If you have symptoms of depression and anxiety associated with depression, some doctors might prescribe both Paxil and Xanax for better effect. However, it depends on what works best for you.

For some, the combination of both drugs at a low dose works best where Paxil is given as a maintenance dose and Xanax for acute reactions. Some may find only either drug to be helpful. Discuss your symptoms and the effect of your drug with your doctor to continue.


The real question is not Paxil vs Xanax but what works best for you. Both the drugs come with their share of advantages and disadvantages but which is the better anxiolytic will vary for every individual.

If a basic outline is to be given, Xanax is the better choice of drug, if taken properly, for combatting anxiety. However, it will vary for every individual so a doctor’s discretion is required.


What is better than Paxil for anxiety?

There are a few options that work better than Paxil. Selective Norepinephrine Inhibitors (SNRIs) can also treat generalized anxiety just like Paxil. Drugs like Effexor XR (venlafaxine) and Cymbalta (duloxetine) are included in the SNRIs group.

Can Paxil and Xanax be taken at the same time?

Taking Paxil and Xanax cannot be a good idea. The combined effect can increase the side effects like confusion, lack of concentration, drowsiness, or dizziness. Aged people may suffer severe motor coordination or judgment impairment.

Is Paxil a good medication for anxiety?

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Yes, Paxil is an FDA-approved medication for anxiety. Despite some side effects, Paxil is highly effective against panic disorder, anxiety disorder, or social phobia.

Does Paxil calm you down?

Drugs like Paxil falls into the Selective Serotonin Reuptake Inhibitors (SSRIs) group. Medications in these groups may improve neuroticism and lower the extraversion levels that will calm any person with depression.

Hey! My name is Shaila. I am a fourth-year medical student all the way from Malaysia. Apart from meeting the patients in the ward, I would love to engage with the readers by writing out articles during my leisure time. Content writing has always had a soft spot in me, as I love spilling out my thoughts that I could actually put into words. I also keep up with my blog on the medical school lifestyle. In fact, writing isn't a hobby, it is a blessing.

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