Paxil vs. Luvox: Which One Should I Take?

Depression and anxiety disorders can make it challenging to think clearly, so comparing medications as similar as Paxil and Luvox can quickly become confusing. Managing a mental illness is already difficult enough without the added frustration of sifting through medical jargon. 

This comparison guide explains the advantages and disadvantages of each medication, including possible side effects, contraindications, and the conditions they treat. Understanding the differences between the two can help you have an informed discussion with your healthcare provider. 

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What is Paxil?

Known as paroxetine in its generic form, Paxil is part of a class of drugs known as selective serotonin reuptake inhibitors (SSRIs). These medications work by stopping receptors in the brain from absorbing serotonin, which boosts the amount of serotonin in the brain. 

Since serotonin is a key component in regulating mood, circadian rhythms, appetite, and the ability to focus, having more of it available can alleviate the symptoms of anxiety and depression. 

Common Doses and Forms of Paxil

Paxil is available via prescription as: 

• Tablets
• Extended-release (ER)  tablets
• Liquid suspension

Regular tablets work well for those taking a lower dose of Paxil or who feel comfortable taking multiple doses per day. ER tablets are better if you prefer the convenience of a once-daily pill, while the liquid form of Paxil is best if you have trouble swallowing pills. 

Both regular and ER tablets are scored and printed with the dosage on one side, with “Paxil” printed on the other. They’re color-coded according to dosage, as follows: 

• 10 mg yellow
• 20 mg pink
• 30 mg blue 
• 40 mg green 

The liquid form of Paxil is orange in both color and flavor and contains 10 mg of Paxil for every 5mL of liquid. 

Regardless of which type of Paxil you take, you’ll likely start with a dose of 20 mg and gradually increase it under your healthcare provider’s supervision to 50 mg daily.

Conditions Paxil Treats

Paxil is effective for treating a range of mood-related disorders and conditions. However, it’s only FDA-approved to treat depression. All other uses are off-label. 

Paxil Can Treat Symptoms of Anxiety and Depression

Depression and anxiety typically go hand-in-hand because both often result from a chemical imbalance in the brain. Low serotonin is associated with fatigue and listlessness but can also cause excessive nervousness, panic attacks, racing thoughts, and other anxiety symptoms. 

If you have either or both of these conditions, Paxil can help alleviate associated symptoms by balancing your brain chemistry. 

Off-Label Uses for Paxil

When a medication is prescribed off-label, it simply means that the medication hasn’t gone through the time-consuming FDA approval process for a specific use. It can still be ethically and safely prescribed to treat conditions other than those approved.

Off-label uses for Paxil include: 

• Obsessive-compulsive disorder (OCD)
• Menopausal symptoms
• Premenstrual dysphoric disorder (PMDD) 
• Anxiety and panic disorder

Paxil Costs

In general, brand-name Paxil costs significantly more than the generic version, paroxetine. A 30-day supply of each is typically priced as follows: 

• Paxil: up to $300
• Paroxetine: between $16 and $40

These prices may change depending on your dose, pharmacy, and insurance.

Paxil Side Effects

As your body acclimates to increased serotonin levels in the brain, you may experience mild to moderate side effects. Some side effects subside after a few weeks, while others may persist. If you’re experiencing continued negative side effects, speak with your healthcare provider to see if you should take an alternative medication or adjust your dose. 

Common side effects associated with Paxil include: 

• Changes in vision
• Weakness, drowsiness, or dizziness
• Sweating, anxiety, or shaking
• Insomnia
• Reduced appetite
• Nausea, vomiting, diarrhea, or constipation
• Dry mouth
• Headaches
• Sexual dysfunction 

Some rarer but more severe side effects could indicate the onset of a potentially deadly condition called serotonin syndrome. This condition occurs when too much serotonin builds up in your brain. 

Side effects associated with serotonin syndrome include: 

• Racing thoughts, requiring less sleep, manic euphoria
• Blurred or tunnel vision 
• Eye pain, swelling, or seeing halos around lights
• Bone pain or tenderness
• Swelling or easy bruising
• Unusual changes in weight or appetite
• Unusual bleeding from the nose, mouth, vagina, or rectum
• Coughing up blood;
• Rigid muscles, high fever, sweating
• Confusion, racing heart or arrhythmia, tremors, or fainting
• Severe headache and slurred speech 
• Severe weakness and reduced coordination

If you’re experiencing serotonin syndrome, contact emergency medical services immediately. 

Paxil Warnings

If you have any of the following conditions — or a family history of them — you should discuss them with your medical provider before taking Paxil:

• Heart disease or stroke
• High blood pressure
• Liver or kidney disease
• Bleeding disorders
• Epilepsy 
• Bipolar disorder 
• Sexual dysfunction
• Glaucoma
• Low blood sodium levels
• Substance abuse disorder

If you experience any changes in behavior or mood, like suicidal ideation or thoughts of self-harm, reach out to your healthcare provider right away. 

Paxil Drug Interactions

The following medications should not be combined with Paxil: 

• Monoamine oxidase inhibitors (MAOIs)
• Pimozide or other Tourette’s syndrome medications
• Thioridazine or other antipsychotic medications
• Stimulant medications, like Adderall
• Opioid-based painkillers
• Herbal supplements, such as St. John’s Wort
• Tryptophan

If your healthcare provider recommends that you replace your MAOI with Paxil, stop taking the MAOI for at least 14 days before starting Paxil.

What is Luvox?

Luvox is the brand name for the medication fluvoxamine. Like Paxil, Luvox is an SSRI that increases serotonin levels in the brain. More serotonin in the brain helps alleviate the symptoms of depression and anxiety, including mood swings, nervousness or apathy, reduced appetite, and insomnia.  

Common Doses and Forms of Luvox 

Luvox is available as a brand-name medication or in its generic form, fluvoxamine. Both versions are available in the following dosages: 

• 25 mg
• 50 mg
• 100 mg

Luvox may be prescribed to both children and adults. Adults 18 and over will start with a daily dose of 50 mg and increase it to 300 mg or more, per day, depending on the healthcare provider’s instruction. Children 8 to 17 typically take 25 mg at first, increasing it to a maximum of 200 mg daily. 

Conditions Luvox Treats

Luvox can treat various mood-related conditions via prescription, either on- or off-label. On-label, it’s FDA-approved to treat clinical depression and obsessive-compulsive disorder. 

Luvox Can Treat Symptoms of OCD and Depression

Insufficient serotonin levels can either cause a person to have very little energy or launch them into ritualistic or repetitive behaviors that the person experiences a sense of relief or reduced anxiety from performing those tasks , like that associated with obsessive-compulsive disorder. OCD is a condition characterized by irrational—sometimes paralyzing—fear, overwhelming intrusive thoughts, and compulsive behaviors meant to relieve internal symptoms. 

Since obsessive-compulsive disorder is related to anxiety, SSRIs are often effective in reducing or completely alleviating symptoms. Luvox can help reduce the fear and anxiety caused by OCD while simultaneously easing the apathy and low energy associated with depression. 

Off-Label Uses for Luvox

Like other SSRIs, Luvox is frequently prescribed off-label to treat conditions related to a chemical imbalance in the brain. These conditions include the following:

• Generalized anxiety disorder (GAD)
• Panic disorder and social phobias
• Borderline personality disorder (BPD)
• Various eating disorders

Luvox Costs

Pricing for brand-name Luvox varies significantly based on the pharmacy used, your insurance coverage, and available discounts. A 30-day supply may cost from $32 to over $400. Prices for its generic counterpart, fluvoxamine, remain relatively stable at $25 to $30 per month. 

Luvox Side Effects

Since Luvox alters your brain chemistry, it causes side effects similar to Paxil. Most should fade over time. Contact your healthcare provider immediately if you experience prolonged or severe side effects. 

The most common side effects of Luvox include: 

• Feeling dizzy, weak, sleepy, or tired
• Constipation, stomach pain, nausea, vomiting, diarrhea, or reduced appetite
• Dry mouth or change in taste
• Insomnia
• Headache or shakiness
• Excess gassiness
• Feeling nervous and easily startled
• Excessive sweating
• Common cold symptoms

Luvox may also cause an allergic reaction or dangerously low sodium. If you experience any of the following serious side effects, seek medical attention immediately: 

• Allergic reaction, including hives; swelling of the face, mouth, and throat; difficulty breathing
• Signs of low sodium, including headache, brain fog, weakness, seizures, or trouble balancing
• Coughing up or vomiting blood; blood in the urine or stool; unusual vaginal bleeding; bleeding that cannot be easily stopped
• Abnormal weight gain or loss
• Difficulty passing urine
• Sexual problems, such as difficulty orgasming or lowered sex drive
  • Erection lasting more than 4 hours
• Unusual menstrual flow

Serotonin syndrome may arise from taking any SSRI, including Luvox. If you experience any of the symptoms of serotonin syndrome listed under Paxil, seek medical help immediately. 

Luvox Warnings

Those with the following conditions or disorders should not take Luvox: 

• Bipolar disorder
• Bleeding problems
• Depression
• Glaucoma
• Heart attack or heart disease
• Heart rhythm problems
• Hyponatremia (low sodium in the blood)
• Mania (feeling elated)
• Seizures
• Liver disease

Luvox Drug Interactions

Luvox should not be taken in combination with the following drugs and supplements: 

• Monoamine oxidase inhibitors (MAOIs)
• Tourette’s syndrome medications, like pimozide
• Warfarin and other blood thinners
• Ibuprofen and other NSAIDs
• St. John’s Wort 
• Tryptophan
• Other SSRIs and antidepressants
• Stimulant medications like Adderall
• Certain pain or migraine medications

This is not an exhaustive list. Be sure to give your healthcare provider a complete list of your prescriptions and supplements.  

Habitual tobacco users should consider quitting before taking Luvox. 

Get Anxiety and Depression Treatment with Klarity

It’s no secret that mental healthcare can be difficult to access. Between finding a provider who can prescribe the right medication when medically necessary, waiting for an appointment, and carving out time to go, treatment can become more exhausting than the condition. 

At Klarity, we streamline this process to make it easier for you to get the best medication and the help you need. We’ll match you with a certified and licensed provider within 48 hours. All care is via telehealth, and you can message your provider 24/7. 

If you’re ready to receive convenient online treatment, find your provider today.

Frequently Asked Questions About Paxil and Luvox

Does Paxil Make You Gain Weight? Does Luvox?

Paxil is more likely to cause weight gain than Luvox. Most people taking Luvox don’t experience weight gain, while those taking higher doses of Paxil may notice some weight gain. 

Is Paxil or Luvox Better for Anxiety?

Paxil is more frequently prescribed off-label for anxiety than Luvox. However, Luvox is an effective treatment for OCD, an anxiety-related condition. If you tolerate Luvox better than Paxil, it can be prescribed to treat anxiety. 

Can I Replace Paxil with Luvox?

Yes, it’s safe to switch from one SSRI to another, though you should only do so under medical supervision. Your healthcare provider will help you replace Paxil with Luvox using one of two methods: 

• Cross taper method: You’ll gradually decrease your Paxil dosage while simultaneously taking a low dose of Luvox, increasing it as you taper off of the Paxil. 
• Direct taper method: You’ll taper off Paxil completely before starting a low dose of Luvox and gradually increasing it to a full dose. 

Is Paxil Energizing or Sedating? What About Luvox?

Both of these medications have sleepiness or daytime drowsiness as possible side effects. However, whether they’re sedating or energizing depends on what you’re treating. They’ll have a calming effect if you’re using them for anxiety. If you’re taking them for depression, you’ll likely feel more energized. 

Does Paxil Cause Brain Fog? Does Luvox?

The side effect of daytime drowsiness may cause brain fog for either of these medications. However, if your brain fog is severe or worsens over time, this may be a symptom of serotonin syndrome and should be addressed immediately. 

Can I Drink Alcohol On Paxil? On Luvox?

No, alcohol enhances the effects of SSRIs and vice versa. Drinking alcohol with these medications could cause seriously impaired thinking, decreased coordination, and other dangerous side effects. 

Can I Drink Caffeine When I’m on Paxil? How About Luvox?

Caffeine doesn’t interact negatively with SSRIs, so enjoying your favorite energizing beverages is safe. However, limiting your intake is best to avoid the onset of side effects like nervousness.

What Is Better For Depression—Paxil or Luvox?

Paxil and Luvox are both FDA-approved to treat depression, meaning they’re both safe and effective depression treatments. Which one you try will be based on your medical history, other medications you’re taking, and which one you tolerate better.