Drug vs. Drug

Paxil vs Prozac: Main Differences and Similarities

SingleCare Logo for author page By | April 3, 2019

Paxil (paroxetine) and Prozac (fluoxetine) are two prescription medications used to treat depression and other psychiatric disorders. Both medications work as selective serotonin reuptake inhibitors (SSRIs). They essentially increase the amount of serotonin in the brain to exert antidepressant effects. Although they are in the same drug class, they have some differences.

Paxil

Paxil is also known as paroxetine. Like other SSRIs, Paxil is primarily used to treat depression in adults. It can also treat other conditions such as anxiety, obsessive compulsive disorder (OCD), post-traumatic stress disorder (PTSD), and other panic disorders. Paxil has a half-life of 21 hours and may need a few weeks to start producing maximum effects.

Paxil can be purchased as a brand name or generic drug. It can be taken as a 10 mg, 20 mg, 30 mg, and 40 mg oral tablet. A 2 mg/1 mL oral suspension is also available. Paxil may need to be adjusted in those with liver or kidney problems.

Prozac

Prozac is known by its generic name, fluoxetine. Unlike Paxil, Prozac can treat depression in adults and children aged 8 years and older. It can also treat obsessive compulsive disorder (OCD), panic disorders, and bulimia nervosa. Prozac has a very long half-life of 4 to 6 days. While it may have less withdrawal effects after discontinuation, it can increase the risk of lingering side effects, particularly in the elderly.

Prozac comes in capsules with strengths of 10 mg, 20 mg, and 40 mg. There are also 90 mg delayed release capsules available. Those with liver problems may need a lower dose of Prozac to prevent the risk of increased side effects.

Paxil vs Prozac Side by Side Comparison

Paxil and Prozac are similar SSRIs that work in unique ways. Their features can be found in the comparison table below.

Paxil Prozac
Prescribed For
  • Major Depressive Disorder (MDD)
  • Obsessive Compulsive Disorder (OCD)
  • Panic Disorder (PD)
  • Post-Traumatic Stress Disorder (PTSD)
  • Social Anxiety Disorder (SAD)
  • Major Depressive Disorder (MDD)
  • Obsessive Compulsive Disorder (OCD)
  • Panic Disorder (PD)
  • Bulimia Nervosa
Drug Classification
  • Selective Serotonin Reuptake Inhibitor (SSRI)
  • Selective Serotonin Reuptake Inhibitor (SSRI)
Manufacturer
Common Side Effects
  • Insomnia
  • Nausea
  • Increased sweating
  • Fatigue
  • Somnolence
  • Decreased libido
  • Ejaculation Disorder
  • Anorgasmia
  • Dizziness
  • Agitation
  • Shaking
  • Diarrhea
  • Dry mouth
  • Decreased appetite
  • Insomnia
  • Nausea
  • Increased sweating
  • Fatigue
  • Somnolence
  • Decreased libido
  • Ejaculation Disorder
  • Anorgasmia
  • Dizziness
  • Headache
  • Indigestion
  • Agitation
  • Shaking
  • Diarrhea
Is there a generic?
Is it covered by insurance?
  • Varies according to your provider
  • Varies according to your provider
Dosage Forms
  • Oral tablet
  • Oral suspension
  • Oral capsule
  • Oral capsule, delayed release
Average Cash Price
  • $226 per 30 tablets
  • $39 per 6 tablets
SingleCare Discount Price
Drug Interactions
  • MAO inhibitors (isocarboxazid, phenelzine, selegiline, tranylcypromine)
  • Tricyclic antidepressants (amitriptyline, nortriptyline, imipramine)
  • CYP2D6 inhibitors/substrates
  • Pimozide
  • Other SSRIs
  • SNRIs
  • Amiodarone
  • Triptans
  • Fentanyl
  • Lithium
  • Tramadol
  • Buspirone
  • Theophylline
  • St. John’s Wort
  • NSAIDs
  • Aspirin
  • Warfarin
  • Cimetidine
  • Lamotrigine
  • Phenytoin
  • Carbamazepine
  • Zolpidem
  • MAO inhibitors (isocarboxazid, phenelzine, selegiline, tranylcypromine)
  • Tricyclic antidepressants (amitriptyline, nortriptyline, imipramine)
  • CYP2D6 inhibitors/substrates
  • Pimozide
  • Other SSRIs
  • SNRIs
  • Amiodarone
  • Triptans
  • Fentanyl
  • Lithium
  • Tramadol
  • Buspirone
  • Amphetamines
  • St. John’s Wort
  • NSAIDs
  • Aspirin
  • Warfarin
  • Cimetidine
  • Ginkgo
  • Lamotrigine
  • Phenytoin
  • Carbamazepine
  • Zolpidem
Can I use while planning pregnancy, pregnant, or breastfeeding?
  • Paxil is in Pregnancy Category D. Paxil should not be taken during pregnancy. Consult a doctor regarding steps to take while planning pregnancy or breastfeeding.
  • Prozac is Pregnancy Category C. Animal studies have shown adverse effects to the fetus. Adequate studies have not been performed in humans. Consult a doctor regarding steps to take while pregnant and breastfeeding.

Summary

Paxil (paroxetine) and Prozac (fluoxetine) are SSRI medications prescribed for depression and other psychiatric disorders. They both work in similar ways with some slight differences in use. Paxil can treat depression in adults while Prozac is also approved to treat depression children aged 8 years and older. Paxil can treat PTSD and anxiety disorders while Prozac can treat bulimia.

Compared to Paxil and other SSRIs, Prozac has an extensive half-life. This means that Prozac may have prolonged effects in some people. Prozac may also have more stimulating side effects compared to Paxil. Therefore, Paxil may be better for those who take their medicines at bedtime.

Both Paxil and Prozac may take at least a week to show improvements in mood. As SSRIs, they also have similar interactions with other drugs such as monoamine oxidase (MAO) inhibitors. Despite their similarities, both drugs should be reviewed with your doctor. The information presented here is meant for educational purposes and should be evaluated by your doctor to find the best treatment for you.