Paxil (paroxetine) is an antidepressant in the class of drugs known as selective serotonin reuptake inhibitors (SSRIs). These drugs are commonly used to treat several mental health conditions, including major depressive disorder (MDD), generalized anxiety disorder (GAD), obsessive-compulsive disorder (OCD), panic disorder, and post-traumatic stress disorder (PTSD). Paxil is also sometimes used to treat premenstrual dysphoric disorder (PMDD).
Although Paxil is widely prescribed and known for its efficacy, it’s not suitable for everyone. For some, it simply doesn’t work well — others might have concerns about the side effects of Paxil. There’s also been a recent uptick in interest and desire for holistic treatments or more natural approaches to treating mental health.
Whatever the reason, keep reading if you’re looking for alternatives to Paxil. We’re discussing everything you need to know and addressing considerations you should be aware of before you switch to a Paxil alternative for anxiety, depression, or any other condition.
If Paxil isn’t working well for you, or if the side effects outweigh the benefits you’re seeing, talk to your doctor about switching to a new drug. They may suggest a different SSRI or want you to try a medication in another drug class. Just be sure to communicate with your doctor as you try new drugs, and keep in mind, if you experience severe side effects from one type of SSRI, you might have similar issues with another.
Drug choice isn’t a one-size-fits-all solution, so sometimes, it can take a while to find the best medication to treat your condition. Be patient as you work through the process of looking for alternatives to Paxil.
1. Xanax (Alprazolam)
Xanax is in a different class of drugs, known as benzodiazepines (or benzos), so it can be a preferred choice if side effects are a concern for people taking Paxil for anxiety. Benzos (like Xanax) work by increasing levels of the neurotransmitter GABA in the brain to induce relaxation.
It’s important to note that Xanax is addictive, and withdrawal symptoms might be more severe than with other anti-anxiety medications. Xanax also has known interactions with other drugs, so it’s important to discuss everything you’re taking with your doctor — both prescription and over-the-counter (OTC) — so they can determine if Xanax might be a safe alternative to Paxil.
Xanax is used to treat:
Anxiety
Panic disorder
Generalized anxiety disorder (GAD)
Xanax off-label uses:
Fear of flying
Depression
Obsessive-compulsive disorder (OCD)
Pain
Post-traumatic stress disorder (PTSD)
Common side effects of Xanax include:
Dry mouth
Constipation
Drowsiness or fatigue
Weight gain or weight loss
Blurred vision
Decreased libido
Change in appetite
2. Buspirone
Buspirone (often known as Buspar) is an anti-anxiety medication in the class of drugs known as anxiolytics. Buspirone works by altering chemical levels in the brain. It can be prescribed for the treatment of anxiety and can reduce feelings of irritation.
While it’s not FDA-approved to treat depression, some research suggests Buspirone might enhance the efficacy of some antidepressants. Some people prefer Buspirone because it tends not to have the sedative effects that many other anxiety medications are known for.
Buspirone is used to treat:
Generalized anxiety disorder (GAD)
Short-term anxiety relief
Panic disorder
Buspirone off-label uses:
Augmentation of unipolar depression
Tardive dyskinesia
Bruxism
Post-traumatic stress disorder (PTSD)
PMS syndrome
Common side effects of Buspirone include:
Headache
Nausea
Dizziness
Fatigue
Nausea or diarrhea
Confusion
3. Zoloft (sertraline)
Zoloft (sertraline) is a popular medication used to treat some mood disorders and depression. Like Paxil, Zoloft is also in the selective serotonin reuptake inhibitor (SSRI) class of drugs and works by increasing serotonin levels in the brain.
If Paxil isn’t having the desired effect you’re seeking, your doctor might suggest trying Zoloft.
Zoloft is used to treat:
Major depressive disorder (MDD)
Panic disorder
Obsessive-compulsive disorder (OCD)
Social anxiety disorder
Post-traumatic stress disorder (PTSD)
Premenstrual dysphoric disorder (PMDD)
Zoloft off-label uses:
Generalized anxiety disorder (GAD)
Autism
Personality disorders
Disordered eating
Common side effects of Zoloft include:
Dry mouth
Nausea or vomiting
Weight change
Dizziness or lightheadedness
Diarrhea
Headache
Sexual side effects
Drug
Generic
Class of Drugs
Conditions Can Treat
Common Side Effects
Xanax
alprazolam
Benzodiazepine
Generalized anxiety disorder (GAD)
Panic disorder
Dry mouth
Constipation
Drowsiness or fatigue
Weight gain or weight loss
Blurred vision
Decreased libido
Change in appetite
Buspirone
(no brand name – Buspirone is the generic version)
Anxiolytics
Generalized anxiety disorder (GAD)
Short-term anxiety relief
Panic disorder
Headache
Nausea
Dizziness
Fatigue
Nausea or diarrhea
Confusion
Zoloft
sertraline
SSRI
Major depressive disorder (MDD)
Panic disorder
Obsessive-compulsive disorder (OCD)
Social anxiety disorder
Post-traumatic stress disorder (PTSD)
Premenstrual dysphoric disorder (PMDD)
Dry mouth
Nausea or vomiting
Weight change
Dizziness or lightheadedness
Diarrhea
Headache
Sexual side effects
If you’re looking for natural alternatives to Paxil, you have several options to consider. Many of these have gained traction in recent years and work well for some people.
You can only decide to switch from Paxil with the help and guidance of your doctor. Discuss the following non-drug options with your healthcare provider to see if one might be a good Paxil alternative for anxiety.
4. Talk therapy
Talk therapy, also known as psychotherapy, is an excellent treatment option for mental health conditions. In studies, using talk therapy in combination with medication produced optimal results that were far superior to using one or the other on its own.
“Talk therapy can be helpful in examining the relationship between your thoughts and behavior. It also can help with understanding the root of your symptoms and which coping skills to use to feel better. “
– Talkspace psychiatrist Dr. Dion Metzger, MD
Cognitive behavioral therapy (CBT) is a first-line treatment for both depression and anxiety. CBT works by helping you identify unhealthy or unhelpful behavior and thought processes so that you can learn coping tools to change them.
5. Lifestyle changes
Making simple lifestyle changes — like committing to a healthy diet, working out, and maintaining a consistent sleep habit — can do wonders for the mind and body.
While for some people, these alone may not be enough to fully treat anxiety or depression, when used to supplement other components of a treatment plan, adjustments to your lifestyle can offer significant results.
6. L-theanine
The amino acid L-theanine can be found in green tea leaves and has become a popular alternative in treating stress and anxiety. It’s known for its calming properties, and studies show it can offer anxiety and stress relief in some people while enhancing sleep quality and mood.
7. Omega-3 fatty acids
Omega-3 fatty acids are an often-used supplement that’s believed to support mental health and offer heart health benefits. According to research, Omega-3s were found to reduce depression and anxiety symptoms in some people.
Omega-3 fatty acids are found naturally in food sources — like oily fish such as salmon and sardines and in eggs and nuts — and they can also be taken in pill-form supplements.
8. S-Adenosyl-L-Methionine (SAMe)
SAMe is a dietary supplement that might be able to raise serotonin levels naturally. Serotonin is an essential neurotransmitter in the brain that’s associated with emotion regulation. While more research is needed, dozens of studies suggest that SAMe could potentially help treat depressive symptoms.
Before you make any decisions about switching from Paxil to something else, you should talk to your doctor. Quitting any medication suddenly can cause symptoms, so be sure to safely taper off through your doctor’s instruction to avoid Paxil withdrawal. They can guide you safely through the process as you explore Paxil alternatives.
With your doctor, you’ll review key factors that may come into play as you try to wean off Paxil, including:
Your health history: Your overall physical condition can affect how well alternative treatment plans might work for you.
Your condition: The specific mental health condition you’re treating with Paxil will influence what alternative options might be best.
Risk vs benefit analysis: All medications carry some risk. Understanding the trade-off of risk vs benefit will be crucial in deciding a new treatment plan.
When it comes to finding an alternative to Paxil, you want a trusted resource you’re confident you can rely on. Talkspace can be your partner as you navigate this journey.
Our online psychiatrists can provide medication management and treatment. If you’re ready to start the process of finding the best treatment plan, reach out to Talkspace today — you don’t have to go through this alone.
Sources:
Questions and answers about the NIMH sequenced treatment alternatives to relieve depression (STAR*d) study – all medication levels. National Institute of Mental Health. 2006. Accessed October 23, 2023. https://www.nimh.nih.gov/funding/clinical-research/practical/stard/allmedicationlevels.
Cuijpers P, Sijbrandij M, Koole SL, Andersson G, Beekman AT, Reynolds CF. Adding psychotherapy to antidepressant medication in depression and anxiety disorders: A meta-analysis. World Psychiatry. 2014;13(1):56-67. doi:10.1002/wps.20089. Cuijpers P, Sijbrandij M, Koole SL, Andersson G, Beekman AT, Reynolds CF. Adding psychotherapy to antidepressant medication in depression and anxiety disorders: A meta-analysis. World Psychiatry. 2014;13(1):56-67. doi:10.1002/wps.20089. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3918025/. Accessed October 23, 2023.
White D, de Klerk S, Woods W, Gondalia S, Noonan C, Scholey A. Anti-stress, behavioural and magnetoencephalography effects of an L-theanine-based nutrient drink: A randomised, double-blind, placebo-controlled, crossover trial. Nutrients. 2016;8(1):53. doi:10.3390/nu8010053. https://www.mdpi.com/2072-6643/8/1/53. Accessed October 23, 2023.
Larrieu T, Layé S. Food for mood: Relevance of nutritional omega-3 fatty acids for depression and anxiety. Frontiers in Physiology. 2018;9. doi:10.3389/fphys.2018.01047. https://www.frontiersin.org/articles/10.3389/fphys.2018.01047/full. Accessed October 23, 2023.
Carpenter DJ. St. John’s wort and S-adenosyl methionine as “natural” alternatives to conventional antidepressants in the era of the suicidality boxed warning: what is the evidence for clinically relevant benefit?. Altern Med Rev. 2011;16(1):17-39. https://pubmed.ncbi.nlm.nih.gov/21438644/. Accessed October 23, 2023.
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