Table of contents


22 min read

Celexa vs. Paxil: Which One Should I Take?

Written by Klarity Editorial Team

Published: Dec 21, 2022

Medically Reviewed by Dr. Zoe Russell

Table of contents

Depression and anxiety disorders are complex conditions that affect each individual differently, so choosing the right medication is important. You deserve to find relief, but where do you start? Klarity can help. 

If you’re taking Celexa or Paxil or are wondering about switching from one to the other, we’ve got you covered. In this comparison guide, we’ll identify the similarities and differences between the two so you can have an informed discussion with your healthcare provider.

At Klarity, we understand that finding the right treatment for anxiety and depression can be overwhelming, which is why we offer access to convenient telehealth services to make it easier. Schedule an appointment, and we’ll connect you with a licensed healthcare professional who will determine the best medication for your symptoms. 

This article discusses suicide, suicidal ideation, and self-harm. If you or someone you know is experiencing suicidal thoughts or is in crisis, contact the Suicide Prevention Lifeline immediately at 800-273-8255.

Drug ClassSelective serotonin reuptake inhibitor (SSRI)Selective serotonin reuptake inhibitor (SSRI)
Brand / Generic StatusBrand name for paroxetine

Brand name for citalopram
Form(s) of the Drug• Color-coded tablets
• Time-release tablets
• Orange-colored and flavored liquid suspension
• Oval capsules
• Round tablets
• Clear, peppermint-flavored liquid suspension

All forms are immediate-release
Standard DosageTime-release tablets:
• 37.5mg of paroxetine

Color-coded tablets:
• Yellow: 10 mg
• Pink: 20 mg
• Blue: 30 mg
• Green: 40 mg

Liquid suspension:
• 5mg of suspension contains 10mg of paroxetine
• 30mg dose

• 10 mg
• 20 mg
• 40 mg

Liquid suspension:
• 10mg of citalopram per dose

Conditions TreatedFDA-approved uses:
• Major depression

Off-label uses:
• Anxiety
• Panic disorder
• Insomnia
FDA-approved uses:
• Major depressive disorder (MDD)

Off-label uses:
• Obsessive-compulsive disorder (OCD)
• Binge eating disorder
• Alcohol use disorder
• Generalized anxiety disorder
• Panic disorder or PTSD
• Premenstrual dysphoric disorder
• Postmenopausal flushing
• Premature ejaculation
CostGeneric form (paroxetine):
• $4 to $25 for a 30-day supply

• $280 for a 30-day supply
Generic form (citalopram):
• $4.50 to $19 for a 30-day supply

• $4 for 30-day supply*

*With coupon codes or insurance
Side-EffectsCommon side effects:
• Changes in vision
• Weakness, drowsiness, or dizziness
• Sweating or shaking
• Anxiety
• Insomnia
• Loss of appetite, nausea, and vomiting
• Diarrhea or constipation
• Dry mouth
• Infections
• Headaches
• Decreased sex drive or impotence
• Abnormal ejaculation or difficulty orgasming

Serious side effects:
• Racing thoughts
• Decreased need for sleep
• Unusual risk-taking behaviors
• Extreme feelings of happiness or sadness
• Being more talkative than usual
• Blurred vision or tunnel vision
• Eye pain, swelling, or seeing halos around lights
• Bone pain, tenderness, swelling, or bruising
• Changes in weight or appetite
• Coughing up blood or bleeding from your nose, mouth, or rectum
• Unusual vaginal bleeding
• Stiff or rigid muscles
• High fever, sweating, tremors, or fainting
• Fast, uneven heartbeat
• Headaches
• Confusion or slurred speech
• Severe weakness, lost coordination, or feeling unsteady

Common side effects:
• Nausea or GI upset
• Dry mouth
• Changes in appetite
• Drowsiness or fatigue
• Increased sweating
• Blurred vision

Serious side effects:
• Worsening depression
• Suicidal ideation
• Serotonin syndrome
• Rapid heart rate and high blood pressure
• High fever, resulting in increased sweating, shivering, or goosebumps
• Irregular heartbeat or palpitations
• Agitation or restlessness
• Loss of muscle coordination or uncontrollable muscle twitching or rigidity
• Diarrhea
• Headache
• Dilated pupils
• Confusion or altered consciousness
Warnings For UseContraindicated conditions:
• Bipolar disorder
• History of suicide attempts
• Liver or kidney problems
• Bleeding problems
• Low sodium in the blood
• Peptic ulcer disease
• Seizure disorders
• Thyroid disease
• Angle-closure type glaucoma
• Pregnancy or breastfeeding

Adverse drug interactions:
• Thioridazine
• Clopidogrel
• Warfarin
• Aspirin
• Atomoxetine
• Phenothiazines
• Pimozide,
• Risperidone
• Tamoxifen
• Tetrabenazine
• Antiarrhythmic medications
• TCA antidepressants
• Antihistamines
• Sleep aids
• Muscle relaxants
• Opiate-based pain relievers or cough suppressants
• Water pills (may cause salt imbalance)
• MAOIs may cause a fatal reaction
• Alcohol
• Marijuana

Adverse drug reactions:
• St. John's Wort
• ADHD medications, such as Adderall
• Antipsychotic medications
• Tricyclic antidepressants
• Buspar
• Some migraine medications
• Lithium
• Antiplatelet and anticoagulant medications
• Drugs that affect heart rhythm

What is Paxil?

Paroxetine, sold under the brand name Paxil, is a medication used for treating depression. It is classified as a selective serotonin reuptake inhibitor (SSRI), which means it blocks certain brain receptors from reabsorbing serotonin. 

By increasing the levels of serotonin in the brain, SSRIs like Paxil can help to regulate mood, sleep, appetite, and energy levels. They can also improve overall well-being by reducing the symptoms of depression, such as low mood, difficulty concentrating, and low energy.

Paxil Forms and Doses

Paxil is available in three forms: tablets, extended-release tablets, and a liquid suspension. Extended-release tablets are taken just once a day, differentiating them from standard tablets, which usually require multiple doses throughout the day. 

Your provider will help you determine which form is right for you, depending on your condition and how you react to the potential side effects of Paxil. 

The tablets come in 4 color-coded dosages as follows:

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

If you are prescribed the liquid suspension, it usually comes in a bottle that is 10mg/5ml. The liquid is orange-flavored and can make taking Paxil easier if you often struggle with the taste of medicine. The normal dose of Paxil usually starts at 20 mg a day and increases to a maximum of 50 mg a day, based on your provider’s advice.

Conditions Paxil Treats

Paxil is classified by the FDA as an antidepressant. However, it can be effective in treating the following conditions.


Generalized anxiety disorder can cause excessive worry, fear, or nervousness that is difficult to control. By increasing serotonin levels in the brain, Paxil can help regulate mood and reduce anxiety symptoms. It may also help improve sleep and reduce physical anxiety symptoms, such as rapid heartbeat, tremors, and muscle tension.


Depression is a mental health disorder characterized by persistent feelings of sadness, hopelessness, and a lack of interest in activities that were once enjoyable. It can also cause physical symptoms such as fatigue, changes in appetite and sleep patterns, and difficulty concentrating.

Paxil works by inhibiting the reuptake of serotonin, a chemical messenger that helps regulate mood and other functions in the body. By increasing the levels of serotonin in the brain, Paxil can help to regulate mood and reduce depression symptoms.


Obsessive-compulsive disorder (OCD) is a mental health condition that often results in intrusive thoughts and behaviors that disrupt daily life. Paxil can increase the levels of serotonin in the brain, which reduces these obsessive thoughts and compulsions by improving overall mood. 

Paxil Costs

The cost of a 30-day supply of brand-name Paxil can be as high as $300, while a generic version of the medication, paroxetine, typically costs between $16 and $40 for the same amount. The exact cost may vary depending on your insurance coverage and the pharmacy you use. 

Paxil Side Effects

It is common for Paxil to cause some moderate side effects, which can fade in just a few days or continue intermittently as you continue taking the medication. If your symptoms worsen or persist, contact your healthcare provider to discuss adjusting your dose or switching medications.

Here are some of the most common mild to moderate side effects:

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

In some rare cases, Paxil can cause more severe side effects. If you begin to experience any of the following symptoms, it is important to immediately contact your provider. 

  • 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, slurred speech 
  • Severe weakness and reduced coordination

Paxil Warnings For Use

Because Paxil is an SSRI, individuals who take it are at risk for a very rare condition known as serotonin syndrome, which occurs when a person has too much serotonin in their body. If left untreated, serotonin syndrome can lead to more serious complications such as high fever, seizures, coma, and even death. 

Symptoms of serotonin syndrome include:

  • Agitation or restlessness
  • Confusion
  • Rapid heartbeat
  • High body temperature
  • Sweating
  • Dilated pupils
  • Headache
  • Nausea or vomiting
  • Diarrhea
  • Muscle spasms or twitching

If you experience any of these symptoms, you must contact your provider or seek medical attention immediately. 

Additionally, there are some conditions that put you at a higher risk when you take Paxil. If you have any of the following conditions, speak to your 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

If you experience an increase in suicidal thoughts or impulses, seek help immediately by calling the 988 Suicide and Crisis Lifeline. 

Paxil Interactions

Medications like Paxil can have adverse reactions to certain medications, so it is important to make your provider aware of any medications you already take, especially if they are one or more of the following. 

  • 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

Additionally, individuals who have had an addiction to narcotics should discuss alternatives to Paxil with their provider. 

Licensed providers on Klarity provide personalized treatment. Find a provider that matches your needs and preferences.

What is Celexa?

Like Paxil, Celexa is a selective serotonin reuptake inhibitor (SSRI) used to treat major depressive disorder (MDD). It works by altering how the brain uses serotonin, a chemical messenger that helps regulate mood and other bodily functions. 

Celexa increases serotonin levels in the brain, slowing its reabsorption into neurons. This can help to improve mood and reduce the symptoms of depression and increase overall mental health. 

Celexa Forms and Doses

Celexa is available in three forms: oral solution, capsule, and tablet. The oral solution has a dosage of 10 mg/5 ml, while the tablets come in three doses: 10 mg, 20 mg, and 40 mg. The capsule is only available in a 30 mg dose. 

The recommended starting dose for Celexa is 20 mg by mouth once daily, and the maximum recommended dose is 40 mg by mouth once daily. Your healthcare provider will help determine the best form and dosage for your individual needs.

Conditions Celexa Treats

Celexa is most commonly known for its ability to treat depression. However, because SSRIs can also help reduce symptoms of other mental health conditions, they can be prescribed as an off-label treatment for anxiety and OCD as well. 

Off-label prescriptions of Celexa just means that it hasn’t been FDA-approved to treat anxiety, which requires extensive testing and resources that aren’t available for every way a medication can be used. Celexas has proven beneficial for those with anxiety, and it’s ethical and safe for your healthcare provider to prescribe it off-label.


Celexa can help reduce anxiety symptoms such as constant nervousness and fear that disrupt daily life. It works by regulating how the brain uses serotonin, which can help alleviate these symptoms and promote calm and emotional stability. When taken regularly, Celexa may help individuals feel more relaxed and in control of their emotions.


Celexa can treat various symptoms of depression, including feelings of hopelessness and low energy. By regulating the brain’s use of serotonin, Celexa can help improve an individual’s sense of well-being and increase their energy levels. 

Obsessive-Compulsive Disorder

Celexa can help reduce the obsessive thoughts and compulsive behaviors associated with obsessive-compulsive disorder (OCD), and improve the overall quality of life. It is important to note that Celexa should be used as part of a comprehensive treatment plan for OCD that may also include therapy and other interventions.

Celexa Costs

The cost of a Celexa prescription can vary based on whether you are prescribed the generic or brand version of the medication. The generic form of Celexa, called citalopram, can be relatively inexpensive, costing around $7 for 30 tablets of the 20mg dosage. 

In contrast, the brand version of Celexa can be significantly more expensive, costing up to $400 for the same quantity and dosage. It is worth noting that Celexa may be less costly if covered by insurance. Other factors that may influence the cost are your pharmacy, dose, and insurance coverage. 

Celexa Side Effects

Like all antidepressants, Celexa can cause some mild to moderate side effects. The side effects of Celexa usually go away in just a few days; however, if they persist, you should speak with your medical provider. 

The most common mild side effects of Celexa include

  • Nausea
  • Dry mouth
  • Sleepiness
  • Insomnia
  • Increased sweating
  • Tremors
  • Diarrhea
  • Loss of appetite

In rare cases, Celexa can cause more severe side effects. If you experience any of the following while taking Celexa, seek medical attention immediately. 

  • Chills 
  • Bleeding gums
  • Nosebleed 
  • Irregular heartbeat
  • Dizziness or fainting
  • Painful urination
  • Seizures
  • Swelling of the face, ankles, or hands

In extremely rare instances, Celexa can cause serotonin syndrome, which is a condition that occurs when too much serotonin is present in the body. Symptoms of serotonin syndrome include sweating, muscle stiffness or spasms, fever, fast heart rate, and confusion, which can lead to coma and even death. 

Celexa Warnings For Use

Celexa may increase the risk of suicidal thoughts or behavior in people under 24. This risk is highest during the first few months of treatment or when the dosage changes. 

It is important to be vigilant about your mental health and seek help immediately if you have suicidal thoughts or impulses while taking Celexa. You can call the 988 Suicide and Crisis Lifeline for help, and you should also inform your healthcare provider about any suicidal thoughts or behaviors.

Celexa Interactions

If you take any medications, it is important to discuss the possible negative interactions they could have with Celexa with your healthcare provider. 

When taking Celexa with the medications below, you could experience reduced effectiveness and increased side effects. Individuals taking the following medications should avoid Celexa unless their provider says otherwise. 

  • Bepridil
  • Cisapride
  • Ketoconazole
  • Metoclopramide
  • Phenelzine
  • Sparfloxacin
  • Toloxatone
  • Ziprasidone 

Get Anxiety and Depression Treatment With Klarity!

If you’re struggling with anxiety or depression, you shouldn’t have to struggle to find the right medications for relief. At Klarity, we connect you with convenient and effective telehealth treatment for anxiety and depression, so you can get the care you need without leaving your home. 

Find the best medication for your symptoms so that you can get back to living your life. Find a provider and be seen within 48 hours.

Paxil and Celexa Frequently Asked Questions

Are Celexa, Paxil, and other SSRIs the same drug?

Although Celexa, Paxil, and other SSRIs are all selective serotonin reuptake inhibitors, a class of medication used to treat depression and anxiety disorders, they are not the same drug. Each SSRI has different chemical structures and works in slightly different ways. 

Different SSRIs can have varying effects on patients, so it’s important to work closely with a healthcare provider to find the right treatment for you. If one medication isn’t working for you or causes unpleasant side effects, your healthcare provider may suggest trying a different medication.

Why is Celexa an off-label treatment for anxiety?

Off-label use refers to using a medication for a purpose that the FDA has not specifically approved. Healthcare providers can legally prescribe medications for any use they believe is safe and effective based on their clinical judgment and the available scientific evidence. Celexa is FDA-approved to treat depression and is used off-label for anxiety.

What’s better for anxiety? Celexa or Paxil?

Both Celexa and Paxil can be prescribed for treating anxiety, but Paxil is more commonly used. Providers may prescribe either of these SSRI antidepressants to treat anxiety if they believe the patient will see better results and fewer side effects.  

What’s better for depression? Celexa or Paxil?

Paxil and Celexa are prescribed for treating depression, but it is difficult to say which is better. Your healthcare provider will consider several factors when deciding which medication to prescribe for the treatment of depression, including the type and severity of your anxiety symptoms, your medical history, and any other medications you are taking.

Can I drive on antidepressants like Celexa or Paxil?

It is generally safe to drive while taking antidepressants, including Celexa and Paxil. However, some people may experience drowsiness, dizziness, or other side effects while taking antidepressants. When you begin taking either medication, assessing whether you are experiencing any of these side effects before driving is important. 

Can I drink alcohol when taking Celexa or Paxil?

When taking any SSRI antidepressant, it is not recommended that you consume alcohol. Drinking alcohol can increase the severity of your antidepressant side effects and reduce the effectiveness of the medication. Additionally, the interaction between the two can make the effects of alcohol, such as blurred vision and impaired motor skills, worse. 

Does it matter what time of day I take Celexa or Paxil?

It is generally recommended to take Celexa and Paxil at the same time each day to help maintain a consistent level of the medication in your body. Both medications can usually be taken once a day without food, so the specific time of day that you take the medication may depend on your schedule and your healthcare provider’s instructions.


IBM Micromedex. “Citalopram (Oral Route)” Mayo Clinic

Mayo Clinic Staff. “Selective serotonin reuptake inhibitors (SSRIs)” Mayo Clinic

Philip Thornton. “Paxil”

John P. Cunha. “Paxil” RxList

“Generic Celexa” GoodRx

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