Paxil vs Zoloft: Differences, Similarities and Which is Better

Paxil and Zoloft are both popular Food and Drug Administration (FDA)-approved antidepressants that are used to treat a wide range of mental health conditions.

Both medications commonly treat major depressive disorder, bipolar disorder, and different types of anxiety disorders in adults, while Zoloft can also be used to treat obsessive compulsive disorder in children as young as six years of age.

When it comes to Paxil vs. Zoloft, which is better?

Drug Class

Paxil and Zoloft belong to the same drug class. Known as selective serotonin reuptake inhibitors (SSRIs), this class of antidepressants works by blocking the absorption of serotonin in the brain, which helps to increase the levels of the neurotransmitter in the brain. 

As a result, this class of medications can help to stabilize and improve mood in patients suffering from common mental health conditions like depression and anxiety.

Other SSRIs include citalopram (Celexa), escitalopram (Lexapro), fluoxetine (Prozac), paroxetine (Paxil), or sertraline (Zoloft).

Conditions Treated

Paxil and Zoloft have considerable overlap in terms of the conditions treated by both medications.

Both Paxil and Zoloft treat major depression, obsessive compulsive disorder (OCD), panic disorder, post-traumatic stress disorder (PTSD), social anxiety disorder, and premenstrual dysphoric disorder (PMDD). 

In addition to the conditions noted above, Paxil also can be used to treat generalized anxiety disorder.

Paxil is only used for the treatment in mental health conditions in adults, while Zoloft can be used for the treatment of obsessive-compulsive disorder in children as young as six years old.


Numerous studies and clinical trials have been conducted that compare the effectiveness of both Paxil and Zoloft. Two studies, one conducted in 2000 and the other conducted in 2004, found that Paxil and Zoloft were equally effective in the treatment of panic disorder and major depressive disorder. 

However, Zoloft was found to be better tolerated by patients and to cause fewer side effects in patients.

Another study, conducted in 2000, compared the effectiveness of Paxil, Zoloft and Prozac, found the three medications to be equally effective and well tolerated.

While most patients will experience similar relief in symptoms when taking the medications, some may tolerate one drug better than the other. 

Side Effects

Paxil and Zoloft are both associated with a lengthy list of side effects.

The side effects associated with both medications are known to cause patients to discontinue the use of the drugs. 


Zoloft causes different side effects in adults and children. However, some side effects are known to affect both populations equally. These side effects include: 

  • Nausea
  • Changes in sleep habits
  • Shaking or tremors
  • Fatigue and drowsiness 
  • Increased sweating
  • Diarrhea
  • Loss of appetite
  • Indigestion 
  • Sexual problems, including reduced sex drive and ejaculation failure
  • Agitation

Additional side effects associated with the use of Zoloft in children include:

  • Frequent urination
  • Slowed growth rate 
  • Nose bleeds
  • Heavy menstrual periods
  • Aggressiveness
  • Abnormal increase in muscle movement or agitation
  • Weight gain or weight loss

Zoloft can cause serious side effects and symptoms that may require immediate medical attention and can potentially be dangerous. Serious side effects of Zoloft include the following:

  • Suicidal thoughts and behaviors
  • Serotonin syndrome. This condition can be life-threatening. Symptoms can include:
    • Hallucinations
    • Nausea
    • Seizures
    • Dizziness
    • Vomiting
    • Changes in blood pressure such as high blood pressure
    • Fast heart rate
    • Sweating
    • Muscle tremor or stiff muscles
    • Sweating
    • Diarrhea
    • Shakiness
  • Severe allergic reactions with signs and symptoms such as:
    • Swelling of the face, tongue, eyes, or mouth
    • Severe rash
    • Trouble breathing
  • Seizures 
  • Abnormal bleeding
  • Manic episodes. Symptoms can include:
    • Racing thoughts
    • Unusually grand ideas
    • Severe trouble sleeping
    • Excessive happiness or irritability
    • Reckless behavior
    • Greatly increased energy
    • Talking more or faster than usual
  • Changes in appetite or weight
  • Low sodium levels with signs and symptoms such as:
    • Headache
    • Weakness or unsteadiness
    • Confusion
  • Glaucoma

Seek medical advice from your healthcare provider if you experience any of these side effects, negative drug interactions (such as interactions with monoamine oxidase inhibitors, also known as MAOIs), or withdrawal symptoms.

This may not be a complete list of side effects.

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Paxil is associated with both common side effects and serious side effects. Side effects that are commonly associated with Paxil include: 

  • Weakness
  • Sleepiness
  • Delayed ejaculation
  • Decreased sexual desire
  • Impotence
  • Dizziness
  • Nausea
  • Decreased appetite
  • Dry mouth
  • Sweating
  • Shaking
  • Anxiousness or sleeplessness
  • Constipation
  • Infection
  • Yawning

Paxil can also cause serious side effects that are potentially life-threatening. If you experience any of the following serious side effects, make sure to seek medical attention immediately: 

  • Changes in mood, anxiety or behavior, as evidenced by:
    • New or worsened depression
    • Thoughts of suicide or dying
    • Attempts to commit suicide
    • Sleeplessness
    • Acting on dangerous impulses
    • New or worsened anxiety or panic attacks
    • Agitation, restlessness, anger, or irritability
    • Acting aggressive or violent
    • Increase in activity or talking more than what is normal for you
  • Serotonin syndrome, which most commonly occurs when the medication is taken with other drugs that influence the amount of serotonin in the brain. Symptoms of serotonin syndrome include:
    • Agitation, confusion, hallucinations, coma, and trouble thinking
    • Muscle rigidity
    • High or low blood pressure
    • Fever
    • Coordination problems or muscle twitching (overactive reflexes)
    • Racing heartbeat
    • Sweating
    • Nausea, vomiting, or diarrhea
  • Eye problems, such as:
    • Changes in vision
    • Eye pain
    • Swelling or redness in or around your eyes
  • Severe allergic reactions. Symptoms can include:
    • Rash
    • Swelling of your face, tongue, eyes, or mouth
    • Fever
    • Hives (itchy welts)
    • Trouble breathing
    • Joint pain
    • Blisters
  • Abnormal bleeding
  • Seizures or convulsions
  • Manic episodes. Symptoms can include:
    • Racing thoughts
    • Severe trouble sleeping
    • Excessive happiness or irritability
    • Reckless behavior
    • Unusually grand ideas
    • Greatly increased energy
    • Talking more or faster than usual
  • Changes in appetite or weight (either weight loss or weight gain)
  • Low sodium levels, as evidenced by:
    • Headache
    • Problems concentrating or thinking
    • Weakness or feeling unsteady
    • Memory problems
    • Confusion 
  • Increased risk of bone fracture, as indicated by:
    • Unexplained bone pain
    • Swelling
    • Bruising
    • Tenderness


Zoloft and Paxil are prescription drugs that have been shown to be equally effective in the treatment of depression and other common mental health conditions like common anxiety disorders.

However, Zoloft can be used for the treatment in obsessive-compulsive disorder in children as young as 6 years old.

The medications cause similar adverse effects, but studies show that Zoloft may be tolerated better by some patients than others. 

Regardless of which medication you choose, you can save on the cost of your prescription with a pharmacy discount card from

References, Studies and Sources:

author avatar
Angel Rivera
I am a Bilingual (Spanish) Psychiatrist with a mixture of strong clinical skills including Emergency Psychiatry, Consultation Liaison, Forensic Psychiatry, Telepsychiatry and Geriatric Psychiatry training in treatment of the elderly. I have training in EMR records thus very comfortable in working with computers. I served the difficult to treat patients in challenging environments in outpatient and inpatient settings

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