How long does it take to adjust to Paxil? (3+ ways to ensure safe use)

In this article, we will discuss how long it typically takes to adjust to Paxil (paroxetine) – a selective serotonin reuptake inhibitor (SSRI). We will also talk about the factors that can affect the time taken by a person to adjust to this antidepressant and what you can do to help your treatment plan.

How long does it take to adjust to Paxil?

It typically takes 4-8 weeks to adjust to Paxil. Some people may take longer than 8 weeks or up to 12 weeks to adjust to this antidepressant (1). Paxil is a selective serotonin reuptake inhibitor (SSRI), also known as paroxetine, which is commonly prescribed for depression. 

It primarily inhibits the reuptake of serotonin by blocking the serotonin transporters (SERT) to exert its antidepressant effects (1). This process takes time, and the enhanced serotonergic activity may feel unusual during the first few weeks. 

It is a known fact that antidepressants take time to work. These medications are not fast-acting; hence, they do not have a rapid onset of action.

Paxil can take up to 4 weeks to show a noticeable difference in your symptoms, and some people may not feel well until 8 weeks after taking this medication (1). The time it typically takes to adjust to Paxil can vary among individuals as people are different and can respond differently to medications. 

Some people process the medication earlier and begin to feel well in less than 4 weeks. This hugely depends on the individuals taking the medication and their body physiology or how the body generally responds to the medication.

Paxil, although considered well-tolerated, may not work well for everyone. Some people may discontinue the medication either because of side effects or because their body never really adjusts to it. 

So, make sure you attend your follow-up appointments and stay in touch with your provider throughout this entire process to make the most out of your treatment regimen.

What does research suggest?

Several researchers have worked on the effects of Paxil and how long it typically takes to see noticeable effects. 

One research study indicated that paroxetine, the active ingredient present in Paxil, may take less than 4 weeks to show improvements in symptoms associated with generalised anxiety disorder (GAD) and the core symptoms may become significantly better by the end of week 8 (2). 

Another research study included 29 patients, 17 of whom responded well to paroxetine treatment and showed signs of improvement in 3 days (3). The remaining people did not show any improvement within the first 3 days (3). 

Another research study included 84 patients in which the effects of paroxetine were monitored. Some people responded earlier as compared to others. The average time taken by people to respond to paroxetine was recorded as 3-4 weeks (4). 

However, the study indicated that people with higher doses responded earlier compared to those who were taking lower paroxetine. This dose-dependent onset of action could be beneficial for people with severe depression or major depressive disorder (MDD) (4). 

However, it is important to note that not everyone can tolerate a high dose of paroxetine. Antidepressants are usually started from the lowest effective dose as you never know how your body will respond to it before taking it. 

This is why lower doses are preferred, as side effects associated with low doses are easier to manage and such doses are easier for your body to adjust to. 

What factors can affect the Paxil adjustment period?

Some factors that can affect the Paxil adjustment period include:

Dosage

The adjustment period for Paxil is closely linked to the dosage prescribed. Higher doses generally require a longer adjustment period. 

Lower doses are easier for your body to get used to and usually come with fewer side effects. Doctors often start with lower doses to help your body adjust to the medication.

Age

Your age affects how your body reacts to Paxil. Older people usually take more time to adjust. This is because your body changes as you get older, affecting how you process medications. Older adults might need more time for their bodies to adapt to Paxil.

Genetics or variations in body physiology

Your genes and how your body works play a huge role in how you respond to Paxil or medications in general. Some people may process the medication earlier due to their genetics. Also, your body’s overall functioning, including your liver functions, influences how quickly you adjust to Paxil.

Underlying health conditions

If you have other health issues, they can impact how fast or slow your body gets used to Paxil. Generally, if you’re in good health, you might adjust more quickly. However, having other health problems could mean a longer adjustment period. 

Does Paxil cause any side effects during its adjustment period?

Paxil is associated with some side effects that show up within the first few weeks of your treatment. These include: (1,5)

• Increased sweating 
• Dry mouth
• Drowsiness 
• Forgetfulness
• Abdominal pain
• Altered sense of taste
• Weight loss or gain
• Acid reflux
• Weakness
• Difficulty concentrating
• Diarrhoea
• Nervousness
• Flatulence 
• Dizziness
• Confusion
• Headache
• Loss of appetite
• Constipation
• Nausea
• Vomiting

Paxil may also cause less common and serious side effects in some people, which can require immediate medical attention. These include: (1,5)

• Allergic reactions
• Breathing difficulties
• Tightness of chest
• Swelling of different parts of the body
• Fainting
• Irregular heartbeat or arrhythmia
• QT prolongation
• Seizures
• Low sodium levels
• Unusual bleeding or bruising
• black stools/bloody stools
• bloody vomit
• Wheezing 

How to ensure the proper use of Paxil to make the most out of it?

The following points are important to ensure the safe and effective use of Paxil to make the most out of it:

• Always take Paxil exactly as your doctor prescribed. If you have any questions or concerns, discuss them with your healthcare provider.

• Take Paxil at the same time every day. This helps maintain a steady level of the medication in your body, making it more effective. 

• Avoid skipping your doses. Doing so can disrupt the balance of the medication in your system, impacting its effectiveness. If you forget a dose, take it as soon as you remember, unless it’s close to the next scheduled dose.

• Be patient as it might take some time for your body to adjust to Paxil. Changes don’t happen overnight. If you experience side effects, talk to your doctor. 

• Attend follow-up appointments. This allows your doctor to monitor your progress or make any necessary adjustments.

• Discuss the use of alcohol or other medications with your healthcare provider while being treated with Paxil.

• Do not stop taking Paxil abruptly. Suddenly stopping the antidepressant can lead to withdrawal symptoms. Your doctor will guide you on how to reduce the dose safely.

As a pharmacist, I always advise my patients to take their meds as properly as possible. Doing so ensures that you are moving forward to reach your therapeutic goals. If you have any concerns regarding Paxil, please reach out to your doctor. Do not try to make adjustments to your treatment plan on your own. 

References 

1. Shrestha P, Fariba KA, Abdijadid S. Paroxetine. 2023 Jul 17. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jan–. PMID: 30252278. https://www.ncbi.nlm.nih.gov/books/NBK526022 

2. Pollack MH, Zaninelli R, Goddard A, McCafferty JP, Bellew KM, Burnham DB, Iyengar MK. Paroxetine in the treatment of generalized anxiety disorder: results of a placebo-controlled, flexible-dosage trial. J Clin Psychiatry. 2001 May;62(5):350-7. doi: 10.4088/jcp.v62n0508. Erratum in: J Clin Psychiatry 2001 Aug;62(8):658. PMID: 11411817. https://pubmed.ncbi.nlm.nih.gov/11411817/ 

3. Inagaki T, Furuya M, Kawamukai T, Okazaki S, Yasuda H, Hayashida M, Miyaoka T, Nishida A, Horiguchi J. Prediction of response within the first 3 days to treatment with paroxetine for depression. Prim Care Companion J Clin Psychiatry. 2008;10(2):129-32. doi: 10.4088/pcc.v10n0207. PMID: 18458726; PMCID: PMC2292438. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2292438/ 

4. Gex-Fabry M, Gervasoni N, Eap CB, Aubry JM, Bondolfi G, Bertschy G. Time course of response to paroxetine: influence of plasma level. Prog Neuropsychopharmacol Biol Psychiatry. 2007 May 9;31(4):892-900. doi: 10.1016/j.pnpbp.2007.02.003. Epub 2007 Feb 15. PMID: 17395353. https://pubmed.ncbi.nlm.nih.gov/17395353/ 

5. National Library of Medicine. Paroxetine: MedlinePlus Drug Information [Internet]. Bethesda (MD): U.S. National Library of Medicine. Available from: https://medlineplus.gov/druginfo/meds/a698032.html#side-effects