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Paroxetine Side Effects

Martin Miner, MD

Reviewed by Martin Miner, MD

Written by Vanessa Gibbs

Published 05/18/2021

Updated 01/20/2024

Paroxetine, sold under the brand name Paxil®, is an antidepressant. And, as with most medications, it comes with side effects. 

It’s pretty safe to say that you won’t want most of these side effects cropping up. But if you’re experiencing premature ejaculation (aka rapid or early ejaculation), one side effect can actually be useful: delayed ejaculation. 

Beyond this, common paroxetine side effects include: 

  • Drowsiness 

  • Sweating 

  • Sleep disturbance 

  • Dry mouth

  • Loss of appetite 

  • Sexual side effects 

Below, we dive into more side effects of the drug, including long-term and sexual side effects in more detail. Plus, for those who are considering taking paroxetine for its delayed ejaculation benefits, we cover other ways you can treat premature ejaculation.

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Paroxetine belongs to a class of medication known as selective serotonin reuptake inhibitors, or SSRIs

It’s an antidepressant, but depression isn’t the only thing it’s used for.

Paroxetine is approved by the Food and Drug Administration (FDA) for: 

Paroxetine can also be prescribed off-label for: 

  • Postpartum depression 

  • Separation anxiety 

  • OCD in kids and teens 

  • Social anxiety disorder in kids and teens 

  • Body dysmorphic disorder 

  • Dysthymia (persistent depressive disorder) 

  • Malignancy-related pruritus (itching caused by cancer) that’s unresponsive to standard treatment 

  • Premature ejaculation (PE)

Did that last one spark your interest? You can learn more in our guide to paroxetine for premature ejaculation

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Paroxetine can help a range of medical issues but, of course, there’s a catch. The medication comes with side effects. 

Many paroxetine side effects are dose-dependent, meaning you may experience more side effects or more severe side effects with higher doses. Paroxetine 20mg side effects may be completely different, for example, to those you’d get from a smaller dose.

But as far as side effects from antidepressants go, SSRIs like paroxetine may be the best.

SSRIs have fewer side effects than other antidepressants like tricyclic antidepressants (TCAs) and monoamine oxidase inhibitors (MAOIs), like linezolid, isocarboxazid, methylene blue injection or tranylcypromine. 

This is because SSRIs have little or no effect on neurotransmitters like dopamine or norepinephrine. As the name suggests, selective serotonin reuptake inhibitors mainly impact serotonin. 

Now for the juicy stuff — what are the side effects of paroxetine? 

Common Side Effects 

The common side effects of paroxetine include: 

  • Drowsiness 

  • Sweating 

  • Sleep disturbance 

  • Dry mouth

  • Loss of appetite 

  • Sexual side effects (hang tight, we’ll cover these in more detail soon)

Side effects may start within the first week of taking paroxetine and gradually disappear within two to three weeks. Phew. 

These side effects may be common, but that doesn’t mean they’re guaranteed to affect you. According to the FDA, the most common side effects affect five percent or more of people taking paroxetine. 

For example, in placebo-controlled clinical trials for major depressive disorder, 23 percent of people taking paroxetine experienced drowsiness, compared to nine percent who took a placebo. And 11 percent of people on paroxetine experienced sweating, compared to two percent on the placebo. 

Other Paroxetine Side Effects 

Beyond the common adverse effects, there are a few others you need to keep an eye out for. 

Other types of Paxil side effects in males include: 

  • Gastrointestinal. Never fun. We’re talking nausea, constipation and diarrhea. 

  • Dermatologic. Think itchiness, eczema, alopecia (hair loss) and photosensitivity (a reaction to sunlight). 

  • Metabolic. Weight gain and hyponatremia (abnormally low sodium levels in your blood).  

  • Nervous system. Headache, dizziness, tremor and extrapyramidal symptoms, like restlessness and involuntary movements. 

  • Cardiovascular. Palpitations, fast heart rate, swelling, chest pain and vasodilation (widening of the blood vessels). 

  • Psychiatric. Loss of interest and emotional flattening, or hypomania and mania (periods of hyperactivity). Kids and teens may also experience an increased risk of suicide — short-term studies have found that antidepressants like paroxetine increased the risk of suicidal thoughts and behavior in kids, teens and young adults. If you’re looking after a young person on paroxetine, look out for unusual changes in behavior or worsening suicidality.

The list of side effects could go on and on, with everything from eye pain to blurred vision and even glaucoma cropping up. And, as with many meds, there’s also a risk of allergic reaction. 

But side effects may get better with time as your body gets used to the medication — there’s evidence that side effects like nausea and dizziness may improve in four to six weeks. But dry mouth, drowsiness and a lack of energy may not improve as much. 

Long-Term Side Effects of Paroxetine 

It’s unclear if there are any long-term side effects of paroxetine. 

But there is a risk of discontinuation syndrome if you suddenly decrease your dose or stop using paroxetine.

Compared to other SSRIs, discontinuation syndrome is more common and more severe with paroxetine.

You may get withdrawal symptoms such as: 

  • Headache

  • Tiredness 

  • Nausea 

  • Vomiting 

  • Crying 

  • Irritability 

  • Dizziness

  • Anxiety

  • Fever

  • Chills 

  • Vivid dreams 

  • Electric shock-like sensations

  • Dyskinesia (involuntary movements)

  • Depersonalization (feeling disconnected from your body and mind) 

These symptoms may kick in within a week of discontinuing an SSRI, and they may clear up within three weeks. 

Seek medical advice if you want to stop taking paroxetine. A healthcare professional can provide a plan to slowly reduce your dose over the course of at least two weeks to reduce the chances of withdrawal symptoms. 

Paroxetine Sexual Side Effects 

If you’re suffering from anxiety or depression, your love life may have already taken a hit. So it’s a cruel twist of fate that paroxetine can come with sexual side effects. 

In placebo-controlled trials with more than 3,200 participants, paroxetine was shown to cause sexual side effects in both men and women. 

Paroxetine sexual side effects include: 

  • Decreased libido (in both men and women) 

  • Ejaculatory disturbance 

  • Erectile dysfunction 

  • Orgasmic disturbance in women 

Paxil’s sexual side effects are usually reversible, although in rare cases, they may last months or even years after you stop taking the drug. Yikes. 

Paroxetine may also affect male fertility by causing abnormal sperm DNA fragmentation. 

Speak to a healthcare provider if you’re experiencing sexual side effects from paroxetine. They may recommend medications, like sildenafil, to help. 

They may also reduce your dose, recommend cognitive behavioral therapy or recommend a different medication altogether. 

Using Paroxetine for PE

There’s a silver lining to all of these sexual side effects though. 

Paroxetine can cause delayed ejaculation. This might be annoying for guys who don’t have any penis problems, but if you find yourself finishing too fast, paroxetine can help treat premature ejaculation.

A 2019 systematic review and meta-analysis looked at 19 randomized controlled trials and found that paroxetine was more effective than a placebo, fluoxetine and escitalopram at increasing intra-vaginal ejaculatory latency time (IELT). In non-science speak, that’s how long you last while having sex. 

For these purposes, paroxetine may work better in a team. The research found that paroxetine and tadalafil or behavior therapy was more effective than paroxetine alone.

Butttt, side effects were more likely when paroxetine was used with another treatment. 

These side effects were mild and tolerable, though.

The most common side effects included: 

  • Nausea 

  • Muscle soreness

  • Palpitation 

  • Flushing 

A 2014 review found that a daily paroxetine treatment of 10mg to 40mg was usually effective at delaying ejaculation. Other SSRIs can help you last longer in bed too, but paroxetine seems to cause the largest delay in ejaculation, increasing IELT about 8.8-fold over baseline measures. 

This can happen quickly too. You might see improvements in the bedroom within five to 10 days of starting treatment — although give paroxetine two to three weeks to fully kick in.

You can learn more in our guide to antidepressant sexual side effects.

Drug Interaction Side Effects 

Paroxetine doesn’t mix well with some other drugs. 

Be sure to let your healthcare provider know about any medication or supplements you take before you start paroxetine to avoid harmful drug interactions. 

You can’t take paroxetine with: 

  • Thioridazine

  • Pimozide

  • MAOIs

Mixing paroxetine with thioridazine or pimozide can cause cardiac arrhythmias, or an abnormal heart rhythm.  

If you mix peroxide and an MAOI, there’s a risk of serotonin syndrome, which can be life-threatening. 

You can also develop serotonin syndrome if you take paroxetine alone or with medications such as: 

  • Triptans 

  • TCAs 

  • Fentanyl 

  • Lithium 

  • Tramadol 

  • Tryptophan 

  • Buspirone 

  • St. John’s wort 

Look out for symptoms like muscle rigidity, agitation, racing heartbeat and high or low blood pressure. 

Paroxetine can also increase the risk of abnormal bleeding, and taking aspirin, nonsteroidal anti-inflammatory drugs (NSAIDs), warfarin and other anticoagulants may increase this risk. 

One final thing — you also can’t take other medications that contain paroxetine, like Paxil CR, Pexeva® and Brisdelle®, with paroxetine itself.

If all these side effects have put you off, you’re in luck. Paroxetine isn’t the only way to treat PE. 

Yes, one paroxetine side effect is delayed ejaculation, but the others can be pretty gnarly and the medication isn’t right for everyone. 

Here are other premature ejaculation treatments to consider. 

Topical PE Treatments

Topical PE treatments don’t involve popping a pill or getting a prescription. You can buy these treatments over the counter and online. 

They usually come in the form of a wipe, cream or delay spray that you apply to your penis to reduce sensitivity. 

Topical PE treatments include

The downside is that you may need to use a topical treatment every time you have sex and they can get a little messy.  

Plus, topical treatments also come with side effects — although you might decide they’re much more tolerable than paroxetine side effects. 

Specifically, they can cause irritation and numbness in your penis. And if you’re having vaginal sex, they can cause numbness in your partner too. Top tip: wear a condom to stop this from happening. 

PE Medications 

Paroxetine isn’t the only medication out there that can give you a helping hand in the bedroom. 

A healthcare provider can prescribe other SSRIs off-label to help with PE. 

These include: 

  • Escitalopram 

  • Fluoxetine

  • Fluvoxamine 

  • Zoloft® (sertraline)

 Anafranil® (clomipramine) is another type of antidepressant called a tricyclic antidepressant, and can also help improve PE.  

Phosphodiesterase 5 inhibitors (PDE5 inhibitors) are a class of medication that are usually used to treat erectile dysfunction. But they can help PE too. 

These include: 

Quick heads-up: tramadol can improve PE, but it’s not a common treatment. The medication can be addictive and it comes with side effects like drowsiness, nausea, vomiting, dry mouth, itchiness and dizziness. 

A healthcare provider can help to determine which medication is best suited to you.

Therapy

Is there nothing therapy can’t fix?! Okay, there are many things. But PE ain’t one of them. 

You can try: 

  • Online therapy 

  • Couples therapy 

  • Sex therapy

Therapy can address any psychological causes of PE and help with the distress and mental health problems that PE can cause. 

Even alternative therapies like meditation and hypnosis for PE may be useful. 

Physical Techniques 

There are a few things you can try at home to help you last longer in bed

You can try: 

  • The squeeze technique. When you’re close to climax, stop what you’re doing and squeeze the tip of your penis with your index finger and thumb. This should decrease arousal and help you keep the party going. 

  • The start-stop technique. Just before you're about to climax, hit pause until the urge to ejaculate passes. Then get back to it. With a few practice runs, you should be able to better recognize what it feels like just before you climax, and stop in time.

  • Distraction. Increase your sexual stamina by thinking about something else while you’re getting it on. Just don’t think of anything too off-putting, as you may lose your erection altogether. 

  • Using a condom. The humble condom could help you control ejaculation. It makes your penis less sensitive, which could buy you more time.  

  • Masturbating before sex. When you know you’re gonna get it on, try masturbating a few hours beforehand. This may help you last longer the second time around.

  • Pelvic floor exercises. This technique involves squeezing of a different sort. You can squeeze and train your pelvic floor muscles to gain more ejaculatory control. Research shows that pelvic floor exercises can help men increase how long they last in bed from 30 seconds to two minutes on average.

  • Talk to your partner. Premature ejaculation isn’t our idea of good pillow talk either. But talking about PE with your partner can reduce the pressure around performing in the bedroom and you can brainstorm solutions together. If you’re reading this article for a partner with PE (aww!) we’ve covered how to make a guy last longer.

Your first step in treating PE is to reach out to a medical professional. 

They can help determine what’s causing your PE and recommend the best treatment options for you, whether that’s paroxetine or something else entirely.  

We know it’s not the most fun topic of conversation, but don’t be embarrassed about PE. It’s more common than you think, affecting about 20 to 30 percent of men in the sexually active age group.

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Paroxetine, just like most meds, comes with side effects. If you’re battling premature ejaculation, you’ll be happy to hear that delayed ejaculation is one such side effect.

Here’s the low-down on the rest: 

  • Common paroxetine side effects are usually mild. These include drowsiness, sweating and dry mouth. They may crop up within the first week of treatment, but try to ride that wave — side effects should go away within two to three weeks. 

  • There’s a risk of serious side effects. Other side effects include erectile dysfunction, trouble sleeping and mania. Mixing paroxetine with some other drugs can also cause some troubling side effects. 

  • Alternative PE treatments exist. Don’t like the sound of these side effects? Try other PE treatments like topical wipes, other SSRIs, therapy and the squeeze technique. 

If distressing side effects pop up, speak to a healthcare provider. If you’re experiencing premature ejaculation and considering paroxetine, speak to a healthcare provider. If you want a different treatment…you get the idea. 

A doctor can give you the best advice, no matter your situation. 

In the meantime, check out our guide to preventing PE to learn more ways to improve your performance in the bedroom.

13 Sources

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  2. Cayan, S., & Serefoğlu, E. C. (2014). Advances in treating premature ejaculation. F1000prime reports, 6, 55. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4108949/
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  4. Nevels, R. M., Gontkovsky, S. T., & Williams, B. E. (2016). Paroxetine-The Antidepressant from Hell? Probably Not, But Caution Required. Psychopharmacology bulletin, 46(1), 77–104. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5044489/
  5. Ferguson J. M. (2001). SSRI Antidepressant Medications: Adverse Effects and Tolerability. Primary care companion to the Journal of clinical psychiatry, 3(1), 22–27. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC181155/
  6. Higgins, A., Nash, M., & Lynch, A. M. (2010). Antidepressant-associated sexual dysfunction: impact, effects, and treatment. Drug, healthcare and patient safety, 2, 141–150. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3108697/
  7. Serretti, A., & Chiesa, A. (2009). Treatment-emergent sexual dysfunction related to antidepressants: a meta-analysis. Journal of clinical psychopharmacology, 29(3), 259–266. https://journals.lww.com/psychopharmacology/Abstract/2009/06000/Treatment_Emergent_Sexual_Dysfunction_Related_to.11.aspx
  8. Zhang, D., Cheng, Y., Wu, K., Ma, Q., Jiang, J., & Yan, Z. (2019). Paroxetine in the treatment of premature ejaculation: a systematic review and meta-analysis. BMC urology, 19(1), 2. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6318994/
  9. Chu, A. & Wadhwa, R. (2013, May 1). Selective Serotonin Reuptake Inhibitors - StatPearls. https://www.ncbi.nlm.nih.gov/books/NBK554406/
  10. Label for Brisdelle (paroxetine) capsules. (n.d.). https://www.accessdata.fda.gov/drugsatfda_docs/label/2017/204516s004lbl.pdf
  11. Mohee, A., & Eardley, I. (2011). Medical therapy for premature ejaculation. Therapeutic advances in urology, 3(5), 211–222. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3199591/
  12. Ciocanel, O., Power, K., & Eriksen, A. (2019). Interventions to Treat Erectile Dysfunction and Premature Ejaculation: An Overview of Systematic Reviews. Sexual medicine, 7(3), 251–269. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6728733/
  13. Premature ejaculation: What can I do on my own? (2022). https://www.ncbi.nlm.nih.gov/books/NBK547551/
Editorial Standards

Hims & Hers has strict sourcing guidelines to ensure our content is accurate and current. We rely on peer-reviewed studies, academic research institutions, and medical associations. We strive to use primary sources and refrain from using tertiary references. See a mistake? Let us know at [email protected]!

This article is for informational purposes only and does not constitute medical advice. The information contained herein is not a substitute for and should never be relied upon for professional medical advice. Always talk to your doctor about the risks and benefits of any treatment. Learn more about our editorial standards here.

Martin Miner, MD

Dr. Martin Miner is the founder and former co-director of the Men’s Health Center at the Miriam Hospital in Providence, Rhode Island. He served as Chief of Family and Community Medicine for the Miriam Hospital, a teaching hospital of the Warren Alpert Medical School, from 2008 to 2018. The Men’s Health Center, under his leadership, was the first such center to open in the US. He is a clinical professor of family medicine and urology at the Warren Alpert Medical School of Brown University in Providence and has been charged with the development of a multidisciplinary Men’s Health Center within the Lifespan/Brown University system since 2008.

Dr. Miner graduated Phi Beta Kappa from Oberlin College with his AB in biology, and he received his MD from the University of Cincinnati College of Medicine. Upon receiving his MD, he completed his residency at Brown University. He practiced family medicine for 23 years, both at Harvard Pilgrim Health Care and in private practice.

Dr. Miner presently holds memberships in the American Academy of Family Physicians, the Rhode Island and Massachusetts Academy of Family Physicians, and the American Urological Association, and he is a fellow of the Sexual Medicine Society of North America. He is the former president of the American Society for Men’s Health and the current historian. He is the vice president of the Androgen Society, developed for the education of providers on the truths of testosterone therapy. Dr. Miner has served on the AUA Guideline Committees for erectile dysfunction, Peyronie’s disease, testosterone deficiency, and early screening for prostate cancer. He has served on the testosterone committees of the International Consultation on Sexual Medicine. He has presented both at the NIH and the White House on men’s health initiatives and has authored over 150 peer-reviewed publications and spoken nationally and internationally in multiple venues. He has co-chaired the Princeton III and is a steering committee member and one of the lead authors of Princeton IV, constructing guidelines for the evaluation of erectile dysfunction, the use of PDE5 inhibitors, and cardiac health and prevention.

Dr. Miner was chosen as the Brown Teacher of the Year in 2003 and 2007 and was recognized by the Massachusetts Medical Society’s Award as achieving the most significant contribution to Men’s Health: 2012.

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