Lexapro Vs. Paxil Side Effects

Paxil (paroxetine) and Lexapro (escitalopram) are selective serotonin reuptake inhibitors (SSRIs) primarily used for treating major depression. Low levels of serotonin, a neurotransmitter in the brain, is a cause of major depression. SSRIs work by increasing serotonin levels in the brain.

Interactions

• Paroxetine and escitalopram should not be taken with monoamine oxidase inhibitors (MAOIs) due to the high risk of a potentially fatal reaction. Taking paroxetine or escitalopram with warfarin may cause rectal bleeding.

Side Effects

• Common side effects of paroxetine and escitalopram include dry mouth, weight gain, hypertension, headache, sexual dysfunction, insomnia, fatigue and gastrointestinal disturbances. These side effects are common for all SSRIs.

Sexual Dysfunction

• Paroxetine has a higher rate of sexual dysfunction than escitalopram. Sexual dysfunction includes decreased libido, inability to achieve an orgasm and erectile dysfunction.

Discontinuation Syndrome

• Paroxetine and escitalopram may cause discontinuation syndrome if use is abruptly ceased. Paroxetine has a greater frequency of discontinuation syndrome, and the symptoms are typically more severe than other SSRIs, such as escitalopram. Symptoms of discontinuation syndrome include dizziness, poor coordination, tiredness, tingling, burning, or "electric shock" sensations throughout the body, blurred vision and insomnia.

Alternatives

• If paroxetine and escitalopram are ineffective or poorly tolerated, other medications should be considered. Alternatives include SNRIs (i.e. velafaxine, duloxetine), NaSSAs (i.e. mirtazepine, mianserin), NRIs (atamoxetine, mazindol), tricyclics (i.e. amitryptyline, doxepine) and bupropion.