Paroxetine (Paxil) is an antidepressant used to treat symptoms of a range of conditions. It may be used for depression, generalized anxiety disorder (GAD), and social anxiety disorder. It may also treat obsessive-compulsive disorder (OCD). Paxil is part of a class of drugs called selective serotonin reuptake inhibitors (SSRIs). It improves mood by altering levels of chemicals in the brain called neurotransmitters.
As with other SSRIs, mixing alcohol with Paxil can lead to some uncomfortable side effects. But Paxil can lead to other potentially surprising problems with alcohol.
People who take Paxil should avoid alcohol while they’re on the medication. One reason is that alcohol can make Paxil less effective. If the drug doesn’t work as well, your symptoms may come back.
Alcohol can also increase some of Paxil’s side effects, especially dizziness, sleepiness, and trouble concentrating. Other side effects that may be exacerbated with alcohol include:
- abnormal thoughts
- changes in vision
- hallucinations (seeing or hearing things that are not really there)
- high or low blood pressure
- increased sex drive
- intense excitement or lack of emotion
- irregular heart rhythm
- joint pain
- loss of feeling
- nausea, vomiting, or diarrhea
- racing thoughts or excess energy (mania)
- rigid muscles, poor muscle control, or uncontrolled muscle movements
- suicidal thoughts or actions
- uncontrollable laughing and/or crying
- weight gain
Some people who rely on alcohol to feel more comfortable in social settings may find help in Paxil. A study in the journal Alcoholism: Clinical & Experimental Research investigated the relationship between Paxil and social drinking. Researchers found the drug could help people engage in social situations more easily, reducing the need for alcohol. In turn, this reduced reliance for social comfort could lead to a reduction in alcohol dependence and abuse.
However, some research has linked SSRIs like Paxil to increased alcohol cravings and abuse. That risk might be higher in people who carry certain genes that already make them more susceptible to alcohol abuse. In a review of studies on SSRIs and alcohol dependence, researchers found the drugs actually led to an increase in alcohol consumption in some groups.
This side effect is very rare, and the research is still in its early stages. More studies need to be done to confirm whether there is really a link between Paxil and alcohol abuse. For now, it’s important to avoid alcohol entirely, or use it very carefully while you’re taking any SSRI. Let your doctor know right away if you start to feel an urge to drink.
Beyond alcohol, Paxil can also interact with a number of other drugs you might be taking. While you’re on Paxil, you should avoid taking MAOI inhibitors and thioridazine (Mellaril). You should also avoid the antipsychotic medicine pimozide (Orap). These medicines can cause serious side effects when taken together with Paxil.
According to information from the National Institutes of Health, other drugs that can cause problems when taken with Paxil include:
- cimetadine (Tagamet), used to treat gastroesophageal reflux disease (GERD)
- fentanyl, an opioid pain reliever
- drugs that thin the blood (warfarin, aspirin, ibuprofen)
- epilepsy medicines
- medicines used to treat irregular heartbeats, schizophrenia, and HIV infection
- metoprolol (Lopressor, Toprol XL), a blood pressure lowering drug
- other antidepressants (tricyclics, lithium, SNRIs, or SSRIs)
- pimozide (Orap), an antipsychotic drug
- procyclidine (Kemadrin), a drug used to treat Parkinson’s disease
- tamoxifen, a breast cancer drug
- triptans used to treat migraine headaches
If your doctor has prescribed Paxil or another drug in this class, ask about all the possible side effects and interactions it can cause. Be careful about using alcohol or medicines that might interact with your antidepressant.
If you feel that Paxil is increasing your alcohol use, talk about it with your doctor. They may be able to recommend a medication better suited for you.