Drug Comparison
For educational purposes only — a decision-support tool, not a substitute for clinical judgment.
Side-by-side rubric across 96 psychiatric medications. Every rating traces to a verbatim primary-source quote — click any cell to see it.
How to read this tool ▾
Rating scale
– Favorable / lower than class baseline
± Minimal / equivocal
+ Low / uncommon
++ Moderate / common
+++ High / very common
++++ Very high / class-outlier
Frequency vs severity
F = frequency, S = severity. Each gets its own pill colored on the same traffic-light scale: green → blue → yellow → orange → red. Click any cell for incidence percentages and NNH.
Evidence tier
A Network meta-analysis / RCT / FDA label
B Cohort / registry / pooled label data
C Expert review / textbook / case series
Sourcing
Click any cell to see the verbatim source quote and citation. Missing data shows n/a.
Data depth
++ Graded — frequency + severity, primary-source traces
+ FDA label — §6 frequency only (dashed border). Click for sub-types.
Blank — not yet checked (not “absent”)
–±++++++++++ABCF = frequency · S = severity · Dashed border = FDA label only · Click cell for details
1 drug selected — Paroxetine(click to collapse)
1/4 selected
Paroxetine
Paxil · Brisdelle
Selective Serotonin Reuptake Inhibitor
FDA-approved indications
- Major depressive disorder (adults)
- Obsessive-compulsive disorder (adults)
- Panic disorder, with or without agoraphobia (adults)
- Social anxiety disorder (adults)
Off-label uses
- Generalized anxiety disorder
- Premature ejaculation
- Vasomotor symptoms (menopause)
Half-life21 hours
Decision GuideWhen to pick each / when to consider an alternative
Paroxetine
Consider when
- Comorbid depression with GAD — only SSRI FDA-approved for GAD (also MDD, OCD, panic, SAD, PTSD, PMDD)
- Top-tier MDD efficacy required when adherence is reliable — Cipriani 2018 top efficacy tier with escitalopram and vortioxetine
- Insomnia or agitation is therapeutically useful — most sedating SSRI (somnolence 23%); anxiolytic effect at initiation
- Breastfeeding when paroxetine otherwise indicated — low relative infant dose, undetectable infant plasma levels
- +1 more
Consider an alternative when
- Pregnancy or unreliable contraception — only SSRI with FDA embryofetal toxicity warning; cardiac malformation OR 1.8–3.3
- Sexual dysfunction is a concern — consistently highest SD rates among SSRIs across multiple datasets (Reichenpfader, FAERS)
- CYP2D6 substrates co-prescribed (tamoxifen, codeine, atomoxetine) — most potent CYP2D6 inhibitor among SSRIs with fluoxetine
- Adherence may falter — worst discontinuation syndrome among SSRIs; short t½ ~21 h with nonlinear PK amplifies missed-dose symptoms
- +1 more
Efficacy & Acceptability (2 axes)— NMA efficacy & discontinuation data (not side effects)
| Axis | Paroxetine |
|---|---|
| 📊 Efficacy (response rates) | |
MDDEfficacy | |
| 🛡️ Acceptability (all-cause discontinuation) | |
MDDAcceptability | |
| Axis | Paroxetine SSRI |
|---|---|
| Boxed Warnings | |
Suicidality (boxed warning) | |
Mania / hypomania induction | |
| CNS | |
Sedation / somnolence | |
Activation / insomnia | |
Emotional blunting | |
Seizure risk | |
| Metabolic | |
Weight gain | |
Bone mineral density / fracture | |
| Autonomic | |
Anticholinergic burden | |
Sweating | |
Angle-closure glaucoma | |
| Cardiac | |
QTc prolongation | |
| GI | |
Nausea / GI (general) | |
| Electrolytes | |
Hyponatremia / SIADH | |
| Sexual | |
Sexual dysfunction | |
| Discontinuation | |
Withdrawal / discontinuation | |
| Interactions | |
Serotonin syndrome risk | |
CYP interactions / DDI profile | |
| Safety | |
Bleeding risk | |
| Pregnancy | |
Teratogenicity | |