Two medicines, side by side
Alprazolam vs paroxetine
Alprazolam and paroxetine are both labeled for anxiety. Drugs@FDA records approvals of alprazolam since 1981 and of paroxetine since 1992. Pharmacies paid $0.0236 per alprazolam 0.25 mg tablet and $0.0611 per paroxetine HCl 20 mg tablet (NADAC, October 7, 2026); the strengths differ, so the two prices are not like for like. In FDA's classes, alprazolam is a benzodiazepine and paroxetine a serotonin reuptake inhibitor.
Check it at the source: the alprazolam FDA label on DailyMed (effective January 18, 2023); the paroxetine FDA label on DailyMed (effective February 12, 2026).
Highlights of the alprazolam record
Alprazolam (Xanax) · label of January 18, 2023
RISKS FROM CONCOMITANT USE WITH OPIOIDS; ABUSE, MISUSE, AND ADDICTION; and DEPENDENCE AND WITHDRAWAL REACTIONS
Concomitant use of benzodiazepines and opioids may result in profound sedation, respiratory depression, coma, and death. Reserve concomitant prescribing of these drugs for patients for whom alternative treatment options are inadequate. Limit dosages and durations to the minimum required.
Used for
From the label: indicationsXANAX is indicated for the: • acute treatment of generalized anxiety disorder (GAD) in adults. • treatment of panic disorder (PD), with or without agoraphobia in adults. XANAX is a benzodiazepine indicated for the: • Acute treatment of generalized anxiety disorder in adults. ( 1 ) • Treatment of panic disorder with or without agoraphobia in adults.
On the market
- Earliest approval on file
- October 16, 1981
- Generic labelers
- 30 labelers
- Pharmacy cost
- $0.0236 per tablet
Supply and safety
- Shortage
- No current entry
- Recalls
- 23
Highlights of the paroxetine record
Paroxetine (Paxil) · label of February 12, 2026
SUICIDAL THOUGHTS AND BEHAVIORS Antidepressants increased the risk of suicidal thoughts and behaviors in pediatric and young adult patients in short-term studies. Closely monitor all antidepressant-treated patients for clinical worsening, and for emergence of suicidal thoughts and behaviors [see Warnings and Precautions (5.1) ]. Paroxetine tablets are not approved for use in pediatric patients [see Use in Specific Populations (8.4) ].
Used for
From the label: indicationsParoxetine tablets are indicated in adults for the treatment of: • Major depressive disorder (MDD) • Obsessive compulsive disorder (OCD) • Panic disorder (PD) • Social anxiety disorder (SAD) • Generalized anxiety disorder (GAD) • Posttraumatic stress disorder (PTSD) Paroxetine tablets are a selective serotonin reuptake inhibitor (SSRI) indicated in adults for the treatment of ( 1 ): • Major Depressive Disorder (MDD) • Obsessive Compulsive Disorder (OCD) • Panic Disorder (PD) • Social Anxiety Disorder (SAD) • Generalized Anxiety Disorder (GAD) • Posttraumatic Stress Disorder (PTSD) […]
On the market
- Earliest approval on file
- December 29, 1992
- Generic labelers
- 45 labelers
- Pharmacy cost
- $0.0611 per tablet
Supply and safety
- Shortage
- No current entry
- Recalls
- 15
Source: FDA drug labels via openFDA (Alprazolam label of January 18, 2023, Paroxetine label of February 12, 2026); NDC Directory, Drugs@FDA, NADAC, FDA shortages and recalls (October 8, 2026)
How do alprazolam and paroxetine differ on the record?
In FDA's classes, alprazolam is a benzodiazepine and paroxetine a serotonin reuptake inhibitor.
How each works, in its label's words: Alprazolam, “Alprazolam is a 1,4 benzodiazepine.”; Paroxetine, “The mechanism of action of paroxetine tablets in the treatment of MDD, SAD, OCD, PD, GAD, and PTSD is unknown, but is presumed to be linked to potentiation of serotonergic activity in the central …”
Half-life, in each label's words: Alprazolam, “Elimination The mean plasma elimination half-life (T 1/2 ) of alprazolam is approximately 11.2 hours (range: 6.3 to …”; Paroxetine, “Elimination Metabolism The mean elimination half-life is approximately 21 hours (CV 32%) after oral dosing of 30 mg …”
Both labels carry a boxed warning; the records quote them.
Generics: alprazolam since 1993; paroxetine since 2003 (Drugs@FDA).
DEA schedule: alprazolam CIV; paroxetine none.
| Alprazolam | Paroxetine | |
|---|---|---|
| Labeled for | Anxiety | Depression, Anxiety, Menopause symptoms |
| Pharmacologic class | Benzodiazepine | Serotonin Reuptake Inhibitor |
| How it works (label) | Alprazolam is a 1,4 benzodiazepine. | The mechanism of action of paroxetine tablets in the treatment of MDD, SAD, OCD, PD, GAD, and PTSD is unknown, but is presumed to be linked to potentiation of serotonergic activity in the central nervous system resulting from inhibition of … |
| Half-life (label) | Elimination The mean plasma elimination half-life (T 1/2 ) of alprazolam is approximately 11.2 hours (range: 6.3 to 26.9 hours) in healthy adults. | Elimination Metabolism The mean elimination half-life is approximately 21 hours (CV 32%) after oral dosing of 30 mg tablets daily for 30 days of paroxetine tablets. |
| Earliest approval on file (Drugs@FDA) | October 16, 1981 | December 29, 1992 |
| First generic approved | October 19, 1993 | July 30, 2003 |
| Generic labelers (NDC) | 30 labelers | 45 labelers |
| Pharmacy cost (NADAC, each one's most listed form; strengths differ) | $0.0236 per tablet (Alprazolam 0.25 mg tablet) | $0.0611 per tablet (Paroxetine HCl 20 mg tablet) |
| 12-month price change | -1% | -16% |
| Boxed warning | Yes | Yes |
| Shortage now | No current entry | No current entry |
| Recalls recorded | 23 | 15 |
| FAERS reports (a report is not proof of cause; counts follow how widely a medicine is used) | 204,916 | 41,809 |
| DEA schedule | CIV | none |
Source: Drugs@FDA, FDA NDC Directory, CMS NADAC of October 7, 2026, FDA shortages and recalls, FAERS via openFDA (FDA files October 8, 2026)
What do the labels say about using others of their kind?
Alprazolam label, drug interactionsCNS Depressants Clinical implication The benzodiazepines, including alprazolam, produce additive CNS depressant effects when coadministered with other CNS depressants.
Paroxetine label, warnings and precautionsIncreased risk when co-administered with other serotonergic agents, but also when taken alone.
Source: FDA drug labels via openFDA
What next?
- Alternatives to alprazolam
- every medicine labeled for the same conditions