duloxetine vs paroxetine

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Side-by-side comparison of duloxetine and paroxetine. Data from FDA drug databases (Orange Book, NDC Directory, recalls, shortages) covering 20,000+ approved drugs, plus CMS pricing; see our methodology.

minor Known Drug Interaction

7.2 Inhibitors of CYP2D6 Concomitant use of duloxetine (40 mg once daily) with paroxetine (20 mg once daily) increased the concentration of duloxetine AUC by about 60%, and greater degrees of inhibition are expected with higher doses of paroxetine.

Drug Class
duloxetine Serotonin-Norepinephrine Reuptake Inhibitor (SNRI)
paroxetine Selective Serotonin Reuptake Inhibitor (SSRI)
Type
duloxetine Prescription
paroxetine Prescription
Summary
duloxetine

Duloxetine is a medicine that can help treat depression and anxiety. It can also help with certain types of pain.

paroxetine

Paroxetine (Paxil) is a medicine that can help treat depression and anxiety disorders. It belongs to a class of drugs called selective serotonin reuptake inhibitors (SSRIs).

What It Treats
duloxetine

Duloxetine can treat major depressive disorder and generalized anxiety disorder in adults and children (7 years and older). It can also treat diabetic nerve pain, fibromyalgia, and chronic muscle or bone pain in adults. In children, it can treat fibromyalgia (13 years and older).

paroxetine

Paroxetine is used to treat several conditions in adults. These include major depressive disorder (MDD), obsessive compulsive disorder (OCD), panic disorder (PD), social anxiety disorder (SAD), generalized anxiety disorder (GAD), and posttraumatic stress disorder (PTSD). It helps to improve mood and reduce anxiety and panic feelings.

How It Works
duloxetine

Duloxetine is a type of drug called an SNRI. It works by increasing the levels of serotonin and norepinephrine in your brain. These chemicals can help improve mood and reduce pain.

paroxetine

Paroxetine works by increasing the amount of serotonin in your brain. Serotonin is a natural substance that helps regulate mood. By increasing serotonin levels, paroxetine can help improve symptoms of depression and anxiety.

Common Side Effects
duloxetine
  • Nausea
  • Dry mouth
  • Sleepiness
  • Constipation
  • Decreased appetite
paroxetine
  • Abnormal ejaculation
  • Weakness or fatigue
  • Constipation
  • Decreased appetite
  • Diarrhea
FAERS Reports
duloxetine
  • Fatigue 4,787
  • Nausea 4,782
  • Pain 3,697
  • Headache 3,654
  • Diarrhoea 3,262
paroxetine
  • Drug Interaction 1,825
  • Fatigue 1,821
  • Nausea 1,738
  • Toxicity To Various Agents 1,579
  • Anxiety 1,476
Serious Warnings
duloxetine

Antidepressants may increase the risk of suicidal thoughts and behaviors in children, teenagers, and young adults. Watch closely for worsening depression or suicidal thoughts. Tell your doctor right away if you notice any changes in mood or behavior.

paroxetine

Antidepressants may increase the risk of suicidal thoughts and behaviors in young adults. Your doctor will monitor you closely for worsening depression or suicidal thoughts. Paroxetine is not approved for use in children.

Pregnancy
duloxetine

Using duloxetine in the last month of pregnancy may cause problems in the newborn. Talk to your doctor about the risks and benefits of taking duloxetine during pregnancy. Women who stop taking antidepressants during pregnancy are more likely to experience a relapse of depression.

paroxetine

Paroxetine may cause harm to your unborn baby. Talk to your doctor if you are pregnant or plan to become pregnant. Taking paroxetine later in pregnancy may cause problems for the newborn.

Also Compare, Nearby Drugs

How to Read This duloxetine vs paroxetine Comparison

duloxetine is classified in the Serotonin-Norepinephrine Reuptake Inhibitor (SNRI) drug class, while paroxetine sits within the Selective Serotonin Reuptake Inhibitor (SSRI) class. Drugs from different classes work through distinct mechanisms, so a head-to-head comparison illustrates trade-offs rather than equivalence. Both drugs are prescription-only, so a licensed provider must authorize use.

Adverse event totals above are pulled from the FDA's Adverse Event Reporting System (FAERS). For these top-ranked reactions alone, duloxetine has 20,182 submissions while paroxetine has 8,439. Those figures reflect cumulative reporting volume, not per-patient risk, so older, widely dispensed drugs typically look worse on count alone. These two drugs have a known minor interaction flagged in FDA labeling, attributed to paroxetine blocks the protein your body uses to break down duloxetine, which can cause duloxetine levels to rise.. Serious warnings, pregnancy guidance, and contraindications can differ even when indications overlap.

A table cannot represent individual circumstances. Data here is sourced from FDA Structured Product Labels (SPL) and FAERS, both of which update as manufacturers and clinicians submit new information. This registry does not provide medical, treatment, substitution, or medication-change directions for duloxetine or paroxetine.

Registry boundary: This comparison displays source-record fields and does not provide individualized medical direction.