Is Paxil Better Than Lorazepam? Understanding the Key Differences for Anxiety

October 10, 2025 •

3 min read

While both Paxil (paroxetine) and lorazepam (Ativan) are prescribed for anxiety, they belong to different drug classes and are intended for distinct treatment strategies. The question, 'Is Paxil better than lorazepam?', cannot be answered with a simple yes or no, as their efficacy depends heavily on the specific condition being treated, whether it requires long-term management or short-term relief. A healthcare provider's recommendation is crucial for determining the most appropriate option based on your individual needs and medical history.

Quick Summary

This article explains why Paxil and lorazepam are not interchangeable, outlining their different mechanisms of action and intended uses. It provides a detailed comparison of these medications for treating anxiety, highlighting key differences in their effects, onset time, side effects, and risk of dependence. The content emphasizes that the 'better' medication is determined by the specific treatment goals and patient profile.

Key Points

Intended Use: Paxil is for long-term management of chronic anxiety and depression, while lorazepam is for short-term, acute relief of severe anxiety or panic attacks.
Dependency Risk: Lorazepam carries a high risk of dependence and addiction, especially with prolonged use, unlike Paxil, which is not traditionally considered addictive but can cause discontinuation symptoms.
Speed of Action: Lorazepam provides rapid relief (within minutes), whereas Paxil takes several weeks of consistent use to achieve its full therapeutic effect.
Withdrawal Symptoms: Abruptly stopping lorazepam can lead to severe and dangerous withdrawal symptoms, including seizures. Paxil withdrawal, or discontinuation syndrome, is also unpleasant but typically manageable with a slow, medically-supervised taper.
Drug Class: Paxil is a Selective Serotonin Reuptake Inhibitor (SSRI), affecting serotonin levels. Lorazepam is a benzodiazepine, which enhances the calming effect of GABA.
Overall Decision: Neither medication is inherently 'better'; the choice depends on the patient's condition and treatment goals. For chronic issues, Paxil is preferred, while lorazepam is reserved for acute situations.

Paxil (Paroxetine): A Long-Term Solution

Paxil (paroxetine) is an SSRI that increases serotonin in the brain to help regulate mood. It is used for long-term treatment of conditions such as depression, GAD, social anxiety, OCD, panic disorder, PTSD, and PMDD. Unlike lorazepam, Paxil takes several weeks of consistent use for its full effect.

Potential risks and side effects of Paxil

Common side effects of Paxil include nausea, headache, dry mouth, sleep problems, weakness, and sexual dysfunction. It may carry a higher risk of sexual dysfunction and weight gain than other SSRIs. Serious risks are less common but can include serotonin syndrome and increased suicidal thoughts, particularly in young adults. Stopping Paxil requires a gradual tapering to avoid withdrawal symptoms, also known as antidepressant discontinuation syndrome.

Lorazepam (Ativan): A Short-Term, Rapid-Acting Rescue

Lorazepam (Ativan) is a benzodiazepine that enhances the calming neurotransmitter GABA, slowing brain activity. It has a fast onset (20-30 minutes) and is used for short-term treatment of acute anxiety, panic attacks, insomnia, and seizures.

Risks of lorazepam and short-term use recommendation

The main risk of lorazepam is physical dependence and addiction, which increases with dose and duration. It is typically recommended for no more than 2 to 4 weeks. Common side effects include drowsiness, dizziness, sedation, impaired coordination, and weakness. Long-term use can lead to cognitive issues, memory problems, and rebound anxiety. Abrupt cessation is dangerous and can cause severe withdrawal symptoms, including seizures, requiring medical supervision for tapering.

Is Paxil Better Than Lorazepam?

Whether Paxil is better than lorazepam depends on the treatment goal, as they serve different purposes. Lorazepam is for acute, short-term relief, while Paxil is for chronic, long-term management.

Acute vs. Chronic: Lorazepam is for short-term symptom management; Paxil is for long-term condition management.
Onset Time: Lorazepam works quickly (minutes); Paxil takes several weeks.
Dependency Risk: Lorazepam has a high risk of dependence; Paxil has a low risk of addiction but can cause discontinuation symptoms.
Withdrawal: Lorazepam withdrawal can be severe; Paxil withdrawal is manageable with tapering.

Comparison Table: Paxil vs. Lorazepam


Feature	Paxil (Paroxetine)	Lorazepam (Ativan)
Drug Class	SSRI	Benzodiazepine
Primary Use	Long-term management of chronic conditions	Short-term relief of acute anxiety and panic attacks
Mechanism of Action	Increases serotonin levels	Enhances GABA's calming effect
Onset of Effect	Slow (weeks)	Rapid (20-30 minutes)
Duration of Action	Long-lasting	Shorter (typically 6-8 hours)
Dependency Potential	Low risk of addiction, can cause physical dependence	High risk of physical dependence and abuse
Withdrawal Symptoms	Can cause discontinuation syndrome; managed with tapering	Can cause severe, life-threatening withdrawal, including seizures
Controlled Substance	No	Yes, Schedule IV

Making an Informed Decision

A healthcare provider should determine the appropriate medication based on a comprehensive assessment of the patient's condition, symptoms, and medical history. Sometimes, lorazepam is used initially for rapid relief while Paxil's long-term effects develop, after which lorazepam is tapered off. The National Alliance on Mental Illness (NAMI) website is a reliable source for more information on medication side effects.

Conclusion: No Simple Answer

Paxil and lorazepam serve distinct roles in treatment; Paxil for chronic management and lorazepam for acute relief. They are not interchangeable, and the best choice is determined by a healthcare provider based on the patient's specific needs. Never stop or switch medications without medical supervision due to withdrawal risks.

Frequently Asked Questions

Yes, in some cases, a healthcare provider may prescribe both. For example, lorazepam might be used for short-term, immediate relief from severe anxiety symptoms while Paxil, the long-term treatment, builds up its effect over several weeks.

Paxil is considered safer for long-term treatment. Lorazepam carries a high risk of dependence and addiction with prolonged use and is not recommended for more than 2 to 4 weeks.

Paxil (an SSRI) increases serotonin levels in the brain to regulate mood over time. Lorazepam (a benzodiazepine) enhances the calming neurotransmitter GABA, producing a rapid sedative effect.

Yes. Paxil can cause side effects like sexual dysfunction, weight gain, and nausea. Lorazepam's common side effects include drowsiness, dizziness, and impaired coordination. Both can cause withdrawal symptoms if stopped incorrectly.

Yes, lorazepam is a Schedule IV controlled substance due to its potential for abuse and dependence. Paxil is not a controlled substance.

Lorazepam starts working quickly, within about 20-30 minutes, providing rapid relief for acute anxiety. Paxil, on the other hand, can take several weeks for its full therapeutic effects to become apparent.

Stopping lorazepam suddenly can lead to severe and dangerous withdrawal symptoms, including rebound anxiety, insomnia, agitation, and even seizures. A gradual tapering under medical supervision is required.

Yes. While not an addictive drug in the traditional sense, Paxil can cause physical dependence. If stopped abruptly, it can lead to a discontinuation syndrome with symptoms like dizziness, nausea, and 'brain zaps.' Tapering down slowly is necessary.