Paroxetine Dosage: What You Need to Know

If you’ve been prescribed paroxetine, the first question on most people’s minds is “how much should I take?” The answer isn’t a one‑size‑fits‑all number. Paroxetine comes in several strengths, and doctors tailor the dose based on what you’re treating, your age, and how your body reacts. Below we break down the most common dosing patterns, what to expect when you start, and how to adjust safely.

Standard Starting Doses

For most adults with major depressive disorder, doctors begin with 20 mg once daily. This dose is usually taken in the morning to avoid nighttime insomnia, a common side effect. If you’re treating generalized anxiety disorder or panic disorder, the same 20 mg start works for many, but some clinicians prefer 10 mg daily for extra caution.

Teenagers (13‑17 years) with OCD often start at 10 mg daily, because their metabolism can be faster and they’re more sensitive to side effects. The dose may be bumped up to 20 mg after a week or two if the medication is well tolerated.

Older adults (65+ years) usually start low—often 10 mg daily—and stay at that level longer. Their liver and kidney function can change with age, so a slower climb helps avoid dizziness, low blood pressure, or excessive sedation.

Adjusting the Dose Safely

Once you’ve been on the starting dose for about 1‑2 weeks, your doctor will check how you feel. If symptoms are still strong and you’re handling side effects, the dose may be increased by 10‑20 mg increments. The typical ceiling for most adults is 50 mg daily, though some people need up to 60 mg for severe OCD.

When you increase the dose, do it in steps. Jumping from 20 mg straight to 50 mg can cause nausea, headache, or a sudden rise in anxiety. A gradual climb lets your body adapt and gives you and your doctor a chance to spot any trouble early.

Never cut the dose in half or stop abruptly. Paroxetine has a half‑life of about 21 hours, so stopping suddenly can trigger withdrawal symptoms like irritability, flu‑like aches, or electric‑shock sensations. If you need to quit, your doctor will taper you down over a few weeks, usually by 10 mg every 1‑2 weeks.

Special situations call for extra caution. If you’re pregnant, breastfeeding, or taking other meds that affect serotonin (like other SSRIs, tramadol, or St. John’s wort), you’ll need tighter monitoring. Your doctor might keep you on the lowest effective dose to reduce risks.

Remember to take paroxetine at the same time each day. Consistency helps keep blood levels steady, which reduces mood swings and side effects. If you miss a dose, take it as soon as you remember—unless it’s almost time for the next dose. In that case, skip the missed one and continue with your regular schedule. Never double up.

Finally, keep a simple log. Jot down the dose, time you take it, how you feel, and any side effects. Bring this log to your appointments. It gives your prescriber concrete data to decide whether to stay, increase, or lower the dose.

Paroxetine can be a powerful tool for depression, anxiety, OCD, and PTSD when used correctly. By starting low, moving slowly, and staying in touch with your doctor, you’ll find the dose that balances relief with the fewest side effects. If you ever feel unsure, reach out to your healthcare provider—adjustments are part of the process, not a sign of failure.