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Paxil Withdrawal: How To Stop Taking Paroxetine Safely

Last Updated: February 14, 2022

Authored by Roger Weiss, MD

Reviewed by Michael Espelin APRN

Paxil (generic name paroxetine) is an SSRI, a class of drugs that are typically used to treat depression and anxiety. Paroxetine for hot flashes and premature ejaculation are also well-known uses of this medication. Studies indicate that about 40 million American citizens use antidepressants. Most of these people do not get their prescriptions from qualified psychiatrists, but rather consult a family doctor. These family doctors may not have the requisite knowledge to properly educate their patients about the health consequences of taking an antidepressant. Some antidepressants are difficult to quit and Paroxetine is one of them. Although it is not habit-forming, there are specific side effects of stopping the drug abruptly. These effects are referred to as paroxetine withdrawal syndrome.

What Is Paxil Withdrawal?

Quitting psychiatric medications can be tricky, even under a physician’s supervision. What is Paroxetine? It is a psychiatric medication that works by inhibiting the reabsorption of serotonin in the brain. When paroxetine is suddenly stopped, the body responds with specific physical and emotional withdrawal symptoms caused by the sudden absence of serotonin.

Withdrawal effects can occur when a low dose such as Paroxetine 20 mg daily is stopped suddenly, but these effects are more likely with higher doses and after a relatively longer duration of treatment.

Symptoms of withdrawing from Paroxetine cold turkey are known to be severely debilitating or even dangerous. These symptoms are collectively referred to as discontinuation syndrome and are more common due to the short half-life of Paroxetine. They require careful medical management, detoxification, and a gradual dose reduction by trained healthcare professionals. In contrast, comparing Paxil vs Prozac, extreme discontinuation is unlikely with Prozac (fluoxetine) due to its long half-life.

Paxil Withdrawal Symptoms

Paxil withdrawal symptoms can take some time to disappear and this can be frustrating for some people. Paroxetine withdrawal symptoms occur between 2 – 4 days after the patient begins quitting. However, the benefits of quitting Paxil far outweigh the health problems the symptoms might pose. So, patients should not give up regardless of the frustration and intensity of the Paxil withdrawal symptoms.

The Main Paroxetine Withdrawal Symptoms Are:

  • Headache
  • Vertigo
  • Nausea
  • Confusion
  • Anxiety
  • Agitation
  • Irritability
  • Insomnia
  • Excessive dreams and nightmares
  • Paxil flu with fatigue, lethargy, achiness, sweating
  • Suicidal ideation

How long the Paxil withdrawal symptoms last depend on the length of the drug usage. Also, a patient who has been administering large doses of the drug may suffer severe Paroxetine withdrawal signs. In any case, people should avoid stopping the drug cold turkey as that could worsen the health condition of the individual. It is advisable to strictly follow a Paxil withdrawal timeline under the supervision of a medical doctor.

A woman experiencing paxil withdrawal symptoms holds paxil pills in her hand.

Paxil Withdrawal Timeline

The intensity and duration of antidepressant discontinuation symptoms depend on the dose and length of treatment. Each patient’s physiology also determines it. It can take the brain about 90 days to get acquainted with withdrawing from the medication. So, it is important for both a health professional and patient to closely monitor symptom changes. This will help them to notice any drastic changes and ensure treatment before the situation worsens.

When do Paroxetine discontinuation symptoms start? And how long do they last?

Here Is a Paxil Withdrawal Timeline and the Effects of the Symptoms:

  • Days 1-2: Typically, the discontinuation syndrome begins 24 to 48 hours after the drug is discontinued, and signs first appear during this timeframe. Mild symptoms may be present even when the dose is tapered slowly.
  • Days 3-5: Signs usually peak during this time. Symptoms are more intense if a larger dose was taken for a longer duration of time.
  • Days 5-21: Signs may persist for 2-3 weeks after quitting the drug cold turkey. However, they should slowly resolve over time.
  • Week 3+: If symptoms last more than 3-4 weeks or continue to worsen, it is imperative to seek medical attention, since this could indicate a relapse of depression rather than discontinuation.

Quitting the drug cold turkey or skipping prescribed doses can trigger Paxil withdrawal symptoms. The solution is to get back to taking the medication while you and your physician work out a Paxil withdrawal timeline. Patients can also try home remedies for Paxil withdrawal including exercising and seeking support from family and peers to help with tapering off. Patients should never quit Paroxetine on their own without a timeline to avoid Paxil withdrawal symptoms.

Stopping Paxil Safely

To quit Paxil safely, there are two methods; stopping abruptly and tapering off. Both methods have their advantages and disadvantages. Stopping the drug abruptly involves going off the medication at once. Though this is very tempting especially when the patient is fed up with the medication, it is not advisable. Doing this can result in serious health consequences. The best way is to use the tapering method which involves reducing the dosage gradually with the help of a physician.

The incidence and severity of discontinuation signs and symptoms vary from person to person but depend significantly on a proper gradual taper. In other words, the risk of discontinuation syndrome can be minimized by reducing the dose of the medication very slowly rather than stopping it suddenly. The duration of the paroxetine taper may be prolonged and depends on the length of treatment, daily dose, and other physiological factors.

Patient education plays an essential role in avoiding withdrawal. People who are prescribed paroxetine should be informed about the possibility of withdrawing upon sudden discontinuation of the drug. Well-informed patients are less likely to stop paroxetine cold turkey. The important thing is to stop Paxil under medical supervision.  A doctor will provide the patient with a precise tapering schedule to minimize the chances of withdrawal syndrome. Following these instructions and taking the medication as directed can go a long way in safely and comfortably coming off paroxetine.

How To Manage Discomforting Paxil Withdrawal Symptoms

Withdrawing from Paroxetine comes with its associated challenges which include symptoms. The gradual dosage reduction may help the symptoms but still, the patient may feel some discomfort. This can be discouraging and may lead to anxiety and depression. However, all hope is not lost.

Here Are a Few Home Remedies for Paxil Withdrawal That One Can Implement To Help Manage the Discomfort That Comes With Tapering off Paroxetine:

  • Exercise, Eat Well, and Sleep Regularly– Staying fit and active can help to reduce the symptoms and discomfort. Regular exercise releases stress and acts as a natural antidepressant. Eating healthy foods also boosts energy levels and helps one to feel good. Sleeping well and regularly improves one’s mental health and boosts the immune system. Combining all three will greatly reduce both the adverse effects of Paxil and withdrawal symptoms.
  • Update Health Officials Regularly– Patients should keep medical doctors in the loop on changes in signs and symptoms. Doctors can help patients understand these symptoms and provide useful and practical advice. Updating doctors can help patients stay calm and rest assured.
  • Other Drugs– Patients can use other drugs to help with the withdrawal symptoms. However, these drugs need to be prescribed by medical professionals. Some SSRIs with lower half-lives can help with the tapering off of Paxil. Some symptoms of antidepressant withdrawals include digestive disorders. So herbal supplements that contain ginger may come in handy.
  • Join Counseling Sessions and Detoxification Programs– Sharing your experience with people who are undergoing similar treatment programs helps with the discomfort. Such groups even provide other alternatives and practical ways to cope with the symptoms. Speaking with counselors also helps to prevent depression due to the nagging and discomforting withdrawal signs.
  • Strictly Follow and Monitor Tapering Dose– To enjoy the benefits of quitting Paxil, patients have to stick strictly to the tapering dosage prescribed by doctors. Skipping a dose can trigger the onset of symptoms and can lead to depression. Even if the dosage is small, patients must still adhere to the timeline. The use of Paxil causes weight gain, thus patients shouldn’t be alarmed when they notice weight changes while adhering to the prescribed dosage.

Getting Professional Help During Paroxetine Withdrawal

Stopping Paxil cold turkey is not a good idea as it can lead to potential discontinuation syndrome. So, how to wean off Paxil? The safest way is to reduce the dose gradually under medical supervision. It is worth noting that there are other safety issues associated with paroxetine. Paxil and Wellbutrin taken together are associated with an increased risk of seizures. The United States Food and Drug Administration (FDA) has issued a warning that withdrawal from paroxetine, a widely prescribed antidepressant, can be severe.

This underlines the importance of knowing how to taper off Paxil. For years, this drug has been promoted by pharmaceutical manufacturers as non-addictive, safe, and easy to discontinue. However, there is enough evidence that withdrawal symptoms from paroxetine can be intolerable and potentially lead to dependence that requires medical treatment. Luckily, many drug abuse rehabs have high success rates in treating antidepressants addiction.

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Page Sources

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  3. A. Framer. (2021). What I Have Learnt from Helping Thousands of People Taper off Antidepressants and Other Psychotropic Medications. Therapeutic Advances in Psychopharmacology. https://journals.sagepub.com/doi/full/10.1177/2045125321991274#_i19
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Published on: May 23rd, 2019

Updated on: February 14th, 2022

About Author

Roger Weiss, MD

Dr. Roger Weiss is a practicing mental health specialist at the hospital. Dr. Weiss combines his clinical practice and medical writing career since 2009. Apart from these activities, Dr. Weiss also delivers lectures for youth, former addicts, and everyone interested in topics such as substance abuse and treatment.

Medically Reviewed by

Michael Espelin APRN

8 years of nursing experience in wide variety of behavioral and addition settings that include adult inpatient and outpatient mental health services with substance use disorders, and geriatric long-term care and hospice care.  He has a particular interest in psychopharmacology, nutritional psychiatry, and alternative treatment options involving particular vitamins, dietary supplements, and administering auricular acupuncture.