Paxil Withdrawal Symptoms And Timeline

Last Updated: December 18, 2019

Authored by Roger Weiss, MD

Paxil (generic name paroxetine) is an SSRI, a class of drugs that are typically used to treat depression and anxiety. Although it is not habit forming, there are specific side effects of stopping Paxil abruptly. These effects are referred to as paroxetine discontinuation syndrome. What are the common signs and symptoms associated with getting off Paxil? Is it safe to quit this medication cold turkey? And what can be done to prevent Paxil withdrawal symptoms? Read on to find out.

What Is Paroxetine Withdrawal?

Quitting psychiatric medications can be tricky, even under a physician’s supervision, and this is true for Paxil generic name paroxetine. What is Paxil? 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.
Paxil withdrawal symptoms cold turkey are known to be severely debilitating or even dangerous. These withdrawal symptoms are collectively referred to as discontinuation syndrome and are more common due to the short half-life of Paxil. They require careful medical management, detoxification, and a gradual dose reduction by trained healthcare professionals. In contrast, comparing Paxil vs. Prozac, extreme withdrawal is unlikely with Prozac (fluoxetine) due to its long half-life.

Signs and Symptoms of Paroxetine Withdrawal

The main signs and symptoms of coming off paroxetine are:

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

man experiencing paxil withdrawal flu-like symptoms

Paxil Withdrawal Timeline

The intensity and duration of withdrawal symptoms depend on the dose and length of treatment. Each patient’s physiology also determines it. When do Paxil withdrawal symptoms start? And how long do Paxil withdrawal symptoms last? Here is a timeline of withdrawal effects:

  1. Days 1-2: Typically, the discontinuation syndrome begins 24 to 48 hours after the drug is discontinued, and withdrawal symptoms first appear during this timeframe. Mild symptoms may be present even when the dose is tapered slowly.
  2. Days 3-5: Signs and symptoms usually peak during this time. Symptoms are more intense if a larger dose was taken for a longer duration of time.
  3. Days 5-21: Symptoms may persist for 2-3 weeks after quitting Paxil cold turkey. However, they should slowly resolve over this time.
  4. 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 withdrawal.

Preventing Side Effects of Stopping Paxil

Discontinuation syndrome and the associated effects can be restricted by tapering off Paxil gradually. How to taper off Paxil? The one-word answer is – slowly. The incidence and severity of withdrawal signs and symptoms vary from person to person but depends significantly on a proper gradual taper. In other words, the risk of withdrawal 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 symptoms. People who are prescribed paroxetine should be informed about the possibility of withdrawal 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.

Paroxetine Detox Process

How to get off Paxil safely and with minimum side effects? Detox from Paxil is the process of letting the drug slowly leave the body while minimizing withdrawal syndrome. Paroxetine detox typically does not require an inpatient stay and can be completed at home. The detox process involves a gradual step down in dose over several weeks to months. Detox from this drug is associated with symptoms such as suicidal ideation, especially in young adults under the age of 25. Therefore, regular monitoring and follow-ups during the detox process are necessary to ensure there are no adverse effects.

Paxil Withdrawal Help: Medications Used During Detox

For patients who have bothersome Paxil withdrawal side effects, one or two doses of another SSRI with a long half-life, such as Prozac, may provide relief. However, it is crucial that this additional antidepressant is taken under medical guidance. A direct switch from Paxil to Prozac (fluoxetine) or Effexor (venlafaxine) saves on weaning time and provides immediate relief of depressive symptoms.

doctor holding two types pf pills

Home remedies for Paxil withdrawal include diphenhydramine (Benadryl), an OTC allergy medication, that is believed to be helpful; however, the use of this drug warrants caution since it can lead to severe sedation in combination with the antidepressant. There are also anecdotal reports that omega 3 fish oil and multivitamins can help with withdrawal effects, although there is no conclusive scientific evidence to support this claim. More research is also needed to study the effectiveness of N-acetyl cysteine and alpha lipoic acid in augmenting withdrawal therapy.

Quitting Paxil and Other Safety Issues

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. Paxil is readily available and commonly used recreationally; however, snorting Paxil is a dangerous habit. Studies have shown that there may be long-term effects of Paxil on the brain, especially in the elderly.

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.


Page Sources

  1. https://www.ncbi.nlm.nih.gov/pubmed/10855379

Published on: May 23rd, 2019

Updated on: December 18th, 2019

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.

Comments

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  • Jules
    Thank you! This is so helpful and also explains my feelings while weaning off Paxil. Thank you again!
  • Douglas
    this has been helpful but i cant get past taking 10 mg the symptoms are horrible i just give up and go back to my 10 mg dose i have been doing this on and off for 20 years because i cant stand the withdrawal . if i knew what i know now and what i would have to endure i would of never ever have taken it it has done way more harm than good by far !!!!
    • Jess
      I was on Paxil for 16yrs. I thought I would never be off of them bc withdrawal was hell on earth. My doctor slowly tapered me off of them by going down 10mg per month (I started at 60mg). That worked well without any real side effects until I got down to about 10mg. Then I started feeling the same withdrawal symptoms. Mostly, constant anxiousness. My doctor then added a low dose of Prozac to help wean me off of the last of the Paxil and thank God it worked!! I know exactly how it feels to be a prisoner of Paxil but I promise you, you can free yourself of it!!
      • Patothief
        May I kindly ask you for how long are you completely off Paxil now?
    • Jan
      I feel your pain. I’m on day 5 after quitting. Note: I’ve been cutting down the dose over three months. I am physically sick right now. But, the feelings and anger I have almost outweigh the detox I’ll feeling. I will never ever start something like this ever again. Screw you Paxil!!!
  • Guillermo Morales
    I’m down to 12.5 for the last 2 months. The withdrawal was infernal. I don’t know how to proceed at this point. I have talked to my doctor and he wants to give me Cymbalta. I’m hesutant to take it because of Im really afraid of the withdrawals. Any ideas how to taper off from 12.5?? Thanks
    • Dana
      Did you go on the cymbalta ? How did it go my doctor is tapering me off Paxil right now and wants to put me on cymbalta ? I’m a lil nervous after reading reviews any advice would be appreciated.
  • Janice
    Got viral sore throat sinus pressure caused headache and high blood pressure with anxiety put on Paxil 10mg at bedtime to reduce anxiety and 0.25 mg Xanax prn been 3 weeks, want to wean off Paxil.
  • Kathy W Holland
    If I slowly reduced my intake of Paxil over a three week period an then discontinued use was that a long enough time span for getting off Paxil. My worst withdrawal symptoms is in my gut.
  • Lori
    I am in the process of weaning myself off Paxil after taking it for about 15 years. I have been taking 30mg and started by going down to 3/4 of a pill and now I am taking 1/2. I don’t feel great, but it is manageable at this point. I am very lethargic, irritable, anxious, nauseous, sweaty but I haven’t had many brain zaps which I really hate and stopped me from going off of it a few times before. I wish I had known how difficult this drug would be to get off of. It did get me out of a very rough place with anxiety in the beginning but I have just continued to take it because it sucks to feel sick getting off of it. But it is time for me to see who I am without this drug in my system.
    • Jan
      You are strong. You’ll get thru it.
    • Cathy
      Hi Lori, I too have been on Paxil for 15 years. I was taking 15ml for ever and decided to cut down to 10ml about a month ago. I would say in the past week I started feeling tired, anxious and a little dizzy but am determined to do this. It’s funny that you said you want to see who you are without this drug because that’s where I’m at… I told my self I was going to write a journal about my journey “revealing the real me” 🙂 Paxil also got me out of a really dark place ( I would say it actually saved my life) but it’s time to stop being numb to whatever got me there in the first place. I do have to say I think a lot of women that go through the whole “anxiety” thing is related to menopausal symptoms and is hormone related. Anyways… wish you luck , wish me luck and cheers to revealing our true selves!!
    • PJB
      I read your comment–I took am on 30 mgs per day-my doctor increased it about 3 weeks ago, I do not like the way it makes me feel, this is not a good drug for me ( I am 72) my poor husband has many, many health issues, and yes it is deoressing for me as I am his caregiver, I am not even thinking about harming my self, that would not serve any useful purpose, pleas tell me what you all did and how you feel now, I am always tired and have no energy and that is NOT normal for me. Thank you and God Bless! PS I should have questioned my doctor more about this med, shame on me!
    • Debbie Farnsworth
      Hi Lori, I took Paroxetine (paxil) for 20 years and decided I needed to wean off, I was starting to do strange things, like move my lips funny an my hands also, I saw a commercial that said long term use could cause these symptoms and that you could get a pill for taking anti-depressants too long, really, no way……I did it very slowly, about 3 months time. I am on day 5 of no pill, I feel confused and scatterbrained, but I am like you I want to see me without this drug…
  • Suzanne
    I have been on Paxil for 20 years. I have tried to switch to other antidepressants but always felt terrible. My depression grew worse and my doctor put me on 60 mg. Holy hell. I was still bed ridden with depression. It’s been 5 weeks of my weaning down. Doctor put me on 20mg Prozac to help with withdrawal. I still have a constant headache when I move my head. Also nausea in the evening. It’s been pure hell. I still had horrible withdrawal and the Paxil wasn’t even working any longer. I wish I could file a lawsuit against the manufacturer. I will never take it again and will tell my story over and over to patients who want to take this horrible drug.
  • Sherry
    This is my fifth time, withdrawing from 10 mgs. of Paxil. I started on that dosage about 30 years ago, while going thru my divorce. I have tried with medical docotors’ thru the years, to get off it. I have always been working, so I could not make it thru, because I was so sick, during the withdrawal. The doctor even tried the other antidepressants, to get me thru the withdrawal and it did not help. Now, due to the Covid virus we are going thru, I have lost my job and will not be working, so I am taking this time to get off of Paxil. It has only been a week, on this withdrawal schedule, but I am starting to have the headaches, gut aches, tired, bowel differences, etc. Hopefully, I can finally get off this poison.
  • Sherry
    My comments about withdrawal, are like many other patients here. I have been on 10mgs. of Paxil for 30 yrs. Have tried with medical help to withdraw with and without another SSRI and it has not worked successfully. I have gone from 10 mg. to 5 mg. over two months and when i went to 21/2, the body aches and pains, headaches, weakness, flu like symptoms, stop me from living. Horrible drug that should never have been on the market, with so little information provided by medical dr’s. at the time. I am miserable.
  • Dave
    My doctor said that I have been on paxil for 12 years that it must not be working for me anymore. So to make a long story short she weaned me off of paxil from 20 mg. That I am cutting in 1/4 pieces now . Last week she said that’s low enough and wants to put me on 30mg. Of Cymbalta. I’m this close to being off paxil but I don’t want to start taking Cymbalta either. But can’t handle being this sick rite now brain shocks and irritated by little things ,and my chest hurting badly. Any ideas what I should do?
  • Lloyd
    I am 54 and have been on SSRI’s for about 29 years. Paxil for about 25 years at 30 mg per day. Over the years I have tried many times to get off this medication with no success. I would get constant zips to the brain as well as everything becoming to bright for my eyes. I would begin to feel irritated very easily and become quick to anger! Eventually I would just give up and resume the pharmaceutical companies planned lifetime consumption program. In early 2020 I decided to try tapering off very slowly. I have shaved the width of a quarter off each pill per month until I was finally free of the stuff. It has been over half a year and I am down to about 8 mg a day. For a few weeks at a time I have gotten pains in my head that feel like internal bruising spasms. These would come on like the beating of a heart and then stop only to return again another hour or two later. During my weening process I have been taking Lorazepam and Ashwagandha to deal with any withdrawals I might have but lately my head feels like it has more mass inside my skull an i’m feeling more anxious and agitated. Another four months and I could be free of this crap or start a class actions lawsuit! I’m hoping it’s not the latter! Good luck people!
  • Toni
    I found your information to be very helpful. Due to the pandemic mental health medications are in back order. I was just told that Paxil CR it’s being discontinued. I needed to learn how to get her off without a bad withdraw. It says that it needs to be slowly. I know that when she has had the generic form it takes only 2 or 3 days before she is irritable and cries incessantly so I am very concerned about these news. She has a very complex epilepsy, high anxiety, social fobias, PTSD. Of course this has to happen right at Christmas, when the doctor is not available, in the middle of a pandemic and when she is doing so well….the best she has been in a very long time. Medication change is frightening. I need to make sure they provide her with the medication for more than a couple of months so that her system doesn’t loose too much balance and ruins our peaceful life. What happens if they tell me tomorrow that there is no way to get the medication???? Thank you
    • Lindsay
      Can you try a different pharmacy? its day 4 for me off 20mg… I feel like my brain is disconnected from my head. It hurts! Any advice?
  • Gloria Fisher
    My blood pressure skyrocketed when stopping paroxetine
  • Faye
    I’ve been on paxil for 20 years. I was up to 40 mgs . A year ago i went down to thirty , then 20 , 6 months ago I went to 10 mgs and down to 5 mgs four months ago. I haven’t take for the last 4 days but feel a little out of sorts . I will take 5 mgs tonight and then wait 4 days and take it again . I’ve tried for years and have never been able to go below 10 mgs . I’m feeling very hopeful because I haven’t had any brain zaps at all and very little symptoms of any kind .
    • Debbie Farnsworth
      My story is the same as yours, 20 years on, I was taking 40mg , then down to 20, cut those in half to 10 for 3 months and then stopped. I am on day 5 of no pill, I feel scatter brained, and confused.. I hope this is all but I just started… I refuse to let this drug control me
  • Steph
    Hi I’m probably in week 4 of no Paxil and Wellbutrin which I did a 2 week taper, then quit. I have cold sweats at night where I have to change my jammies, am really agitated, crying 5 plus times a day, thinking hateful thoughts, no patience. How long before this stuff stops I will not go on other meds just to get off these meds. But I feel pretty shitty
  • James
    Good information. I’ve been on Paxil for a few years now. My prescription ran out last Thursday and I was unable to get a refill until today. Needless to say, the withdrawal symptoms are not fun. I experienced most of the withdrawal symptoms the first night without. Good news is I never experienced any suicidal ideations. But the insomnia (never experienced before) and weird, vivid dreams and nightmares, when I did get to sleep were unsettling. Thanks for the information.
  • cg
    I have been taking for many years. At least 24-25. I am off of 10 mg for 5 days now. I have brain zaps, poor sleep, some irritability. I am post menopausal and 56 years old. I want to live without an SSRI to see how I feel. I had GAD and panic attacks. underlying PTSD. I am a counselor so…practicing what I preach 🙂
  • Erica
    I was prescribed Paxil for anxiety and pain by my GYN back in 98/99. I was taking 30mg for years and wanted to get off this drug about 5 years ago. So I decided to stop the drug. Nope! Can’t do that. My body, my head, all started feeling weird. My worst symptom was the motion vibration and sinus pains. I still to this day get like this weird motion feeling when I move my eyes. Like having a stuffy head or something. About 2/3 years ago I was finally able to cut my dose down to 10 mg and dealt with the feelings I was getting. I even went to my doctor and complained about my sinus and dizzy feeling. You know what my doctor did? Prescribed me medication for vertigo and antibiotics because he said I had a bad sinus infection. Reading now and learning more about “the withdrawal symptoms” I now know it’s not my sinuses. Last week I started speaking to a psychiatrist and explained that I do not want to be on Paxil anymore because of what happens to me if I miss a dose. (I’d love to not have to take anything but I’m afraid) I was told to ween down to half a pill every day for a week then half a pill every other day. I was also given Prozac to be switch onto in replacement for the Paxil. So then I started having pounding heartbeat and other side effects. Which is scaring the crap out of me. I finally spoke to my doc today and she’s now switching me to another drug to help me because I have very bad anxiety. I wish that anyone who is suggested to take this drug to read up on it first. If I would have known that this drug is an addictive drug I wouldn’t have started it. What’s the difference from a narcotic drug addiction and Paxil addiction?