Paxil Withdrawal: Symptoms, Timeline, and Treatment
Dr. Gerardo Sison, Pharm.D.
Paxil is an FDA-approved selective serotonin reuptake inhibitor (SSRI) antidepressant that is commonly used for the treatment of mental health conditions like major depressive disorder, obsessive-compulsive disorder (OCD), generalized anxiety disorder and social anxiety disorder, panic disorder and panic attacks, post-traumatic stress disorder (PTSD), and more.
Paxil is the brand name variant of the generic drug paroxetine.
Other SSRIs include fluoxetine (Prozac) and sertraline (Zoloft).
Due to its short half-life, Paxil can cause withdrawal symptoms that come on quickly and last for months.
Severe or even incapacitating symptoms are not uncommon.
Before you stop your use of Paxil, here’s what you need to know about the symptoms, timeline, and treatment of Paxil withdrawal.
Who is likely to experience symptoms of Paxil withdrawal?
Although it is not habit-forming, Paxil is well-documented as being one of the hardest antidepressants to stop using.
The medication has even been described as the “antidepressant from hell” due to its tendency to cause severe withdrawal symptoms after abrupt discontinuation.
While SSRIs like Paxil have been shown to cause withdrawal symptoms in about 56 percent of patients, Paxil may be associated with an even higher risk of withdrawal than other drugs in its class.
Your risk of Paxil withdrawal can depend on a number of different factors, such as how long you have been taking Paxil, what dose of Paxil you take, and your overall medical history.
Paxil works by gradually increasing the amount of serotonin in the brain over a period of about four to six weeks. While the medication works slowly to treat symptoms of common mental health disorders like depression and anxiety, it can also cause withdrawal symptoms when the medication is abruptly discontinued.
Patients who have been taking Paxil for four weeks or more are considered to be at risk of experiencing discontinuation symptoms if they stop using the drug abruptly.
If you have been taking Paxil for a period of four weeks or longer and want to stop using the drug, it’s critical that you speak to your doctor before discontinuing or reducing your dose.
Your doctor can help you develop a plan to gradually reduce your dose over time in order to minimize your withdrawal symptoms.
What are the symptoms of Paxil withdrawal?
Paxil is known to cause withdrawal symptoms that are similar in nature to withdrawal symptoms caused by other medications in its class.
Common symptoms of Paxil withdrawal include:
- Changes to motor control, including tremors, difficulty controlling movement of the mouth, and unsteady gait
- Digestive upset, including nausea, cramps, vomiting, and diarrhea
- Flu-like symptoms, including headache, fatigue, muscle aches, and chills
- Instability, including dizziness, confusion, or feeling lightheaded
- Mood changes, including mood swings, anxiety, panic, depression, anger, irritability, agitation, suicidal thoughts and behaviors
- Feelings of “electrical shock” or “zaps” in your brain
- Sleep problems, including nightmares, insomnia, vivid dreams, and unusual dreams
What is the timeline for Paxil withdrawal?
The side effects of Paxil withdrawal typically begin quickly after your last dose because the medication has a short life of about 21 hours.
Because of the short half life, which represents the amount of time it takes for half of the drug to leave your body, patients commonly develop symptoms of Paxil withdrawal in about two to three days.
Unfortunately, symptoms of Paxil withdrawal syndrome can last for an extended period of time.
One study examining the duration of Paxil withdrawal in patients who had been using the drug for 4 years or more found that 100 percent of study participants continued to experience withdrawal symptoms for more than 3 months after stopping their dose of the drug.
However, the duration of Paxil withdrawal symptoms may be less severe in patients who have been taking the drug for a shorter period of time, as another study found that of patients who had been taking the drug for one month, withdrawal symptoms lasted for one week or less in 42 percent of patients.
What treatment is available for Paxil withdrawal?
Paxil withdrawal can be challenging, and while tapering down your daily dose of the medication over the course of a few weeks or months can help, it may not be enough to prevent symptoms from occurring.
Many doctors recommend that patients switch to a longer acting SSRI, such as Prozac, that is associated with fewer withdrawal symptoms before you discontinue your dose of Paxil.
The use of over the counter medications, sleep aids, social support, regular exercise, and relaxation techniques can help you cope with the withdrawal symptoms of Paxil.
While inpatient treatment is uncommon, make sure to talk to your doctor if your withdrawal symptoms are severe.
Patients who are concerned about Paxil withdrawal symptoms should know that the medication should never be discontinued without speaking to your doctor first.
Common symptoms of Paxil withdrawal include flu-like symptoms, digestive upset, and potentially severe changes in mood, including suicidal thoughts and behaviors.
Tapering your dose of the medication over time, particularly after switching to a dose of a longer acting antidepressant, can help to minimize your Paxil withdrawal symptoms.