How Long Does Withdrawal From Paxil Last? (2022)

Paxil (paroxetine) is an antidepressant medication used to treat a variety of disorders including major depression, generalized anxiety disorder, and obsessive-compulsive disorder. It is a member of a class of drugs known as selective serotonin reuptake inhibitors (SSRIs), which work by increasing the amount of serotonin available in your brain. It is not uncommon for someone to experience withdrawal symptoms when attempting to quit Paxil.

Overview

More than 40 million people in the U.S. take antidepressants. Most of them received their prescription from a family doctor rather than a psychiatrist. SSRI withdrawal symptoms have been well documented in medical literature, but prescribing doctors, who are often without psychiatric expertise, sometimes neglect to tell their patients about what to expect.

A significant proportion of the people taking Paxil and other SSRIs for a long enough period of time experience withdrawal symptoms when they try to quit or reduce their dose. About 50% of people on antidepressants have been taking them for over five years. and one in four has been on them for ten or more years.

Unfortunately, Paxil is notorious for being among the hardest antidepressants to quit. It has even been described, in the medical literature, as the antidepressant from hell. Due to its short half-life, Paxil withdrawal can hit hard and fast. Overall, more than 56% of people who quit antidepressants experience withdrawal symptoms of some kind. The occurrence rate may be even higher among Paxil users.

Symptoms, which range in intensity from mild to severe, can include irritability, dizziness, nausea, and prickling sensations. Some people describe electric-like sensations in their heads. This is sometimes described as brain zaps, brain shivers, or electric shocks. These sensations may appear rarely or up to several times per day and can sometimes be triggered by rapid eye movements.

Changing or stopping your dose of antidepressants also increases your risk of a recurrence of the mood or anxiety symptoms it was treating. Your risk of suicide may also go up following antidepressant cessation.

Understanding SSRI Discontinuation Syndrome

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Signs & Symptoms

While it is possible to experience withdrawal symptoms after stopping any antidepressant, some are notoriously worse than others. Paxil is among the worst offenders. This is to some degree due to its half-life, which means the amount of time it takes for half the drug to effectively leave your body. Paxil has a relatively short half-life of 21 hours. This means that withdrawal symptoms often develop fast, typically within two to three days.

Symptoms associated with withdrawal from SSRIs include the following:

  • Digestive: You may experience nausea, vomiting, cramps, diarrhea, or appetite loss.
  • Balance: You may become dizzy or lightheaded, sometimes making it difficult to walk.
  • Sleep problems: You may have nightmares, unusual dreams, excessive/vivid dreams, or insomnia.
  • Overall: You may have flu-like symptoms including headache, muscle pain, weakness, fatigue, cramping, and tiredness.
  • Mood: You may have extreme anxiety, agitation, panic, suicidal ideation, depression, irritability, anger, or mood swings.
  • Bizarre sensations: You may experience brain zaps (like an electrical shock or shiver in your brain), pins and needles, ringing in the ears, strange tastes, or hypersensitivity to sound.
  • Heat tolerance: You may have excessive sweating, flushing, or an intolerance to high temperatures.
  • Motor control: You may have tremors, muscle tension, restless legs, unsteady gait, or difficulty controlling speech and chewing movements.

Paxil withdrawal symptoms can range from mildly bothersome to severe and incapacitating. The Discontinuation-Emergent Signs and Symptoms Scale (DESS) is a checklist you can use to evaluate your symptoms and their severity. This checklist should serve as a reference only, your clinician will use this or something similar to diagnose you.

Coping & Relief

Paxil withdrawal can be distressing, but there are things you can do to lessen the blow. Doctors often recommend switching to a long-acting SSRI, like Prozac, before attempting to quit. Once you are stabilized on a dose of Prozac, you can attempt to slowly taper your dose. Recent research suggests a slow taper that continues down past the therapeutic dose until your dose is nearly 0 milligrams.

Additional coping strategies include:

Social Support

Informing your friends and family about potential withdrawal symptoms, such as agitation, may help prevent interpersonal conflicts.

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Sleep Aids

If you are struggling with insomnia, a prescription or OTC sleep medication can be helpful. Consider Tylenol PM or Benadryl.

OTC Medications

You can use over-the-counter pain relievers, like Tylenol and Advil, to help with aches and pains or Pepto-Bismol to help with nausea and vomiting.

Relaxation Techniques

Meditation, yoga, and breathing exercises are all good ways to reduce stress and agitation.

Exercise

Aerobic exercise helps improve your mood and boost energy. Aim for a minimum of 30 minutes of exercise four times a week.

Diet

A diet rich in whole grains, fruits, and vegetables will help keep your body energized during your withdrawal experience.

Mindfulness

One of the best ways to cope with withdrawal symptoms is to recognize that what you are feeling is a result of your antidepressant withdrawal—and is only temporary.

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Warnings

When coming off of antidepressants like Paxil, there is a risk that your depression or anxiety may return. Studies have shown that, overall, compared to people on antidepressants, people quitting antidepressants are more likely to attempt suicide.

Although changes in mood and behavior often occur when going on and off antidepressants, it is important for friends and family to keep an eye out for signs of serious distress. Signs that you or someone you love is suicidal include the following:

  • Planning how you would commit suicide if you were going to do it
  • Talking or thinking about suicide more than normal, for example, “I wish I were dead”
  • Gathering the means to commit suicide, such as bullets or pills
  • Feeling hopeless or trapped
  • Having intense mood swings
  • Engaging in risky or self-destructive activities, such as driving drunk
  • Becoming preoccupied with death, dying, or violence
  • Getting affairs in order or giving away belongings
  • Saying goodbye to people as if it were the last time

If you are having suicidal thoughts, contact theNational Suicide Prevention Lifelineat988for support and assistance from a trained counselor. If you or a loved one are in immediate danger, call 911.

For more mental health resources, see ourNational Helpline Database.

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Pregnancy

If you become pregnant while taking Paxil, it is important to talk with your doctor as soon as possible, because you will have some decisions to make. Your doctor can help you weigh the risks and benefits of continuing on your medication or stopping it.

Further, women with depression who discontinue antidepressants during pregnancy are about five times more likely to have a relapse than women who continued taking them.

There is some data to suggest that women who use antidepressants during the second and third trimesters are at a slightly increased risk of going into pre-term labor and delivering the baby before it is fully developed. There is also a less than 1% risk that your baby could develop a life-threatening condition known as persistent pulmonary hypertension.

Long-Term Treatment

Your long-term treatment plan will depend on your initial diagnosis and your current symptoms. It is best to work with your doctor to make a plan that fits your individual needs. If you didn’t tolerate Paxil well but are still experiencing symptoms of depression or anxiety, your doctor may want to introduce a new medication or combination of medications.

If you no longer wish to take medication, your doctor may recommend alternative therapies, such as psychotherapy.

Psychotherapy (talk therapy) is an evidence-based treatment for depression, anxiety, OCD, and PTSD that can help relieve and prevent depression. Researchers at Harvard Medical School and other universities have found that people who participate in therapy while coming off their antidepressants are less likely to relapse than those who do not.

Complementary and alternative therapies include:

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  • Biofeedback
  • Equine therapy
  • Meditation
  • Mindfulness training
  • Dietary changes
  • Natural supplements

Resources

If you feel your doctor isn’t helping sufficiently with your condition, seek a second opinion or, consider finding a new psychiatrist, psychologist, or therapist in your area. The Substance Abuse and Mental Health Services Administration (SAMHSA) has a searchable directory of qualified providers. You can also call them at 1-800-662-HELP (4357).

If you have health insurance, you can also search the company’s list of local providers who accept your insurance.

A Word From Verywell

Withdrawing from Paxil may not be easy, but it is definitely doable. While Paxil may have been a revolutionary treatment option back in its heyday, there are better options available today. If you are still experiencing symptoms of depression or anxiety, talk to your doctor about switching you to a newer medication with fewer side effects. Don’t forget: Therapy is an excellent evidence-based treatment with no side effects or withdrawal symptoms.

FAQs

How Long Does Withdrawal From Paxil Last? ›

Typically, antidepressant discontinuation symptoms may persist for up to 4–6 weeks. In some cases, people stopping Paxil may have symptoms that last for up to 1 year. Some research notes that some people may experience persistent post-withdrawal disorders following discontinuation of paroxetine after long-term use.

How do you survive Paxil withdrawal? ›

Exercise: Staying physically active with even simple activities, such as jogging, bicycling, or swimming, can help you deal with the withdrawal phase. Exercise boosts your mood by releasing feel-good endorphins and helps ward off the depression that can come with the tapering of the antidepressant medication.

How long do side effects last after stopping paroxetine? ›

Serotonin re-uptake inhibitor withdrawal syndrome generally begins within 24 to 48 hours after discontinuing the drug. Signs reach their maximum on day 5 and usually resolve within 2 to 3 weeks. Withdrawal syndrome is more common with short half-life drugs (paroxetine, fluvoxamine).

Can Benadryl help with Paxil withdrawal? ›

If you were on a very high dose of Paxil (paroxetine) or Effexor (venlafaxine), you may need to take repeated doses of Prozac. Benadryl (diphenhydramine) is an over-the-counter allergy medication that has been reported to help with discontinuation symptoms too, though it has a sedating effect.

How long does paroxetine take to wear off? ›

The half-life of Paxil is documented at 21 to 24 hours, which means that 50% of the drug is eliminated from a person's system within 21 hours after stopping the medication. For example, if you took a single dose of 10 mg of Paxil (paroxetine), in 21 hours, there would be 5 mg of medication left in your system.

What helps Paxil withdrawal symptoms? ›

Gradually tapering Paxil may help prevent or reduce discontinuation symptoms, but this process can take many weeks or months. People can also try some self-care tips — such as eating a healthy diet, getting adequate sleep, and exercising regularly — to further reduce their symptoms.

What supplements help with antidepressant withdrawal? ›

"But vitamins and supplements can also be useful in reducing discontinuation symptoms." Dr. Bergman says these are the mental health supplements everyone should be taking. “Natural agents like GABA, rhodiola, L-theanine, melatonin, valerian root, passionflower, zinc, and evening primrose are also great," she says.

What does Paxil withdrawal feel like? ›

Symptoms are usually mild and are easily managed by gradually decreasing the dose. The following are common paroxetine withdrawal symptoms: insomnia, irritability, dizziness, headache, flu-like symptoms, vertigo, nausea, confusion, anxiety, excessive dreaming and suicidal ideation.

What happens when you stop Paxil cold turkey? ›

Overall: You may have flu-like symptoms including headache, muscle pain, weakness, fatigue, cramping, and tiredness. Mood: You may have extreme anxiety, agitation, panic, suicidal ideation, depression, irritability, anger, or mood swings.

Does your brain go back to normal after antidepressants? ›

"The fact that antidepressant withdrawal can be so prolonged suggests that the drug has changed the brain and that those changes are taking a very long time to return to normal and it may be the case that sometimes they don't go back to normal."

What happens when you stop Paxil cold turkey? ›

Overall: You may have flu-like symptoms including headache, muscle pain, weakness, fatigue, cramping, and tiredness. Mood: You may have extreme anxiety, agitation, panic, suicidal ideation, depression, irritability, anger, or mood swings.

Does your brain go back to normal after antidepressants? ›

"The fact that antidepressant withdrawal can be so prolonged suggests that the drug has changed the brain and that those changes are taking a very long time to return to normal and it may be the case that sometimes they don't go back to normal."

What happens if you suddenly stop taking paroxetine? ›

Stopping paroxetine abruptly may result in one or more of the following withdrawal symptoms: irritability, nausea, feeling dizzy, vomiting, nightmares, headache, and/or paresthesias (prickling, tingling sensation on the skin). Depression is also a part of bipolar illness.

Do you feel better after stopping antidepressants? ›

In studies on adults with moderate or severe depression, 40–60% report improvements within 6–8 weeks. Those who wish to come off antidepressants because they feel better should ideally wait for at least 6–9 months after complete symptom remission before stopping their medication.

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