Depression Treatment Medication How Long Does Withdrawal From Paxil Last? By Corinne O’Keefe Osborn Corinne O’Keefe Osborn LinkedIn Corinne Osborn is an award-winning health and wellness journalist with a background in substance abuse, sexual health, and psychology. Learn about our editorial process Updated on September 26, 2020 Medically reviewed Verywell Mind articles are reviewed by board-certified physicians and mental healthcare professionals. Medical Reviewers confirm the content is thorough and accurate, reflecting the latest evidence-based research. Content is reviewed before publication and upon substantial updates. Learn more. by Steven Gans, MD Medically reviewed by Steven Gans, MD Steven Gans, MD is board-certified in psychiatry and is an active supervisor, teacher, and mentor at Massachusetts General Hospital. Learn about our Medical Review Board Print Verywell / Nusha Ashjaee Table of Contents View All Table of Contents Overview Signs & Symptoms Coping & Relief Warnings Pregnancy Long-Term Treatment Resources 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 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. 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. The Best Mental Health Apps 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 itTalking or thinking about suicide more than normal, for example, “I wish I were dead”Gathering the means to commit suicide, such as bullets or pillsFeeling hopeless or trappedHaving intense mood swingsEngaging in risky or self-destructive activities, such as driving drunkBecoming preoccupied with death, dying, or violenceGetting affairs in order or giving away belongingsSaying goodbye to people as if it were the last time If you are having suicidal thoughts, contact the National Suicide Prevention Lifeline at 988 for 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 our National Helpline Database. 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: BiofeedbackEquine therapyMeditationMindfulness trainingDietary changesNatural 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. 11 Sources Verywell Mind uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy. Pratt LA, Brody DJ, Gu Q. Antidepressant use among persons aged 12 and over: United States, 2011–2014. Mojtabai R, Olfson M. National patterns in antidepressant treatment by psychiatrists and general medical providers: results from the national comorbidity survey replication. J Clin Psychiatry. 2008;69(7):1064-74. Davies J, Read J. A systematic review into the incidence, severity and duration of antidepressant withdrawal effects: Are guidelines evidence-based?. Addict Behav. 2019;97:111-121. doi:10.1016/j.addbeh.2018.08.027 Nevels RM, Gontkovsky ST, Williams BE. Paroxetine-the antidepressant from Hell? Probably not, but caution required. Psychopharmacol Bull. 2016;46(1):77–104. Glenmullen J. The Antidepressant Solution: A Step-by-Step Guide to Safely Overcomming Antidepressant Withdrawal, Dependence, and “Addiction.” New York, NY: Free Press; 2005. Paroxetine (Paxil). National Alliance on Mental Illness. Fava GA, Gatti A, Belaise C, Guidi J, Offidani E. Withdrawal symptoms after selective serotonin reuptake inhibitor discontinuation: A systematic review. Psychother Psychosom. 2015;84(2):72-81. doi:10.1159/000370338 Horowitz MA, Taylor D. Tapering of SSRI treatment to mitigate withdrawal symptoms. Lancet Psychiatry. 2019;6(6):538-546. doi:10.1016/S2215-0366(19)30032-X Valuck RJ, Orton HD, Libby AM. Antidepressant discontinuation and risk of suicide attempt: a retrospective, nested case-control study. J Clin Psychiatry. 2009;70(8):1069-77. doi:10.4088/JCP.08m04943 Mayo Clinic Staff. Suicide and Suicidal Thoughts. Going off antidepressants. By Corinne O’Keefe Osborn Corinne Osborn is an award-winning health and wellness journalist with a background in substance abuse, sexual health, and psychology. See Our Editorial Process Meet Our Review Board Share Feedback Was this page helpful? Thanks for your feedback! What is your feedback? 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