How Long Does Withdrawal From Paxil Last?

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In This Article

Paxil (paroxetine) is an antidepressant medication used to treat a variety of disorders, including major depression, generalized anxiety disorder, bipolar disorder, and obsessive-compulsive disorder. It is a member of a class of drugs known as selective serotonin re-uptake inhibitors (SSRIs), which work by increasing the amount of serotonin 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 experience withdrawal symptoms when they try to quit or reduce their dose. About 50 percent of people on antidepressants have been taking them for over five years.  Remarkably, one in four has been on them for ten or more years.  This isn’t too surprising when you consider the fact that many antidepressants cause challenging withdrawal symptoms when users stop or reduce their dose. 

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 percent 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 relapse, including the return of major depression, anxiety, or mania. Your risk of suicide will also go up in the days and weeks following antidepressant cessation.

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 in large part due to its half-live, which means the amount of time it takes for half the drug to leave your body. Paxil has a half-life of 21 hours. This means that withdrawal symptoms 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, mania, 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, or 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 zero 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 way to cope with withdrawal symptoms is to recognize that what you are feeling is a result of your antidepressant withdrawal--and is only temporary.

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. 

Short-term studies have found that young people may be at increased risk. Paxil comes with a black box warning (the FDA’s most serious warning) stating that children, teens, and young adults are at increased risk of suicidal ideation and behavior when starting, changing, or discontinuing their dose. 

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 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. For example, untreated bipolar disorder is risky for both mother and baby.

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.

Your doctor may help you to discontinue or adjust your antidepressants during your pregnancy, as there is some risk that women who use antidepressants during the second and third trimesters are at increased risk of going into pre-term labor and delivering the baby before it is fully developed. There is also a less than one percent 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. 

Other alternative therapies include:

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

Resources

If you or someone you love is experiencing suicidal thoughts, call the National Suicide Prevention Lifeline (1-800-273-8255). You will be connected with staff or volunteers at a crisis center near you. The people on the other end of the line can help you calm down and figure out what to do next.

If your doctor isn’t helping, 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. Look for a psychologist, psychiatrist, or a licensed mental health counselor (LMHC).

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 less side effects. Don’t forget, therapy is an excellent, evidence-based treatment with no side effects or withdrawal symptoms.

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Article Sources

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