Paxil Withdrawal: Symptoms and How to Manage It

Paxil is the brand name of paroxetine, a selective serotonin reuptake inhibitor (SSRI) antidepressant. Paroxetine is prescribed for a wide variety of conditions, including major depressive disorder, obsessive-compulsive disorder, panic disorder, social anxiety disorder, post-traumatic stress disorder, generalized anxiety disorder, and premenstrual dysphoric disorder. Although Paxil is an incredibly useful medication, the drug does carry some concerns, including Paxil withdrawal.

Paxil withdrawal is a collection of highly unpleasant symptoms that occur when an individual stops taking Paxil suddenly or dramatically reduces their dose. In fact, Paxil withdrawal is widely considered to be one of the most severe, if not the most severe, of any SSRI.

For this reason, it is critical that those who are taking Paxil do not quit “cold turkey” or abruptly cease their intake. Instead, a medically supervised taper-down, or gradual reduction in dosage, is highly recommended.

“Tapering off any medication, including Paxil, should be done under the guidance of a healthcare professional, as withdrawal symptoms can vary in intensity and duration,” says psychiatric mental health nurse practitioner (PMHNP) Valerie Puffenberger. “It’s crucial to work closely with your healthcare provider to create a tapering plan that minimizes withdrawal effects.”

Understanding Paxil Withdrawal

When an individual takes Paxil for an extended period of time, their body will become accustomed to its presence. Eventually, their body will not be able to function “normally” if the person stops taking Paxil or significantly reduces their dose.

As the body and mind struggle to adapt to their new, Paxil-free normal, the individual will experience a collection of highly unpleasant symptoms known as withdrawal. Paxil withdrawal symptoms occur for a number of reasons, but they are primarily caused by changes in neurotransmitter levels in the brain — in particular, serotonin.

The length and severity of Paxil withdrawal varies from person to person and is influenced by factors like:

• How long the patient used Paxil
• What dosage of Paxil the patient was taking
• Whether Paxil use was stopped cold turkey or if it was tapered down
• The patient’s metabolism
• The patient’s age, genetics, gender, weight, tolerance, and other characteristics
• The presence of any underlying medical or mental health conditions
• Whether the patient uses any other drugs or alcohol, especially if their use is at the level of a substance use disorder
• What support and coping mechanisms are used by the patient
• Whether the withdrawal is medically supervised (which is always strongly recommended)
• Lifestyle factors, including diet and exercise

Symptoms of Paxil Withdrawal

Paxil withdrawal can cause a large number of both physical and psychological effects.

Some of the most common and/or important physical symptoms of Paxil withdrawal include:

• Flu-like symptoms
• Headache
• Fatigue
• Muscle aches and pains
• Upset stomach
• Diarrhea
• Abdominal discomfort
• Dizziness
• Vertigo
• Insomnia
• Vivid dreams
• Changes in sleep patterns
• Sensations of being electrically shocked (“brain zaps”)

Some of the most common and/or important emotional and psychological symptoms of Paxil withdrawal include:

• Irritability
• Moodiness
• Mood swings
• Depression
• Crying spells
• Agitation

Paxil withdrawal can also cause cognitive changes. Some of the most common and/or important cognitive changes that occur during Paxil withdrawal include:

• Difficulty concentrating
• Memory issues
• Confusion
• Mental fog

Some people may experience suicidal thoughts as a result of depression and other mood-related symptoms of Paxil withdrawal.

If you or a loved one is experiencing suicidal thoughts, contact a medical professional immediately and/or call 988  for the 24/7 Suicide and Crisis Lifeline.

Paxil Withdrawal Timeline

Although each instance of Paxil withdrawal is different, most individuals will experience two major phases:

• Acute withdrawal: Occurs shortly after the patient takes their last dose of Paxil and lasts from a few days to a few weeks. Withdrawal symptoms are most numerous and severe during acute withdrawal, and it is at this point that the most serious or concerning complications can occur. Acute withdrawal is typified by both psychological and physiological symptoms.
• Protracted or post-acute withdrawal (PAWS): Begins after acute withdrawal ends, generally after a few weeks. Protracted withdrawal symptoms are usually psychological in nature and less severe than acute withdrawal symptoms. However, they last for much longer, possibly up to several years. It is important to note that not all patients will experience protracted withdrawal.

Let’s take a closer look at the Paxil withdrawal timeline:

1-3 Days after Last Dose (Beginning of Acute Withdrawal)

• Individuals typically start experiencing withdrawal symptoms. These symptoms start off comparatively few in number and mild in severity before becoming more numerous and severe.
• Early Paxil withdrawal symptoms are typically flu-like symptoms, dizziness, and mood changes.

3-7 Days after Last Dose

• During the first week, withdrawal symptoms become more numerous and severe.
• Physical symptoms like nausea, gastrointestinal issues, and brain zaps may appear, as well as emotional symptoms like anxiety and mood swings.

7-14 Days after Last Dose

• Symptoms are typically most severe and numerous at this stage.
• Symptoms are generally the same as in earlier stages but typically more severe.

14-31 Days after Last dose

• Some symptoms may begin to subside, but others continue.
• Anxiety, mood fluctuations, and cognitive changes like difficulty concentrating are some of the most likely symptoms to persist.

1-4 Months after Last Dose (End of Acute Withdrawal)

• Most individuals will experience a gradual improvement in symptoms during this period, until their symptoms disappear entirely.
• Some symptoms may remain, especially if Paxil was used for an extended period of time and/or at high doses.

Beyond 4 Months After Last Dose (Protracted Withdrawal or PAWS)

• Some withdrawal symptoms may persist for months or even years after stopping Paxil. These symptoms are known as protracted withdrawal or post-acute withdrawal syndrome.
• PAWS symptoms generally reduce in number and frequency over time until they disappear entirely.
• PAWS symptoms are much more likely to be emotional or psychological in nature.

Managing Paxil Withdrawal

Paxil withdrawal can be very unpleasant, but it is manageable. There are many strategies you can use to help alleviate or eliminate Paxil withdrawal symptoms.

Talk to Your Doctor

By far, the most important method of managing Paxil withdrawal is to seek medical guidance. It is critical to consult with your healthcare provider before making any changes to your medication, but this is especially true with Paxil.

Your doctor will be able to provide personalized advice based on your medical history and current condition. More importantly, they will be able to work with you to develop a tapering plan that will reduce the severity of withdrawal.

Once you are undergoing Paxil withdrawal, it is important to maintain regular communication with your healthcare provider and notify them of any new or worsening symptoms.

Taper Down Your Dose

Tapering off Paxil is recommended over quitting cold turkey, specifically to help mitigate withdrawal symptoms. With your doctor’s guidance, you will slowly reduce your dose over time until it reaches zero.

Remember that tapering off Paxil is a gradual process that takes longer than most other medications. Rushing the tapering can increase the number and severity of withdrawal symptoms.

When tapering, it is critical to monitor your withdrawal symptoms and immediately notify your healthcare provider if they worsen dramatically or become unmanageable. It may be necessary to adjust the tapering plan based on the symptoms you experience.

Take Care of Yourself

Self-care can help with many of Paxil’s withdrawal symptoms, especially those related to mood and emotion. You can lay the foundation for healthy habits during the withdrawal phase so that life beyond Paxil is more enjoyable.

Puffenberger shares a few examples of self-care strategies to use before, during, and after Paxil withdrawal:

• Focus on maintaining a healthy lifestyle, including regular exercise, a balanced diet, and sufficient sleep.
• Establish and maintain a daily routine to stabilize your mood and provide predictability.
• Stay hydrated and eat well to support overall well-being and alleviate physical symptoms.
• Having a support system can provide emotional support during this challenging time. Share your experience with a trusted friend, family member, or support group.
• Engage in moderate exercise, such as walking or stretching, to positively impact mood.
• Practice relaxation techniques such as mindfulness, meditation, and deep breathing to manage anxiety and stress.
• Consider seeking therapy or counseling to address emotional or psychological challenges that may arise during the withdrawal process.
• Engage in activities that you enjoy and can distract you from any discomfort. This could include reading, listening to music, or pursuing hobbies.

Resources and Support for Paxil Withdrawal

If you or a loved one is going through Paxil withdrawal, obtaining the proper resources and support can make a world of difference.

Professional assistance and counseling are perhaps the most important sources of support for those going through Paxil withdrawal. Types of counseling you can seek out include:

• Therapists and counselors: Mental health professionals, like psychiatrists, psychologists, and addiction counselors, can provide individualized support and coping strategies during withdrawal. In most cases, a mental health professional will also be the one to prescribe and taper down Paxil.
• Telehealth services: Online therapy options and other telehealth services provide extra convenience and accessibility.
• Psychiatric nurse practitioners: Psychiatric nurse practitioners can assist with medication management (including taper-downs in some cases) and provide other withdrawal support and guidance.

Support groups and online communities are extremely helpful for those undergoing Paxil withdrawal. Some great ones for you to investigate include:

• Surviving Antidepressants: The Surviving Antidepressants Forum connects individuals going through antidepressant withdrawal, including Paxil.
• The Withdrawal Project: The Withdrawal Project provides resources and information on psychiatric drug withdrawal.
• The Antidepressant Drugs Subreddit: Reddit has many subreddits with resources and support for those going through Paxil withdrawal, but the Antidepressant Drugs subreddit is one of the largest.

Here for Your Mental Health

At Legacy, we understand the difficulties of Paxil withdrawal and are here to support you.

Whether you want to taper off Paxil, heal the depression it was prescribed to treat, or address a co-occurring substance use disorder, we can help.

We use a holistic, three-pronged approach that heals the mind, body, and spirit through proper medication management, scientifically backed psychotherapy, and peer support.

To find out more about what mental health treatment options are available to you, call 888-534-2295 today to speak with a staff member at Legacy Healing Center.

Paxil Withdrawal FAQs

What are the common symptoms of Paxil withdrawal?

Some of the most common symptoms of Paxil withdrawal include:

• Abdominal discomfort
• Agitation
• Brain zaps
• Confusion
• Crying spells
• Depression
• Diarrhea
• Difficulty concentrating
• Dizziness
• Fatigue
• Flu-like symptoms
• Headache
• Insomnia
• Irritability
• Memory issues
• Mental fog
• Mood swings
• Moodiness
• Muscle aches and pains
• Upset stomach
• Vertigo
• Vivid dreams

How long does Paxil withdrawal typically last?

How long Paxil withdrawal lasts for any individual will vary. However, in general, the first two weeks of Paxil withdrawal are when symptoms are most numerous and severe, and the most severe symptoms generally subside by the end of the first month. Most patients will see their symptoms gradually subside and disappear by the end of four months. However, in some cases, PAWS symptoms may last for up to two years.

Are there any remedies or treatments for Paxil withdrawal?

While there are no remedies or treatments that have been specifically developed or approved for Paxil withdrawal, there are a number that can be used to reduce or alleviate symptoms:

• Gradually tapering down Paxil dosage
• Lifestyle adjustments like proper diet and nutrition
• Stress management techniques like mindfulness, meditation, and deep breathing exercises
• Moderate exercise like walking and stretching
• Good sleep hygiene
• Alternative therapies such as acupuncture, massage, or yoga
• Professional support from therapists, counselors, doctors, and nurse practitioners
• Participating in support groups
• Patience and self-compassion

Can Paxil withdrawal symptoms be dangerous?

Paxil withdrawal symptoms are not typically considered life-threatening, though they can be extremely unpleasant and very difficult for many people to get through. However, in some individuals, Paxil withdrawal may cause an increase in the risk of suicidal thoughts. These thoughts are both caused and worsened by the depression, severe anxiety, and panic attacks that can accompany Paxil withdrawal.

If you or a loved one is experiencing suicidal thoughts because of Paxil withdrawal (or any other reason), it is critical that you contact a medical and/or mental health professional immediately and/or call 988 for the 24/7 Suicide and Crisis Lifeline.

Where can I find support and resources for Paxil withdrawal?

You can find support for Paxil withdrawal in a variety of places, including:

• Individual therapy with a mental health professional who specializes in treating depression
• Support groups or group therapy sessions for people who are tapering off antidepressants and/or dealing with depression
• Online forums for people coming off antidepressants

About the Author

Jeffrey Juergens

Jeff Juergens is a leading author in the addiction and recovery field, dedicating the last seven years of his life to helping those struggling with substance use issues find the help that they need. Jeff's work has been used in rehabs across the country as tools to help patients achieve sobriety.

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Dr. Olushola, MSW

Olushola Lawal, MSW, RCSWI Olushola (Shola) Lawal serves as a Primary Therapist at Legacy Healing Detox. Shola was born and raised in South Florida. He is a Florida State University double alumnus graduating with his Bachelor of Social Work in 2013 and his Master of Social Work in 2015. Shola’s...

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