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Paroxetine Tapering (Paxil)

Last Updated on February 6, 2024 by Carol Gillette

Alternative to Meds Editorial Team
Medically Reviewed by Dr Samuel Lee MD

Paroxetine tapering can be notoriously harsh and even unsafe when done incorrectly. Trying to quit paroxetine (Paxil) or other antidepressants needs careful preparation and guidance. Unfortunately, such information is missing in the medical literature given to most doctors who prescribe this medication.

Consequently, the idea of tapering from a drug as potent as paroxetine can seem risky or tricky, troublesome at best. We can help.

Do Your Symptoms Require Paroxetine?

paroxetine tapering
With more than 15 years of specialized experience, Alternative to Meds Center has become a respected authority in tapering off antidepressants safely. Using effective holistic therapies and Integrative Medicine, we have published evidence demonstrating that over 77% of people tapering from antidepressant medication found relief by replacing them with less toxic options. Lifestyle changes, counseling, targeted supplementation, and other guided changes can allow a person to do much better in terms of relief from symptoms, more energy, a better quality of life, etc., compared to their state while on medication.
This video highlights the recovery story of a woman who was so devastated by antidepressant and benzo use that she had nearly lost all ability to function or walk. She now stands a strong, feisty woman of great capacity who is now a licensed therapist helping others. Her story hallmarks the deep level of debilitation that we specialize in and the truly transformative nature of this work.
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Paroxetine Tapering Help is Available

Weaning off paroxetine is a comprehensive process that can be administered safely and gently at Alternative to Meds Center. Our highly specialized medical staff do have the experience and knowledge that is required for a smooth and gentle paroxetine titration experience. Alternative to Meds Center offers programs for persons who have decided that getting off paroxetine or other medications is a better option than continuing on a medication that is ineffective and suffering from side effects. It is possible that antidepressant treatment didn’t meet expectations. Typically, where one drug did not provide the desired results, a prescribing doctor will “try another one,” repeatedly, and this can, unfortunately, lead to further complications in treatment. This experimentation can result in a patient still suffering from the original symptoms, as well as mounting drug side effects, and even withdrawal reactions from switching medications too quickly. There is a better way.

At Alternative to Meds Center, our program has been carefully put together to provide the tools, methods, staff expertise, pleasant environment, and best strategies for how to get off paroxetine in a warm and compassionate, very well-staffed, nurturing setting. We recommend inpatient treatment as the best option for paroxetine tapering. We also understand this may not always be possible. The paroxetine tapering guidelines given below can be discussed with your prescriber and may be beneficial in planning your paroxetine tapering plan with your doctor.

Guidelines for paroxetine tapering include:
  • paroxetine tapering guidelinesDon’t attempt a paroxetine taper without medical supervision and help. Find a health care professional you trust who is sympathetic to your health goals.
  • Gradual cessation is the safest method of discontinuing. Never abruptly stop taking paroxetine.4
  • Improve your diet to help the body and CNS normalize. Provide neurotransmitter support with protein, fresh fruits, vegetables, and microbiome support with fermented foods, yogurt, and probiotics.8,9
  • Avoid sugars, alcohol, and caffeine in foods and beverages, recreational marijuana, and opt out of processed foods. These items have all been shown to increase vulnerability to major depression and other “psychiatric” disorders.10.16
  • Lab testing can indicate toxic bioaccumulation which can be cleansed.2
  • Supplementation can provide support for neurochemistry such as passionflower extract, St. John’s wort, magnesium, saffron, vitamins, omega-three fatty acids, tryptophan, and others that your physician may recommend.11,14
  • The half-life or paroxetine (21 hours) is the expected point where withdrawals will emerge.1,4
  • Paroxetine comes in various strengths (10mg, 20mg, 30mg, 40mg). It may be helpful to have smaller dosage pills to hand for calculating reductions with a minimum of cutting.1
  • Your prescriber may recommend an oral solution for easier calculations.
  • A 5% – 10% reduction is a good starting point, but may need adjusting — if the reactions are too great, make the reduction less and slow the taper.4
  • Provide enough time between dose adjustments, 1 or 2 weeks, or more, for any reactions to diminish before making the next reduction. Slow is fast for medication tapering.
  • Arrange your personal and work schedules to allow for plenty of rest and relaxation.
  • Exercise, tai chi, qi gong, yoga, therapeutic massage, and exposure to sunshine or bright light.12-15

Paroxetine Tapering:  Discontinuation Symptoms

  • Heightened anxiety*
  • Worsened depression*
  • Brain zaps*
  • Digestive tract problems, i.e., nausea, vomiting, no appetite.
  • Headaches
  • Irritability, mood swings, agitation
  • Paresthesia (prickling burning sensation under the skin

*In 2006 and again in 2007, the FDA required drugmaker GlaxoSmithKline to issue warnings about the severity of discontinuation symptoms from their blockbuster drug, Paxil.5

Paroxetine Tapering:  SPECIAL WARNING

Paroxetine tapering should be done gradually over time. The FDA recommends against stopping paroxetine abruptly as doing so can result in severe reactions that can linger on for weeks, months, or even years.1,4

Notes on Paxil and Pregnancy

Drugmakers have shown a pattern of dragging their feet on consumer safety alerts, such as the 2011 decision not to include pregnancy risks on the list of black box warnings. In 2016, new research data emerged once again on Paxil posing pregnancy risks.5,6,7

Women who are planning a pregnancy are advised to research the potential risks of starting on antidepressants, vs non-drug-based therapy. If already on these medications, she may want to consider tapering off and find alternative types of therapy before the pregnancy occurs.

Individualized Paxil Tapering Programs

In order to design a person’s unique paroxetine tapering program, we gather information as the first step from assessments plus testing for biological, environmental, and other factors that we address during the person’s stay at the center.

Using the information that we gather allows for an exact strategic mapping out of the best ways to help a person during their withdrawal from paroxetine. In this way, any symptoms that are typically associated with getting off paroxetine can be softened or even prevented altogether.

Paroxetine Tapering Plus Enhanced Health

inpatient paroxetine tapering sedona drug rehabSome of the tools used in the program are designed to cleanse the body of toxic accumulations that may have compromised the person’s neurochemistry and microbiome for quite some time. Much research has been done that links depression and anxiety to toxins in the body and the detrimental effects that can result.2

When this toxic burden is removed, using gentle and non-invasive means, one can begin to turn back the tide on perhaps years of troublesome toxic contributors to persisting health (and mental health) problems. Many practical methods can be utilized to support this process, such as sauna cleanse, bentonite clay packs, nebulized glutathione treatments, mineral baths, colonics, ozone therapy, therapeutic massage, boosting gut flora, and microbiome support, and others. Supplying the correct measure of nutritional supplements and a clean diet free of pollutants also helps make stopping paroxetine a gentle healing process, not arduous or uncomfortable.

Clients can also find benefits from a wide variety of other therapeutic activities, which are listed below as well as enjoy the warm social setting that allows for camaraderie and friendship, peer support, and a feeling of community and understanding with other clients.

Our clients report better quality of sleep, improved appetite, more energy, improved mood, feeling “lighter,” calmer, and many other benefits. These improvements make stopping paroxetine gradually much easier and much smoother to accomplish.

24/7 Care is Essential for Getting Off Paroxetine

24/7 care to get off paroxetineStaff monitoring and daily staff-client consultations keep everyone on the team apprised of all the changes that are happening throughout the day. Micro-adjustments can then be made with confidence, ensuring the most progress possible during our client’s gradual paroxetine weaning program. There is no one-size-fits-all method for how to get off paroxetine. However, a well-designed combination of alert observation and quick responses to the needs of the client in a compassionate and comfortable setting is an ideal situation for someone trying to get off paroxetine or other medications.

Many adjunctive therapies are available to the client along the way which can provide soothing relief as needed throughout their paroxetine tapering program. Team specialists in various disciplines are standing by ready to administer therapeutic services such as Reiki, therapeutic massage, craniosacral massage, meditation classes, music, and art therapy, equine therapy, yoga and mild exercise in trainer-led sessions, acupressure and acupuncture, and many additional treatments designed for client comfort. Various genres of counseling, including trauma counseling, CBT, DBT, Life Coaching, and others can be blended into an individual’s program to provide the targeted support that is most desirable. We help clients forge new pathways toward stress reduction, increased confidence, and happiness.

Education and Successful Outcomes for Stopping Paroxetine

During our client’s stay at the Center, educational modules are presented that explain the basics of brain health, how diet affects neurochemistry, how nutrition plays a part in reducing symptoms of depression and anxiety, how the digestive system and a functioning microbiome support the CNS, brain health, and many other fascinating topics. We have doctors who come to the center to learn more about these subjects, who can then go back and help their patients with insight on how to get off paroxetine or other drugs safely and without having to suffer through unnecessarily harsh paroxetine withdrawal symptoms.

Educating our clients helps us to ensure that they will be well able when they have finished their paroxetine tapering program to continue on their path forward to bettered health and reduced or eliminated symptoms. How wonderful to be drug-free and symptom-free, sometimes referred to as enjoying natural mental health. That is our goal, and we will do everything possible to help our clients reach their health goals in our beautifully appointed and welcoming residential facility.

Contact Alternative to Meds Center for More Information

Stopping paroxetine can be a truly life-enhancing experience when administered properly. Please feel free to contact us at Alternative to Meds Center for much more information that may be of interest to you or a loved one.

We will take the time to explain more about the details and the benefits of gentle and comfortable inpatient paroxetine tapering programs available at our beautiful and comfortable inpatient facility, nestled in the heart of Sedona’s majestic Red Rocks.

Sources:


1. FDA Paroxetine Label [cited 2022 July 19]

2. Genuis SJ. Toxic causes of mental illness are overlooked. Neurotoxicology. 2008 Nov;29(6):1147-9. doi: 10.1016/j.neuro.2008.06.005. Epub 2008 Jun 24. PMID: 18621076. [cited 2022 July 19]

3. SSRI antidepressants and birth defects. Prescrire Int. 2006 Dec;15(86):222-3. PMID: 17167929. [cited 2022 July 19]

4. Warner CH, Bobo W, Warner C, Reid S, Rachal J. Antidepressant discontinuation syndrome. Am Fam Physician. 2006 Aug 1;74(3):449-56. PMID: 16913164. [cited 2022 July 19]

5. Breggin, P, “Paxil Withdrawal Case Settled in California.” Drug Facts {internet] N.D. [cited 2022 July 19]

6. Bérard A, Zhao JP, Sheehy O. Antidepressant use during pregnancy and the risk of major congenital malformations in a cohort of depressed pregnant women: an updated analysis of the Quebec Pregnancy Cohort. BMJ Open. 2017 Jan 12;7(1):e013372. doi: 10.1136/bmjopen-2016-013372. PMID: 28082367; PMCID: PMC5278249. [cited 2022 July 19]

7. Berard A, “The risk of major cardiac malformations associated with paroxetine use during the first trimester of pregnancy: a systematic review and meta-analysis.” British Journal of Clinical Pharmacology November 27 2015 [cited 2022 July 19]

8. Appleton J. The Gut-Brain Axis: Influence of Microbiota on Mood and Mental Health. Integr Med (Encinitas). 2018 Aug;17(4):28-32. PMID: 31043907; PMCID: PMC6469458. [cited 2022 July 19]

9. Dash S, Clarke G, Berk M, Jacka FN. The gut microbiome and diet in psychiatry: focus on depression. Curr Opin Psychiatry. 2015 Jan;28(1):1-6. doi: 10.1097/YCO.0000000000000117. PMID: 25415497. [cited 2022 July 19]

10. Reis DJ, Ilardi SS, Namekata MS, Wing EK, Fowler CH. The depressogenic potential of added dietary sugars. Med Hypotheses. 2020 Jan;134:109421. doi: 10.1016/j.mehy.2019.109421. Epub 2019 Oct 10. PMID: 31634771. [cited 2022 July 19]

11. Yeung KS, Hernandez M, Mao JJ, Haviland I, Gubili J. Herbal medicine for depression and anxiety: A systematic review with assessment of potential psycho-oncologic relevance. Phytother Res. 2018 May;32(5):865-891. doi: 10.1002/ptr.6033. Epub 2018 Feb 21. PMID: 29464801; PMCID: PMC5938102. [cited 2022 July 19]

12. Abbott R, Lavretsky H. Tai Chi and Qigong for the treatment and prevention of mental disorders. Psychiatr Clin North Am. 2013 Mar;36(1):109-19. doi: 10.1016/j.psc.2013.01.011. PMID: 23538081; PMCID: PMC3917559. [cited 2022 July 19]

13. Jensen AM, Ramasamy A, Hotek J, Roel B, Riffe D. The benefits of giving a massage on the mental state of massage therapists: a randomized, controlled trial. J Altern Complement Med. 2012 Dec;18(12):1142-6. doi: 10.1089/acm.2011.0643. Epub 2012 Sep 4. PMID: 22946452. [cited 2022 July 19]

14. Penckofer S, Kouba J, Byrn M, Estwing Ferrans C. Vitamin D and depression: where is all the sunshine? Issues Ment Health Nurs. 2010 Jun;31(6):385-93. doi: 10.3109/01612840903437657. PMID: 20450340; PMCID: PMC2908269. [cited 2022 July 19]

15. Brinsley J, Schuch F, Lederman O, Girard D, Smout M, Immink MA, Stubbs B, Firth J, Davison K, Rosenbaum S. Effects of yoga on depressive symptoms in people with mental disorders: a systematic review and meta-analysis. Br J Sports Med. 2021 Sep;55(17):992-1000. doi: 10.1136/bjsports-2019-101242. Epub 2020 May 18. PMID: 32423912. [cited 2022 July 19]

16. Lev-Ran S, Roerecke M, Le Foll B, George TP, McKenzie K, Rehm J. The association between cannabis use and depression: a systematic review and meta-analysis of longitudinal studies. Psychol Med. 2014 Mar;44(4):797-810. doi: 10.1017/S0033291713001438. PMID: 23795762. [cited 2022 July 19]


Originally Published Nov 2, 2019 by Diane Ridaeus


This content has been reviewed and approved by a licensed physician.

Dr. Samuel Lee

Dr. Samuel Lee is a board-certified psychiatrist, specializing in a spiritually-based mental health discipline and integrative approaches. He graduated with an MD at Loma Linda University School of Medicine and did a residency in psychiatry at Cedars-Sinai Medical Center and University of Washington School of Medicine in Seattle. He has also been an inpatient adult psychiatrist at Kaweah Delta Mental Health Hospital and the primary attending geriatric psychiatrist at the Auerbach Inpatient Psychiatric Jewish Home Hospital. In addition, he served as the general adult outpatient psychiatrist at Kaiser Permanente.  He is board-certified in psychiatry and neurology and has a B.A. Magna Cum Laude in Religion from Pacific Union College. His specialty is in natural healing techniques that promote the body’s innate ability to heal itself.

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