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Paxil Tapering

This entry was posted in Antidepressant on by .
Medically Reviewed Fact Checked

Last Updated on August 3, 2022 by Carol Gillette

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

Paxil tapering and titration must be done meticulously and under careful guidance due to the horrendous reactions that can occur from incorrectly weaning off Paxil. Equally important, every person’s own heartwrenching story must be listened to and resolved with an individually tailored program.

Being prescribed antidepressants like Paxil, even if it seemed the only option possible during a time of demonstrable crisis, does not mean it was the only option, nor that a lifetime of being medicated must follow.

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Reasons to Consider Paxil Tapering Treatment

There are many reasons for a person to consider Paxil tapering treatment, such as:

  1. Since Paxil is an antidepressant in the SSRI class, the drug is designed to block serotonin reabsorption. Consequently, the suspended serotonin molecules will eventually begin to degrade and become inert, unable to function. Continuing to add an SSRI into the body is a bit like stepping on the accelerator when the gas tank is nearly empty. The result can lead to worsening symptoms, and subsequently opting to begin Paxil tapering. Importantly, of all antidepressants available at this time Paxil is the most aggressive transporter of the neurochemical serotonin. Neither drugmakers nor doctors will claim to know exactly how the drug works. Nonetheless, this potent drug has been shown to have extremely strong negative impacts on many areas of health as it exhausts serotonin levels in the CNS.1
  2. The DSM 5 is the most recent version of the diagnostic manual at this writing, and it is noted therein that prescribing criteria for Paxil and similar antidepressants has been corrected and updated from previous errors. These changes reflect a change in direction in many cases, so that Paxil may not be suitable for the treatment of certain disorders as was previously recommended. Anyone researching Paxil tapering options may be well-advised to be aware of these updates.2
  3. Early studies and FDA warnings have shown that Paxil side effects can be harsh and difficult to tolerate.3
  4. A Canadian study has shown a 620% rise in the occurrence of breast cancer in women taking Paxil.1
  5. The global antidepressant market is a $16 Billion (USD) industry,4 whose profits are founded on products that don’t actually cure anything. To the contrary, for example, detrimental effects on male fertility which were not reported in clinical trials but were shown in later studies are also a concern for men taking Paxil.1
  6. It is well-documented that in Paxil users, including children and young adults, the incidence of akathisia, suicidality, aggression, and hostility have garnered considerable concern from both the medical community and the general population as well. A person taking Paxil can learn more about the side-effects of the drug to help understand that symptoms of poor health ought to be considered as being quite distinct from the common side effects of antidepressant drugs. Often this differentiation becomes blurred.1
  7. Paxil is associated with autism, birth defects, sexual impairment, cognitive impairment in elderly persons, and a long long list of other negative effects that may lead to the decision to wean off Paxil.1

Paxil Discontinuation Syndrome

paxil discontinuation syndromePaxil discontinuation syndrome can cause a number of symptoms such as dizziness, headache, nausea, brain zaps, depersonalization, irritability, hallucinations, and even stroke-like reactions.9 Paxil was found in a 3-year study to be ineffective at decreasing the rate of relapse in panic disorder patients.6 According to a 1997 comparative study published in the Journal of Clinical Pharmacology and Therapeutics, Modell et al discovered that Paxil causes significant sexual impairments in 75% of those taking the drug.8 Many persons opt to stop Paxil not only due to lack of efficacy, but also due to the significant weight gain, and other side effects the drug has long been known to cause.7 The cluster of Paxil withdrawal symptoms is collectively called Paxil discontinuation syndrome. According to a 2017 report published in the Canadian Medical Association Journal, authors Gabriel and Sharma conclude that 20% of Paxil users who took the drug for at least a month experienced discontinuation syndrome after stopping the drug abruptly or when the dose was markedly reduced.6

The authors note that patients should consult with their prescribing physician before attempting to quit taking an antidepressant. They also caution that even when tapering is done slowly, over a number of weeks, this may not alleviate the problems connected with antidepressant withdrawal. In the early 2000s, the maker of Paxil, GlaxoSmithKline was forced to admit that Paxil, its biggest selling drug at the time, can cause severe, intolerable withdrawals when stopped. The FDA issued a specific warning on the matter, although Paxil continues to be sold today.5

Alternative to Meds Center understands the punishing complications that can arise and has developed Paxil tapering programs to provide the level of care and support that is frequently found inadequate in an outpatient setting. More information on Paxil withdrawals can be found below.

Paxil Tapering Guidelines and Schedule

Even when the dosage is cut gradually over time, Paxil tapering can still present formidable challenges. Let your family or close associates know what you are doing so they can understand and be supportive. It can be hard on those around a person to see their loved one suffer. Alternative to Meds designs a unique Paxil tapering program for each client, to significantly mitigate potential discomfort. This allows for surprisingly comfortable withdrawal when the proper protocols are put in place. General guidelines are explained in more detail below, which can be discussed with your prescribing physician. Never try to taper Paxil abruptly, or all on your own.3

Your prescriber may suggest using the lowest dosage pills, which, in the case of Paxil, are 10mg yellow oval tablets. The tablets can be cut in half when needed providing a 5mg option. Paxil has a relatively short half-life (21-24 hours). It has been reported that trying to taper off a drug with a short half-life is more difficult than a drug with a longer half-life.10

Paxil Tapering Guidelines Include:
  • paxil tapering guidelinesTapering should be gradual. The math should be exact. Don’t guesstimate. Have your prescribing physician help you measure and make any cuts exactly.
  • Serotonin syndrome requires immediate medical help. Be alert for sudden fever with rash, racing heart rate, tremors, delirium, sudden changes in blood pressure, muscle rigidity, difficulty breathing, coma, seizure, and other symptoms can occur and can be life-threatening, requiring immediate cessation of the drug in a hospital setting.6,10
  • Sensitivity is different from person to person. Make any reductions cautiously, perhaps discuss a 10-25% reduction with your prescribing physician, and then observe how easy or difficult the drop was. Adjust as necessary.
  • The half-life of Paxil is 21-24 hours, which is about when Paxil withdrawals will begin. This can vary, for instance, within a day, or 2 or even 3 days.10
  • Gauge how long to wait before the next cut in dosage, allowing adequate time for symptoms to settle out at each level. It may be helpful to keep notes for reference as the taper progresses along.

There may develop a protracted withdrawal which does not resolve no matter how slowly the taper is going. Recommended is in-patient care or at least get under the care of a licensed physician who is familiar with Paxil tapering.

Paxil Titration — Important FDA WARNINGS

The FDA and other regulatory and oversight bodies warn those attempting to titrate Paxil that they should engage in stopping Paxil very slowly to avoid dangerous and even life-threatening effects.3,5

paxil weaning helpThe longer a person takes SSRI medications such as Paxil, the more intense the symptoms from Paxil titration may be. Typically, physicians, who are not trained at all in mental health or Paxil titration protocols, continue to prescribe antidepressant drugs for extended periods of time, even for years. As serotonin stores are not increased by these drugs, but only exhausted over time, increasing the dosage is the norm. Consequently, any remaining serotonin can be aggressively purged through the delicate CNS (central nervous system) channels. But eventually, antidepressant medication can no longer function as a numbing agent. This can introduce more intense side effects, and a patient may do well to learn more about how to titrate off Paxil correctly, rather than continue to try to live with the increasingly harsh side effects.

Problems with how to taper off Paxil commonly emerge where patient guidance is less than adequate, and unfortunately, doctors are not as adept at helping a person get off Paxil as they ought to be. This is because physicians receive no training whatsoever in administering Paxil tapering, or medication titration in general beyond the broad brush-stroke approach of reducing by 10% per week that is mentioned on the FDA label. Paxil tapering has to be designed to accommodate an individual’s sensitivity and tolerance to the changes that occur.

Extant medical training simply does not cover the many nuances of caring for a patient during Paxil tapering adequately. This has seen a rise in bloggers and online forums and even drug-company-sponsored “advice” sites springing up that attempt to fill in the gaps of trying to quit Paxil or other antidepressant medications. Anonymous sources of pseudo-advice proffer an outrageous and even dangerous assortment of DIY methods, ranging from randomly substituting hallucinogens or other street drugs to using a “cold turkey” approach while adding to keep a bottle of Scotch near to hand.

There are better ways to safely and comfortably administer a successful Paxil tapering program.

Alternative to Meds Center Paxil Weaning Help

For a decade and a half now, thousands of clients have come to Alternative to Meds Center for an in-patient program designed to assist with weaning off Paxil and other medications in a safe and truly comfortable manner. Our physicians are completely versed in how to wean Paxil and other drugs in a holistic, nurturing setting that allows for constant oversight, flanked by a wide range of helpful treatment options that can significantly reduce or eliminate the otherwise harsh and intolerable symptoms that can arise when trying to quit Paxil.

Finding the Root Cause of Depression and Other Symptoms

depression root causeOf prime importance, there is nothing humane about taking someone off a medication where you do not also help them reduce or eliminate the root cause of their original symptoms. The unwanted and lingering depression, insomnia, or other problems are what possibly led to starting a prescription drug in the first place. Giving a patient an aspirin when a little investigative work could have discovered that their migraines are due to dehydration or elevated blood sugar cannot be considered anything close to comprehensive or optimum treatment.

Antidepressants have been around for many many decades, and in today’s world, much more understanding is available. We have more knowledge today than ever before about the complexity of the human microbiome, natural and healthy neurochemistry, basic nutritional needs, as well as the potential harm that accumulated neurotoxins inflict, and more. All this knowledge can be utilized and integrated into much superior medical options than simply drugging or numbing the patient.

Contact Alternative to Meds Center

antidepressant tapering sedona arizonaPlease contact Alternative to Meds Center for much more detailed information about how our antidepressant tapering programs are designed. You can view the wide array of support systems and therapies in place on our services overview pages, for clients who come to the center for help with Paxil tapering and recovery. The aim and focus of programs delivered at the center are founded on getting to the root causes of troubling symptoms. Symptoms are critical signposts and there is no long-term success by simply attempting to mask these with drugs. Medications can be unnecessarily harsh, aggressive, and invasive and may not always be tolerated for meaningful or long-term treatment.

If you have been suffering from unwanted symptoms for which Paxil or other medications did not provide relief, contact us. We invite you to find out about this opportunity for effective and compassionate help and effective, holistic Paxil alternatives within the context of improving natural mental health. Alternative to Meds Center wants to help you with Paxil tapering and improving quality of life, drug-free, from here on out.

1. Nevels RM, Gontkovsky ST, Williams BE. Paroxetine-The Antidepressant from Hell? Probably Not, But Caution Required. Psychopharmacol Bull. 2016 Mar 1;46(1):77-104. PMID: 27738376; PMCID: PMC5044489. [cited 2022 July 5]

2. APA, DSM5 Update published online 2016 [cited 2022 July 5]

3. Tonks A. Withdrawal from paroxetine can be severe, warns FDA. BMJ. 2002 Feb 2;324(7332):260. doi: 10.1136/bmj.324.7332.260. PMID: 11823353; PMCID: PMC1122195. [cited 2022 July 5]

4. Middleton N, Gunnell D, Whitley E, Dorling D, Frankel S. Secular trends in antidepressant prescribing in the UK, 1975-1998. J Public Health Med. 2001 Dec;23(4):262-7. doi: 10.1093/pubmed/23.4.262. PMID: 11873886. [cited 2022 July 5]

5. FDA Access Data PAXIL® (paroxetine hydrochloride) [cited 2022 July 5]

6. Gabriel M, Sharma V. Antidepressant discontinuation syndromeCMAJ. 2017;189(21):E747. doi:10.1503/cmaj.160991 [cited 2022 July 5]

7. Dannon PN, Iancu I, Cohen A, Lowengrub K, Grunhaus L, Kotler M. Three year naturalistic outcome study of panic disorder patients treated with paroxetineBMC Psychiatry. 2004;4:16. Published 2004 Jun 11. doi:10.1186/1471-244X-4-16 [cited 2022 July 5]

8. Modell JG, Katholi CR, Modell JD, DePalma RL. Comparative sexual side effects of bupropion, fluoxetine, paroxetine, and sertraline. Clin Pharmacol Ther. 1997 Apr;61(4):476-87. doi: 10.1016/S0009-9236(97)90198-3. PMID: 9129565. [cited 2022 July 5]

9. Wilson E, Lader M.A review of the management of antidepressant discontinuation symptoms. Ther Adv Psychopharmacol. 2015;5(6):357-368. doi:10.1177/2045125315612334 [cited 2022 July 5]

10. Gury C, Cousin F. Pharmacocinétique des ISRS: notion de demi-vie d’élimination et implications cliniques [Pharmacokinetics of SSRI antidepressants: half-life and clinical applicability]. Encephale. 1999 Sep-Oct;25(5):470-6. French. PMID: 10598311. [cited 2022 July 5]

11. Volpi-Abadie J, Kaye AM, Kaye AD. Serotonin syndromeOchsner J. 2013;13(4):533-540. [cited 2022 July 5]

Originally Published Oct 16, 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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Paxil Tapering
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