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Paroxetine (Paxil) Withdrawal Symptoms, Timeline, and Treatment

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

Last Updated on July 27, 2022 by Diane Ridaeus

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Tokino, CC BY-SA 3.0 <http://creativecommons.org/licenses/by-sa/3.0/>, via Wikimedia Commons Original Image

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

Doctors prescribe paroxetine, better known by its brand name Paxil, to treat depression and other mental health issues. If you or a loved one has been taking Paxil but would like to stop, you should discuss your options with your healthcare provider.

Although Paxil is not considered a controlled substance, you can suffer from withdrawal symptoms, especially if you stop taking the medication abruptly. To best cope with discontinuing Paxil, seek advice from a medical professional and use this article to learn more about the withdrawal symptoms, timeline, and options for withdrawal treatment.

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What Is Paxil Used For?

Paxil (paroxetine) comes in two forms: immediate release (IR) and Paxil CR (controlled release). Although doctors have prescribed Paxil for the off-label treatment of Premenstrual dysmorphic disorder (PMDD), the Food and Drug Administration (FDA) has approved paroxetine to treat:1

  • Generalized anxiety disorders (GAD)
  • Social anxiety disorder (SAD)
  • Panic disorder (PD)
  • Obsessive-compulsive disorder (OCD)
  • Post-traumatic stress disorder (PTSD)
  • Major depressive disorder (MDD)

As a selective serotonin reuptake inhibitor (SSRI), Paxil works by blocking the reabsorption of a neurotransmitter called serotonin in the brain. In doing so, Paxil increases the concentration of serotonin, at least temporarily, which is thought to improve the transmission of messages between neurons in your brain that impact mood and anxiety.2

SSRI drugs such as Paxil have become some of the most widely prescribed medications both in the United States and worldwide. However, some wish to discontinue their use of Paxil because the adverse effects impact their quality of life, but doing so abruptly can cause withdrawal symptoms.3

Paroxetine Side Effects

The most common side effects linked to paroxetine include drowsiness, dry mouth, loss of appetite, sexual side effects, lack of energy, and sleep disturbances. Other adverse effects include headaches, dizziness, tremors, chest pain, rash, constipation, and nervousness.1

In rare cases (especially if taken with other drugs that increase serotonin), paroxetine may cause a serious condition called serotonin syndrome. You should seek medical help if you develop a fast heartbeat, vomiting, twitching muscles, unexplained fever, loss of coordination, hallucinations, diarrhea, or nausea.4

More severe side effects of Paxil use may include birth defects and suicidal ideation.1

Common Paroxetine Withdrawal Symptoms

paxil withdrawal symptoms

In addition to side effects you may encounter while taking paroxetine, you could experience discontinuation syndrome, causing withdrawal symptoms, especially if you try to discontinue use of Paxil abruptly. To minimize Paxil withdrawal symptoms, experts recommend that you seek Paxil tapering help to reduce your dose of Paxil gradually rather than quitting all at once.

Withdrawal symptoms from SSRIs are likely to emerge when discontinued.  Risks of withdrawals may increase if you’ve been taking these drugs for an extended period. Most frequent complaints include flu-like symptoms accompanied by anxiety and agitation, dizziness, and sensory disturbances.2,5

Common Paxil withdrawal may include: 
  • Sleep problems such as insomnia, nightmares, and vivid dreams
  • Mood-related symptoms — confusion, suicidal thoughts and thoughts of self-harm, and panic attacks
  • Brain zaps or a buzzing feeling
  • Electric shock-like sensations
  • Headache
  • Fever
  • Nausea
  • Hallucinations
  • Tremors
  • Lethargy
  • Chills
  • Vomiting
  • Dyskinesia (impaired or abnormal movement)
  • Diarrhea
  • Irritability
  • Paresthesia (a “pins and needles,” tickling, or prickly sensation)

How Long Do Paroxetine Withdrawal Symptoms Last?

Anyone who takes a selective serotonin reuptake inhibitor (SSRI) like Paxil risks going through a discontinuation syndrome and withdrawal symptoms. The duration of withdrawal symptoms from paroxetine can vary, depending on how quickly your body eliminates the drug, how long you’ve been taking Paxil, and the size of your dose.

Typically, symptoms of Paxil withdrawal begin sometime within 1 to 2 days after the last dose and tend to peak around day 5. While some individuals see their symptoms last no more than 2 to 3 weeks, others have experienced symptoms lasting 4 to 6 weeks.6

A longer-lasting and more severe withdrawal timeline is referred to as post-acute withdrawal syndrome (PAWS or PWS). Those affected by PAWS may see their symptoms anywhere from 1 to 8 weeks, months, a year, or even several years.7 

What Happens When You Stop Taking Paroxetine?

As mentioned above, abruptly stopping paroxetine can cause you to experience withdrawal symptoms, and in some cases those symptoms can be severe and last a very long time. Even missing a dose can trigger withdrawal symptoms and cause your original symptoms to recur. So experts recommend you seek Paxil tapering help from a medical professional.7

Ways To Cope With Withdrawal Symptoms

Coping with withdrawal syndrome can be a challenge, especially if you suffer from severe withdrawal symptoms. You should always obtain medical advice and support and discuss all options with your healthcare provider.

In addition to seeking professional medical advice, you can:

  • Reach out to a support network.
  • Follow a healthy diet.
  • Get regular exercise.
  • Monitor your mood and warning signs.

Alternative to Meds Center has developed an arsenal of Paxil alternative treatments that safely and effectively restore and preserve natural mental health. Along with helping clients complete their paroxetine taper program, we offer other supportive services to address specific health issues relating to sleep, mood, energy level, and much more.

Withdrawal Treatment Options

paxil withdrawal treatment options
Withdrawal from Paxil can be mild for some, and severe for others. To ease your withdrawal symptoms, discuss these options with your healthcare provider.

Therapy

CBT is a form of therapy that can be effective when recovering from withdrawal and dependence. With the addition of psychological therapy to your treatment program, you receive an individualized, customized approach to your health and well-being, allowing you to address your mental health challenges as part of a program of recovery. Working with the advice of a medical professional, you can find the right combination of treatment you need.8

Tapering

Serotonin in your brain works to improve your mood, so when you have more serotonin in your brain, it can act to improve mood and social functioning. If serotonin gets reabsorbed, the reduced levels can lower your mood, for which doctors prescribe antidepressants.9

As a selective serotonin reuptake inhibitor (SSRI) antidepressant medication, paroxetine blocks serotonin reabsorption, but if you stop taking paroxetine abruptly, your brain has to deal with the shock of serotonin once again being reabsorbed. Paxil tapering help can minimize this shock.

Alternative Treatment

When you need to ease your discontinuation symptoms, discuss with your doctor whether any of these alternatives can help:

  • OTC treatment: Your healthcare provider can discuss whether any over-the-counter treatments, such as vitamins, minerals, and amino acids can boost the production of naturally occurring neurotransmitters precursors and help ease withdrawal symptoms.
  • Diet: Discuss with a medical professional how cutting out or limiting caffeine and sugar can help you cope better with withdrawal symptoms.
  • Exercise: Although all exercise plans need to be approved by your healthcare provider, remember that even a short walk can benefit your recovery.

Seeking Support

Paroxetine can interfere with your daily life by creating possible side effects while you are taking the drug and the potential for withdrawal if you decide to stop taking it. If you need Paxil tapering help so that you can discontinue your medication safely or you need help dealing with withdrawal symptoms, discuss all of your alternatives with your healthcare provider.

If you need additional support and want to explore Paxil alternatives, don’t hesitate to reach out to your healthcare provider and contact Alternative to Meds Center.


1. Accessdata.fda.gov. “Paroxetine FDA Label.” [cited Mar. 30, 2022]

2. Chu A, Wadhwa R. Selective Serotonin Reuptake Inhibitors. [Updated 2022 May 8]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK554406/ [cited 2022 July 27]

3.  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 27]

4.  Volpi-Abadie J, Kaye AM, Kaye AD. Serotonin syndrome. Ochsner J. 2013 Winter;13(4):533-40. PMID: 24358002; PMCID: PMC3865832. [cited 2022 July 27]

5. Wilson E, Lader M. A review of the management of antidepressant discontinuation symptoms. Ther Adv Psychopharmacol. 2015 Dec;5(6):357-68. doi: 10.1177/2045125315612334. PMID: 26834969; PMCID: PMC4722507. [cited 2022 July 27] 

6. Belloeuf L, Le Jeunne C, Hugues FC. [Paroxetine withdrawal syndrome]. Ann Med Interne (Paris). 2000 Apr;151 Suppl A:A52-3. French. PMID: 10855379.[cited 2022 July 27]

7. Sage Journals. “Protracted withdrawal syndrome after stopping antidepressants: a descriptive quantitative analysis of consumer narratives from a large internet forum” [cited Mar. 3, 2022]

8. Carroll KM, Onken LS. Behavioral therapies for drug abuse. Am J Psychiatry. 2005 Aug;162(8):1452-60. doi: 10.1176/appi.ajp.162.8.1452. PMID: 16055766; PMCID: PMC3633201. [cited 2022 July 27]

9.  Young SN. How to increase serotonin in the human brain without drugs. J Psychiatry Neurosci. 2007 Nov;32(6):394-9. PMID: 18043762; PMCID: PMC2077351. [cited 2022 July 27]


Originally Published July 28, 2021 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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Paroxetine (Paxil) Withdrawal Symptoms, Timeline, and Treatment
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Nothing on this Website is intended to be taken as medical advice. The information provided on the website is intended to encourage, not replace, direct patient-health professional relationships. Always consult with your doctor before altering your medications. Adding nutritional supplements may alter the effect of medication. Any medication changes should be done only after proper evaluation and under medical supervision.

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