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Paxil Withdrawal (paroxetine), Side Effects, Addiction and Treatment

Paxil Withdrawal (paroxetine), Side Effects, Addiction and Treatment

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Last Updated on March 2, 2021 by Carol Gillette

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Alternative to Meds Editorial Team
Written by Diane Ridaeus Published Feb 13, 2021
Medically Reviewed by Dr John Motl MD

A significant percentage, over 50%, of Paxil users will experience Paxil withdrawal symptoms. Of these, half report their withdrawals as severe.7,43

Antidepressants like Paxil can inflict an extraordinarily harsh backbite that is too often dismissed or minimized by those unfamiliar with the phenomenon. The Alternative to Meds Center has been focused on Paxil withdrawal for over 15 years, offering programs to help a person safely get off Paxil.

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Require Paxil?

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Our published evidence clearly demonstrates the success of our participants. Many ATMC staff have personal experience with antidepressant withdrawal. This is why we feel genuinely called to assist others. We have found that each person needs individualized methods of support. Testing is invaluable, as it reveals neurotoxicity and deficiencies. Assessments demonstrate where lifestyle or other changes may benefit, as well as specific dietary and supplementation programs. There are even genetic factors that act as contributors to symptoms.
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Learning About Paxil Withdrawal

We recommend learning as much as possible about Paxil withdrawal and other info about this medication, such as its side effects, what it is prescribed to treat, how it affects neurotransmitters and other health matters, as well as viable alternatives.

Paxil is an antidepressant belonging to the SSRI class of prescription drugs. It is used in treating various mood disorders as recommended by the APA.

Strategies used at the center for how to get off Paxil comfortably are important subjects that will be discussed further below.

SSRI drugs, such as Paxil or its generic drug name, paroxetine, have become some of the most widely prescribed medications both in the US and worldwide. Market research shows that what has been called the “depression drug market” is set to surge yet again, from $14 billion in 2014 to well over $16 billion in 2020 in the US alone.8

SPECIAL CAUTIONARY NOTE:   The DSM V has recently revised and corrected errors in entries for several disorders for which Paxil, et. al, may not always have been accurately indicated or prescribed. The specific criteria for certain of these conditions have been recently corrected or revised, for which SSRIs have been one of the medications routinely prescribed.1 If you have questions about your prescription or your diagnosis, be sure to ask your primary caregiver or physician for more information. More information on this is given below under the section entitled “Treatment.”

Paxil Withdrawal Symptoms

Some studies have reported Paxil as being the worst in the SSRI class to withdraw from.28 Many patient reports on blogs and in forums discuss the travails people endure attempting Paxil withdrawal and discontinuation. Protracted withdrawal is a term used when these withdrawal symptoms last weeks or months.43 Alternative to Meds has been instrumental for many who were unable to overcome these debilitating withdrawal symptoms. We encourage you and your care providers to learn about the modalities found on the services section of our website.

Paxil Withdrawal Symptoms include:

  • Brain zaps 31
  • Hallucinations 34
  • Suicidal thoughts 35
  • Thoughts of harming self 35
  • Tremors 35
  • Akathesia 35
  • Anxiety 30
  • Confusion 30
  • Rebound depression 31
  • Nausea 29
  • Fever 30
  • Panic attacks 33
  • Vomiting 29
  • Dizziness 29
  • Vivid dreams 30
  • Insomnia 32
  • Diarrhea 32
  • Irritability 29
  • Headache 29
  • Paresthesia (tingling/prickling sensation on the skin) 29
  • Nightmares 29

*Note:  Paxil is the most aggressive of all SSRIs with a 21-hour half-life, meaning that Paxil withdrawal symptoms can onset or escalate if abruptly discontinued, according to a 2001 review by Bourin, Chue, and Guillon.

Discontinuing/Quitting Paxil (paroxetine)

paxil side effectsThe most common reason people give for wanting Paxil withdrawal treatment is overwhelming side effects.25 At the beginning of a treatment phase, certain side effects might be temporarily acceptable, such as sexual side effects or headaches. But there often comes a time when it becomes decidedly untenable to continue taking Paxil, as the negative effects may begin to outweigh any benefits.

However, as stated above, withdrawal from the drug may introduce its own set of adverse feelings and reactions which can be severe. These need careful and compassionate treatment.

Please be careful to never abruptly stop taking Paxil, or try to taper down too quickly. The safest approach is to seek medical guidance and direction for a slow Paxil withdrawal with adequate support as you go through the process. Please read our highly informative Paxil tapering page for more information that you can share with your provider.

Seeking Natural Paxil Withdrawal Treatments

For many reasons, it behooves anyone searching for remedies for depression, anxiety, or other undesired symptoms to select treatments that are the least harmful, and optimally, non-addictive. Search out information from a wide variety of sources, ask questions, and satisfy all your questions before embarking on a particular course of treatment. At Alternative to Meds Center, we offer Paxil withdrawal treatments that address natural mental health goals, without the use of prescription medications. Paxil addiction is not the best or only answer to address symptoms of mental unease.

If one is already tangled up with dependence, there are Paxil withdrawal options at Alternative to Meds Center that are safe and comfortable AND are designed to ultimately address natural mental health goals without prescription drugs.

You may be presently looking for the very first time for natural mental health treatments, or Paxil withdrawal to safely walk back from treatments that did not produce the desired results. There may be unanswered questions as to why a condition like depression got worse on prescription drug treatment, or why other symptoms began to present.

The information offered here may provide some starting points for your health quest.

Testimonial
Paxil Withdrawal
Success

At ATMC I was always supported. The staff was great at providing opportunities for me to work towards stability. What helped me here was always keeping a positive outlook and the constant encouragement and reminders to keep faith in myself.

-Jackie

 

What is Paxil (paroxetine) used for?

Paxil (paroxetine) is an antidepressant drug, used in the treatment of many conditions, some of which are explained in some detail below. Since its approval some decades ago, this SSRI antidepressant drug has received additional FDA approval for treating multiple conditions or disorders.

Paxil is typically prescribed to treat: 9

  • Panic Disorder
  • OCD
  • MDD
  • PTSD
  • GAD
  • SAD (seasonal affective disorder)
  • SAD (social anxiety disorder)

Panic Disorder:

This condition affects 2.5 times as many women as men, most often beginning in the teen years or early twenties. Panic attacks can occur in adult and older populations as well.10 Panic disorder is characterized by recurring episodes called panic attacks. During a panic attack, a person may experience a rapid or pounding heartbeat, a choking sensation, fear of dying, fear of losing control, a breathless sensation, and chest pain. High levels of anxiety develop and linger, because of not knowing when or where another attack may occur.

OCD:

Obsessive-compulsive disorder is diagnosed where a person experiences or carries out repeating thoughts, emotions, or actions, which are beyond their ability to control without significant consequences to the person’s well-being.11 Some persons describe this as being haunted by thoughts that won’t go away. A nagging compulsion to repeatedly check the locks will produce anxiety or distress if the action is not carried out. Other examples are compulsive excessive hand-washing for fear of germs, counting things like stairs or objects for no apparent reason except to reduce the anxiety that is felt if the counting is not carried out, checking and re-checking the stove was shut off, yet still doubting one did it correctly, etc.

MDD:

Major depressive disorder is diagnosed when a person suffers low mood, lethargy, and other symptoms. According to the DSM-5, an individual must be experiencing a combination of 5 symptoms during the same two-week period. One of the symptoms has to be a depressed mood or loss of interest. Other criteria for a diagnosis include: 12

  1. A depressed mood that is constant or nearly constant.
  2. A lack of interest in all or almost all activities
  3. Significant weight loss or gain.
  4. A slowed thinking and movement.
  5. Fatigue.
  6. Feelings of excessive guilt.
  7. Diminished ability to concentrate.
  8. Recurrent thoughts of death or suicide plans.

When MDD lasts for 2 years or more it is called PDD 6 or persistent depressive disorder.

PTSD:

antidepressant withdrawal ptsdPost-traumatic stress disorder is usually diagnosed after exposure to traumatic events has left lingering after-effects such as hypersensitivity to external stimuli, recurring vivid nightmares, flashbacks, fears, etc. While PTSD has trauma as a component, research suggests that there may also be physiological contributors such as depleted endorphin levels. A 2011 article published in Dialogues in Clinical Neuroscience found that PTSD patients have demonstrated heightened CSF p-endorphin levels.15 This suggests that there is increased activation of the endogenous opioid system, which may lead to endorphin depletion. We have certainly observed PTSD patients highly benefit from endorphin boosting amino acid protocols, especially in conjunction with psychotherapeutic interventions.

GAD:

Generalized anxiety disorder is diagnosed where an unusually exaggerated or severe sense of anxiety and tension has been going on for six months or more, yet can not be reasonably accounted for.16

SAD:

Social anxiety disorder resembles extreme shyness or unease, awkwardness, or fear of being negatively perceived by others in social situations.3 Symptoms include reclusiveness, blushing excessively, nervousness about meeting or interacting with people, etc. The condition is reportedly the second most often diagnosed anxiety condition in psychiatric practice.15 Paxil is often prescribed to persons who are diagnosed with “social anxiety,” including those addicted to alcohol.19 Taking two (or multiple) agents that affect the CNS simultaneously could be disastrous.18 The Norwegian University of Science and Technology did a study on social anxiety disorder treatments and found non-drug-based treatment most effective.2

SAD:

antidepressants seasonal affective disorderSeasonal affective disorder is described as a low mood or sadness that begins and ends with a particular season. Some linking factors have been established, such as lack of outdoor activity or decreased hours of sunshine, lack of vitamin D,20 reduced exercise, certain eating behaviors,21 and other environmental factors. The condition appears to be most prevalent in geographic areas that are far north or south of the equator, according to a compilation of research on the subject by Melrose in 2015.23 Light therapy is considered one of the most effective treatments for this set of symptoms.22 Despite the known contributors of seasonal affective disorder, sometimes aggressive and invasive treatments such as electric shock to induce seizures, or antidepressant medications such as Paxil that may have damaging side-effects are prescribed but the APA recommends such treatment be temporary.3,6

Depressive Diagnoses Typically Lack Medical Investigations

We truly feel that the medical or substance use disorder attributes should be treated prior to rendering a psychiatric diagnosis. This level of investigative work is what we do at Alternative to Meds Center. Yet, there is no single test to tell you if the mental health is secondary to a medical malady.24 Each one of these situations needs to be teased apart including a lengthy history and observed while under the benefit of a good diet, counseling, and other medical interventions. It is uncommon for those presenting with psychiatric issues at the hospital to have medical testing ordered.13 And there are essentially no biological tests for psychiatric diagnosis,14 and in conventional mental health settings, little attention is actually put on the physiology of the afflicted. When we get people with depressive diagnoses, in many cases we find that there were a number of physiological contributors. It is strange to us that the connection between physical health and mental health is poorly established as we as an organization that has focused on these attributes have found significant gains for what had previously been only addressed with medication or counseling.

Paxil (paroxetine) Alternative Names and Slang

Paroxetine, the generic name for Paxil, is also sold under various trade names such as Pexeva, Aropax, Seroxat, Sereupin, Brisdelle.

Paxil is not known as a popularized street drug. However, illegal labs and diversion could be possible sources that could end up on the street. Many prescription drugs have been found when analyzing illicit concoctions, designer-type drugs, drugs sold as “ecstasy,” etc.

Paxil Side Effects

paroxetine side effectsNot every person experiences exactly the same set of side effects, nor does each person experience the same intensity of symptoms. However, a significant percentage of those taking Paxil do come to the decision to stop taking Paxil due to, at least in part, the side effects that become problematic.25 Before beginning a prescription of Paxil (paroxetine) it would be advisable to discuss the most common and other Paxil side effects with your prescribing physician. Here are some important points to consider in regards to Paxil side effects that could be encountered:

Breast Cancer:  There has been much reporting on the adverse effects associated with Paxil. Two Canadian studies showed a significant rise in breast cancer and also an increased risk of dying from breast cancer in women who took Paxil over one four-year study, and a second five-year study. The ways in which paroxetine interacted with certain genetic factors, and how it interacted with certain cancer drugs was also found to be significant in these findings.4

Birth Defects:  Prolonged QT interval in infants is linked to various congenital heart defects in newborns whose mothers took Paxil during the first trimester of pregnancy. This results in malformed ventricular tissue, and other defects. If taken during later stages of pregnancy, Paxil is linked to neonatal withdrawal syndrome in the infant. Such symptoms present as respiratory impairment, lethargy, jitteriness, poor feeding, etc.4

Suicidality:  Paxil is not prescribed to the pediatric population due to a doubling of suicidality in trials.25

Serotonin Syndrome:  Paxil contains one of the most aggressive and potent serotonergic agents of all the drugs in its class.25 When too much serotonin becomes activated in the body by Paxil and other antidepressants with a serotoninergic effect, this can result in a life-threatening reaction called serotonin syndrome.26 It is common for other drugs to also be involved in combination with Paxil for this to occur, but can occur from Paxil monotherapy alone.26 Symptoms to watch for are sudden fever, depressed respiration, confusion, dilated pupils, rash, difficulty speaking or thinking clearly, hallucinations, muscle rigidity, etc.27 Immediate medical attention, by ambulance, is recommended for the best chance of survival, to the closest medical facility or ICU.

Other Side Effects:  There is a very wide range of side effects which include adverse effects on male fertility, cognitive impairment in the elderly, sexual side effects, weight gain, aggression, akathisia in children, and adolescents.9

SSRI drugs like Paxil may have many adverse reactions. Be sure to ask your primary caregiver if you are experiencing unusual physical or mental changes while taking Paxil which makes you feel uncomfortable. Be sure to let your doctor know if you are or are planning to become pregnant, and whether you have a family history of breast cancer while considering and discussing starting a prescription of Paxil or any psychiatric medication.

Paxil Alternative Therapies

paxil alternativesAlternative to Meds Center has developed an arsenal of Paxil alternative treatments it uses to provide safe and effective treatments for natural mental health. Many of the Paxil alternatives that we incorporate into the program will be discussed there.

Along with helping clients complete their Paxil taper program, other supporting segments of the programs address specific health issues relating to sleep, mood, energy level, and much more. Stopping Paxil safely starts the ball rolling, and there is much more that can be improved while in the program. Treatments for natural mental health help during and after Paxil withdrawal.

Paxil (paroxetine) FAQs

The following are some of the most frequently asked questions about Paxil (paroxetine) which may help you as you gather the information you need. Please request further information if your questions are not answered adequately here.

Can you OD on paroxetine?

Yes, like all drugs, an SSRI can be deadly if taken in too great a quantity, but particularly if mixed with other drugs or alcohol because of their synergistic effects.36 Because of the suicide risk associated with SSRI drugs, an overdose is of special concern where suicidality emerges or seems to intensify during treatment. If a person does overdose on Paxil, swift medical attention is the best chance for recovery.

How long does it take to get over Paxil withdrawal?

At Alternative to Meds Center, we get most people comfortably through Paxil withdrawal in 8 weeks. With a proper regimen of adjunctive therapies, slow tapering is the best way to go. One thing that might lengthen the process is trying to withdraw too fast. This is especially true after long-term use. It is possible to recover from Paxil withdrawal with proper protocols, guidance, and adequate support in place. But the pace of the withdrawal must be tolerable, not causing severe reactions. At Alternative to Meds Center, clients in our program are individually programmed for the best and most comfortable withdrawal experience possible and treatment plans are designed for their unique situation.

Is Paxil Addictive?

While drug companies are typically reluctant to admit this, GlaxoSmithKline, the manufacturer for paroxetine, was forced in 2002 to acknowledge that Paxil can cause severe withdrawal symptoms when patients stop using it. Additionally, the FDA published a new product warning about Paxil discontinuation. Simultaneously, the International Federation of Pharmaceutical Manufacturers Associations declared GlaxoSmithKline guilty of misleading the public about paroxetine. Charles Medawar, head of Social Audit, stated “This drug has been promoted for years as safe and easy to discontinue. The fact that it can cause intolerable withdrawal symptoms of the kind that could lead to dependence is enormously important to patients, doctors, investors, and the company.” 37,38

Medical News Todaydefines “addiction is a psychological and physical inability to stop consuming a chemical, drug, activity, or substance even though it is causing psychological and physical harm.” 39

We can imagine that someone going through alcohol withdrawal may be “addicted” because they do not want to suffer the headaches, anxiety, and other symptoms that manifest from withdrawal, and so, therefore, continue using alcohol. The same could be said about heroin. Realistically, there are many known uncomfortable side effects of Paxil and Paxil withdrawal. These show up when a person is stopping Paxil, and their severity may deter a person from being able to persist, manifesting what arguably looks and feels like Paxil addiction.

Perhaps a person was taking an antidepressant but originally had an undiagnosed thyroid problem. After correcting the medical contributor (thyroid condition) the person may still be suffering from painful Paxil withdrawal. So the person may elect to continue taking Paxil, which in this case may be medically unnecessary, but the person cannot tolerate such painful withdrawals. if someone continues using the antidepressant despite a demonstrable negative effect on the quality of life, we could call that Paxil addiction or Paxil-dependent.

Based upon the number of patients at Alternative to Meds Center who have successfully overcome these withdrawal side effects and who came out the other side with a higher quality of life, it would be reasonable to conclude that there is likely a fairly large population of Paxil users that would define themselves as addicted, but who would undeniably choose a different path if they had the proper help. Paxil addiction or dependence can be successfully overcome.

Will I Get Brain Zaps if I Stop Taking Paxil?

brain zapsBrain zaps are reportedly a problem that is not uncommon when a person is stopping Paxil,40 especially if done too abruptly and without nutritional and other support. Brain zaps feel like a jolt of electricity, resulting in a feeling of electric shock through the head and sometimes neck.5 The phenomena can be painful and distressing in the extreme, especially if it goes on for a long time or repeatedly. This startling phenomenon can produce a level of anxiety and discomfort that can be hard to tolerate, and sometimes even occurs during a Paxil taper, at what seems like a slow pace. Our methods of building up the natural neurochemistry, at the same time the Paxil withdrawal is occurring, strongly alleviates Paxil brain zaps. We feel that if brain zaps occur, that the most likely sign is that the tapering is going too fast for the body to adjust and it needs to slow down. Serotonin is a neuromodulator that makes nerve de-polarization LESS likely.41 One theory that we have advanced is that the abrupt removal of the drug may be leading to nerve depolarization in an unsynchronized way which may be manifesting as brain zaps. But at the time of this writing, the medical community does not exactly know what causes brain zaps other than attributing it to withdrawal.42

Sources claim that Paxil withdrawal brain zaps are not harmful,42 but we at Alternative to Meds Center are not convinced. If the medical community is unaware of why brain zaps are occurring, it seems a bit adventurous to us to claim that they are not damaging. Maybe they are not, be we feel efforts should be made to avoid them.

You can also request more information from Alternative to Meds Center if you find yourself struggling with this situation, or more information is needed on exactly how to get off Paxil safely and comfortably.

The Alternative to Meds Treatment for Paxil Withdrawal

SSRI medications can produce significant negative impacts on health.26 The Alternative to Meds Center treatment focuses on attaining mental health naturally and need not be confused with addiction programs which may be strongly aligned with morality or philosophical teaching. Thankfully, there are multitudes of effective, easy to tolerate, physical therapies and procedures which we have found to be profoundly useful in making Paxil withdrawal easier and recovery comfortable and gentle.

Dealing with the challenges of Paxil cessation and other factors relating to getting off Paxil while health, in general, is compromised, may suggest that inpatient care would provide the safest, most effective, and most comfortable treatment choice. This is not an uncommon situation and Alternative to Meds Center can help.

In-Patient Paxil Withdrawal

As mentioned earlier, DSM revisions had to do with diagnosing psychiatric disorders. A distinct change was pointing out the importance of discerning whether a set of symptoms is caused by a physical or medical condition. Physical causation here can include alcohol use or ingesting a street drug, leading to mental unease that was drug-induced, rather than “a mental illness.”

Medical causation for depression might even include low sodium.44 This is profoundly important information for caregivers and physicians so that a patient can request that their primary caregiver or physician rule out such causes of symptoms before mechanically diagnosing a psychiatric illness and prescribing drugs or ECT or other seizure-inducing treatments.

paxil withdrawalThese methodologies used in our treatment facility avoid the pitfalls of electrical zapping or drug treatments. For example, the practice of using diagnostic lab testing is one of the most helpful features of our withdrawal program. Where deficiencies exist in vitamins, i.e., vitamin D or minerals, the lack of exercise, or the presence of neurotoxins, Vitamin and mineral deficiencies can be corrected directly. Clients can benefit from neurotransmitter rehabilitation therapy. The normal biophysical synthesis of neurotransmitters is supported with targeted nutrition, supplementation, cleansing, acupuncture, and other holistic comfort therapies, without the use of drugs.

Genetic factors can be mitigated through nutrition and supplementation to smooth out the withdrawal process.45 This concept is called nutritional genomics. Our goal is to enable those recovering after medication withdrawal to regain natural mental health. We have much more information we can share with you on request on the Alternative to Meds Center programs for in-patient, safe Paxil withdrawal.


1. DSM V Updates, Psychiatry Online [Internet] 2016 Sept [cited 2020 Nov 2]

2. Nordahl H et al., ” A cure for social anxiety disorders.” Norwegian University of Science and Technology, Science Daily [Internet[ 2016 Dec 16 [cited 2020 Nov 19]

3. Melrose S, “Seasonal Affective Disorder: An Overview of Assessment and Treatment Approaches.” Depression Research and Treatment 2015 Nov 25 [Internet] PubMed ID 26688752 [cited 2020 Nov 2]

4. Nevels R, Gontkovsky S, Williams B, “Paroxetine – The Antidepressant From Hell?” Psychopharmacology Journal [INTERNET] 2016 Mar 1 [cited 2020 Nov 2]

5. Papp A, Onton J, “Brain Zaps: An Underappreciated Symptom of Antidepressant Discontinuation.” Prim Care Companion CNS Disord 2018 Dec 20 [Internet] PubMed ID 30605268 [cited 2020 Nov 2]

6. NIMH, “Depression Overview” Information portal [Internet] 2018 Feb [cited 2020 Nov 2]

7. Gabriel M, Sharma V. Antidepressant discontinuation syndrome.CMAJ. 2017;189(21):E747. doi:10.1503/cmaj.160991. [cited 2021 Feb 9]

8. Markey Research Store: Global Depression Drug Market Poised to Surge from USD 14.51 Billion in 2014 to USD 16.80 Billion by 2020 May 10, 2016 08:05 ET.

9. FDA Access Data PAXIL® (paroxetine hydrochloride) Tablets and Oral Suspension [cited 2021 Feb 11]

10. Gregory A. Leskin, Ph.D., Javaid I. Sheikh, MD Gender Differences in Panic Disorder Psychiatric Times Vol 21 No 1, Volume 21, Issue 1 January 1, 2004

11. Substance Abuse and Mental Health Services Administration. Impact of the DSM-IV to DSM-5 Changes on the National Survey on Drug Use and Health [Internet]. Rockville (MD): Substance Abuse and Mental Health Services Administration (US); 2016 Jun. Table 3.13, DSM-IV to DSM-5 Obsessive-Compulsive Disorder Comparison.

12. PSYCOM Depression Definition and DSM-5 Diagnostic Criteria Jessica Truschel Last Updated: Sep 25, 2020

13. First10EM Routine laboratory testing is not required prior to admission of psychiatric patients by Justin Morgenstern|Published August 10, 2020.

14. Psychiatric Times The Role of Biological Tests in Psychiatric Diagnosis Allen Frances, MD May 23, 2013

15. Sherin JE, Nemeroff CB. Post-traumatic stress disorder: the neurobiological impact of psychological trauma.Dialogues Clin Neurosci. 2011;13(3):263-278. doi:10.31887/DCNS.2011.13.2/jsherin

16. Substance Abuse and Mental Health Services Administration. Impact of the DSM-IV to DSM-5 Changes on the National Survey on Drug Use and Health [Internet]. Rockville (MD): Substance Abuse and Mental Health Services Administration (US); 2016 Jun. Table 3.15, DSM-IV to DSM-5 Generalized Anxiety Disorder Comparison.

17. Anxiety and Depression Association of America Social Anxiety Disorder [cited 2021 Feb 12]

18. NHS Can I drink alcohol if I’m taking antidepressants? [cited 2021 Feb 12]

19. Gimeno C, Dorado ML, Roncero C, et al. Treatment of Comorbid Alcohol Dependence and Anxiety Disorder: Review of the Scientific Evidence and Recommendations for Treatment.Front Psychiatry. 2017;8:173. Published 2017 Sep 22. doi:10.3389/fpsyt.2017.00173

20. Penckofer S, Kouba J, Byrn M, Estwing Ferrans C. Vitamin D and depression: where is all the sunshine?Issues Ment Health Nurs. 2010;31(6):385-393. doi:10.3109/01612840903437657

21. Yang Y, Zhang S, Zhang X, Xu Y, Cheng J, Yang X. The Role of Diet, Eating Behavior, and Nutrition Intervention in Seasonal Affective Disorder: A Systematic Review.Front Psychol. 2020;11:1451. Published 2020 Aug 4. doi:10.3389/fpsyg.2020.01451

22. Roecklein KA, Rohan KJ. Seasonal affective disorder: an overview and update. Psychiatry (Edgmont). 2005;2(1):20-26.

23. Melrose S. Seasonal Affective Disorder: An Overview of Assessment and Treatment Approaches.Depress Res Treat. 2015;2015:178564. doi:10.1155/2015/178564

24. McKee J, Brahm N. Medical mimics: Differential diagnostic considerations for psychiatric symptoms.Ment Health Clin. 2016;6(6):289-296. Published 2016 Nov 3. doi:10.9740/mhc.2016.11.289

25. Nevels RM, Gontkovsky ST, Williams BE. Paroxetine-The Antidepressant from Hell? Probably Not, But Caution Required.Psychopharmacol Bull. 2016;46(1):77-104.

26. FDA Access Label Paxil CR [cited 2021 Feb 12]

27. Mayo Clinic Serotonin syndrome [cited 2021 Feb 12]

28. Hosenbocus S, Chahal R. SSRIs and SNRIs: A review of the Discontinuation Syndrome in Children and Adolescents. J Can Acad Child Adolesc Psychiatry. 2011;20(1):60-67.

29. NAMI The College of Psychiatric and Neurologic Pharmacists (CPNP) Paroxetine (Paxil) December 2020

30. Belloeuf L, Le Jeunne C, Hugues FC. Syndrome de sevrage à la paroxétine [Paroxetine withdrawal syndrome]. Ann Med Interne (Paris). 2000 Apr;151 Suppl A:A52-3. French. PMID: 10855379.

31. Mayo Clinic Antidepressant withdrawal: Is there such a thing? Daniel K. Hall-Flavin, M.D. Jan. 29, 2019

32. American Academy of Family Physicians Antidepressant Discontinuation Syndrome 2006 Aug 1;74(3):449-456.

33. New York Times Antidepressants and Withdrawal: Readers Tell Their Stories By Benedict Carey April 17, 2018

34. Yasui-Furukori N, Kaneko S. Hallucination induced by paroxetine discontinuation in patients with major depressive disorders. Psychiatry Clin Neurosci. 2011 Jun;65(4):384-5. doi: 10.1111/j.1440-1819.2011.02211.x. Epub 2011 Apr 14. PMID: 21489048.

35. Mireille Rizkalla, PhD; Bryan Kowalkowski, OMS III; Walter C. Prozialeck, PhD Antidepressant Discontinuation Syndrome: A Common but Underappreciated Clinical Problem The Journal of the American Osteopathic Association, March 2020, Vol. 120, 174-178.

36. Gupta AK, Verma P, Praharaj SK, Roy D, Singh A. Paroxetine overdose.Indian J Psychiatry. 2005;47(3):167-168. doi:10.4103/0019-5545.55943

37. Tonks A. Withdrawal from paroxetine can be severe, warns FDA.BMJ. 2002;324(7332):260. doi:10.1136/bmj.324.7332.260

38. Withdrawal from paroxetine can be severe, warns FDA BMJ 2002; 324:260 (Published 02 February 2002)

39. Medical News Today What is addiction? Medically reviewed by Vara Saripalli, Psy.D. — Written by Adam Felman on October 26, 2018

40. The Washington Post Quit Paxil, And Then: Zap! By Brian Reid August 27, 2002

41. Science Direct Serotonin From Textbook of Veterinary Physiological Chemistry (Third Edition), 2015

42. Medical News Today Brain zaps: Everything you need to know Medically reviewed by Alana Biggers, M.D., MPH — Written by Jennifer Berry on April 2, 2020

43. James Davies, John Read, A systematic review into the incidence, severity, and duration of antidepressant withdrawal effects: Are guidelines evidence-based? Addictive Behaviors Volume 97, 2019, Pages 111-121, ISSN 0306-4603

44. University of Iowa. “Salt Might Be ‘Nature’s Antidepressant‘.” ScienceDaily. ScienceDaily, 11 March 2009.

45. Stover PJ, Caudill MA. Genetic and epigenetic contributions to human nutrition and health: managing genome-diet interactions.J Am Diet Assoc. 2008;108(9):1480-1487. doi:10.1016/j.jada.2008.06.430



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

Dr. John Motl, M.D.

Dr. Motl is currently certified by the American Board of Psychiatry and Neurology in Psychiatry, and Board eligible in Neurology and licensed in the state of Arizona.  He holds a Bachelor of Science degree with a major in biology and minors in chemistry and philosophy. He graduated from Creighton University School of Medicine with a Doctor of Medicine.  Dr. Motl has studied Medical Acupuncture at the Colorado School of Traditional Chinese Medicine and at U.C.L.A.

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