Paroxetine, Paxil Withdrawal Symptoms, Timeline, Treatment

Alternative to Meds Editorial Team
Medically Reviewed by ATMC Clinical Review Team

What Is Paxil Used For?

Paxil (paroxetine) comes in two forms:  immediate release (IR) and Paxil CR (controlled release). The FDA approved Paxil to treat a wide variety of conditions, including the following: ^1,10,

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

Off-label uses for adults can include:

• Dysthymia (long lasting mild depression)
• Premenstrual dysphoric disorder
• Vasomotor symptoms associated with menopause

It is not uncommon for clinicians to prescribe Paxil “off-label” to treat children and adolescents for conditions described in terms such as separation disorder, body dysmorphic disorder, and many others.

As a selective serotonin reuptake inhibitor (SSRI), Paxil is thought to work 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 not only in North America, but worldwide. Despite their seeming popularity, a person may wish to discontinue using Paxil either because it didn’t help, or because the adverse effects have negatively impacted their quality of life.

Paxil and Suicide

Paxil packaging contains a black box warning for increased rates of suicide in those aged 24 and younger, which was demonstrated in pre-marketing short-term trials. However, more recent research has begun to revisit the numbers, and has found a similar suicide risk has been observed in the adult population. This is important to note, as it encourages the medical community to take another look at earlier findings limiting risk of suicidality to children and youth only.^1,22

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 if taken during pregnancy, seizures, and suicidal ideation.¹
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Common Paroxetine 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

SSRIs such as Paxil should never be stopped abruptly.³

Common Paxil withdrawal symptoms may include:

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 a day or 2 after the last dose. While some individuals see their symptoms lasting no more than 2 to 3 weeks, others have experienced symptoms lasting 4 to 6 weeks, or a number of months in more severe cases, especially after long-term use.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. Studies have shown abrupt discontinuation can result in serious illness, and a lengthy recovery time that can be avoided by gentle, gradual dose reduction over time.^7,19
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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 rebound or other withdrawal symptoms. Rebound symptoms are typically much harsher than they were before treatment.²⁵

One method that can be useful in approximately predicting when withdrawals may start to occur is based on the half-life of the medication. Be aware, however, that withdrawals can emerge before or well after the half-life point, as there may be many variables involved.

Both versions of paroxetine have a very short half-life, compared to other SSRIs.^1,20,21

• Paxil immediate release has a half-life of 21 hours.
• Paxil controlled release has a half-life of 15-20 hours
• Prozac (fluoxetine) has a half-life of 2-4 days

An important point to consider is that some Paxil products are time-release, or controlled-release, and you may need your prescriber to transition you to an equivalent dose of another SSRI such as Prozac, to avoid complications with measuring and cutting the dosage. The time-release characteristic of a drug will be lost by simply cutting the tablet. In the case of Paxil controlled-release, the half-life is extremely shortened by cutting the pills. So experts recommend you seek Paxil tapering help from a medical professional who can help with this transition, and who can help you navigate a tolerable, gradual reduction of dosage over time.

It is recommended by researchers to ensure adequate time (several weeks, or longer) between dose reductions to allow symptoms of withdrawal to subside before making subsequent reductions. This is an important point as withdrawal symptoms are often misidentified by prescribers unfamiliar with Paxil withdrawal who may interpret these as “relapse.” The symptoms of relapse and withdrawal are difficult to distinguish because the symptoms commonly overlap, which may result in a misdiagnosis.^7,16-18

Ways To Cope With Withdrawal Symptoms

Coping with withdrawal syndrome can be a challenge, especially if you suffer from severe withdrawal symptoms. Always obtain medical advice and support and discuss all options with a trusted healthcare provider. If your prescriber is not certain or familiar with managing antidepressant withdrawal, find one who is confident they can help. It is not uncommon for prescribers to be unaware of the complexities involved with coming off a drug like Paxil.

At the end of this article are valuable references, such as the ones directly below, that can provide guidelines and instructions, and increased understanding of what factors can be helpful to address while attempting Paxil withdrawal — and, how to address them. Take some time to study these to gain practical information that could assist greatly. In addition to seeking professional medical advice, you can:

• Reach out to a support network such as Surviving Antidepressants
• Follow healthy diet options (Mediterranean diet, probiotics for gut health, Omega-3s, etc.)¹²
• Get regular exercise.¹¹
• Exposure to sunlight for vitamin D.²³
• Make lifestyle changes to avoid toxic sources of stress ¹³
• Avoid toxic chemical exposures from foods, water, personal hygiene products, household chemical cleaners, etc.¹⁴

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 treatments you need.⁸

Tapering

As a selective serotonin reuptake inhibitor (SSRI) antidepressant medication, paroxetine blocks serotonin reabsorption causing an artificial buildup. As a result, if you stop taking paroxetine abruptly, this shocks the central nervous system. Antidepressant tapering help can minimize this shock.

Alternative Treatments

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

• Supplements:  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 improving the diet such as the Mediterranean diet, can provide your body the raw materials needed for recovery. Another example, cutting out or limiting caffeine and sugar, can help you cope better with withdrawal symptoms.^12,15
• Restore healthy gut microbiome flora with fermented foods, yogurt, sauerkraut, probiotics, etc.²⁴
• Exercise:  Although all exercise plans should be discussed with your healthcare provider, remember that even a short walk can benefit your recovery.¹¹
• Learning stress reduction and relaxation techniques can be extremely profitable for improving mental health symptoms without relying on pharmaceutical products.¹³
• Removal of accumulated chemical toxins from the body is an often overlooked strategy in mental health symptoms as the presence of symptoms and toxins in the body are often linked.¹⁴

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.

for Paxil Withdrawal Help

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Paroxetine Withdrawal FAQs

Sources:

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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 2026 Mar 13]

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Originally Published July 28, 2021 by Diane Ridaeus

This content has been reviewed and approved by:

ATMC Clinical Review Team

The ATMC Clinical Review Team includes licensed physicians and experienced healthcare professionals dedicated to ensuring the accuracy, quality, and integrity of our medical content. The team reviews articles for clinical accuracy, evidence-based guidance, and relevance while supporting Alternative to Meds Center’s whole-person approach to mental health, recovery, and long-term wellness.

Diane Ridaeus

Diane is an avid supporter and researcher of natural mental health strategies. Diane received her medical writing and science communication certification through Stanford University and has published over 3 million words on the topics of holistic health, addiction, recovery, and alternative medicine. She has proudly worked with the Alternative to Meds Center since its inception and is grateful for the opportunity to help the founding members develop this world-class center that has helped so many thousands regain natural mental health.