How Long Does Withdrawal From Paxil Last?

Paxil Withdrawal

 Verywell / Nusha Ashjaee

What is the most important information I should know about withdrawal from Paxil?

  • Do not stop taking Paxil without talking to your doctor first.
  • Switching to a long-acting SSRI and gradually tapering your dose can help minimize withdrawal symptoms.

Paxil (paroxetine) is an antidepressant medication used to treat various disorders, including major depression, generalized anxiety disorder, and obsessive-compulsive disorder. It is a member of a class of drugs known as selective serotonin reuptake inhibitors (SSRIs), which work by increasing the amount of serotonin available in your brain. It is not uncommon for someone to experience withdrawal symptoms when attempting to quit Paxil. 

This article discusses withdrawal from Paxil, the symptoms you might expect, and what you can do to cope.

Overview of Withdrawal from Paxil

More than 40 million people in the U.S. take antidepressants. Many received their prescription from a family doctor rather than a psychiatrist. SSRI withdrawal symptoms have been well documented in medical literature, but prescribing doctors, often without psychiatric expertise, sometimes neglect to tell their patients what to expect.  

Many people taking Paxil and other SSRIs for a long enough time experience withdrawal symptoms when they try to quit or reduce their dose. About 50% of people on antidepressants have been taking them for over five years, and one in four has been on them for ten or more years.

Unfortunately, Paxil is notorious for being among the hardest antidepressants to quit. Due to its short half-life, Paxil withdrawal can hit hard and fast. More than 56% of people who quit antidepressants experience withdrawal symptoms.

Symptoms ranging in intensity from mild to severe can include irritability, dizziness, nausea, and prickling sensations. Some people describe electric-like sensations in their heads. This is sometimes described as brain zaps, brain shivers, or electric shocks. These sensations may appear rarely or up to several times per day and can sometimes be triggered by rapid eye movements.

Changing or stopping your dose of antidepressants also increases your risk of a recurrence of the mood or anxiety symptoms it was treating. Your risk of suicide may also go up following antidepressant cessation.

Signs & Symptoms of Paxil Withdrawal

 Symptoms associated with withdrawal from SSRIs include the following:

  • Digestive: You may experience nausea, vomiting, cramps, diarrhea, or appetite loss.
  • Balance: You may become dizzy or lightheaded, sometimes making it difficult to walk.
  • Sleep problems: You may have nightmares, unusual dreams, excessive/vivid dreams, or insomnia.
  • Overall: You may have flu-like symptoms including headache, muscle pain, weakness, fatigue, cramping, and tiredness.
  • Mood: You may have extreme anxiety, agitation, panic, suicidal ideation, depression, irritability, anger, or mood swings.
  • Bizarre sensations: You may experience brain zaps (like an electrical shock or shiver in your brain), pins and needles, ringing in the ears, strange tastes, or hypersensitivity to sound.
  • Heat tolerance: You may have excessive sweating, flushing, or an intolerance to high temperatures.
  • Motor control: You may have tremors, muscle tension, restless legs, unsteady gait, or difficulty controlling speech and chewing movements.

While it is possible to experience withdrawal symptoms after stopping any antidepressant, some are notoriously worse than others. Paxil is among the worst offenders. This is to some degree due to its half-life, which means the amount of time it takes for half the drug to effectively leave your body.

Paxil has a relatively short half-life of 21 hours. This means withdrawal symptoms often develop fast, typically within two to three days.

Paxil withdrawal symptoms can range from mildly bothersome to severe and incapacitating. The Discontinuation-Emergent Signs and Symptoms Scale (DESS) is a checklist you can use to evaluate your symptoms and their severity. This checklist should serve as a reference only, your clinician will use this or something similar to diagnose you.

Coping & Relief for Paxil Withdrawal

Paxil withdrawal can be distressing, but there are things you can do to lessen the blow. Doctors often recommend switching to a long-acting SSRI, like Prozac, before attempting to quit. Once you are stabilized on a dose of Prozac, you can attempt to slowly taper your dose.

Research suggests a slow taper that continues down past the therapeutic dose until your dose is nearly 0 milligrams.

Additional coping strategies include:

Social Support

Informing your friends and family about potential withdrawal symptoms, such as agitation, may help prevent interpersonal conflicts. 

Sleep Aids

If you are struggling with insomnia, a prescription or OTC sleep medication can be helpful. Consider Tylenol PM or Benadryl.

OTC Medications

You can use over-the-counter pain relievers, like Tylenol and Advil, to help with aches and pains or Pepto-Bismol to help with nausea and vomiting.

Relaxation Techniques

Meditation, yoga, and breathing exercises are all good ways to reduce stress and agitation.

Exercise

Aerobic exercise helps improve your mood and boost energy. Aim for a minimum of 30 minutes of exercise four times a week.

Diet

A diet rich in whole grains, fruits, and vegetables will help keep your body energized during your withdrawal experience.

Mindfulness

One of the best ways to cope with withdrawal symptoms is to recognize that what you are feeling is a result of your antidepressant withdrawal—and is only temporary.

Paxil Withdrawal Warnings

When coming off of antidepressants like Paxil, there is a risk that your depression or anxiety may return. Studies have shown that, overall, compared to people on antidepressants, people quitting antidepressants are more likely to attempt suicide.

Although changes in mood and behavior often occur when going on and off antidepressants, it is important for friends and family to keep an eye out for signs of serious distress. Signs that you or someone you love is suicidal include the following:

  • Planning how you would commit suicide if you were going to do it
  • Talking or thinking about suicide more than normal, for example, “I wish I were dead”
  • Gathering the means to commit suicide, such as bullets or pills
  • Feeling hopeless or trapped
  • Having intense mood swings
  • Engaging in risky or self-destructive activities, such as driving drunk
  • Becoming preoccupied with death, dying, or violence
  • Getting affairs in order or giving away belongings
  • Saying goodbye to people as if it were the last time 

If you are having suicidal thoughts, contact the National Suicide Prevention Lifeline at 988 for support and assistance from a trained counselor. If you or a loved one are in immediate danger, call 911.

For more mental health resources, see our National Helpline Database.

Pregnancy

If you become pregnant while taking Paxil, it is important to talk with your doctor as soon as possible, because you will have some decisions to make. Your doctor can help you weigh the risks and benefits of continuing on your medication or stopping it.

Further, women with depression who discontinue antidepressants during pregnancy are about five times more likely to have a relapse than women who continued taking them.

There is some data to suggest that women who use antidepressants during the second and third trimesters are at a slightly increased risk of going into pre-term labor and delivering the baby before it is fully developed. There is also a less than 1% risk that your baby could develop a life-threatening condition known as persistent pulmonary hypertension.

Long-Term Treatment

Your long-term treatment plan will depend on your initial diagnosis and your current symptoms. It is best to work with your doctor to make a plan that fits your individual needs. If you didn’t tolerate Paxil well but are still experiencing symptoms of depression or anxiety, your doctor may want to introduce a new medication or combination of medications.

If you no longer wish to take medication, your doctor may recommend alternative therapies, such as psychotherapy. 

Psychotherapy (talk therapy) is an evidence-based treatment for depression, anxiety, OCD, and PTSD that can help relieve and prevent depression. Research suggests that psychological interventions during antidepressant tapering can be an effective alternative for relapse prevention.

Complementary and alternative therapies include:

  • Biofeedback
  • Equine therapy
  • Meditation
  • Mindfulness training
  • Dietary changes
  • Natural supplements

Resources

If you feel your doctor isn’t helping sufficiently with your condition, seek a second opinion or, consider finding a new psychiatrist, psychologist, or therapist in your area. The Substance Abuse and Mental Health Services Administration (SAMHSA) has a searchable directory of qualified providers. You can also call them at 1-800-662-HELP (4357).

If you have health insurance, you can also search the company’s list of local providers who accept your insurance.

11 Sources
Verywell Mind uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
  1. Pratt LA, Brody DJ, Gu Q. Antidepressant use among persons aged 12 and over: United States, 2011–2014.

  2. Villalobos-Madriz JA, Serrano-Arias B, Arguedas-Chacón S, et al. Prescribing trends in psychotropic medications among outpatients of a latin american healthcare setting: a five-year retrospective study. Cureus. Published online April 19, 2023. doi:10.7759/cureus.37832

  3. Davies J, Read J. A systematic review into the incidence, severity and duration of antidepressant withdrawal effects: Are guidelines evidence-based?. Addict Behav. 2019;97:111-121. doi:10.1016/j.addbeh.2018.08.027

  4. Nevels RM, Gontkovsky ST, Williams BE. Paroxetine-the antidepressant from Hell? Probably not, but caution required. Psychopharmacol Bull. 2016;46(1):77–104.

  5. National Alliance on Mental Illness. Paroxetine (Paxil).

  6. Fava GA, Gatti A, Belaise C, Guidi J, Offidani E. Withdrawal symptoms after selective serotonin reuptake inhibitor discontinuation: A systematic review. Psychother Psychosom. 2015;84(2):72-81. doi:10.1159/000370338

  7. Food and Drug Administration. Paxil (paroxetine hydrochloride) tablets and oral suspension.

  8. Horowitz MA, Taylor D. Tapering of SSRI treatment to mitigate withdrawal symptoms. Lancet Psychiatry. 2019;6(6):538-546. doi:10.1016/S2215-0366(19)30032-X

  9. Valuck RJ, Orton HD, Libby AM. Antidepressant discontinuation and risk of suicide attempt: a retrospective, nested case-control study. J Clin Psychiatry. 2009;70(8):1069-77. doi:10.4088/JCP.08m04943

  10. National Institute of Mental Health. Suicide in America: Frequently asked questions.

  11. Breedvelt JJF, Warren FC, Segal Z, Kuyken W, Bockting CL. Continuation of antidepressants vs sequential psychological interventions to prevent relapse in depression: An individual participant data meta-analysisJAMA Psychiatry. 2021;78(8):868-875. doi:10.1001/jamapsychiatry.2021.0823

By Corinne O’Keefe Osborn
Corinne Osborn is an award-winning health and wellness journalist with a background in substance abuse, sexual health, and psychology.