How Long Does Withdrawal From Paxil Last?

Paxil (paroxetine) is an antidepressant medication used to treat various disorders, including major depression, generalized anxiety disorder, and obsessive-compulsive disorder. It is in 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 for up to six weeks when attempting to stop using Paxil, with some having symptoms much longer. Keep reading to learn more about withdrawal from Paxil, including 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 physicians 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.

More than 56% of people who quit antidepressants experience withdrawal symptoms. 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.

Paxil Withdrawal Timeline

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

A 2023 review of published data reports that most people who experience antidepressant withdrawal have symptoms for up to six weeks. However, some people may have symptoms for months or even years.

While several studies have looked at paroxetine withdrawal specifically, determining a timeline for symptoms has been difficult because many people re-start the drug for relief. This makes it hard to know how long withdrawal actually lasts.

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.
• Flu-like symptoms: You may have flu-like symptoms including headache, muscle pain, weakness, fatigue, cramping, and tiredness.
• Mood: You may feel 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) that appear rarely or up to several times per day and can sometimes be triggered by rapid eye movements. Other sensations include 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.

Coping & Relief for Paxil Withdrawal

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

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 dealing with insomnia, a prescription or over-the-counter (OTC) sleep medication may be helpful.

OTC Medications

You can use OTC 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 can 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 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, or 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 

Pregnancy and Paxil Use

If you become pregnant while taking Paxil, it is important to talk with your physician as soon as possible because you will have some decisions to make. Your care provider 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 Options After Paxil Discontinuation

Your long-term treatment plan will depend on your initial diagnosis and your current symptoms. It is best to work with your physician 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 care provider may want to introduce a new medication or combination of medications. If you no longer wish to take medication, they may recommend alternative therapies, such as psychotherapy. 

Psychotherapy (talk therapy) is an evidence-based treatment for depression, anxiety, obsessive-compulsive disorder (OCD), and post-traumatic stress disorder (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 physician 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. The main thing to remember is that help is available, so you don't have to face depression or antidepressant withdrawal alone.