Paxil, also sold under the name Paroxetine (generic), is an SSRI medication prescribed for the treatment of neuropsychiatric conditions, including: major depressive disorder, generalized anxiety disorder, obsessive-compulsive disorder, panic disorder, post-traumatic stress disorder, and social anxiety disorder. While many Paxil users find that the medication effectively alleviates their neuropsychiatric symptoms, others may find it to be ineffective or difficult-to-tolerate. Anyone who doesn’t react well to the effect of Paxil may end up discontinuing treatment only to experience Paxil withdrawal symptoms.
What causes Paxil withdrawal symptoms?
Withdrawal symptoms that emerge after quitting Paxil are likely related to changes in neurotransmitter concentrations throughout the brain following excretion of the medication. It is understood that when someone first starts using Paxil, the brain and body need some time to adapt to its effects (this adaptation usually takes between 2 and 8 weeks). Once the brain and body have fully adjusted to Paxil, they may become reliant upon its daily neurochemical presence to keep neurotransmitter levels in healthy balance.
How Paxil affects brain activity
- Serotonin reuptake inhibition (SERT)
- M1 & M3 receptor modulation
Because the brain and body will eventually expect to receive Paxil on a daily basis, if Paxil is discontinued, the brain and body will need time to readjust themselves or readapt back to pre-Paxil functioning (i.e. homeostasis). As the brain and body revert themselves to pre-Paxil functioning, major changes in neurotransmission, cerebral blood flow, and/or neural connections may occur. It is the combination of these changes (neurotransmission, blood flow, neural connections) that probably account for Paxil withdrawal symptoms.
Paxil Withdrawal Symptoms (Extensive List)
Anytime someone quits using Paxil after regular use, there’s a high likelihood that withdrawal symptoms will occur – compared to most antidepressants, Paxil is associated with some of the harshest withdrawals. That said, the specific withdrawal symptoms that emerge and the severities of those symptoms will be subject to individual variation. In other words, Paxil withdrawal symptoms for one person might be much different and/or more severe than those reported by another.
Listed below are some of the most common withdrawal symptoms that occur after Paxil discontinuation. Know that not all Paxil withdrawal symptoms are formally documented in medical literature. In fact, when the medication first hit the market, most medical professionals didn’t even suspect that there were withdrawal symptoms from Paxil.
- Agitation & restlessness: Coming off of Paxil can result in a wicked combination of agitation (uncomfortable inner nervousness or excitement) and restlessness (the urge to move around). As a result, you may find yourself feeling fidgety, tense, and unable to remain calm – even in places or situations that wouldn’t usually rile you up. To manage the agitation and restlessness in withdrawal, you may want to implement daily stress reduction and exercise into your schedule.
- Anger & irritability: Discontinuing Paxil can cause some people to become profoundly irritable and prone to significant anger. Even the littlest or most modest stressors may provoke you to lose your temper or become enraged. To manage your anger throughout withdrawal, it is recommended that you work with a psychologist and practice daily stress reduction until the anger resolves.
- Anxiety: If you were using Paxil to treat anxiety, there’s a good chance that your underlying anxiety disorder will return during withdrawal. That said, your anxiety may be far worse during Paxil withdrawal than it was before taking Paxil. A worsening of anxiety – or unexpected anxiety during Paxil withdrawal may also be related to fluctuations in serotonin levels, high stress hormone secretion, and an overactive sympathetic nervous system.
- Appetite changes: Some people will experience noticeable appetite changes after quitting Paxil. If you experience very disconcerting withdrawal symptoms like nausea and/or vomiting – this may suppress your appetite, making you not as hungry as usual. On the other hand, if your underlying depression or anxiety cause increased appetite, and anxious or depressive symptoms return during withdrawal, this could cause your appetite to increase in withdrawal.
- Brain fog: If you expect to think clearly during Paxil withdrawal – good luck. After your final dose of Paxil, it may feel as though your brain has entered some sort of twilight zone or haze. Many claim that their thoughts become disorganized, their consciousness becomes clouded, and the brain fog or lack of mental clarity is akin to having brain damage. Though your brain is unlikely to be damaged from Paxil, it may take some time for the mental fog to clear.
- Brain zaps: Compared to discontinuing other antidepressants, discontinuation of Paxil is among the most likely to cause “brain zaps.” Brain zaps are commonly described as electrical jolts throughout the brain or head region. The zaps are usually intermittent or random in their occurrence – and some consider them to be painful. It is thought that the relatively short half-life of Paxil is what increases likelihood of brain zaps in withdrawal.
- Cognitive deficits: If you thought the brain fog was bad, wait until you try to engage in a cognitively-demanding task like problem solving or planning. Many individuals will feel as though their cognitive function is completely impaired in areas of: attention or concentration, memory (storing memories and retrieving them), planning, self-control, and problem solving. If you experience cognitive deficits, the best natural interventions include daily stress reduction and exercise.
- Depression: If you were using Paxil as a medication to treat depression, any depression experienced in withdrawal may simply be a return of your preexisting depressive condition. What’s more, the depression you experience in withdrawal may be worse than the depression you experienced before taking Paxil due to withdrawal-related neurochemical changes. Additionally, even if you weren’t depressed before using Paxil, you may become depressed in withdrawal due to: alterations in neurotransmitter levels, high stress (and stress hormone secretion), and lack of quality sleep.
- Dizziness & lightheadedness: Discontinuing Paxil often causes former users to feel very dizzy and lightheaded. In some cases, the dizziness and lightheadedness could be caused by high anxiety, stress, and/or poor sleep throughout withdrawal. That said, dizziness and lightheadedness can also be a reaction to shifting concentrations of serotonin, stress hormones, cerebral blood flow, and/or blood pressure.
- Fatigue: The fatigue that emerges after quitting Paxil may be overwhelming and difficult to bear. In fact, the fatigue that you experience during Paxil withdrawal may cause you to question whether you’ve developed chronic fatigue syndrome – even if you have no history of fatigue. It is thought that a combination of: serotonin irregularities, high anxiety, poor sleep, and hormone changes might be implicated in fatigue after Paxil discontinuation.
- Headaches: One of the most common Paxil withdrawal symptoms is headache. The headaches that occur are usually intermittent and can be exacerbated by high anxiety, stress, and poor sleep. Causes of headaches in Paxil withdrawal could include: changes in cerebral blood flow, electrolyte imbalances, dehydration, and/or neurotransmitter fluctuations. If you’re experiencing headaches in withdrawal, it is recommended that you focus on: lowering stress, eating a balanced diet, staying hydrated, and adhering to a sleep regimen (as best you can).
- Heart palpitations: Palpitations are characterized as loud (or pounding) heartbeats, heart flutters, and/or the heart skipping beats. If you experience palpitations for the first time during Paxil withdrawal, you may wonder what’s going on with your heart. To be on the safe side, it is recommended that you have a doctor check your heart and rule out potential medical problems. If there’s nothing wrong with your heart, the best way to deal with these palpitations is to reduce anxiety via daily stress reduction, supplements, and/or medications.
- Increased heart rate: Heart palpitations are usually accompanied by an increased heart rate throughout Paxil withdrawal. If your heartbeat seems to be racing or beating more rapidly than it normally does, have a doctor evaluate it and make sure there’s nothing serious going on. Stress reduction can often help normalize the heart rate during Paxil withdrawal by decreasing activation of the sympathetic nervous system.
- Insomnia & difficulty sleeping: It may be difficult to get any sleep – let alone a good night’s sleep – during Paxil withdrawal. If you experience insomnia or other sleep disturbances, it is recommended that you work with a doctor to get your sleep back on track as soon as possible – as this will aid in recovery. A combination of stress management, exercise early in the day, medication, and/or supplements may help normalize your sleep/wake cycles in Paxil withdrawal.
- Nausea & possible vomiting: Nausea is a symptom that some individuals will experience during Paxil withdrawal, especially if they quit the medication too quickly or “cold turkey.” The exact cause of withdrawal-related nausea isn’t known, however, a combination of: changes in vestibular processing and equilibrium, brain region activation, and/or cerebral blood flow – might play a role. If you become severely nauseous and think you might vomit, ask your doctor if it’s safe to use antiemetic medications – these often help with the nausea.
- Sensory sensitivity: Another disturbing aspect of Paxil withdrawal might be that your sensory processing seems to have changed. Sounds or noises may seem much louder and annoying than usual – possibly even distressing. Sunshine, bright lights, or other visuals might seem to give you a headache – such that you start wearing sunglasses more than usual. Realize that sensory sensitivity is an aspect of Paxil withdrawal that usually takes time to recover from.
- Suicidal thoughts: Even if you weren’t depressed or suicidal before using Paxil, you may become suicidal during withdrawal. In the event that you experience suicidal thoughts following Paxil cessation, it is recommended that you seek emergency psychiatric or medical attention. Suicidal thoughts often impair judgment and lead to risky decision making – potentially endangering yourself or others.
- Symptom relapse: After discontinuing Paxil, you might experience a relapse in symptoms of the medical condition for which Paxil was originally prescribed to treat. For example, if you were prescribed Paxil for depression, there’s a good chance that your depression will return in withdrawal. Similarly, if you were prescribed Paxil for anxiety, there’s a good chance that your anxiety will resurface after discontinuation.
- Vivid dreams & nightmares: A symptom that has been reported after quitting Paxil is vivid dreams. In withdrawal, you might notice that your dreams seem very lucid, vivid, or lifelike. Dreams may also become more emotionally-charged such that you might experience frequent nightmares or sad dreams.
- Weight loss: While using Paxil, you may have gained some weight as a result of the medication. In withdrawal, your body may attempt to normalize itself and you might end up losing some (or all of) the weight that you gained during treatment. Furthermore, if your appetite is lower than normal during Paxil withdrawal – this may also explain your weight loss.
Note: The list of Paxil withdrawal symptoms discussed above may be partial or incomplete. If you know of additional withdrawal symptoms that can occur after Paxil discontinuation, share them in a comment. (Read more: “Paroxetine withdrawal syndrome“, “Withdrawal from paroxetine can be severe“, “Paroxetine – The Antidepressant from Hell?”).
What determines the severity of Paxil withdrawal symptoms?
The particular severities of Paxil withdrawal symptoms that you experience may be influenced by many variables. Experts who understand Paxil withdrawal believe that variables such as: duration of Paxil treatment; Paxil dosage; rate of Paxil withdrawal; the former user’s lifestyle; and possibly even genetic expression – might influence the severity of withdrawal symptoms.
- Duration of Paxil use: The total duration over which Paxil was administered throughout treatment may determine how severe withdrawal ends up. It is believed that persons who use Paxil for a short-term tend to experience less severe withdrawal symptoms than long-term users.
- Paxil dosing: The exact dose of Paxil that you used for most of your treatment might affect withdrawal symptom severity. Individuals who used high doses of Paxil tend to have more difficult withdrawals (in most cases) than those who used low doses.
- Rate of Paxil withdrawal: The exact rate at which a person tapers off of Paxil could determine how debilitating withdrawal symptoms become. Discontinuing Paxil “cold turkey” or rapidly may provoke more severe withdrawal symptoms than discontinuing with a slow taper.
- Other substances: Anyone who administers other substances (such as medications or supplements) throughout Paxil withdrawal might reduce the severities of Paxil withdrawal symptoms. On the other hand, persons who don’t support their physiology (brain and body) with other substances during Paxil withdrawal may experience harsher symptoms.
- Lifestyle & genes: The combined effect of lifestyle habits and genetic expression could also influence the severity of Paxil withdrawal. Living an unhealthy lifestyle may cause more severe withdrawals than a healthy one. Furthermore, expressing certain genes might yield fewer withdrawal symptoms – than expressing others.
Best supplements for Paxil withdrawal symptoms
It is suspected that strategic use of supplements could help decrease the severities of Paxil withdrawal symptoms – or could potentially expedite recovery from those symptoms. Listed below are supplements that may prove beneficial among those who are withdrawing from Paxil. Keep in mind though that not everyone will benefit from supplementation after discontinuing Paxil – efficacy of supplementation will vary from person to person.
Disclaimer: Never use any supplement without first consulting a medical doctor to ensure that the supplement is safe for you to use based on your medical status.
Affiliate disclosure: The supplements listed below contain affiliate links which help this site earn money. That said, the links are to products that we think are high quality, reasonably-priced, and potentially therapeutic during Paxil withdrawal.
- Magnesium: If you’re experiencing anxiety, agitation, nervousness, insomnia, or restlessness during Paxil withdrawal – you may want to try supplementing with magnesium.
- L-Tryptophan: Because your serotonin may be imbalanced or low after quitting Paxil, you may want to consider supplementing with a serotonin precursor – L-tryptophan.
- Krill oil: If you aren’t eating much fatty fish, you may want to supplement with krill oil to get omega-3 fatty acids. Omega-3 fatty acids are thought to enhance brain function and might help repair the brain during withdrawal.
- Melatonin: If a combination of stress reduction and early morning exercise isn’t helping you sleep at night, you may want to try melatonin before bed during withdrawal.
- Electrolytes: Electrolyte imbalances might occur during Paxil withdrawal. If your electrolytes are imbalanced, you may find an electrolyte supplement helpful in alleviating withdrawal symptoms.
- Vitamin B complex: Taking vitamin B complex supplements may help counteract restlessness, agitation, insomnia, and muscle tension during Paxil withdrawal.
- Lemon balm: Lemon balm is regarded as a useful supplement for reducing high levels of stress throughout withdrawal.
- Multivitamin: If you aren’t eating a balanced diet in Paxil withdrawal, you may want to take a multivitamin to avoid vitamin deficiencies.
- Probiotics: Restoring healthy gut bacteria may be of critical importance during Paxil withdrawal. Taking a high-quality probiotic supplement should be considered.
- Curcumin: If you have any inflammation throughout the body or brain, curcumin supplementation may help counteract it.
- Rhodiola rosea: Rhodiola is a special herb classified as an adaptogen, meaning it helps regulate arousal – increasing energy when it’s low and reducing energy when it’s high. This may be something to consider trying during Paxil withdrawal.
- L-Tyrosine: Though Paxil isn’t thought to alter dopamine levels, the stressors of withdrawal may reduce dopamine synthesis. Supplementing with L-Tyrosine may help increase any low dopamine during Paxil withdrawal.
- NAC: Because oxidative stress levels throughout the body and brain may be high during Paxil withdrawal – supplementation with NAC may prove therapeutic.
How to withdraw from Paxil safely (Recommendations)
If you’re considering Paxil discontinuation or are already experiencing Paxil withdrawal symptoms – there are a few recommendations you may want to keep in mind to maximize withdrawal safety. Recommendations for individuals facing Paxil withdrawal include: receiving psychiatric support; tapering off of Paxil slowly; living a healthy lifestyle; and using other medications that are recommended by a psychiatrist.
- Receive psychiatric support: Anyone withdrawing from Paxil should seek the help of a psychiatrist or medical doctor with specialized training to understand medications like Paxil. A psychiatrist will help you come up with a tapering schedule and should be able to help prescribe medications that help alleviate Paxil withdrawal symptoms.
- Slowly taper off of Paxil: It is never a good idea to quit Paxil “cold turkey.” Instead, it is recommended that you gradually or slowly taper off of Paxil. With a potent drug like Paxil, it is sometimes recommended to taper off at a rate of just 10% per month – to be on the safe side.
- Live a healthy lifestyle: A healthy lifestyle can go a long way towards alleviating Paxil withdrawal symptoms and increasing your ability to cope with them.
- Use other substances: Use any medications and/or supplements that your medical doctor recommends during Paxil withdrawal – these should help reduce the severity of your symptoms and/or expedite your recovery.
How long does Paxil withdrawal last? (Duration)
The amount of time that it takes to completely recover from Paxil withdrawal symptoms will vary among former Paxil users; not everyone recovers at the same rate. Some former Paxil users might report that their withdrawal symptoms last for a few weeks, whereas others might report that withdrawal symptoms are protracted and persist for a long-term of 6 to 8 months after their final dose. Because withdrawal duration is individualized, it may not be a good idea to compare your withdrawal length to that of another former Paxil user.
It is thought that withdrawing from Paxil under psychiatric supervision should result in the quickest possible recovery from symptoms. Furthermore, in most cases, Paxil withdrawal symptoms tend to improve within 2 weeks to 3 months after a person’s final dose. That said, symptom improvement should not be interpreted to mean full recovery – complete recovery from Paxil withdrawal symptoms may take much longer than expected.
Have you experienced Paxil withdrawal symptoms?
In the event that you recently discontinued Paxil – or have already survived Paxil withdrawal, be sure to share your experience in the comments section. Leaving a comment about your experience may help someone else who’s in the midst of Paxil withdrawal. Comments help others to realize that they aren’t alone in attempting to overcome Paxil withdrawal symptoms. Included below are additional questions to answer if you want to be as detailed as possible in your comment.
- In total, how long did you use Paxil before discontinuing?
- What dose of Paxil did you administer during treatment?
- At what rate did you taper off of Paxil?
- Did you work with a psychiatrist or medical doctor during withdrawal?
- Why did you ultimately decide to quit using Paxil?
- What were the most noticeable Paxil withdrawal symptoms that you experienced?