Symptoms of Paroxetine (Paxil) Cold Turkey Discontinuation
Patients who stop taking Paxil (paroxetine) cold turkey commonly experience a range of distressing withdrawal symptoms including dizziness, electric shock-like sensations, anxiety, irritability, insomnia, headaches, and sensory disturbances that can significantly impact their quality of life.
Common Withdrawal Symptoms
When paroxetine is discontinued abruptly, patients frequently report:
Physical Symptoms
- Dizziness and lightheadedness 1, 2
- Electric shock-like sensations (paresthesias) 1
- Headaches 1, 2
- Nausea and vomiting 2, 3
- Fatigue, lethargy, and flu-like symptoms (myalgia, chills) 2, 4
- Sweating 1, 4
- Tremors 1, 4
- Sleep disturbances and vivid dreams 1, 4
- Sensory disturbances 1, 2
- Fever (in some severe cases) 5
Psychological Symptoms
- Anxiety and agitation 1
- Irritability 1, 2
- Crying spells 2
- Emotional lability 1
- Confusion 1
- Lowered mood 4
- Hallucinations (in severe cases) 6
Risk Factors and Timing
- Withdrawal symptoms typically begin within hours to days after discontinuation 1, 4
- Symptoms can last from several days to weeks (average 11.8 days in one study) 4
- Abrupt discontinuation significantly increases risk compared to gradual tapering 3
- Patients who experienced adverse effects during initial treatment may be more likely to experience withdrawal symptoms 3
- Younger patients may be at higher risk, though this may be related to their tendency to stop medication abruptly 3
Severity and Impact
- While most withdrawal symptoms are self-limiting, they can be distressing enough to:
Prevention and Management
- Gradual tapering is strongly recommended when discontinuing paroxetine 1
- For severe withdrawal symptoms, reinstating the original dose and then tapering more slowly may be necessary 2
- Symptoms typically resolve within 24 hours after restarting the medication 4
- Benzodiazepines are generally not effective in relieving paroxetine withdrawal symptoms 4
Important Distinctions
- Withdrawal symptoms should be distinguished from relapse of the original condition 5
- Unlike some other medications, paroxetine withdrawal is not associated with drug dependence or addiction 1
- Paroxetine has a higher risk of discontinuation symptoms compared to SSRIs with longer half-lives like fluoxetine 4
Clinical Pitfalls to Avoid
- Mistaking withdrawal symptoms for relapse of depression, which may lead to unnecessary continuation of medication 2
- Ordering unnecessary and costly tests when physical symptoms are actually due to withdrawal 2
- Failing to warn patients about the risks of abrupt discontinuation 1, 3
- Not recognizing that even with gradual tapering, some patients may still experience withdrawal symptoms, though typically less severe 4