From the FDA Drug Label
A gradual reduction in the dose rather than abrupt cessation is recommended whenever possible. If intolerable symptoms occur following a decrease in the dose or upon discontinuation of treatment, then resuming the previously prescribed dose may be considered. Subsequently, the physician may continue decreasing the dose but at a more gradual rate The taper-phase regimen used in GAD and PTSD clinical trials involved an incremental decrease in the daily dose by 10 mg/day at weekly intervals When a daily dose of 20 mg/day was reached, patients were continued on this dose for 1 week before treatment was stopped.
Tapering Paxil 20mg:
- A gradual reduction in dose is recommended.
- The taper-phase regimen used in clinical trials involved decreasing the daily dose by 10 mg/day at weekly intervals.
- When a daily dose of 20 mg/day is reached, patients should be continued on this dose for 1 week before treatment is stopped. 1
From the Research
A gradual taper for Paxil (paroxetine) 20mg typically involves reducing the dose by 10% every 2-4 weeks, as this approach has been shown to minimize withdrawal symptoms and is supported by the most recent and highest quality studies, such as 2. For example, you might start by decreasing from 20mg to 18mg for 2-4 weeks, then to 16mg, and so on. Some patients benefit from even smaller reductions (5%) as they get to lower doses. Liquid formulations of Paxil can help achieve these precise reductions, or you might need to cut tablets or use a compounding pharmacy. The entire taper process often takes 3-6 months but may require longer depending on individual response.
Key Considerations
- It's essential to work with your healthcare provider throughout this process, as they can monitor for withdrawal symptoms like dizziness, electric shock sensations, irritability, anxiety, or insomnia, as noted in studies such as 3.
- If these symptoms occur, your doctor might temporarily pause the taper or slow the reduction rate.
- This gradual approach is recommended because Paxil has a relatively short half-life and can cause more pronounced withdrawal symptoms than other SSRIs when discontinued abruptly, as discussed in 4 and 2.
Tapering Process
- Start by reducing the dose by 10% every 2-4 weeks.
- Monitor for withdrawal symptoms and adjust the taper rate as needed.
- Consider using liquid formulations or a compounding pharmacy to achieve precise dose reductions.
- Be prepared for the taper process to take several months, and work closely with your healthcare provider to minimize potential complications, as suggested by the findings in 5 and 2.