Paxil Side Effects

Paxil Side Effects, Dosage, Overdose, Withdrawal Symptoms, & Treatment

What is Paxil?

Paxil is the brand name of paroxetine hydrochloride. It is an antidepressant approved by the U.S. Food and Drug Administration (FDA) and prescribed by doctors for major depressive disorder treatment, generalized anxiety disorders (GAD) treatment, obsessive-compulsive disorder (OCD) treatment, post-traumatic stress disorder (PTSD) treatment, panic disorder treatment, and premenstrual dysphoric disorder treatment [1]. Paxil (paroxetine) is a selective serotonin reuptake inhibitor (SSRI). It boosts serotonin levels in the brain, which may help to improve mood and reduce anxiety.

Serotonin, known as the “happy” neurotransmitter, signals an increase in feelings of happiness or well-being. It’s released into the spaces between your brain cells (synapses) in order to transmit this “happiness” signal through your brain and central nervous system.

Paroxetine, also known by the trade names Aropax, Paxil, Pexeva, Seroxat, Sereupin, and Brisdelle, was first marketed in the U.S. in 1992. By the late 1990s, paroxetine frequently was being associated with serious drug interactions and medication side effects. In a major Canadian epidemiological study examining the relationship between antidepressants and diseases, paroxetine was associated with a 620 percent increase in the rate of breast cancer in women who had taken it over a four-year period [2]. Paxil can cause side effects, including sexual dysfunction and suicidal tendencies. It can also cause unpleasant Paxil withdrawal symptoms if you suddenly discontinue use. 

Paxil Side Effects
Paxil withdrawal can be distressing, but there are things you can do to lessen the blow. 

Antidepressant withdrawal, or antidepressant discontinuation syndrome, happens when an individual abruptly stops taking antidepressants. Unfortunately, Paxil is notorious for being among the hardest antidepressants to quit. It has even been described, in the medical literature, as the antidepressant from hell. Due to its short half-life, Paxil withdrawal can hit hard and fast. A drug’s half-life refers to how quickly the body can break down and remove half of it from the body. Overall, more than 56% of people who quit antidepressants experience withdrawal symptoms of some kind. To prevent or reduce Paxil withdrawal symptoms, most healthcare professionals suggest gradually lowering, or tapering, the Paxil dosage over weeks to months.

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Paxil Dosage 

Typical Paxil dosage includes:

  • Depression: The typical starting Paxil dosage for adults is 20 mg by mouth once daily and maximum dose is 50 mg by mouth once daily.
  • General anxiety disorder and posttraumatic stress disorder: The typical starting dose for adults is 20 mg by mouth once daily and maximum dose is 50 mg by mouth once daily.
  • Obsessive compulsive disorder: The recommended starting dose for adults is 20 mg by mouth once daily, but some people may take up to 60 mg per day.
  • Panic disorder: The recommended starting dose for adults is 10 mg by mouth once daily, but some people may take up to 60 mg per day.
  • Social anxiety disorder: The typical starting dose for adults is 20 mg by mouth once daily, and the maximum dose is 60 mg by mouth once daily.

Paxil for Anxiety 

 Generalized anxiety disorders (GAD) are characterized by persistent and excessive worry about a number of different topics. Most individuals worry about things like money, health, or work difficulties from time to time. But individuals with generalized anxiety disorders are unable to stop worrying about these things. Their fears or worries are often out of proportion to the situation. Just the thought of getting through the day may provoke anxiety. Antidepressants such as Paxil, mainly affect the psychic (psychological distress) symptoms of anxiety, such as fears, worry, irritability, and concentration difficulties. GAD is typically treated with medication, psychotherapy, or a combination of the two.

Side Effects of Paxil 

Typically, these side effects will go away within a couple of weeks of taking the medication.

The most common side effects of Paxil include:

  • Nausea
  • Drowsiness
  • Insomnia
  • Asthenia (abnormal weakness or lack of energy)
  • Headache
  • Dry mouth
  • Constipation
  • Dizziness
  • Sweating
  • Sexual problems
  • Diarrhea
  • Tremor
  • Loss of appetite
  • Nervousness
  • Anxiety
  • Indigestion
  • Agitation
  • Visual disturbances
  • Tingling or pricking sensation in extremities
  • Abdominal pain
  • Rapid or irregular heartbeat

Rare side effects include bleeding, teeth grinding, and low sodium blood levels. Serious side effects are seizures, abnormal bleeding, manic episodes, severe allergic reactions, and serotonin syndrome, which happens when there is too much serotonin in the body and can lead to death.

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Serotonin Syndrome

Serotonin syndrome is a severe and potentially fatal condition in which there is too much serotonin in the body. Paxil works by increasing the levels of serotonin which may lead to excess levels, especially when combined with other drugs that increase serotonin such as other SSRIs, triptans, fentanyl, tricyclic antidepressants, tramadol, lithium, tryptophan, dextromethorphan, buspirone, amphetamines, St. John’s Wort, and monoamine oxidase inhibitors (MAOIs).

Serotonin Syndrome or Neuroleptic Malignant Syndrome-like reactions. This condition can be life-threatening and may include:

  • Agitation, hallucinations, coma, or other changes in mental status
  • Coordination problems or muscle twitching (overactive reflexes)
  • Racing heartbeat, high or low blood pressure
  • Sweating or fever
  • Nausea, vomiting, or diarrhea
  • Muscle rigidity

Paxil Overdose 

According to the National Center for Biotechnology Information (NCBI) [3]. Paroxetine (Paxil) is relatively safe in overdose as compared to tricyclic antidepressants (TCAs) and is rarely fatal when taken alone. The intake of a large amount usually results in drowsiness, tremor, nausea, and vomiting; very high doses of SSRIs (>75 times the normal daily dose) may result in seizures, ECG changes, and decreased consciousness. Symptoms of Paxil overdose are nausea, vomiting, facial flushing, sedation, dizziness, and sweating; and at very high doses, myoclonus, hyperreflexia, and seizures are seen. Deaths involving paroxetine toxicity have generally been a result of ingestion of multiple drugs, and not from paroxetine alone.

Paxil Side Effects
Euphoria is not a common Paxil side effects

Paxil Withdrawal 

More than 40 million individuals in the U.S. use antidepressants. Most of them received their prescription from a family doctor rather than a psychiatrist. SSRI withdrawal symptoms have been well documented in medical literature, but prescribing doctors, who are often without psychiatric expertise, sometimes neglect to tell their patients about what to expect.  

A considerable number of people taking this drug and other SSRIs for a long enough period of time experience withdrawal symptoms when they try to stop or reduce their dose. Paxil withdrawal symptoms can happen when individuals abruptly stop taking the drug. Anyone who wishes to stop taking Paxil must consult with a doctor. The doctor will recommend a dosing schedule to reduce the dose over time gradually. Some individuals describe electric-like sensations in their heads. This is sometimes described as brain shivers, brain zaps, or electric shocks. These sensations may appear rarely or up to several times per day and can sometimes be triggered by rapid eye movements.

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Paxil Withdrawal Symptoms 

While it is possible to experience withdrawal symptoms after stopping any antidepressant, some are notoriously worse than others. Paxil is among the worst offenders. 

Symptoms linked with Paxil withdrawal include the following:

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

Tips for Coping with Paxil Withdrawal Symptoms

A person should never try to quit Paxil without discussing this decision with their doctor and developing an action plan. In most cases, a doctor will recommend slowly reducing the Paxil dosage and possibly switching to an alternative SSRI medication to aid the tapering process.

Some general tips for coping with Paxil’s withdrawal symptoms include:

  • Eating a healthful and nutritious diet
  • Exercising regularly
  • Taking all other medications according to the prescription
  • Completing the tapering process
  • Tracking changes in mood on a calendar or in a notebook
  • Telling a doctor about any Paxil withdrawal symptoms
  • Seeking support from friends, family, or community groups

There is a strong link between mental health and substance abuse. Individuals who struggle with mood disorders like depression and anxiety are more susceptible to developing an addiction to drugs or alcohol, often to self-medicate symptoms of their underlying mental health condition. These co-occurring disorders can make each other worse without proper treatment.

Many rehabilitation programs keep up with the scientific understanding of co-occurring disorders and offer dual-diagnosis treatment for mood disorders alongside therapy for addiction. Paxil withdrawal treatment may be part of addiction treatment to help a mood disorder. 

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Treatment for Paxil Wihdrawal and Abuse

Treatment plans vary for each individual. For occasional substance misuse, occasional counseling may be enough to help a person recover. For more serious cases, time at a rehabilitation facility may be the best option. The only way to truly determine the correct treatment plan for each person is to see a qualified treatment professional.

To determine the most effective ways to treat Paxil’s side effects and addiction, it’s crucial to first get an accurate assessment of all the symptoms. When the symptoms have been evaluated by a mental health professional, it may be determined that another form of depression is present and needs a particular type of treatment. Very often, some combination of psychotherapy, medication, and/or lifestyle changes are effective for coping with functional.

Medically-Assisted Detox

Detox is often considered the first stage of treatment. It will help you navigate the complicated process of withdrawal, but it doesn’t address patterns of thought and behavior that contribute to drug abuse. Various treatment approaches and settings can help provide the ongoing support necessary to maintain long-term sobriety after you complete detox.

Cravings are very common during detox and can be challenging to overcome. This often leads to relapse. Constant medical care provided during inpatient treatment helps prevent relapse. Clinicians can provide necessary medication and medical expertise to lessen cravings and the effects of withdrawals.

Psychotherapy for Depression and Anxiety

Several different modalities of psychotherapy have been used in the treatment of depression including:

  • Cognitive Behavioral Therapy (CBT) – an effective treatment that involves making changes in both the patterns of negative thoughts and the behavioral routines which are affecting the daily life of the depressed person for various forms of depression.
  • Person Centered Therapy – a strategy that allows and encourages clients to understand and resolve their concerns in a safe, support environment.
  • Solution Focused Therapy – an approach interested in solutions which can be quickly implemented with a simple first step leading to further positive consequences.

Dual Diagnosis Treatment

Alcoholism and mental health disorders often co-occur. In many cases, traumatic experiences can result in a mental health disorder and substance abuse. Dual diagnosis rehabilitation treats both of these issues together. The best approach for the treatment of dual diagnosis is an integrated system. In this strategy, both the substance abuse problem and the mental disorder are treated simultaneously. Regardless of which diagnosis (mental health or substance abuse problem) came first, long-term recovery will depend largely on the treatment for both disorders done by the same team or provider.

Medication-Assisted Treatments

Medication-Assisted Treatments (MAT) for alcohol use disorder and mental health disorder are commonly used in conjunction with one another. This includes the use of medications and other medical procedures. During your rehab, the staff from your treatment facility will help you identify what caused your addiction and teach you skills that will help you change your behavior patterns and challenge the negative thoughts that led to your addiction. Sometimes, the pressures and problems in your life lead you to rely on substances to help you forget about them momentarily.

If you or a loved one are struggling with long-term substance abuse and a co-occurring mental health condition such as depression, contact one of our helpful treatment specialists today. We Level Up NJ can provide information on dual diagnosis and detox programs that may fit your specific needs.

Paxil Side Effects
If you or someone you know has been affected by Paxil withdrawal symptoms and abuse, there are resources to help you recover.

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[1] NIH –

[2] NCBI –

[3] NCBI –