Withdrawal from paroxetine can be severe, warns FDA
BMJ 2002; 324 doi: https://doi.org/10.1136/bmj.324.7332.260 (Published 02 February 2002) Cite this as: BMJ 2002;324:260
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I’ve been on paroxetine for years for depression and anxiety. It’s been a very good medication. This is a warning regarding missed doses. For some reason I left my 40 mg dosage out of my med set for five days. I’ve experienced all of the commonly reported withdrawals as well.
In the past I couldn’t afford the medicine.
This time I truly was worried because I didn’t know why I was experiencing the horrid effects. I thought I feel like I hadn't had my paroxetine. Sure enough I looked and hadn’t put in my med set. This time though was much more intense. The sweating was horrid. The nervousness and Electric shock feelings overwhelmed me.
So I Dr. myself, I quickly took 2 doses. Hopefully I will feel normal within a few days. How can this not be on some warning label? There’s no way this only happens to 7% of users. I’m a recovering addict I’ve been clean for years. I went through withdrawals many times off of some potent drugs. Never feeling as bad as just missing a few doses of paroxetine. This should be claims for a lawsuit. I, as well quit jobs after many yrs due to such withdrawals. My life turned upside down. The manufacturers need to be held accountable
Competing interests: No competing interests
Many people who are taking unnecessary psychiatric medications find it very difficult to discontinue them. I am very concerned about unnecessary risks in discontinuing psychiatric medication. I run a peer support Web site for tapering off antidepressants and antidepressant withdrawal syndrome, SurvivingAntidepressants.org.
There are dozens of sites like mine and hundreds of thousands of patient postings all over the Web about the difficulties of quitting psychiatric medication, even under a doctor's supervision. All of the people on my site are there because of their doctor's lack of knowledge about tapering. Some have been medicated since they were small children.
Pharmaceutical company influence has caused a great deal of misinformation to be published about antidepressant withdrawal, encouraging assumptions among doctors that withdrawal symptoms are always mild, transient, and patients complain too much.
Patients are having a very hard time finding doctors who are aware of gradual tapering procedures tailored to individual tolerance.
What's shown up on patient-run Web sites is that some people require very, very gradual decrements in dosage, sometimes 5% or less per month, to minimize withdrawal symptoms. Some can tolerate decreases of only a fraction of a milligram at a time.
Doctors do not sufficiently recognize severe psychiatric drug withdrawal reactions. Contrary to popular belief, withdrawal symptoms do not always resolve within a few weeks or months. Some people (like me) suffer debilitating neurological damage from too-fast withdrawal for years.
These iatrogenic symptoms are often misdiagnosed as relapse or emergence of a psychiatric illness, particularly some exotic variety of bipolar disorder. Patients are overmedicated and made sicker. You may read hundreds of case histories here http://tinyurl.com/3o4k3j5
We are always looking for people with prescription privileges anywhere in the world who are knowledgeable about very gradual, individualized tapering and who can recognize withdrawal symptoms and know what to do if they show up.
This would be for the purpose of local referrals.
Please contact me at survivingads at google dot com
Thank you.
Competing interests: Suffering prolonged Paxil withdrawal syndrome since 2004
I think it is most interesting to hear so many similar bad
experiences regarding paroxetine.
I was diagnosed with depression and anxiety disorder 8 years ago at
the age of 28 and was prescribed Seroxat by my GP. If i had known at the
time what effect this medication would have on me i would gladly have
suffered the anxiety/depression instead..
After 2 years on 20mg the drug was not having the same effect and the
dosage was increased to 30mg daily. This did seem to work out for a number
of years until three months ago when i began to suffer some new
debilitating symptoms which I now have no doubt are as a result of
seroxat. These new symptoms vary from nausea to dizziness/fainting to what
seems like increasingly more severe panic attacks that seem to come and go
whether in stressful situations or not. I did visit my doctor who again
decided to increase the dosage to 45mg daily saying that 30mg was no
longer enough.
Since increasing to 45mg the above symptoms have increased in
intensity and i have now come to the conclusion that this drug is
poisoning my body and I have made the decision to start weaning myself of
the drug slowly or at least to get back to 20mg.
From some research i have done i have read that Omega 3(Fish Oil) can help
with withdrawal effects and having started taking this on a daily basis
before i start my weaning off Seroxat.
Competing interests: No competing interests
Can you tell me whether you got off them in the end because
I am in the exact same situation as you were. How long from when the symptoms started were you finally free of them?
Competing interests: No competing interests
When paroxetine came out first I prescribed it to quite a few
patients. Within six months I stopped prescribing it as several patients
had loss of libido and I wanted my patients to enjoy life to the full. In
recent years venlafaxine has taken over as the new drug for causing loss
of libido so I avoid it too. Both of these drugs have severe withdrawal
symptoms and one wonders why they are so widely used.
My own view is that if one gets the biochemical parameters right one can
greatly reduce the use of psychotropic medication and I have done this for
hundreds of patients with considerable success. Little or no side effects,
good results in most cases, no drugs after a few months in many depressed
patients. It sounds too good to be true but then there is no profit in it
for drug companies as natural nutrients such as vitamins,
minerals,essential fatty acids and amino acids cannot be patented.I
attended the meeting of the Association of European Psychiatrists in
Munich recently and asked a professor from Harvard what natural nutrients
they use in psychiatry. The answer was alpha lipoic acid, n-acetyl
cysteine and fish oil. I use fish oil a lot-I measure essential fatty
acids in many patients and over 90% are low. N-acetyl cysteine (NAC)
appears to be useful as augmentation therapy in bipolar and schizophrenia.
There are reports that alpha lipoic acid, a natural powerful antioxidant,
may be useful in depression and in reducing tardive dyskinesia. More
research is needed but in the interest of patients and to save a lot of
money on drugs with serious side effects this research, which would need
government support, could provide enormous benefits to millions of
patients all over the world.
Competing interests:
None declared
Competing interests: No competing interests
I was interested to read the experiences of people who have had the
same problems with Paroxetine withdrawal that I have had, some of whom who
have had side-effects worse than my own as it turns out, so I thought I'd
share my own experiences and thoughts.
I ran out of Paroxetine when my GP decided he would treat a recent
bout of depression and lethargy by upping my dose from 30mg to 40mg per
day. For a few years, I had been getting by okay on 20mg, but suddenly it
didn't seem to be working. So, he bumped me up to 30mg, and if anything I
felt worse. In order to go from 30mg to 40mg, he explained that I would
have to have a blood test at the local hospital in order to ascertain my
cholesterol levels (which turned out to have shot through the roof). So,
I was left with no medication for two weeks, and I have to say that it has
eventually been much for the best. When I was taking it, I found that I
always seemed hungry, and I piled on three stone in weight over the course
of about three years. Shortly after quitting completely, I had symptoms
such as those listed by people above, the most disconcerting of which was
a bizarre effect that I believe is the same as others have described as
"electric head shocks". To me, it felt (and "sounded") like someone in
the mid-distance banging a tin tray against something every time I moved
my eyes. This was coupled with dizziness.
two weeks on, and the other day I noticed that those side-effects had
disappeared, and hopefully that is for good. Not just that, but my
constant craving for food has gone, I have my energy back and am
exercising, I feel more positive generally, and am feeling probably better
than when on Paroxetine when it was actually working for me, not against
me!
In my personal experience, if I were to require something to get me
through a bad phase again at some time, I would NEVER touch Paroxetine. I
would definitely consider Diazepam (which I am now going Cold Turkey on),
but Paroxetine I wouldn't touch with a long barge pole.
Competing interests:
None declared
Competing interests: No competing interests
I feel Paxil is overrated, and should not be so readily prescribed.
It is a drug that has to be taken exactly the same all the time. also, I
believe that there should be more patient teaching. drug and food
interaction, proper perscription taking.
I've read many peoples' responses to this drug. This is a very
difficult drug to get off of. This is not been part of the patient
teaching anyone ever talks about. Sure the packaging reads to not
discontinue drug without consulting doctor first, but don't they all?
I am now trying to "withdrawal" from 20 mg Paxil after approx 10
years. The doctor prescribed 10 mg for 7 days and then 5 mg for 7 days at
which time I will begin Wellbutrin.
My question: How much of these withdrawal symptoms do I put up with
until I need to see the doctor?
Competing interests:
None declared
Competing interests: No competing interests
I am so glad I found this help for me. I am a 61 year old woman and
have been on Paroxetine for 12 years because of home problems and going
through the change of life. A week ago I decided to go cold turkey on
this med. Each day seems to be getting worse for me. It is now 4:00 am
in the morning and I just woke up from a severe nightmare of leaving my
husband of 42 years and how I would go about it. In the last week I
thought I was getting the flu back that I just got over about 3 weeks
previous. Thanks to all of this information I am going back on my med and
try weaning myself off of it very slowly. The dizzy spells are
dibilating. I cannot think at all and each day seems to get worse for me.
My children were happy that i was going to try this but now I will share
this information and explain how it will work. I have always been a
softspoken person but am now hearing myself yelling..the nausa is also a
problem. Severe headaches for no reason. I have became very abrasive in
the last few days and thoughts of life ending have been entering my mind
which have never before. I so much to live for and could not fathom why
this was happening. I am so glad I found these facts so I now know I am
not going crazy and losing my mind. I am a game player on the internet
and cards with friends; I could no longer do this as I could not
concentrate long enough to do so. Once again I am so grateful for this
information...It very likely has saved a life.....
Competing interests:
None declared
Competing interests: No competing interests
It's been about two months since I started weaning myself off
Paroxetine, and I'm now down to a quarter of a tablet (each tablet is 20mg
so I'm down to 5mg per day), with the expectation that I will be
completely free of the medication within the next 1-2 months.
I was prescribed Paroxetine by my doctor about 20 months ago when I
showed signs of extreme anxiety (I was wringing my hands, breathless,
panicky, agitated and teary) as a result of a number of 'big' events in my
life which all seemed to coincide with each other (divorce, starting a new
job, etc). Even in light of the problems associated with coming off the
pills, I still believe that these antidepressants helped me through a very
difficult time, and that they can be very helpful to people who are
dealing with anxiety, depression or OCD.
Unfortunately for me, because I was so stressed at the time, I took
the drugs prescribed to me and didn't read up on the history of the brand,
nor how it may affect me when the time came to stop taking them. At the
time of prescribing the pills, the doctor didn't provide me with any
information relating to the side-effects of Paroxetine (except to say that
I would originally experience the desire to grind my teeth and that I
would twitch and jump - both of which lasted well into the first six
months of taking the pills).
About 6 months into taking Paroxetine I (foolishly) figured that it
would be good to give my body a rest each weekend and as such I stopped
taking the pill every Friday, and resumed again every Monday. I thought
that this might clear my system of all artificial substances in
preparation for the coming week (kind-of like taking a break from Omega 3,
or multivitamins!). Over the course of the following year, I couldn't
understand why I was getting so sick each weekend, and why I was needing
to take Monday's off work when in the past I had never taken a single sick
day. I honestly thought that there was something bad in the air in the
town that I was working in, and commented as such to my partner. I was
constantly complaining of feeling very dizzy, confused, nauseous, very
lethargic, teary, having terrible nightmares and night sweats. I couldn't
get through the weekend without having to take a nap each day (often up to
four hours at a time), and if we ventured too far away from the house I
became panicky about not having somewhere to 'rest' during the day. These
symptoms were so bad that I went to see my doctor and he referred me to a
sleep specialist and a neurologist (thinking I may have a sleep disorder
as well as MS because of the dizziness, but never once giving thought to
the side-effects of the medication that I was on!!!). I spent a lot of
money and a lot of time undertaking sleep studies and neurological tests,
but (not surprisingly in hindsight) no problems could be found. I started
to think I was going mad, and my family were even beginning to think that
I was a hypochondriac. They blamed the intensely stressful period that I
was going through and told me that all I needed was to relax more.
About two months ago (for reasons unknown to me even now) I decided
to come off Paroxetine altogether...and stopped cold-turkey. I was so
muddle-headed and confused by this stage that I didn't give any thought to
finding out how this might affect me. Unfortunately, within 4 days of
stopping the medication, I became really ill. EVERYTHING upset me so that
I was constantly in tears, I was extremely lethargic and the
dizziness/vertigo got to the point where I just couldn't function and I
was actually walking into walls and lurching sideways like a drunk. My
right index finger kept going completely numb, my legs and arms were
twitching and I really struggled to concentrate at work. Even now I'm
still unsure how I managed the hour long drive to and from work each day
without injuring myself or anyone else...
For the first time in my life I felt suicidal (rather ironic given
that I was on antidepressants!). I seriously couldn't contemplate a life
that involved the ongoing dizziness, nausea and lethargy and I alternated
between feeling frantic and despondent. Fortunately for me it was around
this time that a friend of a friend (who happens to be a doctor),
mentioned that my symptoms sounded like those that would be experienced if
I was coming off drugs. She asked if I was taking any medication, and
when I mentioned Paroxetine, she told me to look it up on the internet and
see if any of the listed symptoms matched mine. They did.
When I read the letters posted on this site I was in tears. Tears of
anger over the lack of information (and insight) from my doctor and tears
of relief to finally find out what was wrong with me. I alternated between
tears and near-hysterical laughter as I read my way through the accounts
from people who couldn't function due to dizziness, who thought that there
was poison in the water they were drinking, who were so tired they
couldn't get out of bed, etc. I was giddy with the relief of knowing that
I wasn't alone, and that I wasn't a). crazy or b). dying of some terrible
disease!
I immediately reverted back to taking Paroxetine EVERY day of the
week and within just one day the dizziness and nausea had subsided. I
went back to the doctor (not my doctor as he was away on leave) and told
her what I had found out about the drug. She said that it was all hype
and that Paroxetine was fine to take and was not addictive, therefore I
wouldn't have any problems coming off the pills. I was very frustrated
with her response and decided to continue to wean myself off the pills...
but this time by doing it slowly, rather than going cold-turkey.
I immediately cut my intake of Paroxetine down to 3/4 of a pill on a
daily basis for one month and there were no side-effects, so I again
dropped the dosage 1/2 a tablet. There were still no side effects, so
after another month I dropped to 1/4 tablet. Unfortunately, as soon as I
got to 1/4 tablet (which is where I am now), I again started feeling
nauseous and dizzy, but the symptoms are relatively mild - nothing like I
was experiencing previously. I think that I can function at this level
and as such I plan to 'wait it out' and hope that the effects disappear
soon. As soon as they go I will get rid of the last 1/4 dosage and -
fingers crossed - be free of the drug altogether.
I realise that I was only ever on 20mg per day, so for me it may have
been easier to wean myself off the drug than what it may be for others who
are on higher dosages. But I believe that if you SLOWLY cut down your
dosages, then you can probably get off them too. My best word of advice
is to continue taking those tablets EVERY day without fail as per the
directions, and be prepared for some very uncomfortable side-effects when
the time comes to wean yourself off them.
Fortunately, it appears that the side-effects are being recognised
now (I saw a show on TV last week which detailed exactly these problems
associated with Arapax/Paxtine/Paroxetine). The problem appears to be the
company that is producing them still won't admit to the withdrawal
effects, and the doctors who are prescribing them don't give enough
information to their patients at the time of writing the prescription...
Good luck :)
Competing interests:
None declared
Competing interests: No competing interests
Re: Withdrawal from paroxetine can be severe, warns FDA
I've been on paroxetine for 2.5 years now due to anxiety, stress and panic attack. It worked well to camouflage these issues however, I felt like I have lost a great deal of my personality, emotions, sexual drive, ability to feel deeply, compassion whilst on this medication. I had constant vivid dreams and felt very tired throughout the day, constantly needing a nap and rest. So I decided to get off this poison and it's working. I'm doing it fast, reducing daily dose my sanding off a fraction of the pill daily, was on 20mg to begin with and dropped to 10mg in only a week. I'm drinking a lot of water, exercising and constantly keeping active and busy. I'm a single gay full-time dad with a 3 year old daughter and it hasn't been easy. After a week or reduction of meds, I was getting buzzing feeling in my head, strange thoughts, twitching all over my body, numb fingers, dry mouth and horrible nightmares. But, I ain't gonna let this shit beat me, I am way too strong for it and my daughter needs me. Jasmine flowers, put them inside your bedroom when you sleep, it helps dramatically. When you begin to get off this meds, don't go back on them, persistence is the key. Withdrawals are bad but you can be a badass too. I'm winning and so will you. Keep thinking positive and continue to reduce the dose ever so slightly, sand it off with sandpaper (I did) every day. By next week, I want to be off them for good and I so need to have sex again, it's been almost 3 year!!!!!!!!!!! Don't give up, the side effects will pass.
Competing interests: No competing interests