Symptoms of paroxetine withdrawal
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Symptoms of Paroxetine Withdrawal
Common Physical Symptoms: Dizziness, Nausea, and Diarrhea
Paroxetine, a selective serotonin reuptake inhibitor (SSRI), is known to cause withdrawal symptoms when discontinued. The most frequently reported physical symptoms include dizziness, nausea, and diarrhea . These symptoms typically appear within 1 to 4 days after stopping the medication and can persist for up to 25 days.
Neurological and Sensory Symptoms: Paresthesia and Headache
Patients discontinuing paroxetine often experience neurological and sensory symptoms such as paresthesia (tingling or pricking sensations) and headaches . These symptoms are more common with paroxetine due to its shorter half-life compared to other SSRIs .
Psychological Symptoms: Anxiety, Irritability, and Agitation
Psychological symptoms are also prevalent during paroxetine withdrawal. These include anxiety, irritability, and agitation . Some patients may also experience confusion, derealization, and difficulty concentrating .
Severe Symptoms: Fever and Vertigo
In more severe cases, patients may develop fever and vertigo. For instance, a case study reported a patient experiencing fever up to 40 degrees Celsius along with vertigo and lightheadedness during paroxetine tapering. These severe symptoms usually subside upon reintroduction of the medication but can recur if the drug is discontinued again.
Rebound and Tardive Symptoms: Panic Disorder and Insomnia
Abrupt discontinuation of paroxetine can lead to rebound symptoms such as panic disorder, anxiety, and insomnia. These tardive rebound symptoms are thought to be related to changes in serotonin receptor sensitivity. Chronic use of paroxetine may lead to downregulation of 5-HT2 receptors, contributing to these rebound phenomena.
Management and Prevention: Gradual Tapering
To minimize withdrawal symptoms, it is recommended to taper off paroxetine gradually over 1 to 2 weeks, although some patients may require a more extended tapering period . Reintroducing the medication and then gradually reducing the dose can help manage severe withdrawal symptoms .
Conclusion
Paroxetine withdrawal can manifest through a variety of physical, neurological, psychological, and severe symptoms. Understanding these symptoms and employing gradual tapering strategies can help mitigate the discomfort associated with discontinuing this medication.
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