Reinstating SSRI use during withdrawal

Sugar Maple


You decide that you want to wean off an SSRI. The reason can vary.  Perhaps you want to see what you’re like without the drug.  Perhaps you think you’ve outgrown whatever problem prompted you to take an SSRI in the first place.  Perhaps the drug no longer works like it did before.  At first, your doctor is taken aback and tries to convince you to continue taking the drug.  Eventually, he or she tells you that it’s relatively simple to get off an SSRI.  A doctor’s schedule usually includes skipping days and reducing the dosage by 25% every 10 days until you’re down to 0.  For many people, that schedule will work, but a significant percentage can’t tolerate a fast weaning schedule.  These people quickly start to feel withdrawal symptoms that can vary from mild to severe.  Persisting in a doctor’s weaning schedule can eventually turn mild symptoms into severe symptoms.  The brain reacts to lower dosages of SSRI at its own schedule, not ours.  There is a lag between a lowered dosage and the onset of symptoms that can catch up with you after several drops.  The result is that you feel the effects of several dosage drops all at once.  In worst cases, patients can experience rage, anxiety, fear, even psychotic symptoms.  The best way to wean off an SSRI is to do it very slowly.  Most people who taper off an SSRI do it very quickly at first.  It’s not until symptoms appear that they question the schedule.

Once withdrawal symptoms have appeared, the nature of SSRI use has changed.  There is a point where you put yourself on a track to wean off the drug and can’t really get back to the previous state of SSRI use.  You can take your original dose, but the effect will be different.  Instead of creating the mental environment that you experienced before, it’s now a mix of withdrawal and the SSRI numbness.  Once you’ve experienced a mental state without an SSRI, it’s very hard to go back.  Just as you’re very aware of the effects of withdrawal, restarting an SSRI makes you very aware of the effects of the drug.  Reinstating an SSRI is a mixed bag.  Deciding to start back on an SSRI should be done carefully.  Be prepared to experience some form of withdrawal symptoms as well as the general slowing of mental functions that accompanies SSRI use.  Reinstating should be done to prevent the worst withdrawal symptoms and provide some relief from symptoms that threaten your well being.  It is an opportunity to slowly wean off the drug after weaning too quickly on your first try.

Reinstating an SSRI should not be viewed as a permanent thing.  It’s another step in weaning off of the drug.  It’s very difficult to try taking another drug to treat withdrawal symptoms.  Often, you will get the start up effects of the new drug, as well as the withdrawal symptoms of the last drug.  It’s best to restart the same SSRI you were taking before.  As an example, say you were taking 40mg/day of Paxil for 5 years.  You begin tapering as recommended and reach 0mg/day after 2 months.  At about the 3 or 4 month point, you feel that your well being is in jeopardy.  Normally, the brain would adjust to reductions in Paxil at about 10% each 4-6 weeks.  After 4 months, your brain would be expecting about 20mg/day.  You can reinstate at 20 mg/day, which should mitigate the worst withdrawal symptoms.  After a month, the worst withdrawal symptoms should dissipate and you can continue weaning off the drug at a slower rate.  The next step should be about 18mg/day.  After another month to six weeks, you can move to 16.2mg/day.  Weaning 10% each month or so will eventually bring you down to 0mg/day with fewer withdrawal symptoms.  The slower schedule does not eliminate withdrawal, but it should allow you to live a mostly normal life while doing it.  It’s very difficult to measure pills to that precision, but small changes in dosage can have large effects on withdrawal symptoms.

In order to decide what dosage to reinstate at, take your previous maximum dosage and reduce that number by 10% for each month since you started weaning.  Since your goal is to wean off of an SSRI, you don’t want to start at too high a dose, but at the same time, you don’t want to start at too low a dose.  A low dose reinstatement will take longer to reach stability, which will extend the whole process of tapering.  It’s very tempting to restart at a low dose.  One of the common feelings for people who are weaning off an SSRI is that they just want to be done with it as quickly as possible.  It’s disconcerting to realize that you’ve been “hooked” on this drug for a long time when you thought it was just a therapeutic drug.  SSRI weaning is a long process, often feeling interminable.  It’s important to stick to a slow schedule, though.  Quality of life is more important than the larger goal of being SSRI free, which will happen eventually.

168 Responses to “Reinstating SSRI use during withdrawal”

  1. Jenn Says:

    I have been experiencing withdrawal from Zoloft for a month now. I was told the appropriate schedule was 50mg for each 1-2 weeks. I was at 150mg. Four weeks later I am completely off of the meds and I am having horrible pulsing feelings in my head and face which get worse with stress or loud sounds. This leads to extreme agitation. I can barely take care of my kids during the day. I am shocked to see the recommended schedule you give because if that is the case I clearly went off WAY too early! Now I’m stuck wondering if should I go back on to taper off more slowly or stick it out a couple more weeks since I’ve already had a week of feeling terrible. I went off because I couldn’t tolerate the extreme fatigue Zoloft was giving me and my postpartum depression has passed so it’s possible I don’t need anything at all. Now if I go back on, I will have withdrawal symptoms AND extreme fatigue? If there is any advice you could give me it would be a life saver! Thanks. 🙂

    • Sarah Says:

      Jenn, I’m so sorry you went through that. I was having the same thing this weekend and trying to take care of my kids, and I had to call in my cousin so I wouldn’t physically abuse them. Are you feeling better now?

    • freestylergbb Says:

      Thank you, James! Excellent, informative and helpful article.

      • freestylergbb Says:

        I’m back, to add to my own comment. One, my x-doctor took me off Prozac (after 20 years!) cold turkey. For the first two weeks it was okay. Then the disorientation, craziness, fear and anger hit. After 23 days w/o Prozac, I resumed taking it and, as you say in your article, I was hit with disorientation and confusion. I’m a swimmer and it even interfered with that. I’ve been trying to re-introduce for three days now, resulting in that all too familiar feeling of disorientation, although by the middle of the night on the second day I felt fine.

        So, I wanted to enjoy that and stayed up communicating normally with friends via social media about their lives, their life issues and sharing my experiences — although the last is impossible to comprehend by those who haven’t had similar experiences.

        Not really sure what the hell to do now — it’s 4 pm and I was afraid to take it today. I’m developing a distrust of doctors who have by-the-book, non-insightful responses to problems although I’m trying yet another shrink this week for meds only. I’m also a writer and I think my next article is “Psychiatrists I Have Known.” There have been many and so very strange experiences that had nothing to do with SSRIs.

        Oh yeah, this is part of treating my bipolar disorder, which also includes Trileptal and Lithium. I wrote a book about this condition years ago as well as an article called Bipolar Drugs: Easy RX, Hard to Take —

        Thanks again for your excellent piece!

  2. npanth Says:

    You were given the standard tapering schedule. Most doctors don’t recognize withdrawal as a legitimate problem. Most likely, if you go back to your doctor, s/he will diagnose your symptoms as a new or pre existing illness… even if your pre existing condition was postpartum depression, a temporary crisis. Just as the standard schedule is too short, the estimation of the length and severity of possible symptoms is too short. The package insert on the drug claims that “discontinuation syndrome” only lasts 1-3 weeks. Withdrawal can be a prolonged experience. From a fast wean or cold turkey stop, withdrawal can extend for months or years. Don’t be discouraged, it sounds like a long time, but it’s much better than withdrawal. I weaned very quickly, twice as long as my doctor recommended, but still three times as fast as I should have.

    Check out, there are people there who are more familiar with Zoloft. It’s similar to Paxil, but there are some differences that they can give you more specific advice about. In my case, I weaned from 40mg/day of Paxil to 0mg/day in 5 months. It was disastrous. I reinstated at 10mg/day and have been slowly weaning from there for the past 3 months. I think that my brain adjusted to lower Paxil doses at about 10% each month, but I was lowering my dose by 20% each month. The disparity between my schedule and my brain’s schedule caused my symptoms to be more intense than they had to be.

    Reinstating isn’t perfect, there will be some lingering withdrawal symptoms that you’ll have to deal with. The object isn’t so much to make symptoms disappear entirely, but to make weaning off the drug easier. Lowering your dose of SSRI at any pace will induce some symptoms. For example, you’ll still feel some agitation, but not as overwhelming as you do now. The more pronounced symptoms like head zaps and shaking hands should go away, too.

    The good news is that your fatigue should diminish as your dose gets lower. Fatigue is a very common symptom of SSRI use. I drank coffee, soda, energy drinks… and still fell asleep at my desk every morning at 10AM. Now that I’m down to a lower dose, I don’t get tired during the day, anymore. There are other symptoms, but they’re much more manageable now that I’m weaning more slowly.

    • Jenn Says:

      Thanks so much for your quick response! I went back on at 50 mg and my withdrawal symptoms were gone by the end of the day! I’m sitting at 50mg with few if any withdrawal symptoms and only mild fatigue and headaches so I’m not going to rush it but my eventual goal is to get completely off. The amazing thing is that now that I’m feeling physically better my moods are really stable. It makes me wonder how long my “depression” was actually being caused by my meds rather than being helped by them. Thanks again for your article and advice!

      • npanth Says:

        I’ve started to wonder the same thing about Paxil. For a decade, I would get inconsolably depressed every 4-6 weeks, like clockwork. Other than the crisis depression that accompanied withdrawal, I don’t get that regular depression anymore. The difference between the two was rather stark. The regular depression I had while on Paxil would slowly build over a couple days and last for a week or more. Then I would revert to an emotionless state until it started to build up again. Withdrawal depression was sudden and overwhelming, and lasted until I stabilized at a lower dose of the drug. It’s made me question everything I assumed about these drugs, everything I was told about them. My symptoms largely disappeared within 2-3 days of reinstating, which points to withdrawal rather than the preexisting or emerging condition that my doctor diagnosed.

        Hang at 50mg for a while, make sure that you’re stable there before attempting another drop. Some symptoms take some time to manifest after reinstating. Dropping too soon can pile on a couple delayed symptoms, which makes the process much harder. Even though I can feel the fog and slowed thinking that reinstating has caused for me, I’m taking a very slow approach to weaning. Perhaps I’m going too slow, but I don’t want to return to the withdrawal state I was in last fall.

        I’m glad you’re feeling better, I wouldn’t wish SSRI withdrawal on anyone. The isolation, pain, depression and anxiety are the harshest punishments I can imagine. The fact that we got into this mess by following the recommended dose and usage just makes this whole thing more perplexing. There aren’t any studies of these drugs past the 8-12 weeks that are required to get FDA approval. I don’t think that anyone really knows what the long term effects are… except those that experience them. Those experiences are dismissed as anecdotal and unscientific, though. I wish that some studies of long term SSRI use and withdrawal would be undertaken to more formally quantify what’s happening, but I understand why companies are not willing to do those studies. With so many people taking, and stopping, these drugs, the issue of withdrawal should become more widely known in the future. Too late for us, but now we know better 😉

    • Alice Says:

      James, I mistakenly filed my comment in your “Bullying” section, so I’ll begin again. Firstly, I so appreciate your very thoughtful and informed posts about withdrawing from anti-depressants. I could really use your feedback on my current situation. I took Lexapro for 12 years and stopped, cold turkey, about 3 1/2 weeks ago. Stopping abruptly was not by choice; my financial situation delayed when I could get a refill from my doctor. I have a refill now and am trying to decide whether to resume taking Lexapro, at lesser dose of 10mg, in order to then gradually wean off the drug. My withdrawal symptoms are like those of so many others; angry, sad, a bit paranoid, anxiety and a fear of driving! I wondered this morning if I was actually losing it. I am uncomfortable around most people, except for one or two close friends. My family doctor who prescribes my Rx said not to resume taking Lexapro, only to then taper off. But not sure what’s best. So, I would really appreciate your feedback. Thanks again James.

  3. liza Says:

    I went on lexamil for 7 month and stop taking it for about 3 weeks now. I didn’t realize what I was struggling with was withdrawal. I have bad head ache, nause dizzy, sinus,, ears trouble, insomnia,, dreams that feel real, stiff neck, flu feeling., sore joints & muscles. My vision is blurred at times. So now that I’ve mess up my poor brain what do I do now? Go back on meds and do it slowly or keep cold Turkey ?

    • npanth Says:

      7 months is an intermediate amount of time. It’s hard to say what the best course of action would be. If your symptoms are getting better, then hanging on would be the best strategy. If your symptoms are getting worse, then reinstating and tapering more slowly would be best. Try to take a catalog of how you feel, and how your symptoms are and make a decision based on that. It’s hard to gauge emotions and physical symptoms during withdrawal, but try your best.

      Since you were on the SSRI for less than a year, you may be able to taper more quickly than 10% each month. Try 80% of you original dose and wait until you feel fairly stable. From there, try reducing your dose by 10% after 2-3 weeks. Stay there for a time to make sure that it is not too fast a taper. After that, try reducing your dose at the time interval that leads to the fewest symptoms. It’s still important to make the drops small, 10% reductions each time. It’s remarkable how sensitive some people are to even small dosage drops. Your taper shouldn’t have to be as long as you were on the drug, but you want to be sure to taper slowly enough to maintain as much of your quality of life as possible. Tapering is a strategy for weaning off the drug, so there will be some symptoms as you drop. The trick is to drop quickly enough to get off in a reasonable amount of time, but not so quickly that symptoms get out of control. You don’t want to rely on a calendar to decide when to taper again. Instead, rely on how you feel. The advantage you have is that you know what bad withdrawal symptoms feel like. It gives you a good sense of when you are feeling stable and when you are weaning too quickly. I hope you feel better quickly, SSRI withdrawal is a rotten feeling.

  4. Tapering off an SSRI « James Heaney Says:

    […] reduction method.  For more information about restarting an SSRI after weaning too quickly, see this post. Like this:LikeBe the first to like this. Posted in People. Tags: dose, paroxetine, paxil, […]

  5. Dan Says:

    My post is very similar to the previous poster. I stopped taking Lexapro cold turkey 3 weeks ago. I, however, had been on it for roughly 3 years at 10mg. I now understand very well that this was a poor decision. I see in your response to Liza that it is hard to say whether to tough it out at this point or not. I have many of the symptoms she listed. My question is different: how long can I expect to have to tough it out? That will probably be the determining factor for me. If I can expect only another week or two, than perhaps I will tough it out. Otherwise if I’m looking at another month+, I am thinking I might prefer to reinstate and taper. Please let me know what you think (anyone who has a clue). Thanks

    • npanth Says:

      Three years of using Lexapro is long enough to require a slow taper. Cold turkey is a hard way to stop taking an SSRI. Stopping suddenly can make symptoms more severe and prolonged. I don’t mean to scare you, but the symptoms you’re experiencing at three weeks could be just the beginning. The more severe symptoms usually start to occur at 1-2 months. Don’t take that as an ominous thing. You’ve recognized the source of the problem and are looking for solutions.
      I think the best course of action would be to reinstate at 9mg/day and do a slow taper from there. Most of your symptoms should dissipate within a few days, but stay at that level for a few weeks until you feel stable. Be certain that you are stable at that dose before attempting another taper.
      In Lexi’s case, she was on the drug for 7 months. She should be able to drop by 10% of her original dose. In your case, you should drop by 10% of your previous dose. For example, your first dose would be 9mg/day (the reinstatement level), then 8.1mg/day, then 7.3mg/day, until you reach a low enough dose that you can stop (usually around .5/1mg/day). The problem with tapering is that symptoms can take some time to manifest themselves. If you drop too fast, a couple tapers can catch up to you all at once. That’s why a very slow taper is the best way to minimize symptoms. After a few tapers, you’ll start to recognize your progress, and can judge when it’s the right time to do another taper. In my case, it’s taken several months to get a feel for when a wave is coming and when it’s going, and to judge the severity of each one.
      In my first attempt, I raced from 40mg/day down to 0mg/day in 5 months, thinking that everything would work out if I could just get to 0. I had to reinstate at 10mg/day a few months later. Since then, I’ve been tapering much slower. At first, I planned to drop by 10% each month, but it seems that my interval is more like 6 weeks. It’s taken 4 months to get from 10mg/day down to 6.8mg/day, but my symptoms are much milder than they used to be, much more manageable. I’ve found that the goal isn’t precisely to get to 0mg/day. It’s more to get off the drug while maintaining as much quality of life as possible. You may be able to taper more quickly than I did, everyone has a different reaction to the drug. Hang in there. Withdrawal from an SSRI is a rotten thing to go through, but it’s manageable.

      • Dan Says:

        Thank you for your reply and your support (and for this site). I wish you a speedy, painless recovery as well. I have noted all your points regarding tapering, taper schedule, taper speed. Thank you for those. When you say that the symptoms are usually at their worst in 1-2 months, do they usually get progressively worse until that point or does it happen all at once? I ask because I wonder if I have already reached that point. I’d hate to reinstate and taper if I am already over the worst. I will give you a breakdown of my 3 weeks in case that helps you to answer:

        1. Week 1 – Hyperactivity, fast-talking excitement, infrequent brain zaps, balance issues
        2. Week 2 – Frequent brain zaps, sluggishness, flu-like head feelings, lucid dreams, no more balance issues, mild headache
        3. Week 3 – Brain zaps largely disappeared, no flu-like symptoms, mild headache. That’s my current state.

        This is all to say that it feels like it is getting better and that the worst may be over. Could it get better like this and then get much worse? If so, I will definitely reinstate, I just wonder if the worst is already over maybe I should ride it out. I am still on the fence on how to proceed. Thanks again.

      • npanth Says:

        Withdrawal isn’t a linear process. I wish it was. Then there would be one crisis to weather, and we’d be clear of it. Instead, it comes and goes. People call them Waves when the symptoms are very bad, and Windows when they get better. The symptoms you describe are very common in withdrawal.
        I understand your desire to be rid of the drug. It’s hard not to feel that way after realizing how profound an effect it has had on you. When I reinstated, I felt the blanket lowering over my mind. It felt like my intelligence and wit were being smothered. It was infuriating to watch myself slip away again. I tapered off Paxil too quickly, though. I had to start taking it again so I could do a slower taper. It takes the brain a long time to adjust to a drug free state. It’s better to do it in little steps.
        It’s hard to describe a non literal state of mind, though. Pay attention to how you feel. You’ve described the first wave very well. For some people, that is all they experience. If that’s the case for you, then you’re home free. If you begin to experience recurring waves, then consider reinstating. In the official literature, withdrawal is described as a mild to moderate period of symptoms like you describe that last 1-3 weeks. I think many people can stop taking SSRI an not get more than one wave. Others get wave after wave until they slowly diminish to nothing.
        See if your symptoms reoccur in a couple weeks. That would be an indication that you are sensitive to the drug and may have to do a slower taper. If you start to feel stronger symptoms, obsessive and circular thoughts or suicidal ideation, reinstate. Those are symptoms of severe withdrawal.

      • Dan Says:

        In light of what you’ve explained to me, I think that I will wait to see if any new symptoms arise before reinstating. I would hate to get back on the drug if the end is in sight. Today I have virtually no symptoms except for light anxiety, a light headache, and a light “locked” feeling in my head, which has been here throughout the 3 weeks. If new symptoms do arise, and this proves to be circular for me, then I will go back on. Thank you so much for your help. It is comforting and supportive to find someone who actually knows what they’re talking about in a sea of misinformation.

      • Valerie Says:

        You are so act correct

  6. Dan Says:

    My post is very similar to the previous poster. I stopped taking Lexapro cold turkey 3 weeks ago. I, however, had been on it for roughly 3 years at 10mg. I now understand very well that this was a poor decision. I see in your response to Liza that it is hard to say whether to tough it out at this point or not. I have many of the symptoms she listed. My question is different: how long can I expect to have to tough it out? That will probably be the determining factor for me. If I can expect only another week or two, than perhaps I will tough it out. Otherwise if I’m looking at another month+, I am thinking I might prefer to reinstate and taper. Please let me know what you think (anyone who has a clue). Thanks

    • npanth Says:

      That’s a good plan, I think. Thanks. When I started researching my own withdrawal issues, I ran into a lot of people who were firmly on one side or the other. There didn’t seem to be any room for compromise. I mean, heck, we all got into this mess because regulators and doctors didn’t apply critical thinking to the problems of SSRI and withdrawal. If you watch youtube videos about SSRI withdrawal, they’re only a “similar” link or two away from New World Order and depopulation videos. Withdrawal is still considered a conspiracy theory, so I figure advocates need to be twice as right, and half as angry about the whole thing. Instead of becoming a vocal advocate or protestor, I decided that the best thing I could do was help describe the symptoms and some techniques to deal with it. It was mostly trial and error for me in the beginning. I didn’t find really good community information until I’d already gotten deep into withdrawal. So, you’re already 12 months ahead of me 🙂

      Pay close attention to how you feel, and how it changes day to day and week to week. It’s a fine line between obsession and observance. Obsession itself is another symptom of withdrawal. As best as you can, try to be aware of how your mood and symptoms change over time. That’s the best indicator of how to proceed, whether to reinstate or stick it out.

      • Dan Says:

        I found your site by doing a search on ssri withdrawal or something of that nature. You were close to or at the top of the list. I had already read through several forums full of misinformation. I could just tell you knew what you were saying where others didn’t. Truth has an unmistakable ring to it.

        I am pretty good at not obsessing, thanks to God for leading me to one Eckhart Tolle who taught me a lot about that. I would definitely recommend The Power of Now if you are not familiar. I will admit that I lost my cool yesterday when I woke up from a disturbing lucid dream and found my right hand was numb (I think I had been sleeping on it but first assumed it was something much worse). That was compounded by some other withdrawal misinformation I found on the internet and subsequently scared myself with (which is not worthy of mentioning here). I agree with you that obsession worsens everything, and I will keep a watch on that. Today I feel much better, and I feel armed with the answers to the questions I had, thanks in part to discussing this with you.

        One other thing I am doing that might help you too is I am taking a fish oil capsule and a multivitamin. Over the years they always seem to greatly improve my mental health. I’d like to start doing power yoga again too, which had unbelievable mental benefits as well as physical, but my head doesn’t feel quite right for that yet.

        If everything clears up and I have no more symptoms, I will try to remember to come back and share that with you too. Thanks again 🙂

      • npanth Says:

        Thanks, I tried fish oil for a few weeks, but I didn’t get a perceptible benefit from it. I’ve heard that a lot of people find it very useful. It seems like a good treatment. I can understand why people talk about withdrawal in superlatives. It can be pretty scary at times. If someone makes a video or blog post about it while they’re at the bottom, it can really scare people. I waited until I was well into the process before I tried to write about it. I figured that I wouldn’t make sense until I had a better understanding of what was happening. I’ve seen some of those videos. Scary stuff.
        I’ve heard of The Power of Now. I’ll get a copy.

        Numbness in the extremities could be a withdrawal symptom. It could be a one time thing, too. I’ve had numb hands from sleeping in the wrong position, too. It’s far too easy to think that everything is related to withdrawal, but normal stuff happens, too. When I started tapering, my hands started to get numb very easily. I never had that problem before. It was very specific. My pinky and ring fingers would go numb if I put any pressure on my elbow or forearm. Sitting in a chair was enough to cause it. I woke up with it almost every night for a while. There are two main nerves in the hand, one for the thumb, index, and middle fingers, and another for the pinky and ring fingers. Somehow, my Ulnar nerve became very sensitive. It was a very strange symptom. It seemed too specific to be anything other than withdrawal. When the severity of the problem started to fluctuate with my other withdrawal symptoms, that seemed to clinch it. It’s all but gone, now, which I’m very happy about.

        I hope you’re in the clear, symptom wise. It would be great to hear back from you either way. Good luck.

      • Dan Says:

        Hello again! I just wanted to check in with you. It has now been roughly 2 months since I first stopped a cold turkey withdrawal of Lexapro after roughly 3 years of daily 10mg use. We discussed this in another thread here, but not this particular one so I just wanted to refresh your memory. For the first 4 weeks or so of withdrawal I had increasingly troubling and unpleasant physical and mental symptoms, with the most intense being in the 3rd week. The 2nd and 4th week was also pretty unpleasant. Update: what I’m here to tell you now is that after about the 4th week the symptoms greatly subsided. The dizziness, brain zaps, balance issues, disorientation, appetite loss and various other symptoms faded out after the 4th week (so after about Day 28). Sometime around roughly Day 26 to Day 31, the symptoms all just phased out. The brain zaps and all other physical symptoms greatly subsided, as well as the lucid dreams and the various other unpleasantness. I would still occasionally get woken up in the middle of the night with one single brain zap upon waking, that may have happened a couple times in the 5th week. This was still very mild in comparison to the hundreds or thousands of brain zaps I was getting all day in week 3. Now in week 7, virtually everything I could possibly notice connected with the withdrawal is gone. The real change came in week 5 (Day 29) and I was telling people I thought the symptoms were pretty much all gone. Thanks again for being here to support me in the tough times, your answers helped me decide to stick with not reinstating and I am very glad I chose that. Thank you! and I hope you are doing well with your recovery.

        • Valerie Says:

          That’s. awesome! You give me hope!

        • Valerie Says:

          That’s great news! This gives me hope! Thanks for the update

          • Jeff Says:

            Valerie – i see you are recently posting to this site. How are you doing? Im in 3rd week of coming off zoloft. Physical symptoms (dizziness, zaps) have largely improved but now crying spells, daze, and lack of focus rearing its ugly head. Im hanging on barely

          • Valerie Says:

            I’m doing better, down to one xanax every 24 hours and 25 days on Cit 10 mg for another month then I’m going to take 8 mg to see how I do! It’s been a living hell! I’m fighting my emotions every hour!

          • Jeff Says:

            Where did start? Are you noticing emotional symptoms at each reduction and seeing improvement? I went to 0 from 12.5mg of zoloft, and am now struggling whether to reinstate or not to supress uncontrolleable emotions.

          • Valerie Says:

            Yes, I think you should reinstate because for me it got worst! Non stop anxiety and panic attacks non stop for 15 days! Finally I had to go to my psychiatristand ask what to do? Were the panic attacks a side effect and she said yes! She put me back on Citalopram 10mg and xanax to help with the anxiety and attacks, but I only take the Xanax when needed! Plus I drink lots tea as opposed to taking the Xanax. I’m just know starting to feel better after 25 days on citalopram 10mg

          • Jeff Says:

            What level of paxil or zoloft did you start at? Did you taper or go cold turkey? How long did you go until reinstatement?

          • Valerie Says:

            I was on 40 for a year, then 20 for 6 months then 10mg for 2 months! Stop cold turkey, about 5 days later woke up with an anxiety panic! Since then non stop for 20 days!

          • Valerie Says:

            The worst part of this, I never needed to be on them! I was recently tested by 2 different professionals and was not bipolar, lol. I suffer from PMS! I have learned a lot from this experience! I never knew about feeling so low, fear nor panic attacks!

          • Valerie Says:

            Chamomile caffeine free has helped me a lot! Plus lots staying busy, talking to people and walking a lot! I loss 25 lbs in 20 days. It was a living nightmare!

      • npanth Says:

        That’s great, Dan. I’m glad you were able to get through it. I was a little bit concerned that your symptoms might increase. Cold turkey is definitely the hard way to stop taking an SSRI. It’s great to hear of someone who went through the “normal” withdrawal and came out ok. The accepted wisdom on SSRI withdrawal is that the symptoms are mild to moderate and last about 2-6 weeks. Most of the folks who come to this and similar sites are the exceptions. They’re much more sensitive to the drug and withdrawal. It’s odd how one person can get through it in a month or two, and others can take months or years to recover.
        I’m doing pretty well. I haven’t had any severe symptoms for months at this point. I’m tapering very slowly, so I’m hopeful that I can continue symptom free all the way to the end. I’m just one of those people who can’t stop SSRI abruptly. I tried a fast taper last year, and it was 7 months of severe symptoms before I reinstated. I’m glad it wasn’t as prolonged for you. Thanks for coming back to give an update.

      • Vivienne Says:

        Hello I know this post is very old but I wonder if you could give me any advice. I got to zero Seroxat from 10mg in december 2016, but after 2 months of awful withdrawal symptoms, I went back on 1mg. This didn’t help, and 4 months later I went up to 3 mg. I am still on that dose, but I have terrible withdrawal symptoms still, and am barely functioning.

        Would you advise me to increase the dose again, or is Seroxat not working for me now? I feel scared about having to taper again whilst I feel so bad.

        Thank you


    • The Rev. Says:

      Does anyone know if you.taken prozac and bupropion for twenty years stopped for three months and went back on them, will they still work as well as they did before? J

  7. Annie Says:

    Hi Npath,
    Lost my way to the other site where we were talking. My SSRI withdrawl symptoms are getting worse, more like high anxiety and panic, non stop headaches, dizziness, hard to sleep, asthma. I did the reinstatement calculation, 20 mg is the correct dosage. I’m getting that today. Do I start at 20 today or taper on? Thanks. It’s so bad that I was wishing for a xanax. That thought stopped my resistance to reinstating!

    • npanth Says:

      When I reinstated, I took 20mg the first day, then started 10mg/day after that. I was pretty desperate that week. I think you could probably start out at 20mg/day. When a patient first starts an SSRI, it takes a ramp up period for the brain and body to get used to it. This situation is a little different. Your body/brain is lacking the drug right now. While you’ve been tapering, your brain has been adjusting to the lack of drug. I think that the brain adjusts at the 10%/month rate, that’s why the slower tapering schedule minimizes withdrawal symptoms. Right now, your brain is still expecting 20mg/day, so it should be ok to give it what it’s expecting. Wait a while until you feel like you’re stable. Make your definition of stable fairly strict. You want to start your slow tapering schedule from a firm place. It took my about 4 months before I felt stable enough to do a taper. Hopefully, it won’t take that long for you. After a while, your first taper would be to 18mg/day, then 17.2mg/day, then 16mg/day, then 14.4mg/day and so on until you get down to .5/1mg/day. Most people can stop once they get down to that level.
      Reinstatement is a mixed bag. It doesn’t always work for everyone. For me, it took away the really bad symptoms, overwhelming anxiety, severe depression, head zaps, etc. I look at reinstatement as a strategy to minimize symptoms as I taper, not a way to get back to my previous state. SSRI seem to have a “Garden of Eden” effect where they don’t have the same efficacy in reinstatement that they did the first time around. I think the experience of withdrawal breaks the mystery or faith in the drugs, somehow. I hope it helps with the symptoms. I’ve been in the same spot, it stinks. I hope you feel better soon.

  8. Annie Says:

    I’m just glad that I found out a out this through your writing. thank you. Today I had a mental health crisis and had to go to Urgent care. I woke with a terrible headache and panic attack and then it all came back in the afternoon, with nausea and dry mouth. The doc says SSRI withdrawl and to go onto 20 mg. she gave me bultalb for the mass headache pain and Xanax .5 for panic to use only until the citalapram gets into me. I took a half tab for the night, I really need to sleep. Its quite a mix of drugs and I am thankful I am sober. I would have thought I was loosing my mind without knowing this. I hope to sleep tonight and that my brain feels better tomorrow. I have a wonderful Art Therapy workshop training in Phoenix this weekend.

    • npanth Says:

      I’m sorry you had a crisis. I’m glad that the doctor recognized it as withdrawal. The worst symptoms should dissipate in a couple days. You may still have some residual effects, but the worst of it should go away. It caught me by surprise when I got the first bad withdrawal symptoms. I thought I was going crazy. I’m glad writing about it helped you. Art therapy sounds like just the thing, have fun.

      • Annie Says:

        Mental health crises are really tough and I used to drink to mask these symptoms. I think it is so I’m
        Rant for all the people working this to get off alcohol. The drugs helped last night but I was very uncomfortable feeling drugged. I slept well and woke only to a headache, size medium today. Taking it slow and opening some space today. Thanks.

      • npanth Says:

        I’m glad you’re doing better today. There may be a couple bumps along the way, but the worst of it should start to get better soon. It was really eye opening to me when I reinstated. It almost felt like someone put a blanket over my mind. I could feel myself slipping away in a way that I didn’t before. It’s a necessary evil, though. When you feel stable enough to start tapering again, it will start to lift.
        In the two months that I was Paxil free, I wrote fiction, read, studied… many things that I had slowly given up over the 10 years that I was taking Paxil. All that was swept away within a month of reinstating. It’s slowly coming back to me, now, and it feels great. Go easy on yourself, try to minimize stress, but test your tolerance to it in small ways. You want to know how much you can handle, but not so much that you start to feel symptoms again. Withdrawal creates a mental fragility that takes a while to go away, but go away it does 🙂

    • Valerie Says:

      Omg, this is exactly what I’m going through! Please tell me more…

    • Valerie Says:

      Annie, I’m going through the same thing! Please please tell me more! How long did it take to kick in and how did it all turned out?

  9. Sarah Says:

    So I reinstated at 5 mg of Citalopram this weekend because my withdrawal symptoms were so horrible and I had my kids on my own. Brain zaps constantly, made worse by noise or turning my head or eyes, and horrible anger/rage for inappropriate reasons, also extreme emotional sensitivity. After going back on the 5 mg on Saturday afternoon by Sunday evening I felt so much better, and even more calm today with barely any symptoms, mostly just mild brain shocks. I am feeling disappointed in my general practitioner though. I am able to write her emails, and I wrote her one this weekend asking for help in knowing what to do. She did recommend that I reinstate at 5 mg every other day (but as you’ve written on this site, it seems to not be the best idea to skip days) for a month, then take 5 mg 3 days a week for a couple weeks, then two days a week, then one day a week, then stop. So, this scares me because I don’t really trust her weaning advice anymore after what happened this weekend. Do you think it’s appropriate for me to ask her to prescribe it in liquid form so that I can do the 10% a month reduction? That feels more safe to me. If she rejects this idea, do I find another doctor? Are some willing to do this?

    I’m also kind of pissed at this sentence in her return email “You seem to be more sensitive to coming off the Celexa than some. Lots of people can taper off over a few weeks and be fine.” Why do doctors have to say this kind of crap? To me, in my withdrawal sensitivity state, it sounds like “you are special and most people could do this a lot better than you, but you are sort of failing at it”. I know that’s not what she means, but I don’t really understand why so many doctors don’t seem to recognize this withdrawal as a real thing?

    Thanks for any advice.

    • notjustamomblog Says:

      Replying to myself. 🙂 One victory: my GP prescribed Citalopram as a liquid today! Wahoo! I’m on day 4 of reinstating 5 mg of Citalopram. And I’m feeling soooo tired. Brain tired. And kind of sick to my stomach. Too much Citalopram you think? At what point do you know if you are stabilized?

      • npanth Says:

        I’m glad you were able to get the liquid form, that should make measuring much easier. I had a lot of trouble convincing my doctor to prescribe smaller pills, let alone liquid Paxil. Oh, well, I’ve gotten pretty good at filing the pills down at this point.
        It’s hard to say how long it will take to stabilize after reinstating. Like you, the biggest symptoms went away fairly quickly when I reinstated. It took longer before I really felt stable, though. It’s a slow process where symptoms dissipate one by one, little by little. It took about 3 months before I could say that I entered a prolonged window of stability. Since then, I’ve been able to taper a few times without any bad symptoms. I agree with you that skipping days is a bad idea. My doctor gave me the same advice several times. Every time I tried his tapering schedule, withdrawal quickly became a brain zap, anxiety ridden nightmare. It wasn’t until I started tapering at a slow, steady rate that the symptoms really became manageable. I’m tapering by 10% every 6 weeks at this point.
        Stability is a nebulous thing after experiencing withdrawal for so long. It gets hard to remember what “normal” feels like. I’ve found that I scrutinize my feelings a bit too much, almost looking for symptoms. As long as it seems to get to a stable place, it takes longer to believe in that stability. I was looking over my shoulder for withdrawal symptoms for a long time. I think it’s better to stay at your reinstatement level for a little too long just to give yourself more confidence when you do decide to taper again. Besides, haven’t we earned a bit of stability after going through all this? After you get stable, there is an impetus to taper again. For some reason, staying at a dosage of the drug for too long can cause symptoms just as tapering too fast can cause symptoms. It’s hard to gauge whether the problems come from stagnating at a dosage or tapering too quickly. The only measure we have of the right time to taper is our own sense of our own mind. That mindfulness takes some time to develop. It starts with over analyzing everything, and eventually becomes a better sense of our internal state.

  10. josh griffis Says:

    Hi I’ll say as fast as possible. Took Zoloft 7 weeks….lost my penis function so quickly tapered off in a week.done 4 months ago. Still numb penis and numb emotions. Super sad that I’m not the man I was for my kids.I’m a robot. Just want to know ..if restarting Zoloft and following your taper suggestion is gonna give me back my old self? Or is it at last possible? And I’d love to hear if this was successfully completed and people really saved themselves.

  11. josh griffis Says:

    hi I’m a 33 year old male took Zoloft for 7 weeks 50 milligram penis went numb so quickly tapered in a week. This was 4 months ago and still no feeling in sex drive .I feel like a robot with no emotions. This is crushing me because I have two question is about reinstating Zoloft and following your taperrecommendation. Will this give me back my old self theoretically? And has anyone successfully done this.thank you for a response if you have 1. I am desperate and hope to hear something positive. Thank you… Josh

    • npanth Says:

      After taking Zoloft for a short time, it may be better to stick it out. Slow tapering is meant for people who have been taking anti depressants for years. Usually, the taper period should be shorter than the treatment period. It’s a little unusual that you’re still experiencing symptoms after 4 months, but not unprecedented. Seven weeks of treatment is long enough for the drug to establish itself. Sexual dysfunction and Anhedonia, the inability to experience emotions, are very common during and after using antidepressants.
      It varies from person to person. For me, I had sexual dysfunction while I was on Paxil, but it dissipated as my dose went down. Recovery has been a crooked road. Some days, I have function, but no desire. Other days, I have desire, but not function. Increasingly, they happen together, now. It’s strange how antidepressants can affect people so differently.
      A man in India was on this site a couple months ago. He took a similar dose of Citalopram for a couple weeks, then stopped. He had similar symptoms as you for several months. He was improving when he stopped posting, so I assume that he has recovered. That’s one of the nuances of recovery. While you’re in the middle of it, it is all you can think about. Once you recover, it fades away. People who have recovered don’t come back to report on it. The body has a remarkable ability to recover from antidepressants. It may take some time, but you should be ok in the long run. I hope you feel better soon.

      • josh griffis Says:

        Thanks for comment.. its scary cause I’ve read many cases of short term use. That have affected people for years with no change. And I can’t feel any change at this point so scared to leave go for fear that I’ll never change.

      • npanth Says:

        Most of the stories that you hear about short term use causing long term problems are the exceptions. It’s the nature of the problem that people who have recovered don’t want to relive their experience by writing about it. Withdrawal happens in a strange way. For a long time, there doesn’t seem to be much improvement. At some point, it breaks like a fever and starts to improve. It’s not a steady improvement, like getting over a cold. It improves in a 2 steps forward, 1 step back kind of way. The way withdrawal breaks up makes it very hard to believe that it will ever happen. It doesn’t show improvement like other sicknesses. It feels like it will be a permanent condition, right up to the point that it starts to get better.
        It’s hard to be certain when giving advice about withdrawal because it affects each person a little differently. That’s one of the frustrating things about withdrawal. For some people, it’s a short, mild experience. For other, it’s prolonged.

  12. josh griffis Says:

    Hi this us Josh again.I was on the loft for 7 weeks quit in 1 week fast taper.4 months later still have all side affects genital anesthesia brain bad I feel like a robot without emotion. Since you so long can be fully functioning in your brain after 6 or 7 weeks it’s probably the same effect as 6 or 7 years I would think? So don’t you think I should do a retaper at a much slower pace to get better?

    • npanth Says:

      It’s a hard question to answer. On the one hand, reinstating may help alleviate some of your symptoms. On the other hand, a slow taper would last longer than your original treatment period. By reinstating, you may wind up extending the whole process of getting off Zoloft. There are other impacts of long term SSRI use as well. By reinstating and doing a slow taper, you may introduce new symptoms to your withdrawal. I would lean towards waiting for the symptoms to go away rather than reinstating.
      7 weeks is long enough for the drug to establish itself and start to have effects on the brain. There are differences between short term and long term use, though. In the long run, the brain adjusts itself to the drug, trying to rebalance itself to its previous state. These changes have large affects on withdrawal because the brain becomes reliant on the drug to maintain the new status quo. Reinstating and doing a slow taper risks establishing the long term pattern in your brain, which would extend the overall withdrawal period.
      I know how desperate withdrawal can make you feel. It’s a terrible feeling to compare the way you were to this new state of mind. It doesn’t feel like it will ever end, either. That’s one of the hardest parts of withdrawal, a meta symptom, almost. The combination of symptoms, and the unrelenting nature of those symptoms, makes it easy to believe that it will never end. I spent a long time in the same state. It does get better, though. I would say that I’m largely normal, now. I don’t mean the “normal” that I was while taking Paxil, either. It’s the normal that my friends and I remember from before I started taking the drug. A clear headed, empathetic, normal that I like much more than the Paxil fueled apathy I experienced for ten years.

      • josh griffis Says:

        Thank you again… I’d live to hear anything about how long for you….and his and when things started to change… its …like you said…hard to believe. I feel like all the hope in the internet is from people posing as victims… but they actually work firctge drug company’s. No one ever details good stuff. Its always just wait… just wait instead if persueing lawsuits… which needs to be happening…

      • josh griffis Says:

        Hi again…. since youseem more knowledgeable. Have you ever heard of someone recovering from genital anesthesia?

        • npanth Says:

          Yes. Sexual dysfunction is very common. It varies from person to person. Some people experience it while they’re taking the drug. Others get it when they try to stop. Some people become very promiscuous while taking SSRI, others become asexual.
          I mostly lost my sex drive and function while I was taking Paxil. I would say that I’m mostly recovered now that my dose of Paxil has reached a non therapeutic dose. For a long time, I thought I was just getting older, or had some other problem that was causing my sex drive to dry up. It turns out that it was caused by Paxil.
          People who experience the opposite problem, active during SSRI use, numb during taper, also recover. SSRI affect more than just the mind. They make profound changes to many systems in the body. Serotonin is used as a neurotransmitter in many parts of the body. Neuron type cells exist in many parts of the body. They serve different purposes and are not as organized as those in the brain, but react to the disruption of Serotonin regulation in similar ways. It takes some time for the body and mind to rebalance itself after the drug is removed. Most of the body’s Serotonin is produced and exists in the gut, not the brain. It makes sense that withdrawal is more than just a mental or emotional process.
          Legal action against the pharmaceutical companies is problematic. Since the drug is intended to treat the same symptoms that occur in withdrawal, it’s very easy to say that it was the cessation of the drug that caused the problems, not the drugs themselves. In fact, most doctors diagnose withdrawal as a recurrence of a previous problem, or the emergence of a new problem. The product, and the way it is marketed, has a built in shield against litigation. I think that regulation will most likely be the way that the manufacturers will eventually be held accountable. I compare it to the process by which tobacco and energy drink manufacturers eventually became responsible for the damage their products do. People have sued pharmaceutical companies, but most of those actions have resulted in individual settlements rather than industry wide changes. The nature of the business will eventually push the companies into an untenable position, though. The balance between marketing and medicine has shifted too far towards profits at most of the pharmaceutical companies. This will drive them to take ever greater risks to maintain profits. At some inevitable point, they will over reach their medical mandate and regulatory action will inevitably follow. I feel that they have already abandoned the higher principles of medicine in the pursuit of profit. We’re just waiting for the regulatory process to catch up, now.

      • josh griffis Says:

        Hi guy(s) thanks for all the comments. One more question if I go back in the SSRI to plan for the slow taper…will I get libido back? Its been over 5 months since a 1 week taper of Zoloft for 7 weeks prior. Love to hear about thus from stories perspective

        • npanth Says:

          It varies from person to person. Some people have increased libido on SSRI, others get it back when they stop taking the drug. Reinstating isn’t like going on the drug for the first time. SSRI seem to have a garden of eden effect where the effects are different the second or third time taking them. You may find that you get your libido back if you reinstate, you may still have the problem, too. It’s frustrating how variable the process can be. The only way to know for sure would be to try it. There are some risks associated with reinstating. You could be adding drug effects to your existing withdrawal symptoms, or swap some symptoms out for others. Reinstating doesn’t work for everyone. That’s why I usually tell people that they shouldn’t look at reinstatement as a solution to their symptoms, but another strategy for weaning off the drug. Slow tapering shouldn’t last longer than the original treatment period, though. Since you took Zoloft for less than two months, sticking it out may be a better strategy than reinstating and doing a 1 month taper.

          • josh griffis Says:

            Thanks… but I can’t see anesthesia going away….ever… so if there’s a chance to get it back…wouldn’t u think I should try? 33 years old and struggling to feel a purpose… thank god for kids or I wouldn’t have one right now

  13. Sarah Says:

    I’ve been experiencing a new set of emotions lately. As a refresher, tried a doctor’s taper, had to reinstate, and I’m down to like 5 mg of Citalopram, doing it in liquid form, trying to get to the point of tapering 10%. Around Christmas, I did try the taper – I’m like “this will be no big deal” and of course, I was wrong. After about 4 days at 4.5 mg, I started getting very irritable, which seems to be my main symptom of withdrawal. No brain zaps or anything. Just irritability, especially in the afternoon, I suspect as less of the drug is in my system, but who knows. I noticed it, my husband noticed it, and we agreed that I would reinstate at 5 mg through Christmas, because it was a very stressful time.

    In general, since I started tapering off the drug, I’ve felt less motivated, and more irritable/angry, less patient with my kids. These things bother me, but I can handle them if they are finite. In the last few days, I’ve started to notice that my mood can drop precipitously in a short period of time. For instance, yesterday, I had been with my kids at Target for quite awhile, got home, took a nap because it had been such a long trip out in the world with two young kids, and when I woke up from my nap, made myself a smoothie to kind of “wake up” and get going again. About an hour later I noticed that I was feeling really angry and irritable. I had told my kids I’d play a game with them, and suddenly that’s the last thing I wanted to do. I felt like my blood sugar had dropped, so I started trying to get dinner together quickly. My mood was awful. And what I realize is that I’m not very forgiving of myself when my mood is awful. I HATE feeling that way. Got dinner made with lots of swearing on my part, got kids fed, but never really felt like I was enjoying the evening with my family. And hence, felt guilty later after they went to bed.

    I am just feeling sad lately that I am not a very happy mom. I have scheduled appts with two different counselors this week, to try out some new people and see if talk therapy will help. I am also seeing a naturopath, which seems to be confusing me a bit. She wants me to try eating a Paleo-like diet and cut out most carbs, so I’ve been trying to do that to a small extent. Definitely not being regimented, but trying to cut out carbs as much as I can. This is the only change that I’ve really made recently, and I wonder if my body is just not happy with the change – and that’s why I’m having these quick mood shifts, drops in blood sugar. Doesn’t make much sense that the blood sugar drops would be happening when I’m eating less carbs. Sigh. It’s confusing trying to figure it all out.

    All I know is, I’m with the rest of you, and just want to feel better. Feel normal. Sometimes, I wonder if I am just depressed and I needed antidepressants in the first place. My reason for going off of them was an experiment to see what happened. I wanted to get rid of my sexual side effects, sweating, and potentially weight gain. I’m not sure how this experiment is going. Am I just experiencing normal life emotions and having a hard time with them because they were blunted by the antidepressant before? Or am I experiencing true depression which needs to be treated? It’s not a severe version, it’s just low grade symptoms like wanting to sleep more, being less motivated, acting more irritable, etc… I want that feeling of contentment and happiness, and that seems to be missing lately. It’s also really shitty weather-wise in Portland. We barely get any sun, and waking up to grey every day doesn’t inspire much energy or enthusiasm. It’s hard to get outside to exercise.

    npath, are you now of the mind that no one needs to be on antidepressants, really? Or do you still believe that there are some people who chemically need help?


    • npanth Says:

      That’s a hard question to answer, whether antidepressants are necessary or not. The only answer I can give is that they are not right for me. Paxil did more harm than help to me. I got more depressed, more irritable, less responsive, while I was taking it. The social anxiety I started taking Paxil to treat is a small problem compared to the problems that the drug introduced into my life. A friend of mine started taking Wellbutrin while I was in withdrawal. Despite the voice screaming in my mind, I only posed mild concerns about it. I couldn’t make myself say nothing or encourage him, nor could I let it go without trying to express my concerns. I needed to say something, for my own conscience and his well being, but I tried my best to temper that advice.
      Irritability is one of the most common symptoms of withdrawal. It’s very hard to differentiate between the frustration caused by withdrawal and that which rises as a “normal” part of your personality. Even now, after more than a year of experience, I have trouble discerning between the two. Sometimes, it’s not until the symptoms go away that I realize that it was a withdrawal symptom. For some reason, it requires hindsight to really see the difference. I’m getting better at it, but it’s still hard to tell, sometimes. I have to remind myself that the compulsive thoughts and irritability aren’t part of my normal personality.
      Try not to feel too bad if you’re short with your family. It’s very common to have trouble dealing with normal day to day interactions while in withdrawal. Remember that it’s temporary. In the worst parts of withdrawal, I came very close to doing things that I know I would regret now. I did strain some friendships, but luckily I didn’t permanently break any. Regret flows from irritability, they seem to be withdrawal counterparts. It’s hard to keep them from entering your mind. I think that points to withdrawal as a cause rather than an inherent issue. Ask your counselor about it. S/he may not be familiar with the specifics of withdrawal, but they may be able to help you sort through them to tell the difference.

  14. Sarah Says:

    One more question – what do you know about Welbutrin? I seemed to have a lot more energy and spunk when I was on it. Granted, when I was on too much of it, I wanted to kill everyone. 🙂 But I’m wondering if it is as hard to come off of? I came off it kind of cold turkey – not sure what affect, if any, that had on me. Sometimes I wonder about reinstating it, to see if I can get back to feeling energized and motivated.

    • npanth Says:

      I’m not as familiar with Wellbutrin. I’ve talked to people who say that they felt more energized taking it, as you did. It’s difficult to taper off of, as many SSRI are. The decision to reinstate is a difficult one, it mostly depends on how you feel you’re dealing with the symptoms. I think that the feeling of energy isn’t as pronounced as it feels. I felt more confident on Paxil. Looking back, I realize that it wasn’t really confidence, it was an insular feeling towards other people. When I talk to people who knew me before I started taking Paxil, they all say that I “checked out” about 10 years ago. They all say that they can see the old me coming back, now. Those observations coincide with my Paxil usage. In a weird way, SSRI change our self awareness, distorting our own sense of ourselves. I thought I was content, but I was really in a state of mind where nothing mattered to me, good or bad.

  15. TooMuch Says:

    So happy I stumbled across this page. I stopped taking Paxil at 40mg on November 25. I did it way too fast – went from 40 to 0 in less than 3 weeks. The first few weeks I had all the classic WD symptoms. Then, about 3 weeks into it I felt like I got the flu (it wasn’t) and i started having terrible joint and muscle pain my headaches became daily and constant. I also started having anxiety,worrying about the headaches. I could not take it anymore and reinstated at 10mg on January 3. I moved up to 20mg on January 9. My joint pain is a bit better, but I am still having headaches. They were mostly on the back of my head/neck and even in my jaw when they were really bad. Since reinstating they seem to be more in the front/top of my head. Still pressure in the back, but not as bad. I’m really worried that these headaches aren’t going away. Am I not taking a high enough dose? Should I move up to 30 since I was only off for about 6 weeks or so? Any advice would be greatly appreciated. I desperately want to feel well again!
    Thanks so much!

    • npanth Says:

      That was a very fast taper. Don’t feel bad, though. My doctor gave me the same schedule. I thought I was being smart by extending that to 5 months. That turned out to be too fast, too. At 6 weeks since starting your taper, you would normally be at about 32.5-36 mg/day at this point. It may be a bit bumpy, but you may be able to stay at 30mg/day until you feel stable again. Once you start to feel stable, you can start to taper slowly. It’s usually best to go by how you feel rather than a set schedule. Some tapers last longer than others. I’ve been able to taper as short as 4 weeks, and had to wait as long as 8 weeks on other tapers. The situation in your life has a lot to do with how fast you can taper. Withdrawal exacerbates stress. So, if you’re in a stressful period, it’s usually best to delay the next taper until you feel very stable, or the stress subsides. I wrote an article about SSRI tapering schedules on this blog a bit ago. A link should be at the top (“Tapering off and SSRI”).
      It may take a while before yous tart to feel stable again. that’s one of the tricky things about reinstating. It’s very hard to live with the symptoms while you wait to see if you’ve reinstated at a high enough dose. You don’t want to reinstate at a low dose, because it will take longer for you body to catch up to that lower dose. On the other hand, you don’t want to reinstate at too high a dose, because that would prolong the process of tapering. You also have to deal with a bit of shock between stopping the drug and then restarting it. Symptoms will be a bit more pronounced while you get used to taking it again.
      I tapered from 40mg/day down to 0mg/day in 5 months. Then I was off Paxil for two months. I had to reinstate at 10mg/day at that time. It took about 4 months before I felt stable enough to start slow tapering again. I know it sounds like a very long time, it did to me, too. It was still the right way to do it. At this point, a year later, I’m down to 6mg/day and my symptoms are very mild. I still get some neck pain, but the whole body joint pain is gone. I still get confused and compulsive thoughts, but they are much milder than they used to be.
      Good luck on reinstating. I hated the idea of going back on the drug. I could feel the veil of numbness lowering over my mind again. It was much more pronounced when I reinstated than it was the first time I started taking Paxil. I think I was more aware of the changes it was making. Still, it was better than lying curled up on my living room floor in agony.

      • TooMuch Says:

        Thank you so much for your reply – and for sharing your story. I moved up to 30mg. Tonight was my second dose. I actually had a few hours today of being headache free (mostly), but it is back now. I’m wondering if you know how long it will take for the headaches to go away?? I started at just 10mg on January 3, moved to 20mg on January 9 and now 30mg on January 14. These headaches are really wearing me down. And of course my anxious side worries that they are being caused by “something more.” I have become quite anxious, again mostly worrying about the headaches. Thank you for all of the great information you have provided!

        • npanth Says:

          The worry about symptoms being caused by other problems is very common. For a long time, I thought I had a tumor, or MS, or any number of other diseases. It’s hard not to think like that, the symptoms are so pronounced and long lasting. Turns out, I was coming off a drug that I was addicted to. Imagine that 🙂
          Reinstating was a crooked road for me. The worst symptoms started going away within two weeks. I still had some lingering problems for a couple months after I reinstated. It took about 4 months after I reinstated before I felt that I was stable enough to start tapering again. I know it sounds like a long time. It’s better than the alternative, though.
          It’s hard to say how long it will take for any specific symptom to go away after reinstating. For me, the headaches lingered for a while, but the head zaps went away fairly quickly. the joint pain and dizziness took a long time to go away, but the overwhelming anxiety dissipated in a short time.
          One of the most common withdrawal symptoms is obsessive and compulsive thoughts. It’s very hard to recognize them, too. They can be about anything… literally. For about a month, all I could think of when I tried to go to sleep was this one fast food restaurant I used to eat at. I also obsessed about health issues. Until you can recognize them as drug induced obsessive thoughts, try to put them out of your mind as best you can. It’s not easy, they keep creeping back in. There may be some things that are legitimate. that’s the hardest thing about compulsive thoughts. You’re not crazy for thinking someone’s watching you, only for thinking it when no one’s watching. It gets easier to recognize compulsive thoughts as drug induced as time goes on. I had an image of myself sitting outside an office in my suit, dead from exposure… ala Jack Nicholson in the Shining. There was no depression or suicidal thoughts associated with it, it was just an image that I couldn’t stop thinking about. I recognized it as a compulsive thought caused by withdrawal, which made it much easier to deal with. The thought took about two weeks to dissipate, but I think I handled it better than I would have a year ago. Hang in there.

          • Teri Says:

            Again, I can not thank you enough for your help. I’ve really messed up. I honestly can not believe what I’ve done! I really think I have been in a total withdrawl fog! 18 doses ago I moved up to what I though was 30mg, but in my fog I just realized today that I have actually been taking 60mg!!! This is not at all like me!! I am really beating myself up right now. I called my doctor and he said to move straight down to 40mg. and hold there for a few weeks. Then, move down to the 30mg. from there, if I want. I’d say this huge jump from 20 to 60mg. explains why my headaches haven’t gone away and why I have insomnia and some anxiety. It’s too much! I’m really worried about jumping back down to 40mg. Do you think it’s ok to do that since I’ve only taken 18 doses of the 60mg?? I’m having surgery on Tuesday and really worried about withdrawl. I really wanted to be as stable as possible by the surgery, but clearly that’s not going to happen. Now I just have to make sure I do the right thing from this point forward. Thank you so much for any help!!

          • npanth Says:

            Don’t beat yourself up too much about taking the wrong dose. Withdrawal is filled with little mistakes and victories. Making a large jump of 40mg/day could be causing many of your symptoms. SSRI have a ramp up period where they can cause all kinds of physical and emotional problems until your brain adjusts to the new dose. Three weeks at 60mg/day is just short of the regular adjustment period. Try 40mg/day and see if you can make the switch. It will be a little while before you know if you’ve adjusted to it. that’s the hard thing about the timing. Since you’re having surgery in a few days, you may not know if you’ve made the drop to 40mg/day before you have to go in for surgery. The recovery from surgery will also complicate things. It may exacerbate symptoms for a time.
            I’m sorry you’re in this spot. It may be difficult for a couple weeks. Try to stay as calm as you can. remember that many of your thoughts are coming from the irrational part of your mind. The normal regulatory functions of you mind are suppressed. Try to think your way through each episode as best you can. Try to recognize when you’ve been thinking the same thing over and over. That circular thought pattern is very common in withdrawal. The self recrimination that doesn’t seem to go away is also a symptom of withdrawal. Taking the wrong dose isn’t a huge mistake. A lot of people make the same mistake. I did for a while, too. And, I felt very down about myself after I realized what I had done. It’s not a failing on your part that caused you to do it, it’s the combination of a lot of withdrawal factors that combined to cause it. Those symptoms, brain fog, restlessness, self recrimination, aches and pains, will all go away in the long run.
            Hang in there, It may be tough going for a while, but you can get through it.

  16. Joroy Says:

    I’m interested in hearing from someone who’s gone from 1 mg to 0, or from .5 to 0. I’ve tried getting off paxil 3 different times, I’m always successful except from 1 mg to 0. Those are the worst withdrawals for me. In the past, I’ve had to reinstate after being paxil free for 45 days. Just wondering about other people’s experiences with this final step. I’m currently taking 2.5mg, I’ve been on 5-10 mgs paxil for 14 years.

    • npanth Says:

      The last time I hit zero, I had two months of clarity followed by a crash. I had to reinstate, too. I’ve thought a lot about that last drop since then. I think there are several things that affect how successful it is.
      Withdrawal comes and goes for many people. Most patients call them waves and windows. Each time I taper, I wait until the waves are barely noticeable before I lower my dose again. On some of the early tapers, I dropped my dose while I was in a window, not realizing that the cycle for that taper wasn’t complete. because of that, I piled up a couple waves so that they came together. On the last taper to zero, I think it helps to linger at 1mg/day longer than normal to make sure there aren’t any more waves waiting to pop up once you’re off.
      The other thing that influences the last drop is psychological. Up until that last taper, you can always pause your taper or increase your dosage. The last drop has a finality that the rest of tapering doesn’t. Going from 1mg/day to zero is different than the rest. It’s taking that last step off the cliff into thin air. The cliff may only be 1 milligram high, but it’s still there. SSRI create dependency while we’re using them. As we taper off of them, that dependency changes, but still exists. I think it’s important to be prepared for life without the drug. Since it’s a mental dependency, which aspects of the drug’s effects are important after reaching zero varies from individual to individual. Good luck. It’s frustrating to get off, then get sucked back in.

      • oldguy Says:

        I realize this is 5 yrs later, but for others reading it in the now I’d like to add my agreement on dropping the last mg. I tapered from 20 mg to 0 in 7 weeks (twice as long as my doctor recommended) and actually did Ok with the zaps, etc. But when I finally hit 0, things got pretty bad, And then, as you point out, there is no more telling yourself “oh, I’ll just slow down”. I think that, after all, there definitely is a mental component to this.

    • Vivienne Says:

      Hello I was wondering if you manaed to get off the paxil?
      I also went from 0.5 to 0 and then had to go back to 1mg after 2 months. I am now on 3 mg, but this hasnt helped the withdrawal symptoms.
      Did you get any help from reinstatement?
      Thank you

      • Valerie Says:

        Vivienne, what are your withdrawal symptoms? What is your symptoms pattern?

        • Vivienne Says:

          Hello Valerie

          I have very bad insomnia and wake up with feelings of dread and fear. I am not functioning because of extreme anxiety and depression. My reinstatement to 3 mg didn’t help. Do you think I should taper or go up again? Glad you are feeling better.

          Thanks. Vivienne

          • Valerie Says:

            How long have you been on 3mg? Is it in liquid form? Sounds like you have it bad, poor you. I have been there, but keep in mind it will pass. Have you tried Benadryl or NyQuil for sleep? Has your doctor given you Xanax for the anxiety? There’s also teas for sleep!

          • Vivienne Says:

            Hi Valerie

            Thanks for the reply. I have been on 3 mg for 6 months, but am not finding any relief from withdrawal. Not sure what to do next. I am using a digital scale to weigh the dose. Today I have very bad anxiety and brain fog. I am frightened of getting worse if I taper. Hope you have a good weekend.


          • Valerie Says:

            Something is not adding up, my symptoms went away after 3 or 4 weeks on 10mg and so far doing well at every readuction. Are you taking anything else? Do you smoke weed or drink? You don’t have to answer that, but think about what you are doing different from all of us!

          • Valerie Says:

            Do you stay busy? Are around people who are supporting you? Are you exercising? Drinking of water to clean out your system. Staying from caffeine and coffee. I don’t like saying this and I’m no doctor, but if I was you, I go up until you are stable. That’s no way to be living! It’s hell, I been there!

          • Vivienne Ohayon Says:

            Hi Valerie I try to exercise but often can’t face going out. I do drink water. I don’t have any support really and am quite isolated. I’m thinking about increasing the dose but am worried about getting worse. I was only on 10 mg to start with and now on 3. I could go up slightly and see what happens. Last time I increased I got diarrhea, which I still have.
            Today I am forcing myself outside for a walk as I know it helps.
            Bye for now

          • Valerie Says:

            Why did you start taking 10mgs to start with? How long were you on 10mgs and did it help you? Why do you want to get off them? A good book to read is “The Antidepressant Solution” by Joseph Glenmullen

          • Vivienne Ohayon Says:

            Hi Valerie Thanks for the book reccomendation. I was actually on 20mg before reducing to 10mg about 10 years ago. I couldn’t continue reducing because of electrical zaps that started. This time when I started to withdraw it was because I was feeling well and thought I didn’t want to be on antidepressants my whole life. If I had known what was going to happen to me, I would never had started the taper.

            You mention Xanax. Did you take it while you were tapering and did it help? Did you take it at night?

            Best wishes


          • Valerie Says:

            Yes, I took xanax during the day as needed. Slowly I tempered off the Xanax with teas!

      • Valerie Says:

        Hi Vivienne, just checking up on you? How are you doing?

        • Vivienne Ohayon Says:

          Hi Valerie Thanks for your post. Actually I am not doing too well at the moment as I have some other physical symptoms (ovarian cyst and narrowing of bowel). I have to have more tests. I don’t know how much is triggered by withdrawal but I seem to have developed so many physical illnesses since starting withdrawal. I haven’t tapered any more Paxil. I hope you are OK

          Best wishes


          • Valerie Says:

            Oh no! That’s not good news at all. I’m 90% Completely over any withdrawl symptoms. I’m now 4 months without taking any meds! Thanks for asking and don’t give up hope. I really believe you will heal inside out.

  17. Joroy Says:

    Thanks for your encouragement. I’m going to taper really slowly this time. I’m currently on 2.5, so I’ll have a few tapers before I get to 1. This time I’m going to taper even lower than 1, instead of going from 1 to 0. I’m definitely ready to be done with paxil. I originally took it for chronic fatigue syndrome, never any mental health concerns. My health insurance (a really good plan) no longer covers name brand paxil, only generics. I take the name brand, a few tries with generics brought on withdrawal symptoms. My fear is that pharmacies will stop carrying the name brand, if no one’s plan will pay for it. That will leave me in quite a pickle! Good luck with your taper. Please keep us posted on your progress, I find your site to be the best info about quitting, very similar to my own experiences. It’s still mind blowing to me how little doctors understand about stopping tis drug!

  18. Misskbarrylee Says:

    I have been tapering off escitolapram down to 2.5mg every other day i eventually stopped last week. Within the space of 5 days i began to feel very anxious again, tearful very emotional, feel as though i have a cold and headaches. Could thos be withdrawal? I reinstated to 2.5mg every day for 3 days and have had slight improvrment. Has anybody experienced the same

    • npanth Says:

      They could be withdrawal symptoms. Flu like symptoms, anxiety, and raw emotions are very common withdrawal symptoms. If your symptoms continue to stabilize after your reinstatement, that would strongly suggest that it is withdrawal related. Give it some time before you try to taper again. Often, it can take longer to stabilize than the time you were off the drug. There seems to be a shock to the system from tapering too quickly. It’s also better to lower your daily dose instead of skipping days. Skipping tends to put the body into a cycle of withdrawal and reinstatement that is more stressful than taking a lower dose each day.

      • comThomas Says:

        Hi, I recently made the decision to reinstate to 10 mg Prozac after a horrendous 7 months off Citalopram. The reinstatement worked pretty good. However, I recently uoped to 20mg 2 days ago, and been feeling restless, anxious, panicky, and it could be the 20mg or the fact I haven’t slept well in months. Do I go back to 10mg, where I was ok or do I try to wait it out at 20mg? The worse things are the insomnia, which less to tiredness and depression. The anxiety sucks too. Please advise.

        • npanth Says:

          Changing doses, whether it’s up or down, can have an adjustment period. Insomnia does create a feedback loop for withdrawal symptoms, too. I noticed that the more I was able to sleep, the milder my symptoms became. SSRI affect normal sleep patterns. Some researchers theorize that they suppress dreams during sleep, so the body reacts by intruding dream states into the waking mind. In withdrawal, that pattern has to revert to its previous state. While it’s making that adjustment, sleep seems to go out the window.
          If you were doing ok at 10mg/day, try going back down to that dose. It may take some time for you to adjust to that dose, too. Try to stick at that dose for a couple weeks before you decide if it was successful. You may be able to adjust to 20mg/day by waiting a similar amount of time. Since you said that you were doing ok at 10mg/day, I’d say that’s a better dose going forward.
          It’s important to try to make you dosage changes as small as possible. I know that contradicts my advice from the above. You may be able to get away with making a bigger drop this time because you’ve only been on the higher dose for a couple days.

          • comThomas Says:

            Yes, I think I will try the 10 mg again. I upped to 20mg for 3 days after 14 days on the 10mg, so I’m hoping to be ok again at that dose. I haven’t been able to sleep in months, as I fall asleep well, but the problem is I wake up in the middle of the night/early morning and can’t go back to sleep. I also have high stressors in my life. I really regret going off my antidepressants in the first place. This has been a horrible nightmare, with no end in sight. I have dark thoughts, and it’s probably because my body and brain hasn’t had a decent night sleep in so long. The Doctor prescribed Ambien, but I didn’t take it and don’t think I will. I have heard that Benadryl and / or Melatonin sometimes help with sleep.

  19. Bill Says:

    I want to say kudo’s for such well written columns with accurate information that’s not overly drama filled. It’s almost criminal to me that these drugs are still being sold with so many folks suffering while trying to discontinue them. I’ve read as many as 40-60% of people suffer significant withdrawal vs. the drug manufactors suggesting numbers in the 10-20% range. I agree these drugs can be life saving for some but I’d think a drug company might see an opportunity to figure out how to correct this and develope a drug to reduce these withdrawals.

    I’ve been on SSRI’s for closing on 10 years. I was put on them for stress and to keep me on a “even keel”. How I wish I didn’t take them. I’ve failed several times to wean off, even following the 10% and hold method. I’ve tried again this year. I was at 20mg of Paxil and cut 2.5 for the first cut, holding a month then another 2.5mg cut which put me at 15mg where I held for another month.

    I then tried to cut another 2.5mg’s and after 5-6 days, I had some serious withdrawal feelings (achy joints, sore muscles, significant morning anxiety, etc.) I had to updose to 15mg for stability as my GF and I broke up adding significant stress and elevated my anxiety further. It’s just shocking to me why such small dose changes can creat so much havoic and severe withdrawal feelings. I continue to be hopeful that science will catch up with this problem and help the millions and millions of these SSRI drug users find an easier route to discontinue these drugs.

  20. cmusic Says:

    Hi npanth,

    Thank you so much for such clear information. It’s horrifying to seek help from the medical world only to be looked at like I’m crazy.

    I’ve been going through hell since 2010 when I abruptly went off Prozac. As I found out, trying to get back on and get back to where you were became an impossibility. For the last several years I have tried Lexapro, Effexor for over a year, and finally Prozac again. Each time I increased a dose I’d get a bit of relief and then horrible anxiety and depression again. It was almost like my body was adapting to the medication. Of course to the Psychs, I had presented with cycling and bipolar and all that.

    I also used benzos on a daily basis for about nine months before the rebound became overwhelming and I had to taper off. Now I use them in emergencies only.

    In January I decided I’d had it with the SSRI’s. I didn’t think a slow taper would do me any good, because how much worse could it get? I was having waves of battlefield level panic every morning soon after waking up, followed by intense depression and crying spells. So I decided, given the ‘longer half life’ of Prozac, that I’d just stop the medication (my Pdoc agreed).

    Well, it got worse. The morning anxiety is so bad it makes my stomach turn and I can’t eat. I cry hysterically all the time. I get no relief before the evening. I’m barely holding onto my job and keeping myself going. Benzos are the only thing that helps, but I make sure not to use them more than once or twice a week.

    I keep thinking I should try to power through this, but at what cost? And I’m not sure going back on the meds is going to make me stable. But I feel like I’m running out of time. I have a few questions about reinstating and other issues..

    1. Would someone looking to reinstate be better off going right to the full dose at the 10% / month redux rate that you recommend? For example, if I’ve calculated that given the time I’ve been off I should be back on X, would one go straight to X or titrate up over a period of time?

    2. Prozac has a horribly long half life, so tapering doesn’t allow you to really feel and get used to the reduction because it takes so long to go down. It also builds up over time much more than other drugs. Given this, I was thinking about going back on one of the others instead. I know you said this is not the best situation, but I’ve been on them all (except Paxil) so was thinking about Zoloft. It would also give me more room to taper given the dosage equivalent is higher.

    3. Is there anything you would suggest for waves of intense panic that come in the morning? Any techniques for minimizing this? The panic is extreme, and quickly gives way to intense depression. Benzos short circuit this but I refuse to get on that train again.

    Any thoughts would be most appreciated. It’s people like you that keep the rest of us going. Thanks again.

    • cmusic Says:

      Hi Npanth – Just wondering if you might have a chance to offer your thoughts in my post above. Thanks and good luck to you going forward.

      • npanth Says:

        Sorry, cmusic. I must have missed your post earlier.
        It is a tough choice. It took me several months after I reinstated before I felt strong enough to start tapering again. Doctors tend to view SSRI as interchangeable and innocuous. They’re much harder to get off than most doctors will admit. I think your doctor might have been a bit optimistic when s/he said that you could just stop taking Prozac. Even with the longer half life of the drug, it’s still rather short compared to the length of time involved in withdrawal. A slow taper is still the best method for getting off SSRI, even ones with longer half lives.
        Switching to another drug to reinstate has some merit, but it also introduces some problems. While you’re getting onto the new drug, you will still have lingering withdrawal issues from Prozac. You will also have the startup effects of the new drug. It’s hard to say how they will interact with each other during your reinstatement period. Withdrawal and reinstatement are notoriously individual and unique.
        When I reinstated, there was a couple months where I still had the panic and anxiety, but I could also feel my mind falling under that old SSRI fog again. It as really unpleasant to watch myself slip away, right before my eyes. Still, the panic and anxiety did begin to recede within a few days. The symptoms that I had were difficult, but they weren’t the debilitating symptoms that I had without the drug. Reinstatement has also given me a chance to taper off Paxil properly and minimize symptoms. It’s a frustratingly long process, but it’s better than the overwhelming symptoms I had before.
        I’m sorry I don’t have specific or sure advice about whether to reinstate or not. I’m reluctant to say definitively one is better than the other. I’ve advised some people to reinstate who have not improved, and others to stick it out who might have been better off reinstating.

        • Cmusic Says:

          Thanks for your reply. When you went back on, did you go up to the dose you thought you needed rapidly, or slowly? I need some relief quickly but also don’t want to shock my system in its sensitized state by throwing in a full dose of SSRI’s on day one.

          Also, I think the withdrawal for the specific drug is less of an issue for me. I’ve been on all of these before and transitioning from one to the other has been relatively painless. What I’m dealing with now is the absence of anything in my system and that having happened too quickly. It’s basically incapacitated me. Like you said, the curled up ball on the floor.

          • npanth Says:

            I think I reinstated in a hard way. I wanted to reinstate at 10mg/day. I took a 20mg pill the first day, then took 10mg pills after that. It’s hard to remember what it was like the first couple weeks. The really big symptoms went away within the first couple days… I was able to get up off the floor, but I was still pretty messed up for a while. I was pretty desperate when I took that first reinstatement dose, so I wasn’t really thinking straight.
            I think the best way to reinstate would be to use the same method that you used when first starting the drug. Start at a low dose, like 5mg/day, then ramp up by increasing your dose once a week or so until you reach your reinstatement dose. The idea is to do it slowly enough to reduce the shock, but fast enough to get some relief. Try to pay attention to your symptoms as you ramp up. Which ones are getting better, staying the same, even getting worse. Symptoms getting worse doesn’t necessarily mean that they will stay worse, just that they are being aggravated by reinstatement.

  21. Josh Says:

    Hi Npanth,

    I stumbled across your blog while going through my nightly searches to see if i’m crazy (due to withdrawal). I’ve found that everything you’ve said on here to be 100% true with me. I was on paxil for 10-11 years and I was at a maximum dose of 40mg for most of it. My doctor had me taper off of paxil in a month and just like you said, after the one month mark, I too experienced STRONG emotions (mainly anxiety) and had a panic attack that landed me in the hospital. That started me on this hellish journey or like you said, “Bigest mental health crisis” that I’ve been through in my life. Also like you said, my doctor flat out denied that i was still going through withdrawal and that technically all the paxil is out of my system and that what i’m experiencing is just the regular “me”. I thought maybe he was right and that I was going crazy and I couldn’t really find any decent information on long-term SSRI withdrawal. Your blog changed that for me, and I would recommend any one who’s struggles with a SSRI withdrawal to come here.

    Again, i just want to thank you for this blog. I feel like it has the most comprehensive information regarding withdrawal that I’ve seen on the net so far ( and I’ve done sooo much searching). I’ve been searching and searching for answers but not finding a lot of quality information regarding withdrawal and what steps you should take. Most places just tell you to “tough” it out.

    I do have a question for you though, i’m on the 4 month mark of my withdrawal and things do still seem very hopeless. Do you think it’s worth reinstating using the 10% per month rule (26mg in my case) of paxil and slowly tapering or am I far enough along that i shouldn’t bother? I still feel like my quality of life at this phase in my withdrawal is pretty poor. I try to do the same things i used to do but it isn’t quite the same. My biggest fear is that if I reinstate i might go through another BIG wave of withdrawal and i’m not sure if i can survive another one of those. Again, thank you and I look forward to your response.

    • npanth Says:

      Thanks Josh
      I had a similar experience when I first started researching my symptoms. I had to wait a long time before I started writing about withdrawal because anything I wrote in the middle of it would be unintelligible or devolve into an incoherent rant. I think that may be part of the reason that a lot of the information on the web about withdrawal is so contradictory. There’s a great need to express what’s happening, but withdrawal suppresses cognition, making it hard to sustain ideas and logic.
      I still have some trouble writing more than a blog entry’s worth of text. My mind starts to wander in a way that it didn’t before I started taking Paxil. I know the other “me” is still in there. During the two months I was off Paxil, I had a remarkable streak of creativity and drive. That faded away when I reinstated Paxil, but I know it’s still there, waiting for me to hit zero again.
      That’s the difficulty with reinstating. It’s a mixed bag. It can help alleviate the worst symptoms, but it doesn’t work for everyone. I don’t see it entirely as a method of reducing symptoms as much as another chance to taper off the drug in a more controlled way.
      Reinstating worked for me. It took about 4 months before I felt stable enough to start tapering again, but my symptoms have been getting progressively milder as my dose gets lower. It’s going to take a lot longer to get off the drug, but I have a much better quality of life doing it very slowly. I think it’s very important to maintain as much stability as you can while tapering, in dose, in life stress, in everything. The fewer disruptions in your life, the better your taper will go.
      I think if your symptoms are disrupting your life, then reinstatement is worth trying. For me, it was a choice between being curled up on the living room floor and the drug imposed numbness. It was infuriating to watch myself slip away again right before my eyes, but I wasn’t really living with the symptoms, so I felt like I had to do it. 4 months is a little on the long side to reinstate. It may take a while to get stable enough to start tapering.
      Try to pay attention to how you feel if you reinstate. You may actually feel worse at first. Its not that the symptoms get worse, they usually get better because you’re getting your “fix”. the hard part of reinstating is the returning numbness, like a wet blanket is lowering over your brain.
      Taper based on how you feel, not a strict calendar. Some of my tapers have gone quickly, others have gone slowly. It’s more important to taper when you’re ready than to get to the next lower dose.

      Sorry for rambling. See what I mean about losing my train of thought? Hehe

      • Vivienne Says:

        Hi npanth

        I was wondering if you are still replying to people regarding Paxil. I got to 0 from 10mg a year ago but after 2 months, I had to go back on 1mg because I wasn’t coping at all. This didn’t help so I went up to 3 mg after 4 months. I am still on 3 mg and I still have terrible insomnia, fear dread, acute anxiety and depression. I can’t function . I am not sure whether I need to increase more or to taper again, as it looks like reinstatement isn’t helping.
        Any advice would be appreciated. Regards


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  23. Asha Kumar Says:

    “Tell your doctor if you experience suicidal thoughts or actions”…
    Seventeen months ago I stopped taking a high dose of Ultram, a drug with effects similar to Effexor. I was assured by my doctor and a dozen pharmacists that Ultram, (tramadol) is NOT any kind of SSRI. Last fall I started to experience terrifying “suicidal thoughts” so I told my substance therapist I needed an appointment with him to deal with my awful thoughts. The therapist never made an appointment or called me back, instead he called the police. They arrived at my house in the pre-dawn dark shouted and pounded on my windows and doors, never identifying themselves. I came out and confronted two terrified patrolmen with their hands on their service weapons. I stood there, bare hands and feet in my bathrobe trying to figure out what was going on, expecting to be shot. A few months later I saw therapists with the State of Michigan, (SOM) Mental Health. Every SOM therapist encouraged me to consider taking an anti-depressant medication to “help me cope”. I refused, they persisted. During the worst of my withdrawal symptoms, I was crying in fear when a SOM therapist angrily told me I was “just screwing up everyone’s schedules and wasting everyone’s time”. I filed a bullying charge against the therapist and the State did a full “investigation”. The therapist lied to protect her State job, (of course) and State of Michigan determined I had no need for psychiatric therapy. Duh?

    • npanth Says:

      Ugh, that sounds terrible. The pressure to take these drugs is astounding. I didn’t experience it to the degree you did, but my doctor did tell me over and over that Paxil was a lifetime drug, that my life would fall apart if I stopped taking it. I was absolutely miserable on Paxil. I was always angry and depressed. I thought Paxil was the only thing keeping it from getting out of hand. It wasn’t until I was able to taper down to a very low dose that I realized that the drug was causing a lot of those problems. There’s no way I can ever convince my doctor that’s the case. Yeah, it’s weird and a little frightening how doctors can deny it to the point of sending the cops after you.

      • Jaime Says:

        Hi Npanth My question to you and I really hope you answer me is where did you read or found out that psychosis is a withdrawal symptom? I haven’t found anywhere that as a withdrawal symptom….on what study do you base this on? Do this bad symptom happen when they lowered their dose (as in withdrawal) or do these symptoms usually get better after the withdrawal process ends ? (when dose is 0mg a day)

  24. melissa Says:

    So I have been on Cymbalta for around 3 years. Before this I was switched around from Prozac to Zoloft to Lexapro to Paxil. It seemed as though Cymbalta helped me the best with Panic Disorder and the least amount of side effects. However, I have had some trouble with side effects of this medicine such as: extreme night sweats, weight gain, emotional “numbness”, depersonalization, and loss of sex drive. In telling my doctor of these side effects, we came to the conclusion that I get off the Cymbalta (30 mg) and begin Buspirone (10 mg 2x daily). He told me to begin taking the Cymbalta every other day for two weeks and then stop Cymbalta to then start taking the buspirone 2x daily. This sudden stop of Cymbalta took me into severe withdrawals such as: dizziness, states of depression followed by states of anxiety, crying spells, flu-like symptoms (vomiting, nausea, diarreah,), shaking of extremities, and pain all over my body. I had never experienced anything like this before. It was difficult to handle. So, I called my doctor and he suggested I open the capsule of Cymbalta and begin taking half of the 30 mg that way. Still, I continued to get all of those symptoms. So, I called the doctor again (feeling defeated) and decided to go back onto the Cymbalta 30mg 1 time daily (like before). However, now I am getting extreme migraines (something which I have never gotten before) and sharp pains on the left side of my shoulder. Along with these, I am also still feeling anxious and also depressed. This is very difficult because I have a full-time job and go to school part time. It is also difficult because I am an individual therapist and have to be surrounded by people’s problems all day everyday. So I wanted to know if these symptoms are normal of Cymbalta after stopping and then getting back on this drug, and, how long it takes for all of this to stop. Also, my doctor suggested that there were other medications to fight the withdrawal symptoms, but never went into any sort of detail. Do you know what these might be? Is he suggesting Methadone!?
    And are there any ways to subdue some symptoms, other than therapy, of panic disorder with herbal supplements or something of the like? Also, what does buspirone do? Thank you!!!!!

  25. Noelle Says:

    Hi All,
    This site is amazing and thank you all for being so honest, makes me feel less crazy. Ive been on Paxil 40-80 mg for the past 14 years. I suffer from Anxiety/Pure OCD. I was very lucky that the first medication I took worked for me. I did have a few hiccups where my dose had to be adjusted but over all did amazing on it. I got married last September and recently had the urge to have a child. I was told by one doc that Prozac was the safest and than got a second opinion and she said Zoloft was safer. So since July I had begun tapering my Paxil from 60mg. On Sept 14th I introduced zoloft 25mg with 20Paxil. I did OK.. Was quite nervous but I managed.. Than the doc told me to stop Paxil – she assured me Zoloft would take over flawlessly. She was WRONG .. I stayed off of Paxil for 4 days an by day 4 I couldnt even work- I was leaving for Punta Cana the next day so I was desperate for relief- I took 20mgs of Paxil- while on vacation I was ok- (not too stressful on vacation) when I got back I was able to work a full week- (I was in hell) anxious depressed would cry for no reason – I never had head zaps that I keep reading about bc I was covered under Zoloft- Friday will be 4 weeks since my crossover to Zoloft and I have decided to run back to Paxil- yesterday I took 40 mg paxil along with 100mg zoloft – extemely dangerous I know- today I took 40Paxil and 50 Zoloft- dont want to shock myself again with no Zoloft? I am feeling a bit better than yesterday- able to work today- just wondering if anyone knows when I should expect to be myself again? In the past it has just taken me a few days but this time it is a diff story- thanks for reading

    • melissa Says:

      Give it a few weeks and you’ll feel better; although, when I did this I needed to increase my dose because it didn’t work as well as it did before. I think my body developed some sort of reverse tolerance or something. Who knows. That said, make sure you keep your doctor in the loop on your situation. Good luck!

      • Noelle Says:

        Thank you very much for your reply- I dont doubt that I’ll need to be at a higher dose at some point- just waiting for my doctor to get back to me regarding when I should stop the Zoloft. Its terrible being in this hole of despair- when things get a bit better its only like another layer of hell! But I am hope that I will feel relief soon, it does come on suddenly and than u can give a sigh of relief

  26. Ruth Ann Adams Says:

    Hi, I have read a number of your articles and found them very helpful. I weaned off 20 mg of paxil to 0 between January and July. Most of the weaning was from 10 mg between March and July. My summer was hellish, with physical symptoms, depression and anxiety. I have been feeling so badly that I went to see my GP today. He doesn’t understand at all about paxil discontinuation and wants me back on it. I have requested to see a psychiatrist, someone who at least has experience with this sort of drugs. My GP has put me back on 10 mg. I don’t want to be on that much, and feel the summer was not worth all the pain I went through. What I am going to do is go to 5mg and see if that stabilizes me. What do you think? I feel discouraged going back on this at all and my purpose in seeing a psychiatrist is to get some proper medical support and advice. Thanks for anything you can tell me. I feel like a bit of a failure tonight. Thanks.

  27. Ruth Ann Adams Says:

    Would you please be able to delete this comment and the one before it, that I have written. I didn’t realize my name and picture were going to come up. You can still reply to me. Thanks!

  28. Sacha Says:

    Please advise how long until I feel normal after restarting meds? I lost a bottle and had to wait 2 wks to get them. Only had 1 dose I cut up the first 2 days.

    Dose: Celexa/60mg 2 yrs
    1 day 40mg, next day 20mg, after that 0 for 10 days.
    symptoms: slurry speeach, brain wooshing, headache, exhaustion, rage, paranoia, panic attacks, hysterical crying, chills, fever, sore throat, aches, runny nose, lifelike nightmares where loved ones stab me and torture me, mental confusion, thoughts slow and uncoordinated, blurry shapes take on disturbing identities, feeling suicidal ideation, difficulty falling asleep even if tired/stay awake 2 days, chewy mouth, bowel cramps/runs, vomits,hot flashes, communication problems/conflicts with strangers.

    1st day back on them I took dose that morning and again that night, after that i took regular dose once every night as normal. Its day 3 and most symptoms have gone or lessened, except the folling:

    slurry speech, thoughts seem slow/muddy/hard to follow, a bit easily irritated, COMPLETE UTTER EXHAUSTION – I slept 10 hrs, after being awake 2 hrs this morning I was ready for a nap, but every time I try i just keep going over an argument with a stranger in my head or out loud to myself, until I catch it. my tongue feels thick and stupid, bowel cramps/runs, concentration problems.

    This sucks because I am in finals week at ivy univ and I have deadlines for research papers Ive barely started – 1 every 48 hrs for the next 6 days, on day 4 I also have a testify at a hearing to get recompensed from an accident. My older boyfried of 5 yrs will be moving in this weekend which is good I will have someone with me but also told him I suspected he was going to take over my home and “devour” me (not in the good way!) 2 nights ago, lol (he is a bit bossy). My eyes keep crossing and closing I’m so tired I run my head under the sink and stick it out window cus its 30 degrees.

    How much longer do you think?

    Thank you!

  29. Alex Says:

    Hi npanth

    I was on ssri luvox 150mg for 4 years . After the first 2.5 years I decided to withdraw from it and did it very gradually over the course of a year. However, i didn’t know about the 10% drop schedule and after I was completely off of it I started experiencing TMJ related problems and some tooth decay and also had to get a root canal done. Further my ocd started coming back and so I decided to go back on it. I stayed on luvox for another 9 months or so and then for some reason I decided that i don’t need it anymore and quit it cold turkey. I thought I can easily brave through the withdrawal and I did so.. I use to get a lot of headaches and used to feel light-headed which would happen occasionally during the first two weeks of withdrawal but after that it went away and I started feeling much better. But after exactly one and a half month I started feeling sensations in all my teeth. It became so bad by the end of two months that I couldn’t even drink water. Any thing even mildly hot or cold would hurt me severely. Doctors or dentist or even my psychiatrist weren’t able to figure out the problem and what was going on. I did get another root canal done but that even didnt stop my severe TMJ and excruciating pain. I had to be on ibuprofen (around 1600mg per day) constantly. I then came across the road back program and then took their neuro endure mini (which contained NAC and another chemical I don’t remember) and it was so helpful that it stopped my pain within 30 minutes of taking it. I felt I got my life back again. Now it has been 11 months since I stopped it I am still taking that supplement. It has reeived me of my pain. However, during the past 4 months not only my ocd has come back but I am going through extreme depression. I don’t know what to do. I am doing lots of Yoga and deep breathing exercises which have been helpful but still it has been very difficult to live. I feel lonely, helpless and dysfunctional. I am deciding to go back on another ssri just in case they would have lesser side effects. Please advise me what I should do. Or should I go back on a lower dose of luvox and start withdrawing again?
    Thanks a lot in advance! I will be deeply indebted to you and anybody else who replies.

    Best regards,

    • N Says:

      Hi Alex!
      I commend you for doing so well off of an SSRI for so long. I am of the belief that anxiety/depression if chemical is a life long battle. I am no longer in a state of mind where I feel I need to be off meds at any point in my life. A diabetic wouldnt go off their meds. Think of it that way. Are you sure you need to be off meds all together? Try a low dose of luvox maybe. Please also look into Deplin- it is a pure form of folic acid, known to help mood along side of an SSRI. I have been taking it since reinstating me SSRI in October and havent had an “episode”. OCD really requires more maintence than just anxiety. OCD is a completely different animal that is a battle in itself.

      • MSTH Says:

        Thanks a lot N!
        My doctor has advised now to start taking a low dose (20 mg) of prozac. I have been taking it for about 4 weeks now but it hasn’t been of much help. I am also thinking to go back on luvox. However, I don’t know what the long term consequences will be of taking these drugs.

  30. Mark Enescu Says:

    Hy I’M Mark from Holland live in Dubai now, and I can tell you that your posts are realy great and I will like to THANK YOU SO MUCH FOR YOUR SUPPORT TO EVERYONE. I took Paxil 10mg for 5-6months (15aug 2013-1march 2014)…all this time I have felt bad, maily dizzines, inceased anxiety. At the end of feb2013 my Doc told me that I can stop the drug which I did cold turkey…..very, very bad ideea. Afther 4 weeks of cold turkey severe dizzines and panick atacks showed up.I had the worst time of my life.

    I went to a different doc. here in Dubai, he gave me seroxat 20mg, to take just 5mg out of it and rivotril 0.25night and I reinstarted at 5mg on the 10th april….but because of the wrong cuting i never give the right doze to the brain/body….either 4.5 or 4 or 5…..a wired allergy came out on my hand fingers after a month 15may (called my doc) and he told me to stop the drug beacauuse it causes me the allergy…I droped to 2.5 and sudenly the worst side effects pop out, heart palpitations!!!, which I never have them before or/and durring paxil….finaly I buy a digital scale and from begining of 25may I give exactly 5.4mg,

    Reinstaling 25may and after 10 days of 5.4mg it looks that the drug it start to work in a way that I feel again bad and dizzy, morning anxiety is the worst.I read all your post and paxil didnt have any benefit for me as for you, in stead it was just poison and now it looks that i cannot get out of my body.

    I have 2 questions please:

    1. Do you think I shall increase the dose? you mention to count the months and deduct 10% for each month, now after march, april, may…I should be at 7mg….?

    2.I am at 5.4mg and I’m planning to tapper very slowly 5% with the help of digital scale…. and that taper it will take oviously longer than my 6months treatment…Shall I taper at 10%every4-6weeks?

    Thank you so much!

  31. tammystt Says:

    Hello npath,
    I’m at a loss and at my wits end. I spent several years on cymbalta then spent a year tapering off of it only to start zoloft toward the end in order to cushion the blow of being totally off of cymbalta. After 6 months of zoloft, I was weaned off of it. That was over a year ago and to be honest, I feel worse now than I did a year ago. I feel like I am numb, in limbo, unable to function, angry, confrontational, and highly fearful. I obsess over whether or not my boyfriend will dump me because I am like this (and it’s almost happened on more than one occasion).

    I have been tempted to go back on something to help ease this so I can function. I am about to embark on a new career path in the medical field and I’m having trouble even envisioning this because of my current frame of mind. I am scared it’s going to cost me school and my career. I have trouble concentrating and making decisions.

    I’m also in menopause and am told that could be kicking me as well.

    I read how people spend years feeling like I do with no relief. I can’t go on like this. Is there any hope?

  32. Audrey Says:

    After 13 years on Celexa, I tried to taper down with the idea of going off it completely. The psych told me to switch from 40 mg daily to 40, then 30, then 40, on alternating days. Three weeks into this, I started to get emotional issue (irritability, aggitation, even rage, some anxiety) and vertigo. Everytime I’d lay day, the vertigo would hit so badly, I felt like throwing up.

    The psych told me to go back on the 40 mg until I was stable, and then taper down more slowly. The problem is that I’ve been back on the 40 mg for 2 1/2 weeks, and I’m still experiencing vertigo and twinges of anxiety. Is this normal for discontinuation syndrome? Everything I’ve read says the symptoms should go away a few days after resuming the normal dose.

  33. Anthony Says:

    Hi npanth,
    I abruptly stopped taking sertraline for 3 months due to side effects, and I was off med for 4 months, but today my gp advised me to reinstate same med 50mg then to reduce the dosage tapering down from that point. I am having withdrawal symptoms of ringings in ears since I had taken this med, I never had tinnitus before. I felt my symptoms got worse about 6 weeks ago.

    Please advise how long I should be stay on 50mg? What dosage should I taper down and how long for before I come off safely? How long does this symptoms last for?

    I’ll appreciated your reply and thank you.


  34. Anthony Says:

    Hi npanth,
    I forgot to inform you that I quit cold turkey and I didn’t tapering the med. I feel ringings in my both ears is getter louder and persistent, my right ears is the slightly worse than the left one. I hope this symptoms will subside soon. I will follow my doctor’s instruction how to tapering down medication.

    Your early reply would be greatly appreciated.


  35. Ruth Henderson Says:

    It’s 4 am and I need some hope.
    I had been on 37.5 mg of effexor for years which managed well both my anxiety and depression. I know, a very small does, but it did the trick so I stuck with it (super sensitive to drugs). However, after about 5 years had break through anxiety and worked on getting my dose up to 75mg without great results for a year.
    So, fast forward to the worst decision I’ve made to date. Dr. and I thought I could try another drug, Cipralex (Lexapro). I, of course, had no idea what a potent drug this was. Weaned of effexor over months successfully, tapering on to 5mg (for about 2-3weeks) and then 10mg of Cipralex, which in it’s self was a mini hell, but worked very hard to struggle past side effects. Tried for 3.5 weeks, but the terrible heart pains (no, it wasn’t indigestion!!) made me sure I wanted out. The dr. told me I could go back on Effexor and wean off Cipralex over 2 weeks, and even though I know I’m sensitive I thought that since I had only been on Cipralex for less than 2 months it wouldn’t be a problem. (Second worse decision of my life!!)
    I was so wrong. The last 3 weeks have been the worst – all aspects of it have come to a crashing halt. Two dr.s (one psychiatrist) told me no way could I be in withdrawal, and even tried to get me to take buspar or something.
    Am now back on 37.5mg of effexor, which may be just starting to help me with the worst depression and anxiety of my life which hit me 4 days after stopping Cipralex, however, still physically very ill – sudden bouts of dizziness and exhaustion. Can’t sleep more that 1.5 hours at a time without waking up with beating heart, more dizziness.
    Before reading your blog, reinstated with about 1.5-2mg, just on instinct desperate for anything to lift this hell. In your opinion, is that enough as I was on the drug for such a short time or should I reinstate at 5mg.
    Since I am on effexor, I don’t want to go too high (pharmacist the biggest help yet!!!) and going back up to 10mg might kill me after what I’ve been through.
    Has anyone just struggle through withdrawal after being on a drug for such a short time
    Kind Regards,

  36. sonny Says:

    I need some advice, I had been for lot of years in Paroxetine (Paxil) around 14years for Anxiety and DPDR. Last year my doctor decided to change it for Fluoxetine to see if It could improve my DPDR and Anxiety but it was almost worst, we also tried Escitalopram. With both we did it in a period of around 3 months jumping from one med to the other (stop paxil, start fluoxetine 3 months, stop fluoxetine and start escitalopram 3 months).

    I decide to stop all the meds, and slowly but not so slow as I now know that it is necessary to go… I stopped Escitalopram.

    During the first months I had anger, irritability, problems with sleep, higher DPDR, no pleasure with sex, etc.

    I have been clean of meds for 5 months, but it is a complete nightmare. These symptoms are still with me and they do not dissapear, they are changing every day, for example the irritability and the anger is better now than before but the DPDR is worst and the insomnia keeps been a problem as I can just sleep 4/5h. I have lot of suicidial thoughts every day, and de derealization is killing me, everyday is more difficult to do my job and to keep contact with friends and family.

    I want to finish this nightmare… my dr suggested to go back to paxil starting with 10mg one week and going to 20mg after and when I will be stable we can practice a slow slow reduction of the med. I am affraid now, confused and of course I do not believe in doctors anymore…

    Some advice please?

  37. David Hernandez Says:

    I was on celexa for 16 years and then switched to prozac during the last year of SSRI use because I heard that it’s easier to taper prozac since it has a longer half life. That was 15 months ago and my symptoms seem to be getting worse. I am in the midst of protracted withdrawal. My withdrawal effects are depression, anxiety, insomnia (I only get around 4-5 hours of sleep at night and I wake up with morning anxiety. For the past month I’ve been feeling a sick feeling almost like a fever without the fever; it’s hard to explain. I also started taking Klonopin to help deal with the anxiety problem and now I’m addicted to it as well.

    I was told on the support boards that it’s too late to reinstate. I did try going back on Prozac a few months back at 10mg a day but the increase in anxiety and depression made me quit after a week. Will I have to endure this protracted withdrawal that seems to be only getting worse or can I go back on a very low dose of prozac or celexa to help with the withdrawal symptoms. I’m getting to the point where I’m having a difficult time doing my job and I can’t afford to be without a job. Please help. Any advise would be greatly appreciated.

  38. Matt Says:

    My predicament is similar to David’s, but my current problem is not anxiety, but rather extreme vertigo and mental confusion. I reinstated after only three days off, but these symptoms do not seem to be improving. Did i miss the window to reinstate?

  39. Catherine Says:

    I cold turkey’d prozac after 17 years of use. I have managed a year off but am very ill. Lost my job, my partner has moved out. Is it too late to try and reinstate ? Please someone advise. Im 36 but feel 100. I was a marathon runner prior to this. I want my life back

  40. Mackenzie Says:

    Hi npanth, first of all thank you immensely for your thoughtful, intelligent and accurate descriptions and analysis of this hellish process. I can say with certainty that your words have helped and given me some clarity and light in very dark moments. I am grateful.
    My situation: I took my last tiny dose of paxil 3 weeks ago. I tapered pretty slowly on a halving schedule recommended by my doctor over the last year or so. The symptoms crept in slowly but steadily, and became pretty unbearable about 6 months ago, when problems became apparent. I pushed on, and am now struggling through withdrawal post cessation… I guess 3 weeks isn’t much but the last dose was so tiny 0.2 ml that it is baffling I am not readjusted yet. I am experience an array of the usual symptoms, and panic is pretty much constant. My question is this: a small dose of clonazepam even 0.25 really helps me regain some clarity and peace, but I am afraid of developing another dependence, if I haven’t already: my doctor has been prescribing clonazepam to me for years (along with paxil) to counteract occasional anxiety or sleeplessness. I have never abused it or taken it regularly, only occasionally, as the doctor suggested. It helps a lot. But now I’m wondering where it’s done me more harm than good. Am I constantly withdrawing from that too, in a way, because of the non daily non routine administration? Do I need to wean off that too now, at the same time as paxil, or use it as an occasional crutch until I am better, then wean off it? My doctor doesn’t really seem clear on this either. I realize you can offer no medical advice, but I would value your opinion. I am also looking to implement Dr. Ilardi’s advice on treating depression without drugs, which so far seems to amount to a healthy lifestyle… Easier said than done at this point. Anyway, thank you for reading this if you have, and again for this blog which is a tonic. All the best to you, Mackenzie

  41. John Sneeringer Says:

    There’s a mathematical error in the article. The author presumes a 10% reduction from each previous reduction (as cited: 20mg/day reduced to 16.2mg/day, etc), not from the starting dose of 40mg. By these calculations you’d be tapering for about 6 years or more and the medicine would be nearly impossible to measure. If you reduce 10% from the starting dose, you’d finish in 10 months.

  42. Victoria Says:

    I have a question about my situation and wonder if you are still answering questions here. Please let me know. Thanks.

    • pearlsbears Says:

      I found myself in horrible withdrawal and have reinstated with the help of the website After a few months I am starting to feel much better. If you have questions and need help please go there.

  43. Gregg Says:

    Hi – I’m hoping someone can relate, as I’m having a very hard time with this experience. I took Zoloft for 3 days (25mgs) in late December 2015. I stopped taking it after the 3rd day after intense panic attacks each night. My withdrawal has been horrible. For 3 weeks after, I had extreme anxiety, insomnia, and panic. I could barely leave my house – and there wasn’t much relief at my house either. I couldn’t escape the experience. I initially decided to take the medication for slight case of panic disorder after it flared up after a recent move out of state and leaving my support system. After the initial withdrawal symptoms, I was able to get back to my day to day life, but was not close to feeling as I felt before. I had this chemical depression – that took away all my hope and optimism. I’ve never had any depression, and was always a very positive person. I couldn’t shake it – it was so palpable. After 4 months, that started to lift from my mind and I was feeling close to normal (pre medication). This lasted for a few weeks. Then – I was hit with the exact same pattern that I experienced for the 3 days on the medication – diarrhea followed by extreme panic. I’ve never experienced that apart from the 3 days on the meds and this one time. That was followed a few days later with extreme depression – crying bouts 10+ times a day, insomnia, hopelessness. That has lasted the last 7 days – to which I’m currently experiencing. I’m wondering if anyone has experienced this severe reaction after only taking it for 3 days. I’m very worried and scared with the uncertainty and my future. Thanks for your time and this forum. If anyone can offer any guidance I would be greatly appreciative.

    • mackenzie Says:

      Hi Gregg, I haven’t had an experience like yours, but I would recommend you check out the site if you haven’t already: it is a trove of information, with members and moderators sharing their own experiences, support, guidance, and advice. There may be members who can relate to your predicament. Wishing you all the best.

  44. Deanooo Says:

    Sooo I’ve been on 150mg of Sertraline since I was 14 years old for suffering with PTSD …I’m now 24, I don’t know why but I decided to quit with them and stopped suddenly as I had missed a few and felt fine… Ohhhhh man what a bad idea…its been around a week and I’m like a monster inside, I can’t think properly, I’ve had the most severe headache of my life for a day or two now, can’t sleep, can’t concentrate, can’t think straight and the worst of it all is I’m convinced I’m snapping at people for real good reason.. Luckily I can see somewhere in my functioning brain that I’ve got to just relax and take a step back although that’s hard. Damn this stuffs dangerous! But I’m now in a catch 22… Do I continue cold turkey? Or do I wean back on them and then wean off properly? Or if it too late and am I pretty much stuffed whatever I do?
    after seeing what they’ve done for me over the years I’ve always been impressed but after seeing what they’ve done in terms of what my body is like without them had actually scared me quite a lot!

  45. Edd Says:

    Dear to anyone that can help. I’ve always had anxiety and panic attacks but was able to control them on my own until about 8 months ago when they got worse. A neighbor of ours cane over one day during an attack and I told her I was having anxiety. She went home and gave me like 200 Zoloft at 25mg each.

    I have always been really extremely sensitive to any meds. So I started taking the Zoloft and then stopped after 2 weeks. I only took 25mg each time. I did this 2 weeks on 1 week off for 5 months. Reason being for stopping is i hated the way Zoloft made me feel by taking it. Always tired, zombie like state n such.

    Well my last endeavor has been rough decided to take Zoloft again for 2 weeks then yup I quit the meds. Well a week later I woke up in what to me seems like hell on earth.

    For 3 weeks now I have had tons of symptoms that I can’t explain. Alot of people tell me I took such a low dose I should not have any symptoms of withdrawal but I’m living it.

    In the 3 weeks I have almost lost my job. Been at the ER 3 times.

    My symptoms are as follows but some did go away a little.

    1. Lightheaded/foggy head (all day every day)
    2. Confusion/loss of memory/lost focus
    3. Depersonalization
    4. Fear I’m dying and this will never end
    5. Increased anxiety/depression
    6. Decreased appetite (force myself to eat)
    7. Very emotional (I never cry and I’ve cried all this week)
    8. The worst one which seems to have passes a huge amount (suicidal thoughts)

    #8 scared me the most because I absolutely love life and I was thinking this bad shit.
    I am scared that it’s never gonna end and I have been tempted to retake the pills to maks the side effects go away but I’ve gone through this living nightmare for 3 weeks I feel I may be close to the end to start over.

    I started taking fish oil today to see if it will ease the withdrawals or not.

    • Valerie Says:

      How are you doing now? What did you do to help deal with your symptoms? I’m in this stage myself. Please give something to look forward to! Thanks!

      • Vivienne Says:

        Hi Valerie

        I am new to this site and enduring awful withdrawal symptoms after coming off Paxil. Reinstatement to 3mg 6 months ago hasn’t helped and I dont know what to do next. How are you?


        • Valerie Says:

          Hi Vivian, I’m doing well thank you believe it or not it was Chamomile tea caffeine free, from Celestial seasonings! No caffeine or sugar. I went to a clean diet. I was constantly outside walking and getting distracted by nature! Walk bear foot if the weather is nice, it helps with sleep! I also learn to cut cords, but that’s too weird for people lol! But this helped with my stomach anxiety.

          • Valerie Says:

            After 5 weeks of hell, I went back 10mgs for 5 weeks then .5ml for 15 days and now at 1.25ml for 11 days and no problems at all! The psychiatrist wanted me to take 1mg of xanax 3x a day, I didn’t do that! I took .25 instead only in the morning for about 10 days along with the 10mg and drank of tea instead! I still drink tea with I feel a little anxiety coming on!

  46. Jim hardy Says:

    Have been taking Effexor 150 mg once a day for four years .
    Went on a two-week cruise forgot my medication decided to go total turkey…
    Restart it when I returned.

    I have now returned and I’m going through all of the with drawl symptoms and my doctor is on available because he’s now on vacation for two weeks should I just restart restart ?
    double the dose? I’m a mess..

    Falling apart

  47. RK Says:

    Your blog is a wealth of information on ssri withdrawal and one that makes most sense to me. I can identify with so much in here. Are you at doctor ? Who are you ? I want to find out and thank you.

  48. Mike Says:

    I have been on Paxil for 15 years. Have tried multiple times to come off. I initiated a taper that was too aggressive not the 10 percent reduction recommended. I thought I was being conservative but not enough apparently. I got down to 2.2 mg and hit a wall with severe panic attacks. Was very scary with extreme anxiety. I have updosed to 5 mg and after 3 weeks I am still not stable. Is it advisable to increase my dose to stabilize than initiate a proper taper? Am i now sensitized to this drug and will an increase throw fuel on the fire?

  49. Deanna Says:

    Hey everyone….i have been on Escitrlopram(lexapro 20mg) for approx 11 years.
    At first i thought it was great then years later i began to feel numb, not a care in the world, lots of weight gain, NO sex drive, No emotions at all really.A funny movie would be on tv & i would just be staring at tv with everyone eles laughing like crazy. Like i was just a zombie numb.
    I had to come off due to job loss. I tried taking what i had left every other day & then a couple times a week to make them last as long as i could. My last pill was taken 11-11-16.I have experienced some brain zaps, insomnia, body jerks, as discontinuation of drug? Ifigured this is not too bad thinking they would go away.
    I then noticed my sex drive came back, i lost my appetite but also lost 26 pounds that i had gained on lexapro so that made me feel really good about myself.
    At week 13 i started feeling jittery but the brain zaps and other symptoms diminished. Somewhat.
    I went to health food store was recommended GABA 300 mg & 5-HTP 100mg. Started taking it and felt good until week 3 and i had the worst panic attack. And body chills, & tremors. Could not stop. Uncontrollable shaking.Anxiety, headaches,insomnia, severe tiredness aound noontime,confusion, trouble carrying on conversation without forgetting what i was saying,burning sensation under skin, tingling of fingertips & toes,blurred vision,dose off only to be jerked awake & body tremors, cant fall & stay asleep, chills, loss of appetite.Was unsure if it was due to no lexapro or starting off herbs.Stopped herbs for 5 days now.
    Its week 17 of NO meds or herbs and the withdrawls are horrible. Insomnia, severe anxiety, body chills, & burning sensation under skin like a internal sunburn throughout the body. Try to doze off asleep only to jerk awake just as your body is about to drift. Its really scary stuff.
    Got squared away with job & insurance and have a dr appt on the 29th of march which cant get here fast enough. After reading some of these horror stories, i dont know if these withdrawl symptoms will ever go away.
    Recently feel like ihave like a lump in my throat and a metal taste in my mouth.
    Has anyone ever sucessfully came off lexapro without long lasting withdrawls? Could there be dangerous affects of coming off meds too quickly?
    Any positive sucess out there with fast taper/cold turkey coming off? As i feel was my situation.

    • Caroms Says:

      Hi Deanna,

      I was on Lex for almost 8 years, and had similar discontinuation symptoms. Although I was only at 5mg for the last year. I also tried 5htp and other neurotransmitter support for the next few months. Body felt OK by four months off, but my mind began deteriorating with anxiety and panic. Now need to go back on. It’s really hard.

      I would suggest going to to 5 or 2.5mg for a long while before completely trying to stop. Unfortunately, slow is the only way to do this.

  50. Corinne Maselko Says:

    I have taken myself of Citalopram after 12 years. It was prescribed for Chronic Fatigue Syndrome. I have been off it for 4 moths fully.I feel like I’m extremely deppressed, irritability and anger are big issues. I went to my primary doctor and he recommended Wellbutrin which made me dizzy. I stopped. Then he prescribed Effexor.One of the side effects is weight gain.I had lost 12 lbs stopping Citalopram! I did not start Effexor. I still feel that something is not right with my head,but refuse to start another one of these medicines.

  51. Pzen Says:

    Hi everybody,

    I am a person that has suffered from protractee withdrawal syndrome for about 3 years now. The journey has been long and really painful. I have tried lots of remedies (about 15 different things including probiotics, antifungals, low dose lithium and all assortments of vitamins), but nothing has worked. So as a last experiment, I decided to try CBD oil and decided to write down my journey in diary form. You can find it at Surviving Antidepressants ( which is a very nice community full of supporting people with the same problems as us.

    I have been having really interesting results with CBD, so follow my journey and dont hesitate to ask questions if you have any.

  52. Carolyn pate Says:

    This article was very helpful except I’m not weaning myself off I just went without celexa for 4 days do to my Dr not call in my refill in till Tuesday after me running out Friday and call in him that morning I started to g we t bad headaches and major fatigue and I didn’t even know that this drug created withdrawal symptoms I never experienced the so called shock to ur brain like being plugged into an electrical socket nor do I want to but now that I got my script I started off with 2 40 mg. Pills instead of one but the withdrawal symptoms are still there . my question was when will this go away cuz I never get headaches but even tho I took 2 pills 12 hours ago the headache has not subsided how long will it take to get back to normal ?

  53. Kat Says:

    Is there a chance a reinstatement could work at 3. 5 years off the ssri? I cold turkey,d and I have been in hell ever since. Iv been waiting to heal and it’s just not happening. Any advice would be gratfully received

  54. lecat Says:

    i m kindled since i reinstated fluoxetine in 2012 i was onit since 2001 .i stopped it gradually by sking days all was ok ,i did not felt any withdrawals but 8 months later i experienced worses symptomes i thougfht that was a relapse and i reinstated then i went through hell years till i knew on differents internet sites that i was kindled due to several on and off ,i did many up and down on dosage though,but i have never felt ok.switched to lexapro in april 2016 and made things more worse i did aquick taper once again & went through hellish protracted withdrawals known as kindled brain damage now itry to copme off slowly by reducing only 5% of my dailly dose every 3-4 weeks i hope that it will work for me this time.i m now at my 20 th years on ssri. GOD HELP ME.

  55. Barbara Kerr Says:

    I was on Celexa for 16 years. It pooped out and I was given Escitalopram 15 mg. I took it x 2 years. I started to have severe tooth pain and read that others had experienced that as well.
    At that point I spoke to my MD in regards to tapering off meds but as good as he is he had the standard taper regime as others have said.
    After 3 months I was at 0mg and after being drug free for 4 weeks I am experiencing severe anxiety,headaches and ringing in my ears. I’m a nurse and keep telling myself that this will pass but I’m having difficulty hanging in there.
    I’m wondering if I should reinstate……

  56. Caroms Says:

    Hi all,

    I discontinued Lexipro four months ago, and thought I was doing well, but ended up with severe anxiety and panic attacks.

    Psychiatrist put me on 10mg Paxil 8 days ago. I do not like it and am having extreme insomnia, and think I would prefer going back to Lexipro.

    Since I’ve only been on Paxil for 8 days, how should I transition to Lexipro? Do I need to taper to 5mg first?

    Thanks of much for any words of wisdom!


  57. Tom Says:

    you still active on this thread ?

  58. Amanda Says:

    Thank you for this article. I am really suffering. I went off 20mg of Lexapro after 2 years. My psychiatrist didn’t know what he was doing, and I tapered way too quickly. My withdrawal symptoms were severe and debilitating, but I still had to go to work and take care of my kid. It was torture. My symptoms were all physical: zapping headache, nausea, congestion, sore throat, dizziness, tight jaw, plugged ears and metallic taste in my mouth. I was suffering so much that I went back on Lexapro, at first 5mg, which did nothing. Now I’m back on 20mg, and although my symptoms are less severe, they are still bad… headache and ear/nose/throat issues. It’s been 3 months all tolled and I’m freaking out, I can’t live like this anymore!! I want to get this stuff out of my system. My question is, do I need to wait until all my symptoms are gone before I start the slow taper down? Or should I start now? I’m looking for a new psychiatrist. Thanks for any advice.

    • Mandy Says:

      Any update on you Amanda?

      • Amanda Says:

        Thanks for asking! I am still on the 20 mg of Lexapro. The symptoms are mostly gone, although maybe once a week or so I’ll have a bad day with the ear/nose/throat/metallic taste symptoms. On those days I get very depressed and start thinking that permanent damage was done. I got a new psychiatrist, I love her. We started to do the slow taper… 17.5mg a day.. and I started to feel horrible and couldn’t tolerate it, so I went back to 20mg. I told her that I want to enjoy the summer and try again in the Fall. I’m so terrified to start the taper but I know I must get this stuff out of my body! Thanks for listening

  59. KatherineC Says:

    Hello, I have been reducing Citalopram for the past 4 months from 30mg and as of last week I am down to 0mg. A few days later I think I have withdrawal effects… I am over-sensitive, emotional, panicky, agitated, exhausted, tearful, achy, see the negative in everything, have weird vivid dreams, just want to stay in bed, can’t concentrate, slight dizziness… Reading this blog and all of these comments is really helpful to see that I’m not alone in what I’m going through and that maybe the final reduction from 10mg to 0mg (all done in consultation with my GP) may have been too big a step. I am going to see how i go over the next couple of weeks and keep a diary of my symptoms / thoughts / feelings, and then at my next scheduled GP appointment in early August will talk it over with my doctor. It’s so reassuring to know I’m not alone. Thank you guys.

  60. Jamie Says:

    I started sertraline in June and by September 11 I was on 100 mg with zero benefits of the medication. I’ve been weaned down to 50 at the same time starting Luvox I started having a lot of palpitations tachycardia and 100 mg of Luvox which my doctor insisted was not Luvox related however I believed it was because it didn’t start until I reached 100 mg on Luvox. And then took it upon myself to wean off of Luvox am 100 and milligrams down to 75 a few days to 50 a few days then to 25 a few days and then I stopped and I was actually feeling OK until about the third day I started having brains apps and other weird feelings in my head I started 25 mg again for three days to no avail so I just stopped altogether. I have now been off of everything for a good two weeks in my brain hurts it feels like it’s been in lightheaded holding my breath sensation along with my ears buzzing all the time and my whole body in general feels like it’s 99 years old my doctor insist this is not any with drawls and drum because I was not on it long enough to develop all the symptoms for this long of time and the medicine should be out of my system by now. So what the hell is going on I’m so irritated with all the stuff I feel worse now than I did for the reason going on which was anxiety and OCD

  61. Caroline Kerr Says:

    I was on 100mg for 10 years and did well for anxiety and then decided to taper off over 2 years and did okay on tapers until the last bit from 25mg – I stayed on that for a year and was fine but then when going to zero in Nov 18 I started to get withdrawal panic attacks nightmares etc. A psychiatrist put me back on after 3 weeks of being off completely at 25mg and then titrated me up weekly until I got to 150mg over last 8 weeks. I have not stabilised in fact I am worse – I have to have lorazepam daily just to survive. I tried going down to 125mg 10 days ago nothing has improved.
    Electric feeling throughout my chest
    Noctrunal Panic attacks every night with electricity feeling running down my arms chest back
    Heightened anxiety 24/7
    Burning skin paraesthesia across my stomach area (past 3 weeks)
    V depressed mood
    I need to know what I should do now as i jnow this did not happen when i first went on it 10 years ago. surely i would be seeing a lessening of side effects and some benefits by now?? could it be that ny body wont tolerate it this time?? and I don’t know what sort of taper I could do to maybe even just get to a lesser dose as the usual 10% would be too slow when this is such hell?
    anyone have any similar experience or advice??

    • Valerie Says:

      It does get better! Drinking tea helped me and staying active outdoors! But it was not an easy process! Took me 3 attempts till I finally got it right.

  62. churts Says:

    Hi James are u still responding to this write up.ive got myself in a bad way lookin for advice from someone who knows withdrawal as my psych does not.After destabilizing 8yrs ago after they gave me antipsychotics which made me Have SI and other horrible fears.After that I weaned off antipsychotics as well as trazodone and added lamictal.After 8months I began to be able to function.I got to 50lamictsl 7.5 remeron and 75 Effexor.after 6 years at that level I had a few panic attacks I figured to lower Effexor some more as I was twitching a lot which I now think was caused by the lamictal.Anyway I titrating E down to 30mgs over a year and became mentally unstable again.I updosed the lamictal to help and got severe SIs and everything else u can imagine.My doc and my wife want me updose the Effexor very low dose and build it to get some quality of life.What are ur thoughts?

  63. pinciukas123 Says:

    Very interesting article. I have tappered 10% per month over 1.5 year from 20 mg Seroxat until 5.5 mg than crashed after 2 months on 5.5. mg week ago I just reinstate to 7 mg all WD symptoms almost disappeared. This was my 3rd tappering attempt and I failed again. I would like to stay for now on Seroxat until summer should I stay on this dose or maybe increase to 10mg? Nobody know doc told me I always come back to 20 mg two times before so I can possibly just go back on 10 or 20 mg

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