Paroxetine: Adverse Reactions, Weight Gain, and Recommendations for Gradual Withdrawal in SSRIs for Anxiety Management

Paroxetine, a selective serotonin reuptake inhibitor (SSRI), is widely used in the treatment of depressive and anxiety disorders. However, its prolonged use may be associated with a range of adverse reactions that physicians must consider when prescribing this medication. Additionally, gradual withdrawal from paroxetine is crucial to minimize withdrawal symptoms, which can be significant and affect the patient's quality of life.

Adverse Reactions of Paroxetine

Among the most common adverse reactions of paroxetine are sedation and weight gain. These effects can be problematic for some patients, impacting their adherence to treatment. Furthermore, paroxetine is associated with an increased risk of withdrawal symptoms, which include dizziness, nausea, flu-like symptoms, as well as anxiety and sleep disturbances. These symptoms typically appear within 24 to 48 hours after discontinuation of the medication and can last for several weeks [1].

The incidence of these symptoms is higher with paroxetine compared to other SSRIs due to its shorter half-life [2]. Additionally, it has been observed that patients who experience adverse reactions at the onset of treatment are at a greater risk of developing withdrawal syndrome [3].

Recommendations for Gradual Withdrawal

To minimize the adverse effects of discontinuation, a gradual withdrawal from paroxetine is recommended. This involves slowly reducing the dose over a period of several weeks, allowing the brain to adapt to changes in serotonin levels [4]. A common approach is to reduce the dose by 10% each week, although the pace can be adjusted based on the patient's tolerance and the emergence of withdrawal symptoms.

It is important to educate patients about the possibility of experiencing withdrawal symptoms and reassure them that these are temporary. In some cases, it may be necessary to reintroduce paroxetine at a lower dose and then continue with a slower reduction [5].

Conclusions

Paroxetine is an effective SSRI for the treatment of depressive and anxiety disorders, but its use may be associated with significant adverse reactions and notable withdrawal syndrome. Gradual withdrawal is essential to minimize these effects and improve the patient's experience during the discontinuation process. Physicians should be attentive to these aspects and provide clear guidance and support to their patients during treatment with paroxetine.

Referencias

• [1] Paroxetine withdrawal syndrome.
• [2] Estimating Risk of Antidepressant Withdrawal from a Review of Published Data.
• [3] Discontinuation syndrome associated with paroxetine in depressed patients: a retrospective analysis of factors involved in the occurrence of the syndrome.
• [4] Antidepressant Withdrawal and Rebound Phenomena.
• [5] Effects of the serotonin 1A, 2A, 2C, 3A, and 3B and serotonin transporter gene polymorphisms on the occurrence of paroxetine discontinuation syndrome.

Created 6/1/2025