I was prescribed Seroxat in 1996 for anxiety. When it was discontinued in May 2025, supplies ran out in pharmacies in December 2025. Dr advised to change to Paroxatine, I couldn't taper as next prescription was for Paroxatine. 3 days in i had to stop the Paroxatine due to adverse reaction and for the past 6 weeks I have lived in what I can only describe as a state of hell... vivid nightmares, constant daily diarrhoea, tingling around my face, nausea, sometimes actual vomiting, crying, and chronically depressed (never suffered depression in my life until early this year) I'm bearly functioning and only just about holding in there. Any advice please. 

Welcome to the forum!

 

This is a volunteer-run, community forum aimed at helping those who are tapering and/or experiencing difficulties with psychiatric medications and withdrawl syndrome. We are not medical professionals and cannot offer medical advice. We simply offer support and opinions which you could use as talking points with a medical provider knowledgeable in withdrawing off psychiatric medications.

 

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Please make sure your signature is kept up to date with your drug history. This will allow members to see some basic information about your drug history and situation so that they may help you best. Information on how to do this is located in the FAQs section above, but here is a direct link: Update Signature

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I'm so sorry to read about the tough time you've had recently you will find plenty of support here for sure.

 

In the mean time this is what I would do if I were you:

 

-Stay Hydrated 

 

-Eat a good clean whole food diet, avoiding processed foods and sugars.

 

-Stay away from caffeine, alcohol and antihistamines and any other psychoactive substances.

 

Supplements are to be avoided initially, as they often irritate our nervous systems. Try to get your nutrition through food.

 

Down the line, you may wish to introduce Fish Oil and Magnesium. Those who can tolerate them have found them calming to the nervous system. Be careful try one at a time and start low and see how you get on should you choose to try them.

 

A daily walk is very important as much as you can manage, if you can manage it. Gets you your fresh air and Vitamin D does wonders for your mind!

 

You have effectively cold turkeyed seroxat, it was totally irresponsible prescribing for your prescriber to wait until seroxat was unavailable without tapering you off of it and then just try you out on another drug and hope that this worked.

 

Sadly, we see a lot of irresponsible prescribing here.

 

It is very early days in terms of how long it has been since you came off the drug, if you are just about able to function (even though it is very difficult), it is likely that you will improve in time and it will gradually get easier. This is often not linear and often "getting better" looks like going up and down and noticing over a long period of time that the average is improving.

 

There really are only two options if seroxat is unavailable:

1. Wait and hope that you begin to improve naturally over time
2. Try a very low dose (smaller than what is normally clinically prescribed) of the most similar, available drug and see if it helps

 

I'd be wary of option 2, given that you reacted adversely to paroxetine, personally. I'd be interested to hear what other experienced members think.

 

 

Hi Nickie Evans

 

Welcome to the forum.

 

On 2/13/2026 at 1:22 AM, Nickie Evans said:

I was prescribed Seroxat in 1996 for anxiety. When it was discontinued in May 2025, supplies ran out in pharmacies in December 2025. Dr advised to change to Paroxatine, I couldn't taper as next prescription was for Paroxatine

Seroxat is a brand name for paroxetine. 

 

Even though you were given the same drug it is not uncommon to experience issues switching brands.

 

Luke is right this is a tricky one.

 

Reinstatement is best done immediately. You are not long off the drug so you certainly could try it (inside the 3 months window).

The issue is obviously you cant get Seroxat any more and what ever version of paroxetine they gave you seemed to have a nasty reaction to.

 

You were on Seroxat a long time and have gained a great deal of dependance on the drug. The CT has had a big big shock to your system.

 

As Luke said you could try a small reinstatement and see if this helps. A small bit of the drug is a good way to test the waters and ADRs are dose sensitive so you would be a lot less likley to have problems then at a full dose.

 

About Reinstating and Stabilizing to Reduce Withdrawal Symptoms

 

How long does it take to stabilize after reinstating or updosing?

 

Hypersensitivity and kindling

 

If you did decide to go this route I would try a very small dose much smaller than your original one like 0.5mg If you don't react badly to it hold there for a week or two before doing anything else.

 

How to calculate dosages and dilutions. Spreadsheets and calculators.

 

This is totally your choice we are with you what ever you decide to do.

 

Chippy

@getofflex @LostinCanada could I get your thoughts?

Thank you for your reply. As you said I cannot reinstate Seroxat as no longer available. Dr has now suggested I start esitalopram, he said will help with the withdrawal and also easier to taper off, which can be done very slowly over time. The thing is I'm so terrified that I will get bad side effects from esitalopram, as many people do when starting a new drug, and I just can't cope with feeling any worse than i do currently. Do you think that starting the esitalopram will be a positive step please?

1 hour ago, Nickie Evans said:

Thank you for your reply. As you said I cannot reinstate Seroxat as no longer available. Dr has now suggested I start esitalopram, he said will help with the withdrawal and also easier to taper off, which can be done very slowly over time. The thing is I'm so terrified that I will get bad side effects from esitalopram, as many people do when starting a new drug, and I just can't cope with feeling any worse than i do currently. Do you think that starting the esitalopram will be a positive step please?

Hey @Nickie Evans Im afraid we cant recommend starting new drugs.

 

It's very typical for doctors to try to treat WD symptoms with more drugs. But this doesnt work and only adds fuel to the fire and will likely make you a lot worse.

 

Seroxat is Paroxetine. They just shifted you to a generic version of Paroxetine as the branded one (Seroxat) is being discontinued. 

 

Its common for folk to struggle with a sudden brand swap.

 

My thoughts with reinstatement was to try a tiny dose of the generic paroxetine they have given you. 
 

It’s totally up to you. RI doesn’t come without its risks but when it works it works well. You need to weigh up how bad you feel. 
 

Im sorry you’re going through all this. 

53 minutes ago, Chippy said:

Seroxat is Paroxetine. They just shifted you to a generic version of Paroxetine as the branded one (Seroxat) is being discontinued. 

 

@Nickie Evans apologies for the confusion in my above post. @Chippy is right here.

 

1 hour ago, Nickie Evans said:

Do you think that starting the esitalopram will be a positive step please?

 

It's totally unpredictable. Given that you reacted quite severely to the same drug but made by a different manufacturer, I doubt it to be honest.

 

If your situation is completely untenable, then you may want to try something, reinstatement of paroextine at a low dose and trying to deal with anything that comes up, as chippy suggests. A new drug might help, but is very risky and absolutely could make you worse as well as helping.

 

Another option is to simply do nothing , other than take care of yourself and hope to improve over time. That you can function after a cold turkey after 30 odd years of taking the drug is pretty significant really. Most people do improve in time, but how much time can be very difficult to say. It can be relatively short term (a couple of months), or much longer term.

Thank you @Luke and @Chippy for your advice.

2 minutes ago, Nickie Evans said:

Thank you @Luke and @Chippy for your advice.

It’s a pleasure. I’m so sorry for what you are going through atm. 
 

We are all here for you. 
 

Chippy

15 hours ago, Nickie Evans said:

prescribed Seroxat

This is made by GSK.

GSK has ceased production and is phasing out supplies.

https://assets.publishing.service.gov.uk/media/67bde6b1729cf14d438d76c8/Seroxat_DHPC.pdf

 

Seroxat is still available at some pharmacies. Are you able to phone around to find some? I know there is still some in Ireland, can your pharmacy help if you explain your situation? 

If you could find a small supply, you would be able to slowly crossover to a generic brand.

15 hours ago, Nickie Evans said:

3 days in i had to stop the Paroxatine due to adverse reaction

What generic company was the paroxetine from? What dose were you on? 

What did the adverse reaction look like? Did this happen within an hour of taking it?

15 hours ago, Nickie Evans said:

vivid nightmares, constant daily diarrhoea, tingling around my face, nausea, sometimes actual vomiting, crying, and chronically depressed (never suffered depression in my life until early this year) I'm bearly functioning and only just about holding in there

These are typical withdrawal symptoms. Unfortunately starting a different drug will not fill the need your body has for paroxetine. 

We need to know the dose you were on and make a suggestion for a reinstatement dose. Also if you cannot find any seroxat, it may help trying a different generic manufacturer of paroxetine .

I will wait for your comments. 

🙏❤️

Edited February 13Feb 13 by LostinCanada

Hi Nickie Evans, welcome to AR! We are here to support you and each other on this Rx journey. I am so sorry you are having the difficulties with the switch to generic. You still are in a good window to reinstate vs go the CT route. I echo the others and would see if you can get some of the left over brand name Seroxat as paroxetine (we call it Paxil in the States). I am not sure if you could compound the 2 in slightly increasing ratios of the generic manufactured with the brand name manufactured--just a thought.

 

Please do let us know about the symptoms (Sx) like LIC asked. It will give us more information that perhaps we can help you with. I will pray for you and the rest on the site this night (it is 10pm here...about to log off soon). Be well, my friends.

@LostinCanada @getofflex @Chippy @Luke dosage was 20mg of Seroxat for almost 30yrs. The generic was Paroxatine at 20mg manufactured by Crescent. Possibly a major breakthrough today, would really like your input please. Went to all local pharmacies in December, told all 3 unable to get Seroxat anymore. Today I've gone in person again and asked to speak to pharmacist, they are in fact able to obtain 10mg Seroxat tablets and suggested i request to Dr he makes a 'batch' prescription for approximately 9mths worth of Seroxat, therefore it will be at the pharmacy for me to collect as usual (2 boxes every 2 months) once back on and taking 10mg and hopefully adjust back to a better state I can then start a taper plan with the Dr. Would value your opinions on this please.

46 minutes ago, Nickie Evans said:

obtain 10mg Seroxat tablets

This is great news.

 

Unfortunately a careful taper takes years especially coming off a cold turkey and so many years on the drug. It could take 6 months or more to stabilize on a reinstatement dose. 

 

It has been 2 months since you stopped paxil...your body has made adjustments to accommodate for no drug. I would recommend reinstating at much less than 10 mg. It would be more appropriate to start with 1 mg.

It is always easier to increase slowly than to decrease after starting to high which can possibly cause kindling. I reinstated at 5 mg which was too high and it made it harder to stabilize.

 

You can either buy a scale or make your own liquid. Instructions are in this link. 

https://antidepressantrecovery.org/topic/240-preparing-doses-for-tapering-weighing-diy-liquids/?do=getNewComment

 

It is recommended, once you are stable, to reduce no more than 10% of your current dose every 28 days. 

See this link please:

https://antidepressantrecovery.org/topic/178-tapering-information/?do=getNewComment

 

Since Seroxat is a limited supply, once you stabilize, you will need to crossover to a generic brand. How to do so is included in this link.

https://antidepressantrecovery.org/topic/181-paroxetine-what-you-should-know/

 

 

We are here to help and answer any questions. ❤️🙏

 

 

Edited February 16Feb 16 by LostinCanada

2 hours ago, Nickie Evans said:

@LostinCanada @getofflex @Chippy @Luke dosage was 20mg of Seroxat for almost 30yrs. The generic was Paroxatine at 20mg manufactured by Crescent. Possibly a major breakthrough today, would really like your input please. Went to all local pharmacies in December, told all 3 unable to get Seroxat anymore. Today I've gone in person again and asked to speak to pharmacist, they are in fact able to obtain 10mg Seroxat tablets and suggested i request to Dr he makes a 'batch' prescription for approximately 9mths worth of Seroxat, therefore it will be at the pharmacy for me to collect as usual (2 boxes every 2 months) once back on and taking 10mg and hopefully adjust back to a better state I can then start a taper plan with the Dr. Would value your opinions on this please.

Hi Nickie its Tom here from Facebook, I am delighted to read that you have found some Seroxat. I actually had my Pharmacist order me 12 months worth of seroxat today before I can't get anymore. I am so happy for you.

17 hours ago, Nickie Evans said:

@LostinCanada @getofflex @Chippy @Luke dosage was 20mg of Seroxat for almost 30yrs. The generic was Paroxatine at 20mg manufactured by Crescent. Possibly a major breakthrough today, would really like your input please. Went to all local pharmacies in December, told all 3 unable to get Seroxat anymore. Today I've gone in person again and asked to speak to pharmacist, they are in fact able to obtain 10mg Seroxat tablets and suggested i request to Dr he makes a 'batch' prescription for approximately 9mths worth of Seroxat, therefore it will be at the pharmacy for me to collect as usual (2 boxes every 2 months) once back on and taking 10mg and hopefully adjust back to a better state I can then start a taper plan with the Dr. Would value your opinions on this please.

This is great news @Nickie Evans

 

@LostinCanada has said everything you need to know. A low dose is best. Just enough to, one probe to see how you react and two it’s likely your nervous will find a small amount enough as a crutch. You can always increase a little in a week or two if needs be.
 

We are here for you as you need. 

On 2/16/2026 at 10:25 PM, LostinCanada said:

This is great news.

 

Unfortunately a careful taper takes years especially coming off a cold turkey and so many years on the drug. It could take 6 months or more to stabilize on a reinstatement dose. 

 

It has been 2 months since you stopped paxil...your body has made adjustments to accommodate for no drug. I would recommend reinstating at much less than 10 mg. It would be more appropriate to start with 1 mg.

It is always easier to increase slowly than to decrease after starting to high which can possibly cause kindling. I reinstated at 5 mg which was too high and it made it harder to stabilize.

 

You can either buy a scale or make your own liquid. Instructions are in this link. 

https://antidepressantrecovery.org/topic/240-preparing-doses-for-tapering-weighing-diy-liquids/?do=getNewComment

 

It is recommended, once you are stable, to reduce no more than 10% of your current dose every 28 days. 

See this link please:

https://antidepressantrecovery.org/topic/178-tapering-information/?do=getNewComment

 

Since Seroxat is a limited supply, once you stabilize, you will need to crossover to a generic brand. How to do so is included in this link.

https://antidepressantrecovery.org/topic/181-paroxetine-what-you-should-know/

 

 

We are here to help and answer any questions. ❤️🙏

 

 

 

I agree with this. You could obtain the batch prescription for Seroxat, and then use it to reinstate at a low dose and hope to stabilise on this.

 

Alternatively, you could hope to continue to improve naturally off of medications, but this can potentially take a very long time- only you can judge whether this is tolerable and you can function through it or not.

 

 

On 2/13/2026 at 4:07 AM, Chippy said:

@getofflex @LostinCanada could I get your thoughts?

 

 

On 2/16/2026 at 4:25 PM, LostinCanada said:

It has been 2 months since you stopped paxil...your body has made adjustments to accommodate for no drug. I would recommend reinstating at much less than 10 mg. It would be more appropriate to start with 1 mg.

It is always easier to increase slowly than to decrease after starting to high which can possibly cause kindling.

I would agree with the advice above.  And, I would not suggest restating to Lexapro, or escitalopram.  It is 2x to 4x stronger than other SSRI drugs.  Reinstating to the same drug, or a cousin, is usually the best choice. Doctors are famous for wanting to jump around on various drugs, and it almost always makes things worse.  

@Chippy @Luke @LostinCanada there's been a huge change 😞 due to the supply of Seroxat being limited Dr is adamant that I now start on Esitalopram, has started me on 1mg liquid drops and then moving up slowly. Please tell me this will help. Its 8 weeks tomorrow that this all started and i feel no better at all, still chronic diarrhoea, nausea, sometimes actually sick, depression is so high and morning waves of high cortisol are horrendous.

On 2/28/2026 at 3:02 PM, Nickie Evans said:

@Chippy @Luke @LostinCanada there's been a huge change 😞 due to the supply of Seroxat being limited Dr is adamant that I now start on Esitalopram, has started me on 1mg liquid drops and then moving up slowly. Please tell me this will help. It’s 8 weeks tomorrow that this all started and i feel no better at all, still chronic diarrhoea, nausea, sometimes actually sick, depression is so high and morning waves of high cortisol are horrendous.

Have you already started the escilatopram?

 

It’s very strong. 
 

I think if it were me I would try a small dose of the generic. It’s better to reinstate the original drug. 
 

SA suggest a substitute alternative to Paroxetine for reinstate as Fluoxetine and Citalopram. Citalopram is a sister of Escilatopram.

 

‘fluoxetine has a long half-life, which may make tapering easier (but correspondingly, any adverse drug effects may also last longer), while citalopram's half-life is only a little longer than the other SSRIs.’

 

https://www.survivingantidepressants.org/forums/topic/7562-reinstatement-about-reinstating-and-stabilizing-to-reduce-withdrawal-symptoms/

 

Im sorry you are having such a hard time. 

37 minutes ago, Nickie Evans said:

Please tell me this will help

Did you get the seroxat that you found? Did you reinstate 1 mg? This is your best option. You found a good supply and can use that to crossover. You have to have a plan and be convinced and go to your doctor being firm.

If you go with the escitalopram, it will take longer to stabilize. Tell your doctor to read The Maudsley Deprescribing Guide by Dr Mark Horowitz.

❤️🙏

No unfortunately the batch prescription of Seroxat was all out of date at the end of April this year, so the pharmacy would only let me have 2 mths supply, so not enough to be able to do a taper.

Did you try a reinstatement of 1 mg? 

This is enough if a supply to do a crossover to a generic brand. This is the best option.

Please read this link...it explains how to do a 1 mg dose as well as how to crossover to another brand.

❤️🙏

By the way...the drug stays potent for years after the expiry.... your supply is safe for the crossover.

Edited February 28Feb 28 by LostinCanada

I said to the pharmacist that surely a few months out of date and they'll be fine still, but they said by law, they're not allowed to give out of date medication out. It was when I crossed over to a generic brand of Seroxat that all this started. I've had 2 days of 1mg of esitalopram now

42 minutes ago, Chippy said:

Have you already started the escilatopram?

 

It’s very strong. 
 

I think if it were me I would try a small dose of the generic. It’s better to reinstate the original drug. 
 

SA suggest a substitute alternative to Paroxetine for reinstate as Fluoxetine and citalopram. Citalopram is a cousin of escilatopram.

 

‘fluoxetine has a long half-life, which may make tapering easier (but correspondingly, any adverse drug effects may also last longer), while citalopram's half-life is only a little longer than the other SSRIs.’

 

https://www.survivingantidepressants.org/forums/topic/7562-reinstatement-about-reinstating-and-stabilizing-to-reduce-withdrawal-symptoms/

 

Im sorry you are having such a hard time. 

Yes I said to the Dr that surely esitalopram isn't the best option as that hasn't got a long life either, but due to limited supply of Seroxat and the generic form starting this all off he said stick to slowly starting Esitalopram. He wanted me to start on 5mg, but having read all the advice you give here, I insisted, if that's the only option he's going to give, that I start on 1mg, which is what I've done the past 2 days.

14 minutes ago, Nickie Evans said:

let me have 2 mths supply

But you have the 2 month supply which will be long lasting if you are reinstating 1 mg. 

If it is a 20 mg pill, you have 20 days supply for each pill. 

https://antidepressantrecovery.org/topic/240-preparing-doses-for-tapering-weighing-diy-liquids/?do=getNewComment