Hi everyone,

I would really appreciate your thoughts on whether a late Paroxetine reinstatement makes sense in my situation and whether anyone has seen success in a similar case.

Here is my history:

• Took Paroxetine 30 mg for about 2 years.

• After reducing to 20 mg, I developed what I believe was PAWS/PWS after about 3 months.

• I increased back to 30 mg and improved for about 3 months, but then the symptoms gradually returned despite being back on the full dose (possible tolerance/tachyphylaxis).

• My doctor increased me to 40 mg, then I was rapidly tapered to 0 mg over only 7 days. My last dose was 25 December 2025.

• Since then I have been suffering from severe withdrawal symptoms.

After stopping Paroxetine, I tried two medications in an attempt to become functional again:

• Venlafaxine, up to 150 mg – it made me significantly worse, so I discontinued it.

• Escitalopram (10 → 5 → 2.5 mg) – it also failed and I stopped it on 16 June 2026.

I am currently taking Pregabalin 300 mg/day.

Initially, Pregabalin helped a lot with the anxiety, overstimulation and constant “fight or flight” feeling. Unfortunately, over the last several weeks it seems to have lost much of its effectiveness and I am now back to severe anxiety, panic waves, depression and extreme CNS sensitivity.

One psychiatrist has suggested trying a late Paroxetine reinstatement. Two possible approaches were discussed:

1. Start at 10 mg, then increase very slowly.

2. Start at 0.2 mg and increase in tiny increments (about 0.2 mg at a time).

My questions are:

• Has anyone here successfully reinstated Paroxetine after being off for around 7 months?

• Is there still a realistic chance that reinstatement could improve PAWS/PWS at this stage?

• Does my previous apparent tolerance (“poop-out”) make success less likely?

• Given my history, would you personally consider a very tiny test dose more reasonable than starting at 10 mg?

I understand nobody can give medical advice. I’m mainly looking for experiences from people who have been through something similar, especially with Paroxetine/Paxil and late reinstatement.

Thank you for reading.

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

14 hours ago, tanos75 said:

I would really appreciate your thoughts on whether a late Paroxetine reinstatement makes sense in my situation and whether anyone has seen success in a similar case.

Here is my history:

• Took Paroxetine 30 mg for about 2 years.

• After reducing to 20 mg, I developed what I believe was PAWS/PWS after about 3 months.

• I increased back to 30 mg and improved for about 3 months, but then the symptoms gradually returned despite being back on the full dose (possible tolerance/tachyphylaxis).

• My doctor increased me to 40 mg, then I was rapidly tapered to 0 mg over only 7 days. My last dose was 25 December 2025.

• Since then I have been suffering from severe withdrawal symptoms.

I think it possible you hit tolerance or gained an irritation to the drug due to moving the dose around suddenly. The subsequent increase to 40mg followed by a rapid taper would have been very hard on your nervous system which was already senstive. Each time we make a move like this is causes more and more problems. Hypersensitivity and kindling

14 hours ago, tanos75 said:

After stopping Paroxetine, I tried two medications in an attempt to become functional again:

• Venlafaxine, up to 150 mg – it made me significantly worse, so I discontinued it.

• Escitalopram (10 → 5 → 2.5 mg) – it also failed and I stopped it on 16 June 2026.

It is common for the doctors to try to treat the symptoms of WD with more drugs, this almost always makes things worse unfortunately causing more Kindling.

14 hours ago, tanos75 said:

I am currently taking Pregabalin 300 mg/day.

Initially, Pregabalin helped a lot with the anxiety, overstimulation and constant “fight or flight” feeling. Unfortunately, over the last several weeks it seems to have lost much of its effectiveness and I am now back to severe anxiety, panic waves, depression and extreme CNS sensitivity.

I know @RachelSusan was in a similar boat and started Gabapentin to treat WD symptoms. I think she stablised on that and Zoloft before tapering sucessfully off the Zoloft, she has now just started tapering from Gabapentin. So different drugs but an example of someone taking both a Gabapentinoid and an SSri at the same time.

14 hours ago, tanos75 said:

My questions are:

• Has anyone here successfully reinstated Paroxetine after being off for around 7 months?

• Is there still a realistic chance that reinstatement could improve PAWS/PWS at this stage?

• Does my previous apparent tolerance (“poop-out”) make success less likely?

• Given my history, would you personally consider a very tiny test dose more reasonable than starting at 10 mg?

No one can know for sure what would be the best move for you. You are certainly suffering from an injury caused by all the different events your nervous system has had to endure, this will take time to heal, more drugs won't solve this.

However some of what you are suffering with is likley WD from Paroxetine, so adding in some of this drug may answer the brains dependance on it and cushion the WD for you.

I think there certainly is a chance a RI would help, but it may also worsen you. Ultimately you have to decide if this is something you would like to try.

My thoughts would be if you wanted to RI I would only try a very low dose. Here is our guide the RI. Reinstating an Antidepressant

 

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 are very welcome here and I hope you find the site supportive.