Adverse events after the abrupt discontinuation of paroxetine

Paroxetine is an antidepressant of the selective serotonin reuptake inhibitor (SSRI) class. In contrast to other SSRIs, it has a relatively short half-life and lacks active metabolites. In three patients the abrupt discontinuation of paroxetine seemed associated with sudden and impairing effects. All three reported marked sleep disturbances and dizziness. They were prescribed the drug for a minimum of 10 weeks, and the maximum dosage was 40 mg/day. All patients experienced rapid remission of symptoms after paroxetine was reintroduced. We failed to observe similar reactions from the abrupt discontinuation at lower dosages. Gradual tapering of the agent for patients receiving more than 20 mg/day is recommended.