Paxil (Paroxetine) Onsite Taper

Paroxetine is reviewed before you travel rather than assumed to follow the standard onsite taper. It carries the most severe discontinuation profile of the SSRI class. You are not asked to taper alone at home (the reduction is still done onsite), but our medical team confirms your specific timing and dosing in advance. A small number of other medications (MAOIs, lithium, tricyclic antidepressants, tramadol and certain QT-prolonging cardiac medications) do still need to be cleared before you arrive, so our medical team reviews your full medication list in advance.

Typically 14-28 days onsite (longest of the SSRI class). That range is driven by paroxetine's short half-life (≈ 21 hours (no active metabolite)) and your baseline dose, usually 10-60 mg/day. Reductions are hyperbolic rather than linear, so the schedule follows how you actually respond instead of running to a fixed calendar.

The paroxetine discontinuation profile covers: Severe brain zaps (worst of the SSRI class); Profound dizziness and vertigo; Anxiety crises, panic, derealization; Anticholinergic rebound: sweating, flushing, GI urgency; Insomnia, vivid dreams, nightmares. The onsite protocol bridges the taper with sub-psychoactive iboga total alkaloid (75-150 mg BID) to cover the receptor-occupancy gap as your dose comes down, with symptom-driven support and continuous monitoring throughout.

Paroxetine has no active metabolite to soften the falloff and is highly anticholinergic. Discontinuation syndrome onset within 24-48 hours of dose drop. Hyperbolic micro-tapering is essential. Linear tapers almost always fail. Frequently misdiagnosed as anxiety relapse, leading to reinstatement.

Yes. Aggressive hyperbolic taper using compounded liquid: 50% step reductions every 5-10 days. Iboga TA bridge 75-150 mg BID: paroxetine taper requires the higher end of TA bridge dosing. Continuous cardiac telemetry; anticholinergic-rebound monitoring. Symptom-driven adjuncts: hydroxyzine, ondansetron, magnesium, electrolyte support.

A flood dose of ibogaine HCl is only administered once paroxetine has been reduced to a protocol-defined safe threshold and your cardiac screening is still within limits. Eligibility is confirmed at that point rather than promised in advance. Ibogaine is an investigational compound, is not approved by the FDA, and results vary between patients. If your medication picture or your screening makes treatment unsafe, we will tell you honestly.