Hereigoagain: Yay paxil withdrawal!

[hereigoagain]

I have been taking Paxil 20 mg as a migraine prophylactic since 2011.  I am very serotonin sensitive and it seems to play a role in my migraines and migraine-associated vertigo.  The paxil has been great at limiting these, but I have gained 50 lbs since being on it.  I am now starting to have weight-related health issues and weight-related depression so I am determined to find another method of controlling the migraines and vertigo.  I have gained about 12-15 lbs a year on the paxil.  I was on it for two years, 2011-2013, tried 3 times to get off and finally did, and then tried lexapro.  I stopped gaining weight (didn't lose it either) but the migraines came back.  I then went to try effexor but had a bad reaction (my vision blurred and snowed and it continued to worsen instead of clearing up over a couple months) and since I was trying to finish grad school I ended up back on the paxil.  (My vision did clear up after stopping the effexor).  I then gained the rest of my weight.  Last summer I moved a few states over so I have all new doctors except for my neurologist who is really not that familiar with SSRI discontinuation, but she is a good listener (when I see her) and trusts my research.  But playing phone tag through an MA is rather difficult at times in this matter.

 

So I began decreasing by about 2 mgs every week starting in mid-January and have worked down to 8 mg.  I was at a pattern of feeling rather sick (flu-like), brain zaps, dizziness, headache, panic attacks (that I refer to as adrenaline rushes - a more positive connotation), nausea starting about 3 days after the dose change and then clearing up by the end of a week.  As I only have a part-time online job, it hasn't been much of an issue.  Now that I am in the single digits, the fun has started.  I am now experiencing severe vertigo episodes every day, severe insomnia, brain zaps, pretty much the entire list of withdrawal symptoms on the www.quitpaxil.org website.  I am struggling right now with really wanting to get off as quickly as possible so i can start to get this weight off as well as while I have the lower daily responsibility versus slowing it to avoid worse symptoms and possibly messing myself up even more.

 

I am looking for supplements and other ideas to take to help control the withdrawal symptoms.  So far I am on 1300 mg of fish oil twice a day, 800 IU of Vitamin E, Ginger Root as needed for nausea, diphenhydramine for dizziness and sleep, and diazepam 2mg for when the severe vertigo hits.  I remember taking the JNK capsules from www.theroadback.org the last time I successfully came off the paxil, but it did not seem to agree with me the last time I tried it.  Perhaps it was too soon in the withdrawal?  I will be posting and searching for ideas.  

 

Best of luck to us all!

Edited August 5, 2016 by scallywag
tags added

[KarenB]

Hello Hereigoagain,

 

Thanks for your signature and the details about what's been happening for you lately.  Awesome that you are already taking fish oil and vit.E.  You might also find Magnesium useful during withdrawal.  We don't recommend anything produced by theroadback - you can read why here:  http://survivingantidepressants.org/index.php?/topic/5048-truehope-the-road-back-labelmesane/

 

We recommend a gentle taper, reducing by no more than 10% of your current dose each month.  This allows your brain time to adjust as you go, and lessens any withdrawal.  You've been going a bit faster that this, which will account for the worsening withdrawal symptoms.  Interestingly it is more important to slow the taper as you get to lower doses.  As you say things have been much worse of late, you could consider up-dosing to 10mg (was that your last fairly stable dose?).

 

Then after a few weeks or a month, when things have settled down again, you could continue to decrease by smaller amounts. 

 

Keeping things simple is your best bet:  Keep it Simple; Keep it Slow; Keep it Stable

 

There are lots of helpful ideas in this thread:  Non-Drug Techniques to cope with emotional symptoms.

 

Have a read of those and then you can come back to this thread to discuss things further.  What do you thing about up-dosing to stabilise?  It's usually better than waiting what could be a very long time for symptoms to improve. This can be your journal to record your tapering and healing progress, and to ask questions. 

 

Welcome to s/a,

Karen

[Petunia]

Welcome Hereigoagain,

Paxil is known as being a difficult drug to come off, so I'm glad you found us, we have a lot of good information and supportive members here to help.

 

Please have a look at the links Karen kindly posted for you, I was about to write similar advice, but now don't need to

 

Please be careful with your diazepam use, this is a benzodiapepine and highly addictive, especially in a nervous system already sensitized by withdrawal. Its possible to become physically dependent on it in as little as two weeks if taken regularly. I suggest not taking it more then once or twice a week. Please would you add this to your signature.

 

...and a couple more links:  Why taper? Paper demonstrates importance of gradual change in plasma concentration  

 

Tips for tapering off Paxil (paroxetine)

 

Please stay in touch and let us know how you are doing.

 

Petunia.

[SkyBlue]

Hi there, and welcome to SA. We are in the same city and both weaning off Paxil! 

 

There is such wonderful information here. 

As KarenB (hi Karen!) said, it seems that for some, it is necessary to go even more slowly toward the

lower doses. This seems so paradoxical, but it's true for me. 

 

I would recommend looking into getting liquid Paxil for the near future.

Again, welcome.

[hereigoagain]

Hi!  Thank you all for the ideas and info!  I have been trying to stick with the 8mg since the worst of the vertigo seemed to have passed, but then last night I was up most of the night with adrenaline rushes and I am still having them periodically throughout the day.  I think I will back up to 9 or 10 mg starting tonight.  My head is definitely feeling pretty messed up right now, but I also just had a couple of migraines this week and the Relpax I take for that also messes with serotonin (which was fine to take before I started lowering the paxil).   I am wanting to get off rather quickly (like everyone else!) because of the 50 lbs weight gain and the health issues that it is starting to cause, but I may need to slow it down to stay sane and functioning.   So yeah, backing up a little and regrouping my senses sounds like a good idea.

 

Thanks for the caution about the diazepam.  I was actually on it (2 mg bid) for the entire duration of the paxil/lexapro/paxil, so 5 years.  I was on it in the past too when doctors were trying to figure out my vertigo.  I can definitely notice the physical addiction to it when I am on it for prolonged periods (or just the memory of it when I take a single dose for vertigo).  I came off of it last November by tapering over 3 weeks.  For me, anyway, that withdrawal is a breeze compared to paxil.  

 

Thanks again!  I will check back in next week and let you know how it goes. 

[Hopeinahpwr]

Hereigoagain,

This should be my screen name too! I'm absolutely terrified, but itching to get back to tapering! Thank you for your story and I am praying for you!!!

[hereigoagain]

Hello!  Well I went back up to 10 mg Saturday.  I am feeling a lot better (still far from normal, but that seems like a distant dream).  The zaps, adrenaline rushes and severe vertigo have disappeared.  I am still feeling a bit unbalanced and dizzy at times, but as I am also dealing with spring allergies, it may be coincidental.  I did have a few strange sensations Sat and Sunday that I felt were remnants of the adrenaline rushes, but they have abated.  I am also still a bit anxious from the last 2 weeks - I don't trust my body/head at all.  At least this is making me want to slow down and give my body some time to recover before trying to taper to 9 mg.

[Jlynn]

I can totally understand wanting to get the weight off but I have had to come to terms with the fact that I can't live with the severe symptoms being constant. I have to be able to live. As I have gone along I have continued to slow my taper even more. Many have reported weight loss even as they taper slowly. The withdrawal is not worth rushing it. I think you are on the right track now and so happy you are getting better!

[ChessieCat]

Hi HIGA,

 

It sounds like things are settling down nicely.  It's not that long since you got off diazepam and also you attempted to drop by 20%.  It would probably be worthwhile holding for at least a couple of months to stabilise and you might also want to consider tapering by smaller drops than 10%, eg 5% with a 3 week hold.

 

Sometimes we have to think outside the box (in this case 10% with 4-6 week hold) and work out what best suits our individual situation.  This is what I have had to do because I found 10% was too much but up until recently I've managed dropping by 2/3 of 10%.  From now on I am going to have to slow down but I am feeling much better and more old myself than I was at a higher dose.

[hereigoagain]

UPDATE:

 

So I left off having tapered down to 10mg of paxil.  I tried last month to do the prozac switch and am now pretty bad.  Here's what I did:

July8-14: Paxil 10 mg, Prozac 5mg; July 15-20: Paxil 5mg, Prozac 10mg; July 21-31: 0 paxil and 15mg prozac.  I was doing pretty good until July26, about 6 days of no paxil.  I started having dizziness and adrenaline rushes and extremely shaky.  It has kept getting worse.  So I met with my Dr on Monday, 8/1 and we decided that this didn't work and i needed to get back on the paxil to end the adrenaline rushes.  He has pretty much left it up to me on how fast to go up and down on both.  I tried adding in 5mg of paxil but the panic is still very bad and the dizziness (and since I am wearing out, it is getting harder to stay calm with it).  I am thinking I may not feel relief until I am back to 10 paxil - before I couldn't even go from 10 to 8mg on the paxil without severe withdrawal - so this is just kind of delayed.  I realize these are pretty low doses, but we are all pretty sensitive.  Since the 5mg of paxil is not giving any relief, do I just up to 10mg?  Do I need to wait some time for the prozac to leave before going back to 10 on pax?  Please let me know that this will end and I will be sane again soon!  

 

Thanks,

HIGA

 

PS:  I have learned my lesson.  I will be doing the painfully slow, year plus taper from now on....  At least then I know what to do when the withdrawal symptoms get out of hand....

[ChessieCat]

Hi HIGA,

 

I have simplified your dosing below.  Please confirm that this is correct and provide a date for your reinstatement of Paxil.  Thank you.

 

July 8-14:         Paxil 10 mg    Prozac 5mg

July 15-20:       Paxil   5 mg    Prozac 10mg

July 21-31:                             Prozac 15 mg

 

I was doing pretty good until July 26

 

Aug:                Paxil 5 mg      Prozac 15 mg (?)

 

It takes 4 days for the drug (in this case Paxil) to get to a steady state in the blood.  That means getting a consist daily dose.  So it may take a couple more days before you start to improve.

 

I'll ask the other mods for their suggestions so I suggest you stay at 5 mg Paxil until you get a response from them.

[hereigoagain]

Hi CC,

 

I reinstated the paxil (5mg) August 1 and took 10 mg of prozac last night (aug 1).  I was planning on no longer taking the prozac (stopping it aug 2) thinking it will taper out on its own.

 

Thanks for the help!  It's very hard right now.

 

~HIGA

[Altostrata]

Hello, hereigoagain.

 

You've been taking 5mg Paxil for two days, have your symptoms changed?

 

It takes up to 4 days for the Paxil to ramp up to full strength in your system. Then you might reduce the Prozac.

 

Please let us know how you're doing.

[hereigoagain]

Hi Altostrata,

 

The adrenaline has just let up some in the last two hours.  I have only had one good wave of it since then.  My fingers are crossed that maybe the paxil is starting to get built back up.  I looked back and I did take just over 6mg today of the paxil.  

 

So it sounds like i may not want to just stop the prozac?  or at least not yet?  I initially thought about trying to stabilize at a combo of the two, but it seems like that will make fine tuning withdrawal more difficult, since i won't know which one i am reacting to...  I had successfully done the prozac switch and then off all in the past (about 15 years ago), but my system seems to be more sensitive now.  I am hypersensitive with sensory integration issues so I will likely need to find a low dose of something that I can live with... but we will save that discussion for a better day.

 

Thanks so much!

~higa

[hereigoagain]

Well, today I woke up pretty shaky and off-balance, but the shaking calmed down shortly after my morning paxil dose.  I have only had a minor adrenaline rush all day, and I think that was my normal fear response to a bit of dizziness (I have a severe vertigo phobia from childhood).  I was definitely dizzy and off-balance all day, but the panic has abated and my head feels a little clearer.  For the devil that it is, the paxil does work fast.  This evening I am getting shaky and more dizzy again, but since I split my paxil dose up between morning and night, that is probably why.  I have actually upped to 6 mg of paxil just b/c it is easier to measure.  I have not taken anymore prozac since aug 1.  Do you think my body might adjust to the 6 mg of paxil being enough (that would be awesome!) or will I likely need to up it over the next couple weeks as the prozac fades?

[Jlynn]

I have found when I reinstated I had to wait a lot longer than the 4 to 14 days before I felt any relief from symptoms. When I went back to my full dose it was about a month before I started leveling out and they started easing. This last major wave took time as well. Paxil is brutal when it comes to giving symptoms and then they hang on which is so frustrating! I hope you get some relief soon! Hang in there!

[hereigoagain]

Hi Jlynn, I do hope I find relief sooner than later!  Yesterday I did pretty good comparatively but I woke up really early this morning with more adrenaline, shaky and dizziness after not so great sleep....

[hereigoagain]

The adrenaline is not letting up today.  Yesterday was so good though.  I took 4 mg of paxil this morning and am trying to hold out until this evening to take anymore (usually split the dose up am and pm).  It is hard tho because I am getting panicky with all of the adrenaline rushes....

[hereigoagain]

Well things have calmed down to waxing and waning, moment by moment.  It feels nice to have better moments.  The adrenaline rushes stopped for a couple days (I could feel them start to build, but then it was like they snuffed out).  Today I had a couple minor ones and was a lot dizzier.  I rode to the store and back, but was too dizzy to drive or go to more than one store.  Small victories though.  I am taking the growth in my dizziness and break through adrenaline as a sign that I probably need to up the paxil a bit more now that the prozac is getting more out of my system (I took 10mg of prozac on Aug 1st as my last dose of that).  I have been taking about 6mg of paxil for the past 4 days and I am thinking of going up to 8 mg.  

 

I was pretty stable at 10mg before I messed this all up, but if I can find a lower effective dose, why not!  I was still anxious at the 10 mg before, but I have a lot of other issues going on including severe allergies and migraines with vertigo (triggered by... allergies!)  I have also gained a lot of weight on the paxil (50 lbs) and just had an emergency surgery to take out my gall bladder on June 30.  My blood pressure has also creeped up and is nearing stage 1.  So instead of torturing myself trying to find a quick solution to get off the paxil, I am thinking of stabilizing on it, adhering to my new gall bladder post-op diet (its a great low fat diet that I should be following anyway), and being more serious about exercising.  Until we are able to move back to the dry mountain climate, my allergies will probably keep my body taxed, so throwing in severe withdrawal is really not such a great idea (hindsight is always so insightful!).  

 

So as for now, I just want my equilibrium back and to calm down the hypersensitivity.  All of which I know will come with time.  Thanks for the support everyone!!!

 

~higa

[hereigoagain]

Phew!  I have stabilized (I think) back at 10mg.  I still have some residual dizziness and headaches, but I know it can take time for my vestibular system to reset.  I think I am just going to sit still at 10mg for a while (months) and let everything calm down.  No rushing.  Thanks everyone!

[scallywag]

Good plan, higa -- two thumbs WAAAYYYYYY up!

[hereigoagain]

Well, after 9 days at 10mg of paxil, I was very dizzy and shaky and starting to get adrenaline rushes again, so I upped it to 12mg on 8/29.  Was great for the first few days, best I have felt in a long, long time.  Then the dizziness, shaking and anxiety started to increase again.  I upped it to 12.4mg today 9/2.  I know if I find the right dose, the side effects of the dizziness, shakes and adrenaline rushes (caused by the discontinuation - I only have them when I am trying to come off this stuff) will dissipate.  Right now I feel like I up it a small amount, am great for about days 2-4 and then the symptoms start creeping back in.  I am trying to find my lowest effective dose, but I am worried that my body is setting up this pattern of wanting more every week.  My dr assured me that this is not the case as it is with the benzo's and its just a slow process of increasing the dose in small increments until the symptoms stop and don't return in a week.  I know I really messed up my system this year trying so hard to get off the paxil, but now I want my life back and so am trying to fight the cravings (I can feel them already) and control what I can while being on the paxil for a while so my system can calm down.  Will I eventually reach a stable dose this way?  Or am I teaching my body that it can get more and more setting up a bad habit?  

Thanks!

[hereigoagain]

Same story as the last post... I have now increased up to 13.2 mg and may increase it by another .4 mg soon.  

But my original question from the post above remains: Will I eventually reach a stable dose this way?  Or am I teaching my body that it can get more and more setting up a bad habit?  

 

Thanks,

Higa

[scallywag]

When increasing dose with an SSRI such as Paxil, you won't be creating an addiction with drug-craving and drug-seeking behavior.  So that isn't really the issue.  What you are doing with weekly dose changes is regularly challenging your CNS (central nervous system) instead of allowing it to stabilize.

 

It's hard to say how your CNS (central nervous system) will respond to this. You might be better off holding for longer than 1 week, possibly for a month or more, to see how your symptoms respond to steady dosing over a longer period.

[hereigoagain]

I held at 13.6 for a while, through a sinus infection. As I started to recover from that I started getting really shaky and dizzy again so I tried a small increase to 14.4 on 9/21. It didn't seem to help any as I am now very shaky and dizzy with some vertigo, and the adrenaline rushes have returned and are getting worse. My husband is going out of town for a few days and I am feeling very vulnerable and alone (not to mention scared). I am wondering if since I am getting to the part of the Paxil curve where it begins to flatten some, past that steep slope that makes it so hard to get off, if I should be increasing my upward titrations by more than before? So like when increasing by less than 1mg before helped for a short while, I need to go up by 2 to 3mg or more. Part of me wonders if I just jump back to 20mg if this will all be over and I will stabilize back at my old dose. My Dr is leaving it all to me. I'm so scared right now, I feel like I really messed myself up and it will never end.....

[scallywag]

What did you take, if anything, for the sinus infection? How much and for how long?

 

The immune system and the CNS (central nervous system) are interconnected. It could be that the infection had an effect on your CNS and your withdrawal symptoms. 

[hereigoagain]

I took amox/clav 875/150 for 10 days.... I felt better until about day 7 when I started getting really shaky and dizzy. I just finished the amox/clav 3 days ago and have been getting worse withdrawal symptoms since. It still seems weird to be getting strong withdrawal symptoms when I am back on it.

[hereigoagain]

Well, it seems that increasing my paxil to 16.4mg from the 14.4 stopped the adrenaline rushes and has calmed most of the shaking (I still get shaky some in the evenings and when I wake in the morning before my doses) and the dizziness is better but not all gone.  I'm hoping that once I reach 20mg I will stop needing more with time.  Right now the increases seem to only last a week before the side effects/withdrawal symptoms start to breakthrough again.  Once I up the dose, it takes about 4-5 days before I am feeling comparatively a lot better.  Can't wait for the better feeling to be permanent and more like the real me.

[hereigoagain]

Well it has been about 11 days since getting up into the 16.X mg of paxil.  I am trying to hold it longer, but I am starting to feel the shakes coming back and the dizziness is increasing.  I also had a killer headache for a few days, much like a migraine, but nothing seems to help (I do get migraines from serotonin sensitivity, which is why I was on paxil in the first place - it was terrific at keeping them at bay).  Driving has also become very hard, I can barely make it 6 miles to the next town to go to the store.  The next time I up the paxil, I will go back to 20mg.  I am worried now that I will not stabilize at my long time usual dose...  Usually when the shakes and dizziness start up, the adrenaline is not far behind and upping the dose quiets it down for a short time.  I am very nervous now that I only have one increase left that I will not stabilize and need more in a few weeks time...

[hereigoagain]

I have found when I reinstated I had to wait a lot longer than the 4 to 14 days before I felt any relief from symptoms. When I went back to my full dose it was about a month before I started leveling out and they started easing. This last major wave took time as well. Paxil is brutal when it comes to giving symptoms and then they hang on which is so frustrating! I hope you get some relief soon! Hang in there!

Hi jlynn, How are you doing?  I am reinstating the paxil.  My Dr wanted me to do it slowly.  I am up to about 17 mg now and have held it for about 2 weeks, but I am getting shaky, anxious and dizzy again.  Driving is very difficult if not impossible most of the time.  I am planning on going back up to my 20 mg and hoping it holds.  I am worried that 20 mg won't be enough now for whatever reason (whatever = the damage I did to my CNS this past year trying so many ways to get off...).  I really don't want to go over 20, but I want to feel human again.  It seems my symptoms first ease when I increase the dose and then they start to creep back in and get worse with time instead of better.  Is this what you noticed when you reinstated?  Did you quickly go back up to 20 mg or did you take your time reinstating?  Hope you are still feeling steady!

~Higa

[hereigoagain]

I am back up to my full 20 mg as 10/15.  I am hoping it is enough, but worried that it will fade within a couple weeks like it has been...

[scallywag]

From your signature it appears that you are updosing weekly or more often.  I hope that you'll consider holding for at least 2 weeks to allow your CNS (central nervous system) to catch up a bit to a new dose.

[hereigoagain]

Hi!  I've been here a long time ago struggling to get off Paxil.  I am now on what I dub a 10-year taper.  I drop about .004 mg of paxil pill weight every few weeks.  (For perspective, a 20mg tablet weighs .25mg.)  I am at about 17.25 mg strength now.  Painfully slow and steady, but I've tried every trick in the book to go quicker only for withdrawal to hit.

 

What I am wondering, for those who have done the long, slow taper over years... was there a point where your metabolism returned and you began to naturally shed the pounds gained from Paxil?  (I'm up 60 lbs.)

 

Thanks!