hugodrax: tapering makes no difference

[hugodrax]

Hi,

 

I have been taking Paxil for almost 20 years. I currently take 5 mg/day. I have tried tapering off twice already and both times failed. The first time I tapered from 5/day to 0/day over the course of several months. Then anxiety set in. I felt terrible and fearful. I experienced a panic attack for the first and only time in my life. And it was terrible. I had to go to the hospital to get sedated.

 

So I went back to my 5 and felt myself again.

 

A year later I tried to make it more gradual. I went from 5 mg/day and over the course of 2 years got myself down to about 2.3 mg/day. At that point anxiety started to set in again and I went back to 5 and felt myself again. I can't function with that level of anxiety.

 

Both my doctor and I agreed that tapering that slowly could never cause withdrawal symptoms, so what I was experience was my underlying depression symptoms re-emerging.

 

I started anti-depressants 21 years ago because i was experiencing IBS which was triggered by sub conscious anxiety. After taking the medication, I started to feel more relaxed almost immediately. I started to regain the lost weight and started feeling well.

 

But it seems that 21 years later, without my anti-depressants, I have an even worse anxiety problem now and tapering makes no difference.

[ChessieCat]

Hi hugodrax,

 

Welcome to SA.  It's really good that you have found this site.  The members are very supportive and encouraging and there is a wealth of information here.

 

Many members here have found getting off the low doses very difficult.  One thing it is advisable to do is to learn non-drug coping techniques for your original problem.

 

Please put your Withdrawal History in Signature  Include ALL drugs, dates, doses and how you decreased/increased.  This will allow us to give you suggestions based on your individual situation.

 

This site recommends a 10% taper of the previous dose followed by a 4-6 week hold to allow the brain to adapt to not getting as much of the drug.  Some members are doing 5% tapers and some are doing micro tapers.  Some are holding for longer after a dose drop.  The idea is to get off the drug/s with minimal withdrawal symptoms.

 

I'm listing some links which you can read:

 

Introduction to AD Withdrawal Syndrome

Why taper by 10% of my dosage?

 

Tips for tapering off Paxil (paroxetine)

 

The slowness of slow tapers

 

These might help you to understand why slow tapering is recommended:

 

Brain Remodelling

Video:  Healing From Antidepressants - Patterns of Recovery

 

Please ask questions here in your Intro/Update topic.  You can use it to journal your progress.  Click FOLLOW (top right) and you will be notified when someone responds.

Edited April 4, 2016 by ChessieCat
corrected name

[nz11]

Welcome hugodrax

Wow 20 yrs on paxil is a long time...well done on getting to 5mg. You are nearly there.

There are people here who were on that long and are managing to get off. You might like to check out member Brassmonkey.

 

Both my doctor and I agreed that tapering that slowly could never cause withdrawal symptoms, so what I was experience was my underlying depression symptoms re-emerging.

 

hugodrax this is not true ..don't buy into it.

Don't allow the doctors to put words into your mouth.

 

These drugs are very potent and after 20 yrs use the brain has been severely altered to accomodate the presence of the drug.

 

Here is a recent comment from K Brogan

"[ad] withdrawal i would argue is potentially the worst of all chemical withdrawals, i cannot think of a chemical on earth that is more challenging to come off of than 15 yrs on celexa' for example. I have patients in my practice that i taper off by one thousandth of a mg a month. I have never heard of someone struggling to come off of heroin or oxycontin at this rate. I have never heard of anything comparable to this it is so disabling that patients develop neurologic symptoms, they  develop cataclismic mood syndromes, they develop impulsivity and violence totally out of character for them. Its pretty horrifying." 

                                                                                                                               K. Brogan, NY Psychiatrist, 11 March 2016

Heres the talk

 

http://seancroxton.c...8-kelly-brogan/

 

I feel you could replace the word celexa in this quote with any ssri

 

 

Please dont give up hope of getting off this drug. 

You can do it. You havent told us how you tapered in the past attempt but you could try at 5% or less of the previous dose per month or hold for longer between drops. I know of two people now in there 7th yr of tapering. (At 5% of the previous dose per month would take 33 months to get to from 5 to 1 mg and some people are taking it down to 0.1mg...dont give up maybe you jumped off too soon in your previous effort. Who cares if it takes 3yrs to get of 5mg if you have a life and can function that is the key).

 

Your doctor is in error to diagnose your brain with an xyz when you are trying to withdrawal from a psychotropic drug.

I would like to tell you my doctor said exactly that to me too. I had never described myself as depressed so i replied that is not correct and he then referred me to a pdoc. Totally wasted my time trying to get any answers from that clown. In fact when i tried to make a verbal complaint i was told i was a person who was unique, sensitive to drugs, an outlier, atypical. And then over the next  hour proceeded to tell me more than once that "as we both agreed you are a person who is sensitive to drugs" but here's the thing ...i never agreed to such nonsense at  all !! He then later tried to push propanolol on me ...seemed to have forgotten i was supposedly a person sensitive to drugs at that moment...! I refused the offer.

 

Doctors do not acknowledge withdrawal period.

 

Can you get hold of the book Anatomy of an epidemic by R Whitaker.

Its very insightful.

[ChessieCat]

If you can't get the book, just go to YouTube and type in "Anatomy of an epidemic"

 

or from Ethical Human Psychology and Psychiatry, Volume 7, Number I, Spring 2005: 

 

Anatomy_of_an_Epidemic_Psychiatric_Drugs_Rise_of_Mental_Illness.pdf

[ChessieCat]

I thought there was one on micro tapering:

 

Micro-taper instead of 10% or 5% decreases

[hugodrax]

Thanks everybody.

 

Getting to 5 mg/day was not a problem. I just went to 5 from 10. So I started my tapering at 5 both times. Since I can't cut a pill more than in half, and I can't get 5 mg, I start my tapering by skipping a dose once per week. And I hold it there for three months. Then I skip a dose twice a week and hold it there for another three months. Then I skip a dose for three days, and hold it there for another three months. And so on. So when I got down to about 2.5 mg/ day, my anxiety kicked in. And like I said, I can't tolerate that so I give up and go back to 5 mg/day.

[SquirrellyGirl]

Hello hugodrax,

 

Alternating days on and off is not recommended because it confuses the nervous system, cold turkey one day and full dose the next, what's the nervous system to do with that?

 

Nz11 gave you the links on why to do a 10% taper and that micro tapering might be the way to go. Your long term use and failed attempts have left your system sensitized so this is probably the approach you will need to use. I would ask your doctor about getting liquid Paxil for this purpose, or you can make your own. See the link for tips for tapering paxil. Also search the intro forum for brassmonkey, one of our mods who is tapering successfully off Paxil.

 

SG

[SquirrellyGirl]

Here is a link to a paper which illustrates why it is so hard to get off the lowest dosages of several ssris and why you encountered that anxiety...destabilization! See the fourth page for occupancy graphs.

 

http://www.ncbi.nlm.nih.gov/pubmed/15121647

[Altostrata]

Welcome, hugodrax.

 

It looks like your tapering method is the problem. Skipping doses is a terrible way to taper, we have many people here who have tried it and ended up with severe withdrawal symptoms.

 

Please consider the "slow and steady" method of tapering. As your nervous system has already experienced upset from tapering a number of times, micro-tapering might be best for you.

[nz11]

Thanks everybody.

 

Getting to 5 mg/day was not a problem. I just went to 5 from 10. So I started my tapering at 5 both times. Since I can't cut a pill more than in half, and I can't get 5 mg, I start my tapering by skipping a dose once per week. And I hold it there for three months. Then I skip a dose twice a week and hold it there for another three months. Then I skip a dose for three days, and hold it there for another three months. And so on. So when I got down to about 2.5 mg/ day, my anxiety kicked in. And like I said, I can't tolerate that so I give up and go back to 5 mg/day.

Well there you go as SG pointed out - skipping doses is sooooo not the way to get off.

 

cc gave great links

 

For a doctor to tell a patient to skip doses is to reveal their  schoolboy error ignorance. The FDA warned that abrupt changes in does can trigger homicidal and suicidal ideations. So drug one day and then none the next is like doing a CT then a reinstatement then a CT etc.You are playing ping pong with your brain.The low doses as SG has pointed out are extremely difficult to navigate through and require slowness and stability.

 

oops just got beaten by The Alto to post..! only 10 secs in it.

[Altostrata]

Well put, nz.

[nz11]

Well i might be wrong....it could have been 5 secs!

[hugodrax]

For me paxil works on a long term basis, not day by day, so skipping a dose has no effect on me. The first time I went cold turkey I was fine for about 6 weeks before the absence of Paxil took effect. It is only when I have gone on for so long with not enough in my system, that I get anxiety. So if I skip Sundays for example over the course of a month - which for me is about the minimum amount of time Paxil takes to become either fullly effective and lose all effectiveness - the effect of Paxil in my system on any given Sunday in that month is not 0 mgs. It is effectively 5 mg/day x 26 days ÷ 30 = 4.33 mg vs. the usual 5 mg. While the actual chemical may be much less due to the half life, the long term effect of the chemical is still there.

 

I don't know how much more gentle of a taper I can do. I took 12 months to go down 2.86 mgs from 5 to 2.14.

[Fresh]

Please fill in a signature block with details of your drug history , so we can see it at a glance each time you post.

 

The way to do a more gentle taper that's less disruptive to your cns is stop skipping days.

The anxiety you experience is because you're keeping yourself in a little bit of w/d every time you miss a day.

 

bw , Fresh

[nz11]

The way to do a more gentle taper that's less disruptive to your cns is stop skipping days.

 

This.

 

If you fly a plane from LA to NY you don't land the plane safely by bunny-hopping the plane all the way from Kansas to NY (there is a chance you might hit a power line and crash) the safest approach is a long slow smooth descent following the way-points( a corridor of space thats been calculated and known by the aviation industry and proven to be safe).

SA is to tapering as the aviation industry is to way-points.

Doctors do not have a clue regarding aviation or tapering way-points.

 

For me paxil works on a long term basis, not day by day, so skipping a dose has no effect on me.

Don't be so sure. Withdrawal symptoms are delayed, brain accommodated paxil structures can be weakened just like in a scaffolding.

 

The first time I went cold turkey I was fine for about 6 weeks before the absence of Paxil took effect.

This is a classic withdrawal  progression. You have just written everyones story.

Read the brain remodelling link above from cc.

You need to see this from a different angle. You are seeing the young lady but we telling you be cautious there is a nasty old one hiding there !

 

It is only when I have gone on for so long with not enough in my system, that I get anxiety.

What you are calling anxiety is in fact paxil withdrawal.

Withdrawal is delayed

These are delayed symptoms of abstinence manifesting because you havent tapered correctly.

 

So if I skip Sundays for example over the course of a month - which for me is about the minimum amount of time Paxil takes to become either fullly effective and lose all effectiveness - the effect of Paxil in my system on any given Sunday in that month is not 0 mgs. It is effectively 5 mg/day x 26 days ÷ 30 = 4.33 mg vs. the usual 5 mg.

Look i'm easily bamboozled by having numbers thrown at me but the fact is 5 mg one day then zero the next is a 100 % change in dose and thats one abrupt change. And the FDA said dont do that.

You can only keep taking 5 pipes out of the scaffolding every sunday and then feeding them back in over the next week for so long, eventually things weaken and structures start falling down. The collapse may not be immediate it often is delayed.

 

While the actual chemical may be much less due to the half life,

Yes i agree. By skipping doses once twice three times a week the paxil chemical  imbalance is being kept in a  state of continual fluctuation.

A 'steady state' is no longer achievable'

The brain and cns cant handle 'much less'. They need an environment of stability.

 

the long term effect of the chemical is still there.

Exactly and these long term effects need to be reversed slowly and carefully with minimal disruption as possible.

 

But it seems that 21 years later, without my anti-depressants, I have an even worse anxiety problem now and tapering makes no difference.

This might come as a surprise but tapering makes every difference!

Look at moderator Brassmonkey.

 

What you are calling an anxiety problem is really ssri withdrawal. Don't worry it fooled me for many years too.

 

You are not alone look at member songbirds taper.

[apace41]

NZ,

 

Absolutely awesome response.

 

Nothing to add to that.

 

Andy

[nz11]

Thanks Andy.

[JanCarol]

Hey Hugo - believe what you want.  I can't say it any better than NZ did, so I'll try a different tack.

 

Those of us who have been in SA for awhile (some, quite a long while) see people come in skipping doses, making too fast tapers "on doctor's advice," etc.  We see them experiencing the SAME SYMPTOMS that you are claiming is your "original condition."

 

Easily a huge number of us have been told "you must be on meds for life," and "those symptoms are just your (original condition) coming back."

 

But you know what?  It's simply not true.  There is no such thing as a chemical imbalance.  http://survivingantidepressants.org/index.php?/topic/4291-again-chemical-imbalance-is-a-myth-stop-the-lies-please

 

The chemical imbalance begins when the doctors start fiddling with your neurotransmitters.  THEN, you get effects that are the result of a chemical imbalance!

 

Most of us had our "original condition" made worse by the addition of brain altering chemicals.

 

But - you have to choose your own path, so believe what you want.  

 

If you want help with a slow, gradual harm-reduction taper, this is the place.  If you feel you are already in charge of the drug and your "original condition" then you don't need us at all.

[hugodrax]

I did not come here for help, I just came to share my experience with tapering. I am quite fine on 5 mg of Paxil. I tried to taper just to see if it could be done. But rather than accept a different experience, you want to maintain that what is true in your case is true for everybody and they should just open their eyes to receive your wisdom. It does have almost a religious vibe to it.

[apace41]

I did not come here for help, I just came to share my experience with tapering. I am quite fine on 5 mg of Paxil. I tried to taper just to see if it could be done. But rather than accept a different experience, you want to maintain that what is true in your case is true for everybody and they should just open their eyes to receive your wisdom. It does have almost a religious vibe to it.

Not at all, Hugodrax. This site maintains that it is TOTALLY AND COMPLETELY up to each individual to determine what is best for him or herself. HOWEVER, this is a site that is dedicated to helping people come off of antidepressants in a manner that reduces harm to the maximum extent possible. We assume, therefore, that the reason people come here is because they DO want to get off the meds. It is fine for you that you don't want to get off of them. What I think about that decision is largely irrelevant.

 

Having said all that, given that you don't have any desire to get off your current meds, I will assume that your business here, expressing your views on the benefits of the medicine FOR YOU, is now complete.

 

Thank you,

 

Andy