Intro - Mrj

[mrj]

Hello everyone, 
Very grateful to this site, all the best with your journeys. 

New here so please be gentle. I am currently about 5 months off of Paroxetine 20mg. I went through some pretty nasty withdrawals (initial two weeks, then for the last few months). Things seem to have gotten a bit better, but now along with the anxiety, panic and depression I have this real negative energy / aggression in me, I am hyper sensitive to sounds and feel like I can't control this 'rage' that comes up inside of me. Also, I can't go another week dealing with the ups and downs, the racing head constantly, the cognitive impairment (comprehension, memory). I am going to reinstate in the next few days to try numb my brain a bit, but feel like it's a shame as the withdrawals have been so rough and a bit of improvement was finally happening. Is it a good idea to go back to Paroxetine or should I try Escitilopram (both have been prescribed.)? 

 

[ChessieCat]

Hi MrJ and welcome to SA,

 

There is lots of excellent information here on this site.  To search the site I use Google and type in survivingantidepressants.org + topic.

 

I'm going to list some links for you to check out:

 

Introduction to AD Withdrawal Syndrome

About reinstating and stabilizing to reduce withdrawal symptoms

Why taper by 10% of my dosage?

Dr Joseph Glenmullen's Symptoms Checklist

 

Generally it is suggested that you reinstate the same drug, because that is the one your brain has adapted to.  Also, please note that if you reinstate, please start with a SMALL DOSE as explained in the reinstating link.  Your brain will have made adaptations during the time you have been off the drug so it is better to try a small dose to see how you respond.  If you do decide to reinstate, you can post that intention here in your topic and we can suggest a dose to try.

 

Tips for tapering off Paxil (paroxetine)

 

Thank you for completing your signature.  Please update it whenever you make a change so it remains current.

 

What doses of 5 HTP and St John's Wort are you taking?  Please add these to your signature.

 

5-htp-5-hydroxytryptophan-and-l-tryptophan

 

st-johns-wort-hypericum-perforatum

 

These helped me to understand SA's recommendations:

 

Brain Remodelling (Rhi's Description of Brain Healing)

Video:  Healing From Antidepressants - Patterns of Recovery

 

Your Intro/Update topic is the place for you to ask questions and to journal your progress.  Click "Follow" top right and your will be notified when someone responds.

[mrj]

Thank you for your reply and warm welcome Chessie Cat. I hope you are doing well. 

I updated the signature. 

I have stopped with the 5 HTP and st john of wart's now though. I found I would wake up very on edge and feeling fragile / shaky. 
I also found that Vitamin B gave me extremely aggressive energy, could feel it tingling in my fingers and couldn't calm down for at least an hour, was quite scary. Thank goodness that stage has passed.

Personal Update: Tmrw I'm gonna go see my psychologist for the 6th time, I'm on a major dose of cbt as despite the 3 perscriptions written for me by doctors I just couldn't face the thought of returning to ssri. However, the last few days have brought me closer than ever to returning to the medication. But I do feel very depressed about it, I feel that paroxetine really affected my cognitive abilities (slow processing, memory, interpretation, ability to communicate fluently & understand complexity)
 
...I have made an incredible amount of progress over the last 5 months. I feel that I have overcome so many things, panic attacks decreased, mood swings decreased, the extreme up and downs... but unfortunately the recovery is just not fast enough. For the last 5 months I have been hiding out at my family house. I barely leave the house except for when I'm with a family member. I am too anxious about life and socialising and getting a job, I'm still so on edge. I can't keep living this way, I've isolated all my friends due to panic & anxiety about the world & people, and now the anxiety of just vanishing from life for 5 months and not being able to really explain why (without looking like some paranoid, lazy person)  is really large.
 
I wouldn't of been able to get to where I am without the incredible support of my family, they saw me through the toughest times when I was ready to give up and get back on medication every single day. When I threw literal tantrums because I wanted the drugs so bad, the major depression, the mood swings. They tell me they've seen such great improvements and I feel my brain slightly improving.
But I'm 25, and need to start living my own life and get my confidence a bit back to face what life holds. I've come to the realisation that ssri was anaesthetising my brain and in turn causing quite severe cognitive impairment.
 
Over the last 5 months I've reflected over everything countless times, something I don't remember doing on ssri's (being able to reflect deeply)...I've noticed I lived a life that was always in the moment, yes I had some vague plans of the future but no real sense that I'd ever get there...I don't know if that was me or the meds to be honest though. I wish I had more time and less anxiety to slowly get back out there in the world, but I don't. Life goes on, people move on. I'm just wasting away. If I go back on the meds this week I will be devastated, but I don't see another option, I can't spend any more time locked up, and I can't go through the panic attacks, anxiety and life (facing people and the world) knowing that I am at such a disadvantage. ie: I need to interview for jobs, and I know with such high anxiety just at home I will be a complete wreck. Also the inability to handle stress, the feeling my brains impaired and slowness in my actions / ability to complete tasks
 
... I'll be sad because I know how much my family was there for me going through these withdrawals, how lucky I was that I had time and support to recover, something I don't think I'll ever get again to the same extent, I was so out of it and had a complete meltdown, they brought me back to health. In the future I will have a job, I'll have responsibilities, I'll have commitments, I won't ever have the ability to just stop life for 5 months to recover. I truly believe if I go through that again I will end up in a mental hospital and be drugged up for the rest of my life. I just can't go through withdrawals like that ever again, it was the worst months of my life. However, I can't move forward in life with this anxiety and depression and the thought of it being there forever. It is too hard a decision for me to make, one I've been struggling with for months.
 
Do I return to ssri's and throw away all the work I did to get off them and accept the fact that I will be impairing my brain for the rest of my life (most likely crippling my abilities and memory) but gaining some confidence to do things, or do I push on and suffer panic attacks, anxiety and stress melt downs...in order to one day hopefully feel like i can manage without meds. I don't know. I really don't know. 

Edited September 1, 2016 by Altostrata
increased font size, inserted paragraph breaks

[scallywag]

Mrj - thank you for coming back to post and let us know how you're doing.
 
Thinking that the drugs are bad and not wanting to them again is very, very common. And then after experience distressing and disturbing withdrawal symptoms we think the drugs are EVIL and HATE the idea of taking them again.

Sadly, that thinking that extends our suffering the symptoms of withdrawal and the exact opposite thinking offers the possibility of relief.  So many people have experienced reduced symptoms by reintroducing their SSRI -- at a teeny tiny dose, as little as 0.5 or 1 mg. Improvement takes at least 7-10 days to be noticed. 
 
Please read the thread about reinstating.  Testing a small dose of paroxetine is the best way, perhaps the only way, to ease your withdrawal. Reinstatement doesn't work for everyone but it may work for you.
About reinstating and stabilizing to reduce withdrawal symptoms
 
The hypothesis that best explains symptoms is that your CNS (central nervous system) adjusted to paroxetine over the 4+ years you took it: Some neurotransmitter cell functions and related processes were shut down in order to keep a balance in the face of the action of paroxetine.  When we stop taking the drug, especially all at once or "cold turkey," your CNS works overtime to get those functions and processes back up and running.  As that "rewiring" work is being done, frequently there are signals sent that trigger symptoms of withdrawal.  For a more detailed explanation of this please read the link that ChessieCat provided called "Brain Remodeling (Rhi's Description of Brain Healing)."
 
 
This recovery period is a terrific time to learn behavioral and other non-drug techniques to deal with social anxiety:
Non-drug techniques to cope with emotional symptoms

Dr. Claire Weeks Method of Recovering from a Sensitized Nervous System

Cognitive Behavior Therapy (CBT) for anxiety, depression

Cognitive Behavior Therapy lessons

 

There are probably other techniques and topics here at SA. I hope other members post their suggestions.

[mrj]

Thank you for all the wonderful information Scally Wag. 

The thing is, I don't think it's withdrawal symptoms so much anymore if at all (apart from lingering cognitive impairment & return of original social anxiety). I am anxious about how I lived my life on paroxetine and have years of regrets. I also didn't learn things while taking it that I would need later in life which has put me in a very difficult situation, never faced years of fears. I have been to three doctors and they have all just thrown whatever meds (ssri's) they want at me, I feel like they don't have a clue how powerful these things are and how much they can affect life. I don't want to return to paroxetine, so I am going to try Lexapro. I am extremely scared that this will ruin my brain even more and dread having to go through the side effects / withdrawals that this will bring. Won't ever go cold turkey again though. 

Has anyone jumped from paroxetine after 5 months withdrawals to lexapro?

[ChessieCat]

Hi mrj,

 

Many members here can relate to how you are feeling at the moment.  The most important thing is to learn as much as you can so as to make an informed decision.

 

"I don't think it's withdrawal symptoms so much anymore if at all"

 

Many people and doctors make the mistake about not recognising that withdrawal symptoms can last for longer than a few weeks.  This means that when WD symptoms arise down the track (which can occur several weeks and even many months later) they may assume that the person’s original condition has returned or they diagnosis a new condition and may reinstate the drug at the previous dose, at an even higher dose or prescribe an alternative or additional drug. Of course a person’s original condition, for which they were prescribed an antidepressant, will still need to be addressed and non-drug methods of coping taught/learnt.

 

What you are most likely suffering from is Paxil withdrawal symptoms.  When you took Paxil your brain adapted to getting Paxil.  Now that it is not getting it you are suffering withdrawal symptoms.  The way to reduce those symptoms is reinstate a small amount of the drug your brain is still needing.  Switching to a different drug does not always work.  You can end up still getting withdrawal from the original drug as well as getting start up and side effects of the new drug.  And my concern is that if you switched and suffered symptoms you would then end up on additional drugs.  If reinstatement of Paxil worked, after stabilising you could then do the recommended 10% taper to get off Paxil.

 

Please read the link about reinstating that scallyway posted. 

[mrj]

Thank you Chessie Cat, 

Have read the reinstating post by ScallyWag, very informative. 
Upon reading your reply and more thought, I think reinstating paroxetine will be the best way to go. The three separate doctors I have seen have all prescribed different medications (paroxetine, escitalopram/lexapro)..so the choice is ultimately up to me. 

I am currently trying to deal with the underlying anxiety issues with CBT but they are going to take a long time as they are so deep rooted. I don't think I will survive the anxiety long enough to start fixing that underlying issue, it is not anxiety at the withdrawal symptoms and how long they'll last although up to a month ago it was and I do feel I have come through the severity of it (or at least am in a window). 

What would be the best dose to get back on paroxetine, and try to maintain for a few years?

I am so scared that my nervous system has readjusted and the medication won't be affective, if that is the case I don't know what I'll do, I am on my last legs. Is there a save dose to minimise undoing all the recovery I've made, 1mg as suggested in ScallyWag post?

many thanks, and god bless

 

[scallywag]

Mrj - please confirm the following or provide the correct information:

 

Your last dose was

- in February 2016

- 10 mg paroxetine

- after you had been skipping several daily doses a week.

[mrj]

HI ScallyWag, 

That's correct apart from taking a half pill (10mg) in May 2016 that I thought would help alleviate panic attacks I was having. 

[Altostrata]

Welcome, mrj.

 

Your description of the initial acute withdrawal symptoms and recent symptom pattern indicates you have post-acute withdrawal syndrome (PAWS) or prolonged withdrawal syndrome. This is not the same as a relapse or intensification of "depression" or "anxiety." See What is withdrawal syndrome?

 

Paroxetine is the most difficult SSRI to quit. As you've been off it for 5 months, if you want to try something, you might try 1mg Prozac, as it may be easier to finally go off after stabilizing for a good while. See Tips for tapering off Prozac (fluoxetine)

 

It takes at least 4 days to feel the full effect of 1mg Prozac. If it is immediately helpful or neutral, stick with it for some months. If it very soon feels bad, stop.

 

Before taking a drug again, you might try this: Many people do better with fish oil and magnesium supplements, see
http://survivingantidepressants.org/index.php?/topic/36-king-of-supplements-omega-3-fatty-acids-fish-oil/
http://survivingantidepressants.org/index.php?/topic/1300-magnesium-natures-calcium-channel-blocker/
 

Please let us know how you're doing.