Albert: preparing to get off Paxil / paroxetine for good

[Sebas]

I've figured out what has been causing your current symptoms.

Taking two different dosages within 24 hours will upset CNS due to fluctuations in drug levels. This creates continues “ups-and-downs”. We want drug levels to be steady.

Divide taper equally over both morning and evening dosage.

In stead of 100% and 95%, apply 97.5% (9.75 mg) both morning and evening dosage.

As an alternative you could switch to consuming your drug 1 time a day and then take 19.5 mg.

Start switch tomorrow to avoid quantitative dosage changes.

Good luck,

bye Sebas

[Albert]

Thank You, Sebas !!!! I will just keep pushing and hopefully they will start to settle before to long.  I did sleep just a wee bit better last night so that is a good sign.  

[Albert]

21 hours ago, Sebas said:

The taper strategy seems to be just fine at current dose. An increase of light symptoms after a couple of days is also normal. It may last a couple of days to weeks.

 

Several external factors can influence WD. Take notes of what you eat and drink (and weather there was a response), supplements etc.

 

Avoid herbs, caffein, chocolate, products rich in sugar, alcohol.

 

Those are all known paxil wd symptoms. Nothing to be worried about even though they're annoying especially under working circumstances.

 

Take it easy at work (work from home), be gentle to yourself, go outside for a walk, take a nap during afternoon. Give CNS time to recover.

 

Bye Sebas

Thanks a bunch!!!  I will stay put and see what happens

[Albert]

I am now stabilizing again!!   I started to feel better about 6 days ago.  I am going to wait till the 5 week mark to drop again.  

[Sebas]

Thats great. Give yourself 1 or 2 weeks of rest so that life doesn't just consist of tapering. In these 2 weeks you can recharge yourself for next taper. Good luck and note your current and future steps in personal SA profile ⬆️

[Albert]

Thanks Sebas, does anyone ever complain about the Gemini being inconsistent when weighing a tablet?  I am running into this and just wondering if it is my Gemini, or if it is just something that people just have to deal with?  I Have tried to calibrate it several times but that does not seem to change anything.  Thanks 

[ChessieCat]

10 hours ago, Albert said:

Thanks Sebas, does anyone ever complain about the Gemini being inconsistent when weighing a tablet?  I am running into this and just wondering if it is my Gemini, or if it is just something that people just have to deal with?  I Have tried to calibrate it several times but that does not seem to change anything.  Thanks 

 

Q:  Have you changed the batteries?

 

Also, you might wear a mask and be in a room with minimal drafts.

 

I suggest you check out/post here; you can do a search in the topic for the word gemini.  If that doesn't bring up what you need you could try scale or other similar words:

 

using-a-scale-to-weigh-and-measure-doses

[Albert]

I am currently now down to 19mg - 10mg in the AM and 9 mg in the evening.  Seem to be doing pretty well overall.  It has been 12 days since my last drop so I am starting to get a few symptoms.  Question:  I have developed a nasty ear infection and I am currently leaving urgent care.  They have prescribed me some ear drops as well as an oral antibiotic " AUGMENTIN"  I don't recall this  one to steer away from.  She recommended this one it is a combination of amoxicillin and clavulanate potassium.   Is this one OK?  Just checking

[Albert]

I was looking over the website in attempt to locate a list of antibiotics to try to stay away from, but having trouble finding it.  Is there a link or a document around that.  Thanks AJ  

[Believer]

AJ, did you have a look at this? 

 

[Albert]

8 minutes ago, Believer said:

AJ, did you have a look at this? 

 

Thank YOU !!! 

[Albert]

Just had to go back to the Urgent care and they had to give me a shot of penicillin.  My ear infection is spreading to the other ear and into my throat.  They also had to give me a steroid pill as well.  It was just a one time pill.  Hope this al does not throw me in a tail spin!!!!

 

Also, I was looking back at post from Sebas and I am just wanting to confirm.  As I continue to cut dose, cutting off of just the evening tablet would not be recommended?  I was going to taper the evening dose in hope that once that was done, I could stabilize for 3-6 months at 10mg once per day.   Looking at the post from Sebas, should I just try to slowly work my way back to one dose in the AM and then resume taper?    I am currently doing 10mg in the AM and 9 in the pm.  I could go back to 19 in the AM and then continue the taper from there.  According to my gene test, I am a moderate metabolized and fast.   It seems like I recall seeing that post but then I failed to act on it.   Which would be more recommended?  If I stay at twice per day, I would be doing double the work .  If it is presumed that I might be able to get same results by going back to once per day, I would be a fan of that. 

[ChessieCat]

At this time whilst you are fighting the infection it would be best not to make any reductions your psychiatric drug.

[Albert]

I am still about 3 weeks from my next possible reduction.  I will play it make sure infection and all of this medication is out of the way and everything ok before doing so. Thanks 

[Albert]

I have been holding and trying to get past a nasty ear infection!!!!  I did begin to split my medication equally twice daily.  I have been on several rounds of antibiotics but the infection build up is still built up in the ear.  Dr has prescribed Naproxen twice daily.  That is basically an extended release ibuprofen which I know is kind of a no go.  He wants to get the inflammation reduced out of the ear canal so it will heal up.   He also prescribed a decongestant.   Am I doomed, should I continue to try natural remedies?  I am just not responding well to natural remedies.  Thanks for the advice.  I am  not symptom free but I would say I am somewhat stable at this point. 

[Albert]

*** Help Please ***  I have made it through my ear infection and well past that.   About three weeks ago, I started to get soreness in both elbows.  Left more than the right.  It has slowly progressed to the point where I can hardly move my arms and I can barely touch my left elbow.  I tried to do some mild exercise yesterday evening but I think that only made it worse.  Could this be WD?   I am getting kind of tire of going to the Dr all of the time.   Just looking for some advise before I call the Dr again.  Thanks AJ 

[Sebas]

Joint issues (in arms, legs, back) could certainly be related to WD.

Naproxen, decongestants and paxil definitely will conflict. I've had conflict with nosespray, and NSAID myself and it's not funny. Most sprays also concist of alcohol/glycerin, anti bacterials and other chemicals.

 

It may take some time to become WD free again, don't worry, you might visit a fysiotherapist or a chiropractor for some relieve. I've had good experience with both dry needling and shockwave therapy for tendon issues.

 

Bye Sebas

 

 

[Sebas]

On 10/12/2022 at 7:53 PM, Albert said:

They have prescribed me some ear drops as well as an oral antibiotic " AUGMENTIN"  I don't recall this  one to steer away from.  She recommended this one it is a combination of amoxicillin and clavulanate potassium.   Is this one OK?  Just checking

 

I know from 1st hand that these antibiotics are quite heavy. But sometimes due to medical circumstances they are just necessary. My girlfriend recently had these after appendix surgery. Side effects were heavy.

 

Keep in mind that in general during WD;

Abstain as much as possible from ANY - antibiotics, caffein/coffein, alcohol/glycerin, amino acids, chocolate, anti inflammatory, bacterials, neurotransmitters, steroids etc. 

 

These kind of drugs not only conflict with paxil (especially during WD) but frequently also interact with eachother.

 

As for now, give CNS some time to re-stabilise, keep notes of your symptoms and monitor your progress (daily to weekly). 

[Sebas]

On 10/16/2022 at 10:22 PM, Albert said:

Also, I was looking back at post from Sebas and I am just wanting to confirm.  As I continue to cut dose, cutting off of just the evening tablet would not be recommended?  I was going to taper the evening dose in hope that once that was done, I could stabilize for 3-6 months at 10mg once per day.   Looking at the post from Sebas, should I just try to slowly work my way back to one dose in the AM and then resume taper?    I am currently doing 10mg in the AM and 9 in the pm.  I could go back to 19 in the AM and then continue the taper from there.

 

What was originally the reason to spread twice daily? And since when?

Your CNS may have become quite used to it. Changing back to only AM is possible but might take a while to stabilise again. You could start by taking your pm dose an hour earlier and then slowly come down over a couple of weeks. Make a schedule. But not right now, first wait until joint issues are solved.

 

Tapering only from the PM is not a good idea. Drug levels should be stable throughout the day without fluctuations from am to pm to am the next day.

 

[Albert]

About a year ago, it was recommended to me by Colonial to split the doses in an attempt to stabilize.  Not sure if it helped, but I did wind up improving.  I have now been doing equal splits twice per day. My joints have just become so sore, I can hardly touch my arms and I am physically pretty weak.  Does this sound like a normal WD symptom?  Thanks again.  

[Albert]

Also, do you think that in the long run that I would be better off going back to one single dose per day? 

[Sebas]

If you Google paxil and joint pain you'll get more than enough hits. Other people have had joint pain, nerve and skin complaints during WD before. Also check for side effects in other medicines prescription (antibiotics etc.). It could be from either one or the combination. 

[Albert]

Sebas, we have a Burnie doodle and I noticed your Avatar.  We love the personality so much, we have actually considered a full blown Burmese.  But no shedding is nice.  My dog goes everywhere with me.   

Do you think I would be better off holding where I am at, and slowly closing the gap between the two doses to get back to once per day, or just go ahead and continue with the split doses?    

[Albert]

Preparing to drop to 17.5 daily.  Still have symptoms 

[Sebas]

5 hours ago, Albert said:

Preparing to drop to 17.5 daily.  Still have symptoms 

What are your current symptoms? Dropping may further destabilise your CNS. Have you noticed any improvement over the last months? Is there a pattern?

[Albert]

I went ahead and dropped 1% about 2 weeks ago and I am going to drop another 1.5% here in about another week and then hold there for 3-4 weeks and see if I can manage.  That gets me to the 17.5mg daily dose.  I am currently functioning.  Still dealing with symptoms but the rotate like a revolver and are less intense than a year ago.  One thing I notice is my mind / train of thought will only last about 30 seconds to maybe a minute at best.  I will loose train of thought and then onto something else.  Like I will have a really positive emotion for 10-15 seconds but that is about as long as I can hold it.  Then I can loose train of thought .  Sometimes I can reel it back in, but I could walk from the living room to the bedroom and forget what I was doing.  I am managing to work and I am able to work through it.  But I get about 1/2 as much done as I used to.   Is there anything that I can take to help with this symptom, or just kind of ride it out?  Thanks AJ 

[Sebas]

On 4/3/2023 at 3:10 PM, Albert said:

but I could walk from the living room to the bedroom and forget what I was doing

This happens to me too very regularly. For me its a symptom/proove that im in WD on that certain day. Or sometimes i have more trouble remembering names of quite familiare stuff or people. Or lack of concentration/focus, they are all cognitive symptoms nothing to worry about.

[Albert]

Thanks Sebas.  My sleep has seemed to improve some.  There are some nights where I seem to fall in and out of sleep all night long.  like I really never fall into that deep / relaxed sleep.  As you recover, do you find yourself being able to sleep better or take a nap during the day? 

[Sebas]

My only sleep issue is sometimes i have sudden insomnia and lay awake when rest of the world is sleeping. When WD gets nasty i take a powernap (coma style) during the daytime. May range from 30 to occasionaly 90 minutes. Like completely shutting off the brain function. I always feel better after.

 

Falling in and out of sleep is something that could be caused by general restlessness of anxiety (WD). 

[Albert]

On 4/10/2023 at 11:34 AM, Sebas said:

My only sleep issue is sometimes i have sudden insomnia and lay awake when rest of the world is sleeping. When WD gets nasty i take a powernap (coma style) during the daytime. May range from 30 to occasionaly 90 minutes. Like completely shutting off the brain function. I always feel better after.

 

Falling in and out of sleep is something that could be caused by general restlessness of anxiety (WD). 

Well, that is something that I for sure deal with.  I have been managing, but I tend to pop awake at about 5:30 and just can't really go back to sleep.  Then trying to take a nep during the day is just non existent.  I would just lay there awake.  But I am going to try not to complain as I know that there are several in a much worse place than I am in and I have myself been in a much worse place before as well. 

[Albert]

Need some advice please .  I have slipped into a little bit of a bad place.   I have a continuing back condition that I deal with and have had 4 surgeries.  By cervical has developed another problem and I am dealing with chronic pain.  I just finished 5 days of Prednisone and I am now unstable again.  I felt like I was headed toward a place that was pretty stable before all of this.   Now I am playing a waiting game as they will have to run several tests to see what is going on and I am in so much pain I can’t even sleep.  They want to put me on Hydrocodone or something for pain, but I really don’t want to do that.  How do I find out what will not interfere with liver enzymes that Paroxetine works off of and what would not interfere with Paroxetine?  Thanks 

[Albert]

OK, now I am starting to think I am going into severe WD from the Prednisone !!!   The final day of my dose was on Saturday.  It was 20mg per day for 5 days.   Now my symptoms are starting to increase and mimic symptoms that I have not had in 18mo to 2 years.    Should I go back on the Prednisone and request to slow taper, or should I just ride it out and hope I start to improve soon?  I am really starting to get worried.  Thanks  

[Sebas]

It's not prednison WD that you are in. Prednison has been interfering with paxil for 5 days (during withdrawal that is) and that's what has been building up until today. Do not go back on prednison for this reason. 

 

As for the other one, also a negative advice:

https://www.drugs.com/drug-interactions/norco-with-paroxetine-71-8487-1800-0.html

 

If you are on pain medication on quite a regular base then consult your GP if tapering would currently be a smart thing to do.

 

You will need a very clean forecast without any triggers.

[Albert]

22 hours ago, Sebas said:

It's not prednison WD that you are in. Prednison has been interfering with paxil for 5 days (during withdrawal that is) and that's what has been building up until today. Do not go back on prednison for this reason. 

 

As for the other one, also a negative advice:

https://www.drugs.com/drug-interactions/norco-with-paroxetine-71-8487-1800-0.html

 

If you are on pain medication on quite a regular base then consult your GP if tapering would currently be a smart thing to do.

 

You will need a very clean forecast without any triggers.

Sebas, thank you for the reply !!!!   I have slipped back into a really bad place.  I have not taken back up Prednisone, but good to know you think that is what caused it and I will refrain from going back on that.  I have not started or accepted any opioids either.    About two weeks before this episode, I made a 1/2 % cut to Paxil after holding for 2 months and getting pretty stable.  Should I go back up 1/2 percent to where I was at when I had stabilized?     How long do you think it will take me to balance back out?   

One other thing:   Is there anything I can take for pain?  If I have to resort to taking something, what would be recommended?  Can I take Tylenol?  If I can remember, it is suggested to avoid ibuprofen.  Thank you very much Sebas.  I can't tell you how good it was to hear from you. THX 

[Albert]

Sebas, thank you for the reply !!!!   I have slipped back into a really bad place.  I have not taken back up Prednisone, but good to know you think that is what caused it and I will refrain from going back on that.  I have not started or accepted any opioids either.    About two weeks before this episode, I made a 1/2 % cut to Paxil after holding for 2 months and getting pretty stable.  Should I go back up 1/2 percent to where I was at when I had stabilized?     How long do you think it will take me to balance back out?   

One other thing:   Is there anything I can take for pain?  If I have to resort to taking something, what would be recommended?  Can I take Tylenol?  If I can remember, it is suggested to avoid ibuprofen.  Thank you very much Sebas.  I can't tell you how good it was to hear from you. THX

 

[Sebas]

1 hour ago, Albert said:

  About two weeks before this episode, I made a 1/2 % cut to Paxil after holding for 2 months and getting pretty stable.  Should I go back up 1/2 percent to where I was at when I had stabilized? 

That confirms you were in WD. During WD the CNS is extra sensitive for triggers. Try to plan in advance; don't combine tapering periods with pain relief.

 

1 hour ago, Albert said:

Should I go back up 1/2 percent to where I was at when I had stabilized?

 

No. New changes will only destabilise CNS even more.

 

1 hour ago, Albert said:

How long do you think it will take me to balance back out?   

 

That's impossible to predict. Let these waves settle out for a couple of days to weeks, then there will probably be windows again. Keeping daily notes will help recognize healing process. 

 

1 hour ago, Albert said:

Is there anything I can take for pain?  If I have to resort to taking something, what would be recommended?  Can I take Tylenol?  If I can remember, it is suggested to avoid ibuprofen.

 

That would be a better choise indeed. Avoid anti inflammatory meds. But for now first let CNS settle down.

 

Bye Sebas