Akriti: about tapering paroxetine and clonazepam

[ChessieCat]

Is your Paxil tablet 25mg?

 

When introducing a new form of drug it is better to do a cross over.  That means not going straight to the new form of drug.  It is gentler on your system.

 

You will take 3/4 tablet + 1/4 liquid for about 3 days (or longer if needed), then 1/2 tablet + 1/2 liquid for about 3 days (or longer if needed), then 1/4 tablet + 3/4 liquid for about 3 days (or longer if needed), then all liquid.

 

 

Do not make a dose reduction at the same time (or any other changes to drugs or supplements).  You will still take Paxil 25mg dose.

 

Instructions:

 

Step 1:

 

Cut your 25mg tablet in 1/2.  And then cut one of the 1/2 pieces in half so that you have 1/2 tablet and 2 x 1/4 tablet.

 

Dissolve 1/4 tablet (6.25mg) in 6.25mL water.  

 

Take 1/2 tablet plus 1/4 tablet plus the dissolved tablet for your 25mg Paxil dose.

 

Do that for 3 days.  If you feel okay then you can go to the next step.  If not, stay on that combination for more days until you feel okay.

 

Step 2:

 

Cut your 25mg tablet in 1/2.

 

Dissolve 1/2 tablet (12.5mg) into 12.5mL water.

 

Take 1/2 tablet plus the dissolved tablet for your 25mg Paxil dose.

 

Do that for 3 days.  If you feel okay then you can go to the next step.  If not, stay on that combination for more days until you feel okay.

 

Step 3:

 

Cut 25mg tablet in 1/2.  And then cut one of the 1/2 pieces in half so that you have 1/2 tablet and 2 x 1/4 tablet.

 

Dissolve 1/2 tablet and 1/4 tablet (total of 18.75mg) in 18.75mL water.

 

Take 1/4 tablet plus the dissolved tablet for your 25mg Paxil dose.

 

Do that for 3 days.  If you feel okay then you can go to the next step.  If not, stay on that combination for more days until you feel okay.

 

Step 4:

 

Dissolve whole 25mg tablet in 25mL water.

 

Take all the liquid for your 25mg dose.

 

 

You will then need to stay on all liquid for a little while until you feel okay.  We don't know how long that will be.  It will depend on whether you have any symptoms.  We call it "listening to your body".

 

The 25mg tablet dissolved in 25mL water give a ratio of 1:1.  This means that if you measure 1mL of liquid it will contain 1mg of Paxil dose.

 

You need to use the same equipment and do everything the same each time so that you get a consistent dose.

 

To calculate a 10% reduction you multiply 25mg x 0.9 = 22.5mg.  You take 22.5mL.

 

The next reduction is calculated on the new dose, so 22.5mg x 0.9 = 20.25mg.  You take 20.25mL.   If that amount is difficult to measure you can take 20.5mg / 20.5mL.  Always round up so that the reduction is no more than 10%.

 

If you take 20.5mg / 20.5mL you will calculate your reduction on the dose you take, not 20.25mg / 20.25mL

 

 

I hope that helps you.  Please ask questions if you do not understand what I have written.

[Akriti]

My tablet are 12.5 ×2 =25 mg .....I take two 12.5 mg tablet. I totally got that but one thing I have to ask that if I am dissolving 25 mg into 25 ml , how much time it will take to become liquid and how should I know? And how should I measure 10 %less dosage? What are equipment for that? 

[Altostrata]

Hello, Akriti.

 

Are you still taking paroxetine with clonazepam? What is your daily drug schedule, with dosages?

 

Are you taking Paxil CR or immediate-release Paxil? You're taking 25mg a day in two 12.5mg tablets?

 

If you read Tips for tapering off paroxetine (Paxil, Seroxat), you will see explanations about how to taper Paxil.

 

The easiest way for you to taper would be to substitute 12.5mg liquid paroxetine for one of your 12.5mg tablets, maintaining a total daily dose of 25mg. Then, you'd taper the liquid part. Can you get the prescription paroxetine liquid from the chemist? Ask the chemist to give you an oral syringe with which to measure your liquid dose.

 

If you cannot get the prescription paroxetine liquid, can you get your prescription filled with 3 10mg immediate-release paroxetine tablets or capsules? You would start out with dividing one of them in half so as to make your daily dose 25mg. Then you can make a liquid from one of the tablets or capsules and taper with that.

 

If you cannot get liquid or immediate-release paroxetine tablets or capsules, you may need to shave your tablet with a razor blade or sharp knife. It's best to be weigh the tablet with a jeweler's scale when you do this, but If you cannot get a jeweler's scale, you'll have to estimate how much you shave off and keep it as consistent as possible each month. This is a little dodgy because dosages can be irregular, but if you do it carefully, it is at least more gradual than cutting tablets in half or quarters.

[Akriti]

I have already read this https://www.survivingantidepressants.org/index.php?/topic/405-tips-for-tapering-off-paxil-paroxetine/

so I really don't know what to do. I am so confused 😣 .I wish I had some people with me who would help me taper these drugs. I don't want to suffer any more as I am 25 and got weak and left with no spark in me .I am just too broken right now to decide anything because if I would taper these drugs I would again become extremely depressed and dysfunctional. 😢

[Altostrata]

Don't we all wish we had people with us to help us out. Please answer any questions from the staff.

[Akriti]

So I have to ask ChessieCat. ..please  let me know if 12.5 ×2 tablet of paxil cr can be made into liquid, for that what kind of equipment I should get from the store? ?

[ChessieCat]

Are you able to get 12.5mg immediate release tablets where you are living now? 

 

If you can get immediate release tablets please get them. 

 

You would then take 1 x 12.5mg extended release tablet plus 1 x 12.5mg immediate release made into liquid.

 

 

Edited September 3, 2020 by ChessieCat

[ChessieCat]

If you can get immediate release Paxil tablets you will need to buy some syringes.

 

Please note that if you cannot get immediate release tablets you will not need to buy the syringe/s.

 

It would be good if you can get 1 x 5mL syringe.  If you cannot get a 5mL syringe then you will have to buy 10mL.  If you can get a 1mL syringe please buy that too.

[Akriti]

Okay but I am getting anxious about the tapering schedule 😣. ..what would happen if I taper and not able to function again because I get side effects taking the drugs such as oversleeping and little shakiness. 

[ChessieCat]

7 hours ago, Akriti said:

Okay but I am getting anxious about the tapering schedule

 

One step at a time.  First you need to try and get 12.5mg immediate release tablets.  If you can get these you also need to get the syringes.

 

7 hours ago, Akriti said:

what would happen if I taper and not able to function again

 

When we have had a bad experience it is normal to be scared to try again.  But SA uses a harm reduction approach to sneak the drug away.

 

The best way to taper is to reduce the drug slowly enough (no more than 10% of current dose followed by a hold of about 4 weeks Why taper by 10% of my dosage?) so that if you do experience withdrawal symptoms they are only mild.  When you take the drug away too quickly the brain has to do a lot of work to change what it does.  That is why we experience withdrawal symptoms.

 

If we get sick with a cold it is a good idea to hold on your dose for longer until you are recovered from the cold (I hurt my back 2 months ago and am currently holding on my dose longer because my withdrawal symptoms increased a little bit).  Some members find that if they do too much vigorous exercise that their withdrawal symptoms are worse so then it is better for them to do gentle exercise.  Taking an antibiotic can make withdrawal symptoms worse for a little while.  Some members find that listening to loud music, playing exciting games or watching exciting movies, or bright lights can increase their withdrawal symptoms.  This is why it is important to listen to your body.  It is a good idea to keep a personal diary so that if your symptoms get worse you can look back and see if there might be something that caused it so you know not to do it again or do less of it.

 

This might help you to understand it better:

 

On 8/31/2011 at 5:28 AM, Rhiannon said:

 

This is something I posted somewhere else and then saved. I know it's all stuff I've said before, but it bears repeating and further discussion. A lot of people, including healthcare practitioners; in fact, I guess, most people-- are operating from entirely the wrong paradigm, or way of thinking, about these meds. They're thinking of them like aspirin--as something that has an effect when it's in your system, and then when it gets out of your system the effect goes away.

 

That's not what happens with medications that alter neurotransmitter function, we are learning. What happens when you change the chemistry of the brain is, the brain adjusts its chemistry and structure to try to return to homeostasis, or biochemical and functional balance. It tries to restabilize the chemistry. For example: SSRI antidepressants work as "serotonin reuptake inhibitors." That is, they cause serotonin to remain in the space between neurons, rather than being taken back up into the cells to be re-used, like it would be in a normal healthy nondrugged brain. So the brain, which wants to re-establish normal signaling and function, adapts to the higher level of serotonin between neurons (in the "synapse", the space between neurons where signals get passed along).

 

It does this by removing serotonin receptors, so that the signal is reduced and changed to something closer to normal. It also decreases the amount of serotonin it produces overall. To do that, genes have to be turned on and off; new proteins have to be made; whole cascades of chemical reactions have to be changed, which means turning on and off OTHER genes; cells are destroyed, new cells are made; in other words, a complex physiologic remodeling takes place. This takes place over time. The brain does not grow and change rapidly. This is a vast oversimplification of the amount of adaptation that takes place in the brain when we change its normal chemistry, but that's the principle.

 

When we stop taking the drug, we have a brain that has designed itself so that it works in the presence of the drug; now it can't work properly without the drug because it's designed itself so that the drug is part of its chemistry and structure. It's like a plant that has grown on a trellis; you can't just yank out the trellis and expect the plant to be okay. When the drug is removed, the remodeling process has to take place in reverse. SO--it's not a matter of just getting the drug out of your system and moving on. If it were that simple, none of us would be here. It's a matter of, as I describe it, having to grow a new brain. I believe this growing-a-new-brain happens throughout the taper process if the taper is slow enough. (If it's too fast, then there's not a lot of time for actually rebalancing things, and basically the brain is just pedaling fast trying to keep us alive.) It also continues to happen, probably for longer than the symptoms actually last, throughout the time of recovery after we are completely off the drug, which is why recovery takes so long.

 

With multiple drugs and a history of drug changes and cold turkeys, all of this becomes even more complicated. And if a person is started on these kinds of drugs at an early age before the brain has ever completely established normal mature functioning--well, it can't be good. (All of which is why I recommend an extremely slow taper particularly to anyone with a multiple drug history, a history of many years on meds, a history of past cold turkeys or frequent med changes, and a history of being put on drugs at a young age.)

 

This isn't intended to scare people, but hopefully to give you some idea of what's happening, and to help you respect and understand the process so you can work with it; ALSO, because you are likely to encounter many, many people who still believe these drugs work kind of like aspirin, or a glass of wine, and all you need to do is stop and get it out of your system. Now you can explain to them that no, getting it out of your system is not the issue; the issue is, you need to regrow or at least remodel your brain. This is a long, slow, very poorly understood process, and it needs to be respected.

 

 

Edited September 4, 2020 by ChessieCat

[Akriti]

ChessieCat you are a very intelligent person, even I recently came across different YouTube channel in which renowned doctors are telling that these drugs do more harm than benefit. The way you have an understanding of these drugs their mechanise in the brain, I think you're very amazing person ❤ thankyou for informing me about slow taper and remodeling of the brain getting it's chemistry back .

I think I can't trust anybody else than you in the matter of slow taper, it is a very good thing that at least we got a platform where we found each other and discuss these things that nobody knows. 

Today I am going to take medicine from the store and ask about the liquid paxil and syringe. 

Also tell me if I have to make liquid from my 12.5mg  tablet where I can strore it ?how would I measure 12.5 ml ?

[ChessieCat]

 

7 minutes ago, Akriti said:

ChessieCat you are a very intelligent person, even I recently came across different YouTube channel in which renowned doctors are telling that these drugs do more harm than benefit. The way you have an understanding of these drugs their mechanise in the brain, I think you're very amazing person

 

As I said before:

 

On 9/3/2020 at 6:15 PM, ChessieCat said:

It's only what I have learned from information on SA and the other moderators.  There are some areas that I don't have much knowledge about but other moderators do.

 

 

8 minutes ago, Akriti said:

thankyou for informing me about slow taper and remodeling of the brain getting it's chemistry back .

 

You are very welcome.  I was very thankful the mods giving me information and suggestions when I first joined SA.

 

 

9 minutes ago, Akriti said:

ask about the liquid paxil

 

Please ask about immediate release Paxil tablets too.

 

If you can't get either prescription liquid Paxil or immediate release tablets you will need to use another method to taper the extended release Paxil tablets NOT making a liquid with extended release.

 

So before we spend time working out what to do, you first need to find out what you can get.

[Akriti]

It is going to take a lot time ,so I am sticking to my dosage right now. 

Please keep in touch with me. From next month my college will get started, so please do not get bothered if I asked too many questions with you. .

I need my supplements to taper which I cannot get here. I think I need to meet my ayurveda doctor who is not in my town. Only then I could carry on with the taper program otherwise I will fall down. 😕

[Akriti]

7 hours ago, ChessieCat said:

 

 

As I said before:

 

 

 

 

You are very welcome.  I was very thankful the mods giving me information and suggestions when I first joined SA.

 

 

 

Please ask about immediate release Paxil tablets too.

 

If you can't get either prescription liquid Paxil or immediate release tablets you will need to use another method to taper the extended release Paxil tablets NOT making a liquid with extended release.

 

So before we spend time working out what to do, you first need to find out what you can get.

I cannot taper like that without correcting the problem because I am afraid to do so as I will start to taper paroxetine, the benzo will start to bother me if below 12.5 mg paroxetine, it is going to take a lot time. 

[Altostrata]

3 hours ago, Akriti said:

I cannot taper like that without correcting the problem because I am afraid to do so as I will start to taper paroxetine, the benzo will start to bother me if below 12.5 mg paroxetine, it is going to take a lot time. 

 

Hello, Akriti. Please explain. Correcting what problem? How will the benzo bother you? What times of day do you take your drugs, with their dosages?

[Akriti]

I was in depression and anxiety, insomnia after a guy harassed me, I really don't know but after that I was so anxious that I cannot do simple tasks and sleep. 

I visited psychiatric who put me on 25 mg paroxetine extended release and clonazepam 0.25 mg ,since three years I am taking it daily at night. 

It helped me though so currently I am pursuing MBA from a reputable university which due to lockdown is closed now. 

So I have tried quitting the drugs so many times and the withdrawal symptoms are horrendous, beyond hell. I am bothered about the fact that if I will taper even one of these drugs , it will bother me a lot. So I am concerned about which drug to taper first? As I know from the moderators that I need to taper paroxetine first but still l am very concerned about it. 

I don't want to fall ill again 😑 because it is going to take a lot time . 

Currently I take -25 mg paroxetine extended release and 0.25 mg clonazepam daily at night. 

[Akriti]

On 9/5/2020 at 10:47 PM, Altostrata said:

 

Hello, Akriti. Please explain. Correcting what problem? How will the benzo bother you? What times of day do you take your drugs, with their 

Hello.....Altostrata maam can I ask your age ???please  help me tapering clonazepam 0.25 mg.....if you have any information on it. ..kindly share this with me because I am quite confused about how should I approach tapering 0.25 mg clonazepam, and what is the best method to taper clonazepam as it is very small and I cannot substitute it with longer acting diazepam or valium.so tell me the best approach to taper it. 

Thanks. ..

[Akriti]

On 9/5/2020 at 3:55 AM, ChessieCat said:

 

One step at a time.  First you need to try and get 12.5mg immediate release tablets.  If you can get these you also need to get the syringes.

 

 

When we have had a bad experience it is normal to be scared to try again.  But SA uses a harm reduction approach to sneak the drug away.

 

The best way to taper is to reduce the drug slowly enough (no more than 10% of current dose followed by a hold of about 4 weeks Why taper by 10% of my dosage?) so that if you do experience withdrawal symptoms they are only mild.  When you take the drug away too quickly the brain has to do a lot of work to change what it does.  That is why we experience withdrawal symptoms.

 

If we get sick with a cold it is a good idea to hold on your dose for longer until you are recovered from the cold (I hurt my back 2 months ago and am currently holding on my dose longer because my withdrawal symptoms increased a little bit).  Some members find that if they do too much vigorous exercise that their withdrawal symptoms are worse so then it is better for them to do gentle exercise.  Taking an antibiotic can make withdrawal symptoms worse for a little while.  Some members find that listening to loud music, playing exciting games or watching exciting movies, or bright lights can increase their withdrawal symptoms.  This is why it is important to listen to your body.  It is a good idea to keep a personal diary so that if your symptoms get worse you can look back and see if there might be something that caused it so you know not to do it again or do less of it.

 

This might help you to understand it better:

 

 

ChessieCat ❤ I want to ask you about how should I measure 1 ml of liquid titrated paxil? if I will buy 1 ml of syringe with needle , is there any chance that the needle used for measuring liquid paxil get corroded or is it harmful to use needle for daily measuring liquid paxil? ?how you measured your dosage? is it safe to use syringe with needle to measure liquid paxil? I mean if we are preparing our reduced dosage. Please reply. 

[Altostrata]

We have been talking about tapering paroxetine before tapering clonazepam. Why do you prefer to go off clonazepam first?

 

You need to read Tips for tapering off paroxetine (Paxil, Seroxat)  again. I gave you detailed instructions in this post 

 

You will NOT be able to make a liquid from Paxil CR tablets. Is that all you can get? Have you tried to get immediate-release Paxil?

[ChessieCat]

4 hours ago, Akriti said:

syringe with needle , is there any chance that the needle used for measuring liquid paxil get corroded

 

You do not use a needle with the syringe.

[Akriti]

It means that you get to measure the liquid without needle based syringe?how could then the syringes will measure accurately? 

[Akriti]

12 hours ago, Altostrata said:

We have been talking about tapering paroxetine before tapering clonazepam. Why do you prefer to go off clonazepam first?

 

You need to read Tips for tapering off paroxetine (Paxil, Seroxat)  again. I gave you detailed instructions in this post 

 

You will NOT be able to make a liquid from Paxil CR tablets. Is that all you can get? Have you tried to get immediate-release Paxil?

Yes I know that paroxetine cr cannot be made into liquid form because it has glue like thing in it. I can get immediate release tablets through online. Talking about tapering clonazepam first with the help of some supplements....and many people take paxil cr only ,so how they manage to taper? I take clonazepam 0.25 mg with paxil 25 mg cr.

I am talking about tapering clonazepam first because my neuropsychiatrist said it do so with the help of some supplements before tapering paroxetine cr.

 

[ChessieCat]

14 minutes ago, Akriti said:

my neuropsychiatrist said it do so with the help of some supplements

 

What specific supplements is he suggesting that you take?

[Akriti]

No I have not started to take this supplement yet it is L-theanine.my neuropsychiatrist said to taper clonazepam first but I have not started yet to taper. 

L-theanine-200 mg maybe 

[Altostrata]

We advise tapering the Paxil first. The supplements will not help you taper clonazepam, you need to taper it carefully.

 

Please read the links we give you. Use of oral syringe is included in the information in the links.

[Akriti]

1 hour ago, Altostrata said:

We advise tapering the Paxil first. The supplements will not help you taper clonazepam, you need to taper it carefully.

 

Please read the links we give you. Use of oral syringe is included in the information in the links.

But is that the safest to do ??do you have any experience over that? ?how did you tapered your medicine ? can you share your experiences with me. 

[ChessieCat]

Please see Post #1 of this topic.  It is written by Altostrata, this site's owner:

 

taking-multiple-psych-drugs-which-drug-to-taper-first

 

 

[Akriti]

I have read it all taking-multiple-psych-drugs-which-drug-to-taper-first....I have seen Altostrata on YouTube talking about her struggle and this website. she is a senior citizen. .I was asking you why you took so long to taper? ?please tell me. ..

[ChessieCat]

SA has helped many members since it was started in 2011.  The information which SA provides is a result of years of observing members' tapers, reading research papers and contact with medical professionals who are knowledgeable about tapering psychiatric drugs.

 

SA provides information to members so that they can make an informed decision.  SA will not try to convince a member how to taper or which drug to taper first. 

 

There are many SA members who have tapered or are currently tapering their antidepressant before they taper their benzo.

 

This is the SA Benzo tapering and recovery forum.  You can easily see a member's drug history from their drug signature (but sometimes they do not keep them up to date).

 

3 hours ago, Akriti said:

can you share your experiences with me. 

 

Alto is a very busy person and spends many hours voluntarily assisting members on this site.  Unfortunately she does not have the time to answer everyone's questions about her drug history.  I suggest you check out this forum:

 

Success stories: Recovery from withdrawal

[Akriti]

18 minutes ago, ChessieCat said:

SA has helped many members since it was started in 2011.  The information which SA provides is a result of years of observing members' tapers, reading research papers and contact with medical professionals who are knowledgeable about tapering psychiatric drugs.

 

SA provides information to members so that they can make an informed decision.  SA will not try to convince a member how to taper or which drug to taper first. 

 

There are many SA members who have tapered or are currently tapering their antidepressant before they taper their benzo.

 

This is the SA Benzo tapering and recovery forum.  You can easily see a member's drug history from their drug signature (but sometimes they do not keep them up to date).

 

 

Alto is a very busy person and spends many hours voluntarily assisting members on this site.  Unfortunately she does not have the time to answer everyone's questions about her drug history.  I suggest you check out this forum:

 

Success stories: Recovery from withdrawal

ChessieCat ❤ I had said about Altostrata I know she assist people instead I asked about you that why did you took so long to taper? Please do not get me wrong if I am asking this because it is my concern about tapering drugs and in between your tapering schedule how was your sleep?well I am just asking about your sleep between your tapering schedule till now. 

Please do not get me wrong I am sorry if my words hurt, pardon me for my bad English 😌 maybe my English writing skills are not up to date. 

I know you guys are super intelligent and very well researched, there no doubt it. Again thanks for providing me all the links. 

[ChessieCat]

Sorry about the confusion.  It was Alto's quote that you posted and I thought that you were asking her about her taper.

 

I'm also a "senior citizen", 63 years old.  During my taper I have had some times that I've had problems sleeping but I have used non drug coping techniques and acceptance.  Currently my sleep is okay but I do sometimes find it hard to go back to sleep when I wake during the night.

 

Because I'm taking a different drug to you and have not taken a benzo, it is difficult to compare my taper to your taper.  And because everyone reacts differently to drugs/going off drugs, even finding someone who is taking the same drugs as you does not mean that you will have the same experience as they do.

 

I've done a search for Paxil and paroxetine in the Benzo Forum.  These are the links to the results:

 

https://www.survivingantidepressants.org/search/?q=paxil&quick=1&type=forums_topic&nodes=29

 

https://www.survivingantidepressants.org/search/?q=paroxetine&quick=1&type=forums_topic&nodes=29

[Akriti]

11 minutes ago, ChessieCat said:

Sorry about the confusion.  It was Alto's quote that you posted and I thought that you were asking her about her taper.

 

I'm also a "senior citizen", 63 years old.  During my taper I have had some times that I've had problems sleeping but I have used non drug coping techniques and acceptance.  Currently my sleep is okay but I do sometimes find it hard to go back to sleep when I wake during the night.

 

Because I'm taking a different drug to you and have not taken a benzo, it is difficult to compare my taper to your taper.  And because everyone reacts differently to drugs/going off drugs, even finding someone who is taking the same drugs as you does not mean that you will have the same experience as they do.

 

I've done a search for Paxil and paroxetine in the Benzo Forum.  These are the links to the results:

 

https://www.survivingantidepressants.org/search/?q=paxil&quick=1&type=forums_topic&nodes=29

 

https://www.survivingantidepressants.org/search/?q=paroxetine&quick=1&type=forums_topic&nodes=29

Maam much respect to you, I thought you are 35 or 40 year old woman because you are so prompt in your response or actively giving me information and suggestions unlike people of my age who just don't care about other concerns , I mean it happens that people in their youth just do not get the time to respond or concerning about other problems. You're an inspiration to us on how you provide research links, informative links, who does that? Much love to you maam ❤