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quickquestion: Should I reinstate paxil?


quickquestion

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Please move if not in the right forum - I was unable to post in tapering!

 

I was placed on 20mg paxil last December after suffering a brain injury. The paxil did not help, but through neurofeedback am now back to 90ish%. In May (after 5 months of being on paxil), I began to taper off as follows:

 

15mg for 3 weeks - maybe a couple of nights of insomnia, but nothing notable

10 mg for 2 weeks - similar to above

5 mg 11 weeks - had flu like symptoms for a few weeks, which then re-appeared a few weeks later. After about 10 weeks, had a week of headaches and severe insomnia. Overall I was fine, but my most problematic symptom was severe brain fog when trying to study (currently in school)

0 mg for the past 10 days - pretty strong anxiety and depression, as well as insomnia - these are starting to clear up. Also had severe brain fog and flu like symptoms the first few days.

 

I believe that I went from 15 to 5 too quickly, and am concerned that this issue of brain fog when studying will persist.

 

My questions are:

 

given the short amount of time I was on paxil, is it better to tough this out or to reinstate at 10mg and go slowly from there? My goal is to get rid of the brain fog issue. 

given that its been 12 weeks since I was 10 mg, is it too late to reinstate? I have read that reinstatement should occur quickly, but I am unsure if his means since your last time taking the drug at all, or since the last time you were at a given dose. I.e. because I have only been off for 10 days, can I still reinstate 10mg even though I was last at that dose 12 weeks ago?

 

My main concern is causing a long term issue and want to be conservative. I have miraculously overcome two health issues that I thought would be lifelong, and I am not in a position for another problem to occur. Thank you for all of your help!

Late Dec 2019 - due to misdiagnosed brain injury, I was put on 20mg paxil (ramped up from 10mg) and 50 seroquel for sleep 

May 2020 - down to 15mg paxil (stayed for 3.5 weeks) - minimal withdrawal

June 2020 - down to 10 mg paxil (stayed for 2 weeks) - minimal withdrawal

June 2020 - down to 5 mg paxil (stayed for 12 weeks) - flu like symptoms that would come in waves, insomnia randomly at week 10

September 2020 - 0 mg paxil and have been at this for two weeks. Moderate depression, anxiety, and strong insomnia - debating what to do

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  • ChessieCat changed the title to quickquestion: Should I reinstate paxil?
  • Moderator Emeritus

Hi and welcome to SA,

 

It is good that you have found SA.

 

Yes, you have tapered much too quickly.  And consequently you have been experiencing withdrawal symptoms.  The brain can become physiologically dependent on an AD in as short as 1 month.

 

Dr Joseph Glenmullen's WD Symptoms Checklist

 

 

2 hours ago, quickquestion said:

 

15mg for 3 weeks - maybe a couple of nights of insomnia, but nothing notable

 

10 mg for 2 weeks - similar to above

 

5 mg 11 weeks - had flu like symptoms for a few weeks, which then re-appeared a few weeks later. After about 10 weeks, had a week of headaches and severe insomnia. Overall I was fine, but my most problematic symptom was severe brain fog when trying to study (currently in school)

 

0 mg for the past 10 days - pretty strong anxiety and depression, as well as insomnia - these are starting to clear up. Also had severe brain fog and flu like symptoms the first few days.

 

 

When reinstating it is better to start with a small dose than to risk reinstating too much.  Going back to 10mg could possibly make things worse.

 

You could try reinstating 2.5mg and see if your withdrawal symptoms improve.  The lower the dose you can stabilise on the less you will have to taper off later on.  Please note that it takes about 4 days for the dose to get to full level in the blood and a bit longer for it to register in the brain.  You will need to be patient during this time and try not to panic.  We have seen members panic and taken more of their drug and made things worse.  Keep daily notes on paper so you can be objective about your symptoms. When we feel awful we just feel awful even if yesterday we felt worse.  Having the notes can help you to see improvement that you might not feel.

 

The idea of reinstating isn't to get rid of symptoms completely but to bring them to a bearable level.  It may take several months holding on the reinstatement dose before you can recommence tapering.  In your case, because of the very fast and large reductions you made, it could be 6 months.

 

Please continue to let us know how you are.  If your symptoms remain unbearable a small updose (because these drugs are strong possibly as little as 0.5mg for a total of 3mg) might help.  The increase amount will be based on how much the symptoms have eased on 2.5mg and how severe they are.  We can suggest an increase.

 

Please read Post #1 of this topic:

 

About reinstating and stabilizing to reduce withdrawal symptoms

 

This topic explains how to get your dose:

 

Tips for tapering off paroxetine (Paxil, Seroxat)

 

Stabilising after a reinstatement is not linear.  It happens in a windows and waves pattern.

 

Windows and Waves Pattern of Stabilization

 

We strongly encourage members to learn and use Non-drug techniques to get through the difficult times.

 

This is your own Introduction topic where you can ask questions and journal your progress.

 

Please continue to let us know how you are doing.  Once your withdrawal symptoms have improved we can provide you with more information about tapering.

* NO LONGER ACTIVE on SA *

MISSION ACCOMPLISHED:  (6 year taper)      0mg Pristiq  on 13th November 2021

ADs since ~1992:  25+ years - 1 unknown, Prozac (muscle weakness), Zoloft; citalopram (pooped out) CTed (very sick for 2.5 wks a few months after); Pristiq:  50mg 2012, 100mg beg 2013 (Serotonin Toxicity)  Tapering from Oct 2015 - 13 Nov 2021   LAST DOSE 0.0025mg

Post 0 updates start here    My tapering program     My Intro (goes to tapering graph)

 VIDEO:   Antidepressant Withdrawal Syndrome and its Management

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Thank you for your quick response. I would say that my symptoms are not unbearable, but I would like to avoid any disastrous consequence down the road. I have a few more questions:

  • So it seems like I cannot go back fix going down from 15 to 5 too quickly, which is when the brain fog started. Given that I was still experiencing the brain fog at 5 mg, I imagine I will have it at 2.5mg, correct? Is there any other solution here?
  • How will I know that I have stabilized and am ready to start tapering again?
  • I have also seen a few people who seem to get some of the bad side effects like PSSD after reinstating - is this possible if only going back to 2.5mg? 
  • I am planning on continuing nuerofeedback for my other issues, but it does make me quite exhausted. Will being tired interfere with my healing from withdrawal?

Thanks again!

Late Dec 2019 - due to misdiagnosed brain injury, I was put on 20mg paxil (ramped up from 10mg) and 50 seroquel for sleep 

May 2020 - down to 15mg paxil (stayed for 3.5 weeks) - minimal withdrawal

June 2020 - down to 10 mg paxil (stayed for 2 weeks) - minimal withdrawal

June 2020 - down to 5 mg paxil (stayed for 12 weeks) - flu like symptoms that would come in waves, insomnia randomly at week 10

September 2020 - 0 mg paxil and have been at this for two weeks. Moderate depression, anxiety, and strong insomnia - debating what to do

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Also - what is the best scale to use for tapering? I am only finding those with .001 g accuracy, but that is not enough for fractions of mg. Please advise!

Late Dec 2019 - due to misdiagnosed brain injury, I was put on 20mg paxil (ramped up from 10mg) and 50 seroquel for sleep 

May 2020 - down to 15mg paxil (stayed for 3.5 weeks) - minimal withdrawal

June 2020 - down to 10 mg paxil (stayed for 2 weeks) - minimal withdrawal

June 2020 - down to 5 mg paxil (stayed for 12 weeks) - flu like symptoms that would come in waves, insomnia randomly at week 10

September 2020 - 0 mg paxil and have been at this for two weeks. Moderate depression, anxiety, and strong insomnia - debating what to do

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@ChessieCat

 

One last thing - if I am still having issues at 2.5, do I slowly keep going up, or just stay at 2.5?

Late Dec 2019 - due to misdiagnosed brain injury, I was put on 20mg paxil (ramped up from 10mg) and 50 seroquel for sleep 

May 2020 - down to 15mg paxil (stayed for 3.5 weeks) - minimal withdrawal

June 2020 - down to 10 mg paxil (stayed for 2 weeks) - minimal withdrawal

June 2020 - down to 5 mg paxil (stayed for 12 weeks) - flu like symptoms that would come in waves, insomnia randomly at week 10

September 2020 - 0 mg paxil and have been at this for two weeks. Moderate depression, anxiety, and strong insomnia - debating what to do

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  • Moderator Emeritus
8 hours ago, quickquestion said:

So it seems like I cannot go back fix going down from 15 to 5 too quickly, which is when the brain fog started. Given that I was still experiencing the brain fog at 5 mg, I imagine I will have it at 2.5mg, correct? Is there any other solution here?

 

Not necessarily.  Because your system may have become sensitised by withdrawal you might not need as much of the drug.  It is better to start low and increase slowly.  Other members have increased too much and/or too quickly and have made things worse.

 

8 hours ago, quickquestion said:

How will I know that I have stabilized and am ready to start tapering again?

 

WDnormal

 

Reinstatement

 

Stability

 

8 hours ago, quickquestion said:

I have also seen a few people who seem to get some of the bad side effects like PSSD after reinstating - is this possible if only going back to 2.5mg?

 

Lower dose reinstatement is suggested to keep the risk of adverse affects to a minimum.

 

Please read Post #1 of this topic:

 

About reinstating and stabilizing to reduce withdrawal symptoms

 

8 hours ago, quickquestion said:

I am planning on continuing nuerofeedback for my other issues, but it does make me quite exhausted. Will being tired interfere with my healing from withdrawal?

 

I think it would be better to hold off on doing neurofeedback until you have stabilised.  It is better to try to be as stress free as possible so that the brain isn't busy trying to cope with other things when we want it to work on stabilising after the drug changes.

 

See this post which applies to reinstating as well as tapering:

 

before-you-begin-tapering-what-you-need-to-know

 

5 hours ago, quickquestion said:

what is the best scale to use for tapering?

 

Many members use the Gemini-20.  BrassMonkey, one of the mods, did his entire taper (other than the last few doses which he weighed and then divided up with a knife "like druggies do" 😉) even down to very low weights using this scale.

 

using-a-digital-scale-to-measure-doses

 

* NO LONGER ACTIVE on SA *

MISSION ACCOMPLISHED:  (6 year taper)      0mg Pristiq  on 13th November 2021

ADs since ~1992:  25+ years - 1 unknown, Prozac (muscle weakness), Zoloft; citalopram (pooped out) CTed (very sick for 2.5 wks a few months after); Pristiq:  50mg 2012, 100mg beg 2013 (Serotonin Toxicity)  Tapering from Oct 2015 - 13 Nov 2021   LAST DOSE 0.0025mg

Post 0 updates start here    My tapering program     My Intro (goes to tapering graph)

 VIDEO:   Antidepressant Withdrawal Syndrome and its Management

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@ChessieCat

 

Great that all makes sense, other than the scale. I still don't quite understand how to get fractions of milligrams using that scale. I just took a look at the link but am not understanding! Sorry if I am being thick!

 

Thanks

Late Dec 2019 - due to misdiagnosed brain injury, I was put on 20mg paxil (ramped up from 10mg) and 50 seroquel for sleep 

May 2020 - down to 15mg paxil (stayed for 3.5 weeks) - minimal withdrawal

June 2020 - down to 10 mg paxil (stayed for 2 weeks) - minimal withdrawal

June 2020 - down to 5 mg paxil (stayed for 12 weeks) - flu like symptoms that would come in waves, insomnia randomly at week 10

September 2020 - 0 mg paxil and have been at this for two weeks. Moderate depression, anxiety, and strong insomnia - debating what to do

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  • Moderator Emeritus

I suggest you ask your question in that topic.  I've never used a scale myself.

* NO LONGER ACTIVE on SA *

MISSION ACCOMPLISHED:  (6 year taper)      0mg Pristiq  on 13th November 2021

ADs since ~1992:  25+ years - 1 unknown, Prozac (muscle weakness), Zoloft; citalopram (pooped out) CTed (very sick for 2.5 wks a few months after); Pristiq:  50mg 2012, 100mg beg 2013 (Serotonin Toxicity)  Tapering from Oct 2015 - 13 Nov 2021   LAST DOSE 0.0025mg

Post 0 updates start here    My tapering program     My Intro (goes to tapering graph)

 VIDEO:   Antidepressant Withdrawal Syndrome and its Management

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  • Moderator

You can get fractions of a milligram for your dose strength because the scale is actually weighing something else. All these medications are made with fillers to bulk up the tablets to make them easier to manufacture and handle. For example my 40mg paxil tablets actually weighed 500mg. Which meant that each 1 milligram of pill weight (mgpw) contained only .08mgai (milligrams active ingredient or dose weight) Because of this it's fairly easy to hit the fractions most of the time.  If not, one time rounding usually isn't a problem.

20 years on Paxil starting at 20mg and working up to 40mg. Sept 2011 started 10% every 6 weeks taper (2.5% every week for 4 weeks then hold for 2 additional weeks), currently at 7.9mg. Oct 2011 CTed 15oz vodka a night, to only drinking 2 beers most nights, totally sober Feb 2013.

Since I wrote this I have continued to decrease my dose by 10% every 6 weeks (2.5% every week for 4 weeks and then hold for an additional 2 weeks). I added in an extra 6 week hold when I hit 10mg to let things settle out even more. When I hit 3mgpw it became hard to split the drop into 4 parts so I switched to dropping 1mgpw (pill weight) every week for 3 weeks and then holding for another 3 weeks.  The 3 + 3 schedule turned out to be too harsh so I cut back to dropping 1mgpw every 4 weeks which is working better.

Final Dose 0.016mg.     Current dose 0.000mg 04-15-2017

 

"It's also important not to become angry, no matter how difficult life is, because you can loose all hope if you can't laugh at yourself and at life in general."  Stephen Hawking

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@ChessieCat

@brassmonkey

 

Thank you that makes much more sense. 

 

To be honest I feel incredibly torn about making this decision to reinstate. My withdrawal seems to be improving - the flu like symptoms are mostly gone, but still have some anxiety, depression, and insomnia (probably the reason I am so anxious about this decision). I have read so many horror stories about getting back on the meds and causing anhedonia and PSSD. At the same time I am terrified of making the brain fog I have long lasting, or triggering anhedonia etc. by coming off too fast. I see that the idea of tapering is to have symptoms be manageable, which mine are getting close to being.

 

I guess I am not sure what I am asking for, just some guidance or advice would be much appreciated, or reassurance one way or another.

 

Thanks again, this forum has been a blessing.

 

Late Dec 2019 - due to misdiagnosed brain injury, I was put on 20mg paxil (ramped up from 10mg) and 50 seroquel for sleep 

May 2020 - down to 15mg paxil (stayed for 3.5 weeks) - minimal withdrawal

June 2020 - down to 10 mg paxil (stayed for 2 weeks) - minimal withdrawal

June 2020 - down to 5 mg paxil (stayed for 12 weeks) - flu like symptoms that would come in waves, insomnia randomly at week 10

September 2020 - 0 mg paxil and have been at this for two weeks. Moderate depression, anxiety, and strong insomnia - debating what to do

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  • Moderator Emeritus
10 minutes ago, quickquestion said:

I guess I am not sure what I am asking for, just some guidance or advice would be much appreciated, or reassurance one way or another.

 

We can't make the decision for you.  All we can do is give you the information so you can make an informed decision.

 

This is what happened to me:

 

I reduced my Pristiq from 100mg to 50mg and for 2 weeks I experienced severe cog fog, and even walking took my whole concentration.  I joined SA but didn't updose as suggested because I was trying, through the brain fog, to learn about what was happening.  A couple of days after joining I got to the stage that I was unable to type.  Having been a typist for 40+ years I knew that something was really wrong.  I was very thankful for SA's suggestion.  I went and took extra Pristiq.  Astoundingly after only about 4 hours (not days) I was able to type again and the brain fog was lifting.  Because I had a benchmark I knew that it was because of the drug.

 

Since then I have been tapering with minimal withdrawal symptoms, have held for longer periods several times due to circumstances when it was better to hold due to additional stress not related to tapering/withdrawal (dental issues and back injury), and I'm about to make a reduction to 6.125mg.

* NO LONGER ACTIVE on SA *

MISSION ACCOMPLISHED:  (6 year taper)      0mg Pristiq  on 13th November 2021

ADs since ~1992:  25+ years - 1 unknown, Prozac (muscle weakness), Zoloft; citalopram (pooped out) CTed (very sick for 2.5 wks a few months after); Pristiq:  50mg 2012, 100mg beg 2013 (Serotonin Toxicity)  Tapering from Oct 2015 - 13 Nov 2021   LAST DOSE 0.0025mg

Post 0 updates start here    My tapering program     My Intro (goes to tapering graph)

 VIDEO:   Antidepressant Withdrawal Syndrome and its Management

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  • Moderator

If you are seeing slight improvements in your symptoms, then I would hold at your current dose. Reinstatement is quite a gamble, if it helps then its good, but the chances are about 50/50. If your symptoms are debilitating to the point you can't care for your self, get out of bed, wash, get dressed, eat, then reinstatement might be a good option.  But if things are stable and even improving slightly, then in my mind it's not worth the risk. ADWD improves at an incredibly slow pace so we want as few setbacks as possible.

20 years on Paxil starting at 20mg and working up to 40mg. Sept 2011 started 10% every 6 weeks taper (2.5% every week for 4 weeks then hold for 2 additional weeks), currently at 7.9mg. Oct 2011 CTed 15oz vodka a night, to only drinking 2 beers most nights, totally sober Feb 2013.

Since I wrote this I have continued to decrease my dose by 10% every 6 weeks (2.5% every week for 4 weeks and then hold for an additional 2 weeks). I added in an extra 6 week hold when I hit 10mg to let things settle out even more. When I hit 3mgpw it became hard to split the drop into 4 parts so I switched to dropping 1mgpw (pill weight) every week for 3 weeks and then holding for another 3 weeks.  The 3 + 3 schedule turned out to be too harsh so I cut back to dropping 1mgpw every 4 weeks which is working better.

Final Dose 0.016mg.     Current dose 0.000mg 04-15-2017

 

"It's also important not to become angry, no matter how difficult life is, because you can loose all hope if you can't laugh at yourself and at life in general."  Stephen Hawking

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@Altostrata

@Gridley

 

Would either of you possibly be able to weigh in? Thank you!!!

Late Dec 2019 - due to misdiagnosed brain injury, I was put on 20mg paxil (ramped up from 10mg) and 50 seroquel for sleep 

May 2020 - down to 15mg paxil (stayed for 3.5 weeks) - minimal withdrawal

June 2020 - down to 10 mg paxil (stayed for 2 weeks) - minimal withdrawal

June 2020 - down to 5 mg paxil (stayed for 12 weeks) - flu like symptoms that would come in waves, insomnia randomly at week 10

September 2020 - 0 mg paxil and have been at this for two weeks. Moderate depression, anxiety, and strong insomnia - debating what to do

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  • Mentor

Hi @quickquestion

Wanted to drop by and give you some support.

I can see that you are torn about reinstatement. You are seeing slight improvements and that is for sure a great sign of healing. If I were you I would avoid horror stories and focus on your positive improvements, which seem to be happening. Make this journey your own, don’t compare to others. As brassmonkey said it is a slow process, so keep that in mind. 
 

10 hours ago, quickquestion said:

My withdrawal seems to be improving - the flu like symptoms are mostly gone

 

10 hours ago, quickquestion said:

I see that the idea of tapering is to have symptoms be manageable, which mine are getting close to being.

This is a great indicator that you are healing.

What ever you decide, know that you will heal. One day at a time is what we have. 
All the best to you.

 

 


1999-2020  20 mg Paxil

Bridged with Fluoxetine to help me get off Paxil.

2022 Fluoxetine 15 mg 12/12 14mg 27/12  13mg jan 12mg feb 11mg mars 10mg, 9 mg 8,5 mg 7.6mg 7.0 mg 6,3 mg 5,6 mg 5,0 mg 4,5 mg 4,0 mg 3.6mg 3,2 mg 2,9 mg 2,6 mg 2,3 mg 2,0 mg 1.8 mg

 


I am not a medical professional nor is this a medical advice. I only talk from my own experience.

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  • Moderator Emeritus

@quickquestion

 You're seeing improvements--which means you're healing.  My suggestion would be not to reinstate.

Edited by Gridley

Gridley Introduction

 

Lexapro 20 mg since 2004.  Begin Brassmonkey Slide Taper Jan. 2017.   

End 2017 year 1 of taper at 9.25mg 

End 2018 year 2 of taper at 4.1mg

End 2019 year 3 of taper at 1.0mg  

Oct. 30, 2020  Jump to zero from 0.025mg.  Current dose: 0.000mg

3 year, 10 month taper is 100% complete.

 

Ativan 1 mg to 1.875mg 1986-2020, two CT's and reinstatements

Nov. 2020, 7-week Ativan-Valium crossover to 18.75mg Valium

Feb. 2021, begin 10%/4 week taper of 18.75mg Valium 

End 2021  year 1 of Valium taper at 6mg

End 2022 year 2 of Valium taper at 2.75mg 

End 2023 year 3 of Valium taper at 1mg

Jan. 24, 2024: Hold at 1mg and shift to Imipramine taper.

Taper is 95% complete.

 

Imipramine 75 mg daily since 1986.  Jan.-Sept. 2016 tapered to 14.4mg  

March 22, 2022: Begin 10%/4 week taper

Aug. 5, 2022: hold at 9.5mg and shift to Valium taper

Jan. 24, 2024: Resume Imipramine taper.  Current dose as of May 2: 6.1mg

Taper is 92% complete.  

  

Supplements: multiple, quercetin, omega-3, vitamins C, E and D3, magnesium glycinate, probiotic, zinc, melatonin .3mg, iron, serrapeptase, nattokinase


I am not a medical professional and this is not medical advice but simply information based on my own experience, as well as other members who have survived these drugs.

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@Altostrata I would love your opinion if you get a second. Thanks again for this wonderful forum and for all of your help!

 

FYI I am now unsure if the anxiety and depression are improving or not. It has now been 13 days off the meds. 

Late Dec 2019 - due to misdiagnosed brain injury, I was put on 20mg paxil (ramped up from 10mg) and 50 seroquel for sleep 

May 2020 - down to 15mg paxil (stayed for 3.5 weeks) - minimal withdrawal

June 2020 - down to 10 mg paxil (stayed for 2 weeks) - minimal withdrawal

June 2020 - down to 5 mg paxil (stayed for 12 weeks) - flu like symptoms that would come in waves, insomnia randomly at week 10

September 2020 - 0 mg paxil and have been at this for two weeks. Moderate depression, anxiety, and strong insomnia - debating what to do

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  • Administrator

Hello, quickquestion.

 

If over the last week you've seen some improvement, you may not need to reinstate, you might be a person who can recover in a month or two. Many people find fish oil and magnesium supplements helpful, see
https://survivingantidepressants.org/index.php?/topic/36-king-of-supplements-omega-3-fatty-acids-fish-oil/
https://survivingantidepressants.org/topic/15483-magnesium-natures-calcium-channel-blocker/

 

You might try a little bit of one at a time to see how it affects you.

 

Please let us know how you're doing. If you find your symptoms getting worse, you may wish to try reinstatement of a very low dose, such as 1mg-2mg. Paxil stands out as being difficult to go off. It is so difficult, that if you want to try reinstatement, we suggest substituting a very low dose of another drug, such as fluoxetine or citalopram. All three SSRIs come in liquid form for easy titration.

 

To help us out, follow these instructions Please put your drug and withdrawal history in your signature You may need to use a computer to do this.

This is not medical advice. Discuss any decisions about your medical care with a knowledgeable medical practitioner.

"It has become appallingly obvious that our technology has surpassed our humanity." -- Albert Einstein

All postings © copyrighted.

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@Altostrata thank you for your quick response.

 

Would it be safe for me to wait another week or so and see how my symptoms are before deciding to reinstate or not? In the scenario you propose, would I first get back on paxil and then switch over to fluoxetine or citalopram, or just start with one of those?

 

I was hoping I would be able to recover quickly, but it does worry me that I had intense insomnia at week 10 of being on 5mg, and that I was still experiencing brain fog while studying at that time as well, i.e. i still had some symptoms when dropping from 5 to 0, although most had improved by that point. Does this indicate anything?

 

I have been taking both the magnesium and fish oil for many months now because of the brain injury, so its tough to say what they are doing for withdrawal. 

 

Thank you, this forum has been a massive help to me these past few days.

Late Dec 2019 - due to misdiagnosed brain injury, I was put on 20mg paxil (ramped up from 10mg) and 50 seroquel for sleep 

May 2020 - down to 15mg paxil (stayed for 3.5 weeks) - minimal withdrawal

June 2020 - down to 10 mg paxil (stayed for 2 weeks) - minimal withdrawal

June 2020 - down to 5 mg paxil (stayed for 12 weeks) - flu like symptoms that would come in waves, insomnia randomly at week 10

September 2020 - 0 mg paxil and have been at this for two weeks. Moderate depression, anxiety, and strong insomnia - debating what to do

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  • Administrator

It's up to you if you want to wait and see which way your symptoms go.

 

No, I would not touch Paxil ever again. We recommend very low doses of the others to avoid potential adverse reactions.

 

2 minutes ago, quickquestion said:

I had intense insomnia at week 10 of being on 5mg

 

You have been suffering withdrawal symptom since you dropped to 5mg. This does put your nervous system in a vulnerable condition, but your recovery could still go either way without reinstatement.

 

Please read the topics on fish oil and magnesium. You may not be taking enough of either.

 

We really need you to put your drug history in your signature!

This is not medical advice. Discuss any decisions about your medical care with a knowledgeable medical practitioner.

"It has become appallingly obvious that our technology has surpassed our humanity." -- Albert Einstein

All postings © copyrighted.

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@Altostrata Okay thank you. Does the 1-2mg refer to fluoxetine or citalopram, or both?

 

I am very grateful for your time and feedback!

Late Dec 2019 - due to misdiagnosed brain injury, I was put on 20mg paxil (ramped up from 10mg) and 50 seroquel for sleep 

May 2020 - down to 15mg paxil (stayed for 3.5 weeks) - minimal withdrawal

June 2020 - down to 10 mg paxil (stayed for 2 weeks) - minimal withdrawal

June 2020 - down to 5 mg paxil (stayed for 12 weeks) - flu like symptoms that would come in waves, insomnia randomly at week 10

September 2020 - 0 mg paxil and have been at this for two weeks. Moderate depression, anxiety, and strong insomnia - debating what to do

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  • Moderator Emeritus
1 hour ago, Altostrata said:

We really need you to put your drug history in your signature!

 

Instructions:  Withdrawal History Signature


Account Settings – Create or Edit a signature

* NO LONGER ACTIVE on SA *

MISSION ACCOMPLISHED:  (6 year taper)      0mg Pristiq  on 13th November 2021

ADs since ~1992:  25+ years - 1 unknown, Prozac (muscle weakness), Zoloft; citalopram (pooped out) CTed (very sick for 2.5 wks a few months after); Pristiq:  50mg 2012, 100mg beg 2013 (Serotonin Toxicity)  Tapering from Oct 2015 - 13 Nov 2021   LAST DOSE 0.0025mg

Post 0 updates start here    My tapering program     My Intro (goes to tapering graph)

 VIDEO:   Antidepressant Withdrawal Syndrome and its Management

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@Altostrata 

@ChessieCat

 

added signature!

 

I just realized that in January, I took nyquil along with paxil on two different nights. I had tachycardia for a few hours each time but no lasting impact. I now realize this was mild serotonin syndrome. Does this factor into withdrawal? Is it possible this was similar to a toxic adverse reaction? Quite concerned. Thank you.

Late Dec 2019 - due to misdiagnosed brain injury, I was put on 20mg paxil (ramped up from 10mg) and 50 seroquel for sleep 

May 2020 - down to 15mg paxil (stayed for 3.5 weeks) - minimal withdrawal

June 2020 - down to 10 mg paxil (stayed for 2 weeks) - minimal withdrawal

June 2020 - down to 5 mg paxil (stayed for 12 weeks) - flu like symptoms that would come in waves, insomnia randomly at week 10

September 2020 - 0 mg paxil and have been at this for two weeks. Moderate depression, anxiety, and strong insomnia - debating what to do

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  • Administrator
On 9/9/2020 at 2:48 PM, quickquestion said:

Does the 1-2mg refer to fluoxetine or citalopram, or both?

 

Either.

 

Your nervous system may be very sensitive from withdrawal and you may react oddly to drugs, even over-the-counter drugs, for quite a while. Try to let your nervous system settle down.

This is not medical advice. Discuss any decisions about your medical care with a knowledgeable medical practitioner.

"It has become appallingly obvious that our technology has surpassed our humanity." -- Albert Einstein

All postings © copyrighted.

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  • 3 weeks later...

Hi everyone,

@ChessieCat @Altostrata @Gridley

 

4 days after my last post I entered a window and started sleeping again and the anxiety/depression improved quite a bit. This lasted for a week and a half and I am now in a wave and barely sleeping at all. 

 

I have been taking ZZZquil for quite a while now to help with sleep, and just now learned it has mild SSRI properties. Is it possible this could interfere with recovery? Is it recommended that I taper off this, and if so, at what rate?

 

Thanks!

Late Dec 2019 - due to misdiagnosed brain injury, I was put on 20mg paxil (ramped up from 10mg) and 50 seroquel for sleep 

May 2020 - down to 15mg paxil (stayed for 3.5 weeks) - minimal withdrawal

June 2020 - down to 10 mg paxil (stayed for 2 weeks) - minimal withdrawal

June 2020 - down to 5 mg paxil (stayed for 12 weeks) - flu like symptoms that would come in waves, insomnia randomly at week 10

September 2020 - 0 mg paxil and have been at this for two weeks. Moderate depression, anxiety, and strong insomnia - debating what to do

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Is taking ZZZquil each night going to cause an issue similar to taking meds one day on, one day off, due to its short half life? In other words, is taking it each night desensitizing the receptors similar to improper withdrawal practice or one day on, one day off?

 

Thanks

Late Dec 2019 - due to misdiagnosed brain injury, I was put on 20mg paxil (ramped up from 10mg) and 50 seroquel for sleep 

May 2020 - down to 15mg paxil (stayed for 3.5 weeks) - minimal withdrawal

June 2020 - down to 10 mg paxil (stayed for 2 weeks) - minimal withdrawal

June 2020 - down to 5 mg paxil (stayed for 12 weeks) - flu like symptoms that would come in waves, insomnia randomly at week 10

September 2020 - 0 mg paxil and have been at this for two weeks. Moderate depression, anxiety, and strong insomnia - debating what to do

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I found the following which is interesting: https://onlinelibrary.wiley.com/doi/full/10.1111/j.1440-1819.2011.02234.x

 

It looks like ZZZquil is about 10,000 times weaker than paxil when it comes to inhibition of serotonin transporter. Interesting!

Late Dec 2019 - due to misdiagnosed brain injury, I was put on 20mg paxil (ramped up from 10mg) and 50 seroquel for sleep 

May 2020 - down to 15mg paxil (stayed for 3.5 weeks) - minimal withdrawal

June 2020 - down to 10 mg paxil (stayed for 2 weeks) - minimal withdrawal

June 2020 - down to 5 mg paxil (stayed for 12 weeks) - flu like symptoms that would come in waves, insomnia randomly at week 10

September 2020 - 0 mg paxil and have been at this for two weeks. Moderate depression, anxiety, and strong insomnia - debating what to do

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  • Moderator Emeritus

Some members find that if they take a supplement continually that it sometimes turns paradoxical.  If you think that a drug or supplement may cause physiological changes/dependency then it is generally a good idea to taper it.  But you might be able to do a fast taper.  You need to listen to your body/symptoms and hold longer/reduce less if needed.

* NO LONGER ACTIVE on SA *

MISSION ACCOMPLISHED:  (6 year taper)      0mg Pristiq  on 13th November 2021

ADs since ~1992:  25+ years - 1 unknown, Prozac (muscle weakness), Zoloft; citalopram (pooped out) CTed (very sick for 2.5 wks a few months after); Pristiq:  50mg 2012, 100mg beg 2013 (Serotonin Toxicity)  Tapering from Oct 2015 - 13 Nov 2021   LAST DOSE 0.0025mg

Post 0 updates start here    My tapering program     My Intro (goes to tapering graph)

 VIDEO:   Antidepressant Withdrawal Syndrome and its Management

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  • 4 months later...

@brassmonkey

@Altostrata

 

I thought my days on the forum were coming to a close, but unfortunately not!

 

Since getting off of Paxil in September, my withdrawal has been manageable. I have a few symptoms for 1-2 weeks, and then they go away and are replaced by others - no one symptom lingered and all were pretty tolerable. Getting off ZZZquil was uneventful, which is probably because I have been on Seroquel and that outcompeted it for histamine receptors anyways. 

 

However, for some reason, my colon reacted poorly to a steak I had on Christmas. I have had an unbelievably pure diet for the past year, with zero processed foods and everything organic. This steak had probably 250g of fat and wasn't organic, I believe this was part of the problem.

 

Because of this colitis, I went to a BRAT diet. I also cut out the vitamin D (5000IU) and fish oil that I have been taking for a year. I began to lose weight and was very fatigued. I tried to hold off on taking anything for my stomach out of fear of worsening withdrawal. My sleep started to decline again, but I am unsure if this was the same type I experienced during withdrawal or because of malnutrition. 

 

Two weeks ago, I decided that I needed to try something, as this diet was worse for me than anything else. On Tuesday the 26th, I added back in Vitamin D at the same dose, thinking it wasn't a problem as I had only been off it a month. I woke up sad on Wednesday, but didn't think much of it. I also noticed my heart pounding when going to bed Wednesday night, although it was slight. On Thursday, I took a child's advil, which also happened to have aspartate in it (did not realize at the time). I took this at the same time as Vitamin D. A few hours later, I started to have some intrusive thoughts, which I have had during withdrawal but not for a long time. I then had a panic attack which I have only had once before in my life. However, I do believe that this panic attack was circumstantial - I had been so worried about taking advil, and then when it felt like I was having an adverse reaction to it, I panicked. It lasted like 10 minutes and the rest of the day I was exhausted and a little anxious, but by bedtime felt fine. The next morning I took Vitamin D again, and a few hours later slight anxiety returned.

 

Since that Friday I have taken nothing, but many of my withdrawal symptoms are returning and this is probably the worst I have felt during all of withdrawal. Rather than one or two symptoms at a time, I have many and I only seem to be getting more. They are:

 

- sadness, hopelessness, and crying

- body anxiety - pounding heart, sweaty feet, cold feeling in arms

- jolting awake after falling asleep

- day long malaise (only once)

- a bad nerve feeling in penis. Sexual function is all normal, but it just feels like a mild burning. 

- intense dreams that stress me out because I am so convinced of the thing in my dream being real, when it is clearly nonsense upon waking up

- same diminished sleep as a couple weeks ago

- shortness of breath

- new, weird upper GI symptoms 

 

Other than the upper GI symptoms, which could be from this diet, I have had all of these symptoms during withdrawal. The worst two are definitely the sadness and anxiety, neither of which seem to be improving. 

 

I still need to address my colon, and doctors have advised mesalamine, aloe vera, or starting with NSAIDs. I am scared to start anything given what has happened. At this point I am trying to determine the cause of this wave so that I can determine next steps for my colon; my theories are:

 

1) Vitamin D - this is based on feeling sadness and thumping heart - although these were mild compared to now. Also based on anxiety returning the next day after taking it, although this could be coincidental. 

2) Advil or aspartate - this is based on the intrusive thoughts starting a few hours after taking them, and that day really kicking off this wave.

3) The stress of the colitis and malnutrition set me off, as well as not being on fish oil and vitamin D, and the rest is coincidental. This is based on disrupted sleep and a day of malaise prior to starting Vitamin D.

4) The panic attack in of itself threw my system off (not sure if this is possible)

5) some combination of the above

 

Now I realize this is a loaded post. I guess I am just trying to determine the cause of this wave so that I can gauge what is safe for me to take next. I can't find anything on mesalamine on the forum, so do not know the potential for making me worse. I could also try taking another advil (without aspartate) to see if this was the cause. 

 

I have been quite concerned about this as I have never had a traditional wave like this before. I always just have transient symptoms. If this was due to the advil, aspartate, or Vitamin D, I am confused as to why that happened and why it persists 2 weeks later - would this be akin to an adverse reaction? I scoured the site before taking the advil, and it really seemed to me that the people who reacted poorly had had adverse reactions to an AD in the past, which I have not. 

 

Sorry for the long post and thanks again for all you do here. Looking forward to hearing what y'all think.

Late Dec 2019 - due to misdiagnosed brain injury, I was put on 20mg paxil (ramped up from 10mg) and 50 seroquel for sleep 

May 2020 - down to 15mg paxil (stayed for 3.5 weeks) - minimal withdrawal

June 2020 - down to 10 mg paxil (stayed for 2 weeks) - minimal withdrawal

June 2020 - down to 5 mg paxil (stayed for 12 weeks) - flu like symptoms that would come in waves, insomnia randomly at week 10

September 2020 - 0 mg paxil and have been at this for two weeks. Moderate depression, anxiety, and strong insomnia - debating what to do

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  • Administrator

It sounds like you might have had a histamine reaction to an aged steak. You may wish to go on a mild exclusion diet to enable this to settle down.

 

 

Elimination or exclusion diets for reactions to food (food intolerance)

 

Histamine intolerance

 

I would avoid NSAIDs, they exacerbate gut sensitivities. You may wish to join a histamine intolerance or exclusion diet group for more detailed support.

 

Vitamin D is a daytime vitamin that can be activating.

 

Please do visit and let us know how you're doing.

This is not medical advice. Discuss any decisions about your medical care with a knowledgeable medical practitioner.

"It has become appallingly obvious that our technology has surpassed our humanity." -- Albert Einstein

All postings © copyrighted.

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@Altostrata

 

Thanks for the quick response! I have been off of all those foods for years, this seems to be more of a physical injury given the symptoms.

 

Do you have any insight into what could have triggered this unusual wave? Is it possible for Vitamin D or Advil to have kicked this off?

Late Dec 2019 - due to misdiagnosed brain injury, I was put on 20mg paxil (ramped up from 10mg) and 50 seroquel for sleep 

May 2020 - down to 15mg paxil (stayed for 3.5 weeks) - minimal withdrawal

June 2020 - down to 10 mg paxil (stayed for 2 weeks) - minimal withdrawal

June 2020 - down to 5 mg paxil (stayed for 12 weeks) - flu like symptoms that would come in waves, insomnia randomly at week 10

September 2020 - 0 mg paxil and have been at this for two weeks. Moderate depression, anxiety, and strong insomnia - debating what to do

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@Altostrata and would you have any concerns over mesalamine?

Late Dec 2019 - due to misdiagnosed brain injury, I was put on 20mg paxil (ramped up from 10mg) and 50 seroquel for sleep 

May 2020 - down to 15mg paxil (stayed for 3.5 weeks) - minimal withdrawal

June 2020 - down to 10 mg paxil (stayed for 2 weeks) - minimal withdrawal

June 2020 - down to 5 mg paxil (stayed for 12 weeks) - flu like symptoms that would come in waves, insomnia randomly at week 10

September 2020 - 0 mg paxil and have been at this for two weeks. Moderate depression, anxiety, and strong insomnia - debating what to do

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Sorry you are feeling like this.  
 

I saw you tried Neurofeedback, how was that?

Med History - 2014 - 2020 - Zoloft, Effexor, Klonopin, Lexapro, Buspar (No longer on any of these)

Went to my doctor for an annual and mentioned I was stressed, gave me Zoloft, stopped it after 3 months because it didn't do anything, ended up in withdrawal and was told I had a mental illness.  I've been diagnosed Bipolar and Clinically Depressed.  

Current Med Taper 

Lamotrigine - 25mg (May 21') -> 24mg (May 23') -> 23mg (July 23') -> 22mg (Aug 23') -> 21mg (Oct 23') -> 20mg (Dec 23')

Supplement: Magnesium, Fish Oil

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It is essentially the cure for TBI if symptoms are caused by neurovascular decoupling. It is based on the same premise as: https://www.cognitivefxusa.com/

 

However, I have not tried for withdrawal.

Late Dec 2019 - due to misdiagnosed brain injury, I was put on 20mg paxil (ramped up from 10mg) and 50 seroquel for sleep 

May 2020 - down to 15mg paxil (stayed for 3.5 weeks) - minimal withdrawal

June 2020 - down to 10 mg paxil (stayed for 2 weeks) - minimal withdrawal

June 2020 - down to 5 mg paxil (stayed for 12 weeks) - flu like symptoms that would come in waves, insomnia randomly at week 10

September 2020 - 0 mg paxil and have been at this for two weeks. Moderate depression, anxiety, and strong insomnia - debating what to do

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@brassmonkey

 

Adding up calories yesterday, this diet has put me at quite the deficit. Whereas I was eating 3500-4000 calories a day prior to this, which was an unbelievably clean diet with healthy fats, I have fallen to 1500 a day with very little dietary fat (as it wasn't being absorbed). This has gone on for six weeks and I have lost a lot of weight, feel weak, and hair is falling. I am increasing my caloric intake today and will aim to get back in the 2500-3000 per day range. 

 

Is it possible that this stress is the cause of my unusual, longer lasting wave? Or is vitamin D or advil a more likely culprit?

 

Thanks

Late Dec 2019 - due to misdiagnosed brain injury, I was put on 20mg paxil (ramped up from 10mg) and 50 seroquel for sleep 

May 2020 - down to 15mg paxil (stayed for 3.5 weeks) - minimal withdrawal

June 2020 - down to 10 mg paxil (stayed for 2 weeks) - minimal withdrawal

June 2020 - down to 5 mg paxil (stayed for 12 weeks) - flu like symptoms that would come in waves, insomnia randomly at week 10

September 2020 - 0 mg paxil and have been at this for two weeks. Moderate depression, anxiety, and strong insomnia - debating what to do

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  • Moderator

Waves have a mind of their own. It is practically impossible to pin down a specific cause for a wave starting and continuing. Any sort of stress can trigger one and prolong one, any change in medications, diet, work patterns, television shows or a fight with your SO.

 

One thing I surprised that the other mods haven't pointed out is the fact that, according to your signature, last year you tapered from 20mg of paxil to 0 in just nine months. For paxil, and most other drugs, that can be considered a fast taper, and can result is a lengthy period of instability after the jump to "0". In my opinion what you are experiencing is protracted withdrawal caused by a too fast taper, this wave just being one of the symptoms. Protracted WD will contain many large swings in symptoms, new symptoms, and some intense waves. A too fast taper is not as bad as a CT but can be pretty intense for an extended period of time. The symptoms you describe are consistent with this.

20 years on Paxil starting at 20mg and working up to 40mg. Sept 2011 started 10% every 6 weeks taper (2.5% every week for 4 weeks then hold for 2 additional weeks), currently at 7.9mg. Oct 2011 CTed 15oz vodka a night, to only drinking 2 beers most nights, totally sober Feb 2013.

Since I wrote this I have continued to decrease my dose by 10% every 6 weeks (2.5% every week for 4 weeks and then hold for an additional 2 weeks). I added in an extra 6 week hold when I hit 10mg to let things settle out even more. When I hit 3mgpw it became hard to split the drop into 4 parts so I switched to dropping 1mgpw (pill weight) every week for 3 weeks and then holding for another 3 weeks.  The 3 + 3 schedule turned out to be too harsh so I cut back to dropping 1mgpw every 4 weeks which is working better.

Final Dose 0.016mg.     Current dose 0.000mg 04-15-2017

 

"It's also important not to become angry, no matter how difficult life is, because you can loose all hope if you can't laugh at yourself and at life in general."  Stephen Hawking

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@brassmonkey

 

I absolutely agree that I have been in prolonged withdrawal. To clarify, I was only on the Paxil for 9 months, but still understand I tapered too quickly. However, my waves were always a handful of symptoms at a time, and then they would go away. After the first month or so, it was manageable and I was on a clear upwards trajectory. 

 

Right now, however, I am experiencing almost all my symptoms at once, and each is worse than at anytime I have had them previously. Is it possible for stress to cause such a type of wave, or does this type of setback only occur from adverse reactions? My shift in diet was immense, going from a fully balanced diet with 3500 calories a day and lots of healthy fats, to 1200-1500 calories a day of BRAT diet.

 

I was initially concerned about this being due to vitamin D or advil, but after reading about the half-life of Vitamin D, the levels in my system should have still been quite high from taking it everyday for the past year, even with taking the past month off, and thus adding it in seems unlikely to have kicked this off. I also think I was on this downward trajectory prior to the advil. 

 

If this is indeed diet related, how long would you expect it to take for me to start improving once my diet returns to normal? I have noticed only worsening of my condition over the past three weeks and am non-functioning. I apologize for the all of the questions - I am just looking for someone knowledgeable to bounce these ideas and concerns off of. 

Late Dec 2019 - due to misdiagnosed brain injury, I was put on 20mg paxil (ramped up from 10mg) and 50 seroquel for sleep 

May 2020 - down to 15mg paxil (stayed for 3.5 weeks) - minimal withdrawal

June 2020 - down to 10 mg paxil (stayed for 2 weeks) - minimal withdrawal

June 2020 - down to 5 mg paxil (stayed for 12 weeks) - flu like symptoms that would come in waves, insomnia randomly at week 10

September 2020 - 0 mg paxil and have been at this for two weeks. Moderate depression, anxiety, and strong insomnia - debating what to do

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