Reshan30: Paxil

[Reshan30]

I've been on & off Paroxetine for 12 years. I stupidly decided to cut my drug off cold turkey due to several unsuccessful attempts from physicians to taper off the drug safely. At first, all was good until about 3 months into being off of the drug & then the withdrawal symptoms started to take effect. Symptoms included, hair thinning, joint aches all over, weakness of joints, heart palpitations, excessive anxiety, lesions on the inside of the roof of my mouth, dry skin, rashes on my face around the nose, rash or red patch in the back of my scalp, sore throat prior to legion, loss of muscle mass due to significant weight loss in a short amount of time, headaches, confusion, lumps in the breast that ache, etc. I had to get back on the drug after being off it for 6 months because the symptoms were so bad. I had several labs done to see what was going on, labs came back with a positive ANA & inflammation was high like the drug over time weakened my immune system & now I think I'm on the verge of an auto-immune disease. I'm in a debilitated state and feel miserable being back on this horrible drug. I just want to successfully & safely taper off but not sure I should until my immune system can be strengthened or perhaps maybe it's not that at all but purely withdrawal syndrome?? Idk but I'm searching for help as I do not find it in docs offices. It's also hard to find any help in Oklahoma where I live. I just want my life back. 

[getofflex]

Hello, and welcome to SA.  We are a volunteer-run community of people who have been or are getting off of psychiatric drugs.  I'm sorry to hear that you've had so much trouble with Paxil.  There is a way off of this drug, and it is an extremely slow and careful taper, when you are ready.  

 

Can you please give us specific information in your signature about your drug history for all drugs you are on and have been on, especially for the past 18-24 months?  It would be especially helpful to have the details of your drugs in a concise vertical list (no symptoms), only drug names, specific dates (as best you can say for example early March if you don't recall the day) and dosages of each medication decrease or increase.  Use this format:

 

Drug name: date, dose, date, dose, date, dose…

Drug name: date, dose, date, dose, date, dose…

Etcetera

 

Please read the link below for instructions.  This will allow us to give you the best guidance.  

 

How to List Drug History in Signature

 

Here is some important information about how these drugs actually work.  This explains why we get symptoms from going off of these medications, and why it's so important to taper slowly and carefully, and be very cautious about changing our doses: 

 

How Psychiatric Drugs Remodel Your Brain

 

 

This helps you understand what withdrawal syndrome is: 

 

Video on Recovery from Psych Drugs

 

Windows and Waves Pattern of Stabilization

 

 

Tapering is best done extremely slowly, and we generally taper by 10% of the current dose no more than once every 4 weeks, so that the reduction becomes exponentially smaller.  However, in your case, you may want to give your system a break and a rest before you start another taper.  You say you feel miserable being on the drug.  Specifically what symptoms do you have while you are on Paxil now?  

 

 Why Taper by 10% of my Dosage  

 

Tips for Tapering Paxil

 

Here is a link with checklists of common WD symptoms: 

 

Dr Joseph Glenmullen Withdrawal Symptom Checklists

 

 

Here are some techniques to cope with symptoms: 

 

Non Drug Ways to Cope with Withdrawal Symptoms

 

Stability is really important when we are tapering off psych meds.  Please read the link about stability:

 

Keep It Simple, Slow, and Stable

 

 

We don't suggest many supplements, but 2 that many of us find helpful are magnesium and omega-3 fish oil. Here are the links for info about those. It is suggested to add one at a time, and start with a low dose to see how it affects you. 

Magnesium

Omega 3 Fish Oil

 

On 4/19/2022 at 11:18 AM, Reshan30 said:

I had several labs done to see what was going on, labs came back with a positive ANA & inflammation was high like the drug over time weakened my immune system & now I think I'm on the verge of an auto-immune disease.

What does the doctor say is going on here?  I'm not sure what an ANA is.  When we know more about your situation, we can give you advice as to how to proceed.  

Edited April 20, 2022 by getofflex

[Reshan30]

Just now, getofflex said:

Hello, and welcome to SA.  We are a volunteer-run community of people who have been or are getting off of psychiatric drugs.  I'm sorry to hear that you've had so much trouble with Paxil.  There is a way off of this drug, and it is an extremely slow and careful taper, when you are ready.  

 

Can you please give us specific information in your signature about your drug history for all drugs you are on and have been on, especially for the past 18-24 months?  It would be especially helpful to have the details of your drugs in a concise vertical list (no symptoms), only drug names, specific dates (as best you can say for example early March if you don't recall the day) and dosages of each medication decrease or increase.  Use this format:

 

Drug name: date, dose, date, dose, date, dose…

Drug name: date, dose, date, dose, date, dose…

Etcetera

 

Please read the link below for instructions.  This will allow us to give you the best guidance.  

 

How to List Drug History in Signature

 

Here is some important information about how these drugs actually work.  This explains why we get symptoms from going off of these medications, and why it's so important to taper slowly and carefully, and be very cautious about changing our doses: 

 

How Psychiatric Drugs Remodel Your Brain

 

 

This helps you understand what withdrawal syndrome is: 

 

Video on Recovery from Psych Drugs

 

Windows and Waves Pattern of Stabilization

 

 

Tapering is best done extremely slowly, and we generally taper by 10% of the current dose no more than once every 4 weeks, so that the reduction becomes exponentially smaller.  However, in your case, you may want to give your system a break and a rest before you start another taper.  You say you feel miserable being on the drug.  Specifically what symptoms do you have while you are on Paxil now?  

Yes, I lack any motivation to do anything, I feel drowsy, vision changes, hair not growing staying stagnant, red patch on the back of my scalp that itches & is flaky, depression, & sometimes joint aches. 

 

Just now, getofflex said:

 

Just now, getofflex said:

 

 Why Taper by 10% of my Dosage  

 

Tips for Tapering Paxil

 

Here is a link with checklists of common WD symptoms: 

 

Dr Joseph Glenmullen Withdrawal Symptom Checklists

 

 

Here are some techniques to cope with symptoms: 

 

Non Drug Ways to Cope with Withdrawal Symptoms

 

Stability is really important when we are tapering off psych meds.  Please read the link about stability:

 

Keep It Simple, Slow, and Stable

 

 

We don't suggest many supplements, but 2 that many of us find helpful are magnesium and omega-3 fish oil. Here are the links for info about those. It is suggested to add one at a time, and start with a low dose to see how it affects you. 

Magnesium

Omega 3 Fish Oil

 

What does the doctor say is going on here?  I'm not sure what an ANA is.  When we know more about your situation, we can give you advice as to how to proceed.  

An ANA is a test that detects antinuclear antibodies in the blood. This test is usually used to see if you're positive for these antibodies to see if further testing is needed for diagnoses of an auto-immune disease. I've been tested for Rheumatoid Arthritis which was negative. My current PCP ran the test again and the ANA showed positive again but he said that the numbers were too weak to indicate an auto immune disease. My guess is if I don't have an auto-immune disease yet, I'm on the verge of one. I read an article posted in 2006 by these scientists of SSRI's triggering an immune response that can ultimately lead to an auto-immune disease. I'll post the link below. 

 

https://www.sciencedaily.com/releases/2006/01/060119230939.htm

[getofflex]

Do you mind adding to your drug history what dose of Paxil you are currently on?  Thank you. 

 

Has going back on the Paxil helped your withdrawal symptoms? Overall, do you feel better since reinstating the Paxil, than you felt during the withdrawal?  

[Reshan30]

Hello, I have in my signature that I'm currently on 20mg. Yes overall as far as the withdrawal symptoms but as far as feeling like myself no. I lack motivation, I feel consistently drowsy, depressed, emotionally numb, etc. I could feel the heaviness/drowsiness after being back on the drug for 3 days when I first started taking it again in 2021. Not sure if it's a mix of a compromised immune system or purely withdrawal syndrome triggering the positive lab results. Just wanting some guidance and a way to safely taper as regular family docs have all failed me & their traditional approach to tapering.

[Fosca]

Hi Reshan, have you ever had an ANA test done previously?  It's quite possible that you were ANA positive even before Paxil and before withdrawal.  I know you are understandably worried about developing an autoimmune condition because of your symptom pattern and test results, but I wouldn't jump to that conclusion.  It's great that you tested negative for RA.  Also, even though you were ANA positive, it sounds like you had a low titer, which is also a good sign.  I've read varying statistics, but a significant portion of healthy people (~approx. 20%) test positive for ANA (despite not having an autoimmune condition).  Hang in there, and I hope things get better 🙏🏻    

[Reshan30]

Yes I have and it was positive but the RNA was negative along with a few other ones that is apparently a key component for further testing to diagnose an auto-immune disease so that is a relief. I do not think that I was ANA positive prior to taking Paxil but definitely prior to the withdrawals as I was completely healthy at the age of 18 when I first started to take Paxil.  With my research over the years I've read articles from scientists completing a study linking antidepressants to possible auto-immune diseases over an extended usage over a period of time. I feel that the drug Paxil is responsible for my weakened immune system based on research I've done. I hope that I can get off this horrible drug for good and repair my system from these awful withdrawals & weakened immune system. I'm trying to hang in there and remain optimistic each day but it does get hard when a new symptom comes up out of no where. Thank you for your words of encouragement.  🙏

[getofflex]

On 4/21/2022 at 10:18 AM, Reshan30 said:

Yes overall as far as the withdrawal symptoms but as far as feeling like myself no. I lack motivation, I feel consistently drowsy, depressed, emotionally numb, etc. I could feel the heaviness/drowsiness after being back on the drug for 3 days when I first started taking it again in 2021.

I'm glad it took care of the withdrawal symptoms.  The other symptoms you describe being on the Paxil sound like ordinary side effects of the drug.  

 

Proper tapering instructions are in my first post.  You can begin by reducing your Paxil by 10% of your current dose, which would be 18 mg.  The link above about tapering Paxil will tell you how to do this. Good luck, and let us know how it goes.  

 

If you want a gentler tapering method, you could consider micro tapering. 

 

Brassmonkey Slide Method of Micro Tapering

[Reshan30]

Thank you very much for all your help. God bless. 🙏

[ChessieCat]

I have moved your new topic to the existing topic.

 

recommended-doctors-therapists-and-clinics

 

You might also like to post your question in the relevant topic for the area where you are living.  See Post #1 of this topic:

 

check-in-topics-survivingantidepressantorg-members-near-you

[Reshan30]

MOD NOTE:  Post moved from the How to Make a Liquid topic.

 

Hello, I'm looking to taper off of Paroxetine but to do so in liquid form making it easier to measure out. I was going to see if my PCP would prescribe me my regular dosage of 20mg in liquid form so that I could start the taper. Is this something I should do? Anything that I need to know before pursuing this? I would likely taper only a half of 1mg at a time but any idea on how long I should take it before tapering another half mg?

 

Thanks for any help.

 

Edited May 15, 2022 by ChessieCat
added topic title before merging with intro topic

[brassmonkey]

I saw your post in "how to make a liquid" and will answer you here so you have a better record.

 

Using a liquid is the most accurate way to taper and will offer the greatest control. If you can get a prescription for it that is the best way to go. Next best would be making your own liquid, it's pretty easy and still as accurate. Using a scale and crushing your tablets is also a very good way to taper, that's how myself and many other members have done it.

 

If you are currently using tablets, then you will need to do a cross taper to start the liquid. Unfortunately, some people can't tolerate the liquid, so the cross taper is needed to make the transition smoother or to find out if the liquid is a viable option.

 

I would not recommend tapering by half a milligram at a time. This gives a linear taper that will cause problems as your dose decreases. It is much better to decrease by a percentage. The math is really easy and any of the mods can help with it.

 

The recommended minimum time between reductions is 4 weeks. Reducing at one half milligram a time will take you many, many years to complete your taper. I would highly recommend doing a Brassmonkey Slide. This would involve reducing by 2.5% a week for 4 weeks and then holding for an additional 2 weeks. This will give a total reduction of 10% every 6 weeks. It will still take a very long time to get to "0" but it is a very gentle and effective way to go. Very many of our members are having great success using this method.

[ChessieCat]

6 hours ago, brassmonkey said:

If you are currently using tablets, then you will need to do a cross taper to start the liquid. Unfortunately, some people can't tolerate the liquid, so the cross taper is needed to make the transition smoother or to find out if the liquid is a viable option.

 

Please see this topic about how to do this:

 

cross-over-changing-form-eg-tablet-to-liquid-of-drug-or-changing-brand-of-same-drug

 

16 hours ago, Reshan30 said:

MOD NOTE:  Post moved from the How to Make a Liquid topic.

 

Hello, I'm looking to taper off of Paroxetine but to do so in liquid form making it easier to measure out. I was going to see if my PCP would prescribe me my regular dosage of 20mg in liquid form so that I could start the taper. Is this something I should do? Anything that I need to know before pursuing this? I would likely taper only a half of 1mg at a time but any idea on how long I should take it before tapering another half mg?

 

Thanks for any help.

 

 

It is possible to make a liquid from paroxetine tablets but some members are able to get prescription liquid.  It is up to you whether you choose to make your own or use prescription liquid.  One thing to be aware of is the strength of the prescription liquid. 

 

Using a liquid to taper is more accurate than crushing and weighing and you can dilute the liquid and get very small doses.

 

If you are currently taking 20mg paroxetine, then you might consider taking a 10mg tablet and make up the dose using liquid.  Then after you get under 10mg you could change to all liquid.

 

Post #1 of this topic has information about the expiry of prescription liquid Paxil brand and Seroxat.  It might be more economical to get the Paxil brand version of the prescription liquid because it will last longer expiry-wise.

 

Tips for tapering off paroxetine (Paxil, Seroxat)

[Reshan30]

Thanks for the info. Do you happen to know anyone that could help me with this like a physician you would recommend for tapering antidepressants? I don't feel comfortable with trying to do this on my own. I would accentually have to get two prescriptions one in tablet form and the other in liquid form for the cross taper then I assume. One is Paroxetine could the liquid not be Paroxetine as well? I have way too many questions and would rather to speak to someone on the phone and have them help me every step of the way as I've already had horrible withdrawal symptoms. 

 

Thanks,

Reshan

[ChessieCat]

The reason SA and the other sites like this exist is because there are not many medical professionals who know how to get their patients off psychiatric drugs carefully, and the ones who taper their patients very often taper them off their drug too quickly.

 

It is your decision whether you talk to your doctor about tapering.  However the most important thing is to make sure that you will be able to continue getting a prescription for your drug for the duration of your taper.  We have some members whose doctors stop providing a prescription because they think the patient should be do a taper at a rate which is much faster than SA, or stop taking the drug at a dose much higher than SA suggests.

 

Please see the following topics. 

 

recommended-doctors-therapists-and-clinics

 

Post #1 of this topic has links to some information about withdrawal/tapering that you could print out and give to your medical professional.

 

how-to-talk-to-a-doctor-about-tapering-and-withdrawal-what-to-expect

 

[Reshan30]

Hello, I understand but all this info is overwhelming and very time consuming to be able to thoroughly read everything in detail, comprehend, and make sure you're doing it correctly. I'd feel much more comfortable with being recommended to a physician that doesn't mind following this system as I know they are out there, they're just hard to find. If anyone can please help me find a physician that is willing to utilize SA method of tapering that would take so much stress off of me. Thank you for any further help.

 

-Reshan

[ChessieCat]

I understand what you mean and why.  However as you say it might be very hard to find one.  I have PMed a couple of members in your state asking if they know of anyone.

 

Q:  What is your current doctor like?  Do you think that they would be willing to learn about tapering?  If yes, then you could give them this link:

 

https://www.survivingantidepressants.org/topic/300-important-topics-in-the-tapering-forum-and-faq/

 

It is an "umbrella" topic and contains links to many helpful topics as well as links to the Tips for Tapering specific drugs.  It would make it easy for you just to write it down and give it to them for them to look up themselves, instead of printing out information for them to read.

 

And if they wanted to know more information about SA:

 

Search for:  survivingantidepressants.org about altostrata

 

There is a link to a recent interview that she did - look for Mad In America in Post #1.

 

There is also this topic which explains what SA is all about:

 

https://www.survivingantidepressants.org/topic/54-about-survivingantidepressantsorg/

 

Edited May 19, 2022 by ChessieCat

[ChessieCat]

SA has helped many members to taper their drugs.  I understand it can be overwhelming.  You are fortunate that you can make a liquid from the tablet.  We have members who are having to weight crushed tablets or count very tiny beads which are taken out of a capsule.  I have made liquid of varying strengths using the powder contained in my compounded capsules to get very small doses at the end of my taper.  I can assist you with calculating your dose and how to make a liquid.  And if there is something that I am not able to help with then I can ask another staff member for their assistance.  Sometimes there are other members who drop in and help the "newbies".

 

If you want our help we can walk you through the process.  But instead of me trying to imagine the questions you have it would be better for you to let me know what you need help with.

 

I am following your topic and whenever you post here in your Introduction topic I get notified that you have posted.  I do not get notification if you post elsewhere.

[Frogie]

@Reshan30

 

You can take a look at this link to see if you can find a dr in your area that understand tapering these medications.

 

 

Recommended doctors, therapists, and clinics

 

As @ChessieCat has reassured you, this site has helped 10's of 1,000's of members taper off these medications. 

 

I will also follow you so if you have any questions we can answer I will also be notified.

 

 

[Heath]

Hello @Reshan30 and welcome ! 
you are getting the greatest advice on tapering thus far. I just thought I would add a couple of things from my experience. 
 

I understand the overwhelming information. It sounds like you are pretty stable rt now and experiencing some side effects. So if time permits you to read and understand this information first it will serve you well. 
 

The liquid should be available where you are. I understand the frustrating anxiety of asking the dr. Been there. As for the 4 week cross over- you only need about 20 pills at most. So if you get the tablets filled then maybe 2 weeks after get the liquid prescription from dr. Also where I’m at you can get prescriptions filled at 3 weeks so you accumulate extra tablets. Heck they start calling you at 2 weeks after a refill. 
 

I found a taper calculator here it makes it so easy!

taperoff.co

http://www.taperoff.co/

 

I would highly recommend starting slow less than 10 % a month- brass monkey slide. And get a feel for it first.
Slow steady stable. 

 
 

[Reshan30]

4 hours ago, Frogie said:

@Reshan30

 

You can take a look at this link to see if you can find a dr in your area that understand tapering these medications.

 

 

Recommended doctors, therapists, and clinics

 

As @ChessieCat has reassured you, this site has helped 10's of 1,000's of members taper off these medications. 

 

I will also follow you so if you have any questions we can answer I will also be notified.

 

 

 

Hello, thanks for the info but I've already taken a look at the list and none happen to be in my state. Thanks for the info.

[Reshan30]

Hello, thanks for the info but I've already taken a look at the list and none happen to be in my state. Thanks for the info.

[Reshan30]

20 hours ago, ChessieCat said:

SA has helped many members to taper their drugs.  I understand it can be overwhelming.  You are fortunate that you can make a liquid from the tablet.  We have members who are having to weight crushed tablets or count very tiny beads which are taken out of a capsule.  I have made liquid of varying strengths using the powder contained in my compounded capsules to get very small doses at the end of my taper.  I can assist you with calculating your dose and how to make a liquid.  And if there is something that I am not able to help with then I can ask another staff member for their assistance.  Sometimes there are other members who drop in and help the "newbies".

 

If you want our help we can walk you through the process.  But instead of me trying to imagine the questions you have it would be better for you to let me know what you need help with.

 

I am following your topic and whenever you post here in your Introduction topic I get notified that you have posted.  I do not get notification if you post elsewhere.

 

I'm not sure where to even start with lowing my dosage or what would be best for my body. I take 20mg Paroxetine currently in tablet form. I have a PCP but he is NOT someone that would be open to this tapering method as he's very arrogant and not helpful at all. I know when he does my refills he does so 3 month supply at a time giving me 90 tablets so that's no a problem, the problem could arise when I ask him if he would fill the medicine in liquid form. I guess I could have him refill the tablet and get a new PCP who's willing to prescribe liquid. So I guess I would need 10mg filled in Paroxetine or Paxil of liquid and then I would half the tablet making 10 mg in that and decrease the 10mg liquid by 2mg so all together I would be taking 18mg to start? I mean I don't know how all this works, I'm exhausted with the run around prior to joining this community, depressed, & frustrated because I just want a plan I can immediately put into action. 

 

[Reshan30]

22 minutes ago, Heath said:

Hello @Reshan30 and welcome ! 
you are getting the greatest advice on tapering thus far. I just thought I would add a couple of things from my experience. 
 

I understand the overwhelming information. It sounds like you are pretty stable rt now and experiencing some side effects. So if time permits you to read and understand this information first it will serve you well. 
 

The liquid should be available where you are. I understand the frustrating anxiety of asking the dr. Been there. As for the 4 week cross over- you only need about 20 pills at most. So if you get the tablets filled then maybe 2 weeks after get the liquid prescription from dr. Also where I’m at you can get prescriptions filled at 3 weeks so you accumulate extra tablets. Heck they start calling you at 2 weeks after a refill. 
 

I found a taper calculator here it makes it so easy!

taperoff.co

http://www.taperoff.co/

 

I would highly recommend starting slow less than 10 % a month- brass monkey slide. And get a feel for it first.
Slow steady stable. 

 
 

Hello and thanks for the reply. Yes the liquid should be able to be ordered here. I'm actually going through withdrawal symptoms as well as side effects of being back on the medication. I went cold turkey for 6 months and had to seek medical attention twice in a 4 day period. I've taken this drug for 12 years. This drug is just one of my issues, I also have a PFO that has caused me to have a TIA (mini stroke) and has damaged parts of the left side of my brain. I also have a congenital syndrome that I deal with everyday that doesn't get easier (KTS) that includes very poor circulation to the point to where I can't even sleep some nights because it's so bad. I like to lay on my side but as soon as I do my arm is numb within sec forcing me to turn on my back & when I'm on my back I have nightmares that make me wake up with panic attacks. I'm miserable, frustrated, and just want a plan I can follow so I can take action and at least get off this drug once & for all. Then I can start trying to address all my other issues. 

[ChessieCat]

On 5/19/2022 at 4:19 PM, ChessieCat said:

But instead of me trying to imagine the questions you have it would be better for you to let me know what you need help with.

 

Please let us know specifically what you need assistance with regarding tapering your drug.  If you list your questions/things that you don't know how to do, we can try to answer them.  The staff are all unpaid peers (people who are currently tapering or are now off their drug; but we do still have issues related to taking/getting off our drug/s) and we do want to help members, but we have limited time and so we need members to help us to help them.  By being specific it will save time and energy.  Thank you.

[Reshan30]

Hello and thanks for your reply.

 

1. What tapering system would be best for me? 

2. How much do I decrease at a time?

3. Cross tapering tablet form and liquid at the same time?

4. How long do I stay on a specific dose before decreasing again?

5. Do you know of any physicians that utilize your taper system? If so what is there names so I can reach out to them. 

6. Depending on the mg at a time that I'm decreasing what would a time frame look like for me in terms of being fully off of it?

[ChessieCat]

Thank you for listing your questions.  That will make it much easier.  I appreciate it.

 

Just work you way systematically through the information.  You don't have to read it all in one go.  You might find it helpful to write down some notes and/or questions as you go through it.

 

Please ask any questions that you have.  There are no silly questions.  If you have a question, please ask it.  It is better to ask it and have it answered, if we are able to do that (there are some questions that cannot be answered), than for you to be continually thinking about it and being stressed/worried/anxious.

 

I hope this is helpful:

 

1. What tapering system would be best for me? 

 

If you mean taper method (there are different terms that people use so I will have to make an assumption of what you mean) then there are 2 to choose from:

 

Reducing by 10% or less (calculated on the current dose, not the original/starting dose; there are graphs at the bottom Post #1 in the link given below showing the difference between the 2 types of taper) and holding for at least 4 weeks before the next reduction.  It is important to listen to your body/symptoms and only reduce again if you are feeling stable.  I provide information about this in a new post.  It will be easier for you to refer back to later.  If you need help calculating the new dose, we can help with that.

 

Why taper by 10% of my dosage?

 

The following a gentler tapering method and it gives you more control over your taper.  You reduce by 10% or less over a 6 week period.  You divide the monthly taper amount (eg 10%) by 4 and you reduce every week (using the example amount 2.5%) for 4 weeks and then instead of reducing again the next week you hold for an extra 2 weeks.  So you reduce weeks 1, 2, 3 and 4, then you hold for weeks 5 and 6 and then start another reduction cycle when you get to week 7.  You need to calculate a new reduction amount for the new reduction cycle based on the dose before.  Staff/members can help with this if you need it.  It can be a bit tricky when you first start doing this method but once you have done it a few times it will become easier.

 

Brass Monkey Slide

 

2. How much do I decrease at a time?

 

You can choose the taper rate that you want, however it is strongly recommended not to reduce by more than 10%.  If you are reducing by 10% and when you calculate your reduction, it is a number which is difficult for you to measure accurately, then it is better to round up, not down which will keep your reduction under 10%.  As an example if the new dose is 7.432mg you would round up to 7.5mg.  Please note that the next reduction needs to be calculated on the dose you took 7.5mg not the 7.432mg.  Please note that if you are making smaller reductions, eg 5%, you might choose to round up, depending on how big the difference is.  The aim is to keep the monthly reduction at 10% or less.

 

3. Cross tapering tablet form and liquid at the same time?

 

I am not quite sure what you mean by this.  The cross over from tablet to liquid is done in stages.  No reduction of the total dose is made at the same time.  See:

 

cross-over-changing-form-eg-tablet-to-liquid-of-drug-or-changing-brand-of-same-drug

 

4. How long do I stay on a specific dose before decreasing again?

 

I think I have explained this above and I will provide more information in the next post.  If you are going through a stressful time or are sick then it is suggested to hold for longer.  I'm assuming from you picture that you are female of menstruating age.  Some members find it better to align their tapers with the cycle, choosing to make their reduction at a particular stage.  This would be difficult to do with the BrassMonkey Slide taper, however at any time during the 6 week reduction period you can always hold on a dose.  It is generally better to hold for longer than to reduce too soon.  Remember that every reduction you make, however small, is heading in the right direction of getting to the goal of being off your drug.  The aim is to do it carefully and be able to live your life as normally as possible.

 

menstruation-periods

 

5. Do you know of any physicians that utilize your taper system? If so what is there names so I can reach out to them.

 

I have contacted 2 members by PM who live in your state, but they do not know of anyone who can help you taper.

 

6. Depending on the mg at a time that I'm decreasing what would a time frame look like for me in terms of being fully off of it?

 

I used a tapering calculator and I have based your taper on 20mg, reducing by 10% every 4 weeks.  To get to 0.0236mg (see next paragraph out last dose to take) will take 64 x 4 week periods.  If you started today the ETA is 17-Apr-2027.  Obviously this is only a guide.  Yes it will take much longer than you want it to take, but the goal is to get off comfortably.  It took me 6 years to get off 100mg Pristiq, but I actually started from 75mg because I had to get my dose down quickly because I was experiencing mild serotonin syndrome.  You can see this in the link provided in the next paragraph.  And yes it was frustrating at times (members here gave me a lot of encouragement and support along the way and helped me to not try and go faster whenever I started getting impatient), but I managed to get off successfully, have been off now for 6 months (after having been on a AD for 25+ years) and I am glad that I did it slowly.

 

It is difficult to know at what dose you will be able to stop at.  It is suggested to go at least down to 0.025mg but some people find that they need to go lower.  I went lower because I was dealing with other health issues at the time and decided to go very low and stopped at 0.0025mg (so even less) but I started reducing weekly.  You can see my full taper here which includes the doses and how long I was on a particular dose for.

 

Also, some members find that the lower their dose gets the slower they need to go, reducing less and/or holding longer.  Also, some members have found that there as dose which they have more issues getting past than others.  There is no rule about this; it seems to be very individual so it is not possible to say at this dose hold for longer.  This is why it is important to use your body/symptoms as a guide, and not the calendar.

 

Edited May 21, 2022 by ChessieCat

[ChessieCat]

Dr Joseph Glenmullen's WD Symptoms Checklist

 

Stability

 

WDnormal

 

And Brassmonkey talks more about it here:

 

tao-of-the-brassmonkey

 

 

There is no guarantee that you will have a symptom free taper but generally if you listen to your body/symptoms and only taper when you are stable then hopefully the withdrawal symptoms will be minimal and/or only last for a short time.  It is good to remember that the withdrawal symptoms are because your brain is making adjustments to not getting as much of the drug.  The goal is to sneak the drug away so that the brain only has to make a few adjustments at a time.  If the drug is taken away too quickly or stopped suddenly, then the brain has to do a lot of adjustments which is why we can experience bad withdrawal symptoms.

 

To get through the times when you experience withdrawal symptoms SA strongly encourages members to learn and use:

 

Non-drug techniques to cope

[Reshan30]

Wow!! Information is very overwhelming but much needed. I used the taper calculator the other member mentioned to me and that makes it so much more easier. Can I just create a liquid from my tablets? How would I go about doing this? I have no idea what I'm doing. And estimated time frame of 5-6 years is a tough pill for me to swallow. I'll be 30 in a couple of months and still don't have children and am wanting them but can't while on this horrible drug. That makes me worry about a host of other womanly problems such as eggs etc. I'll be 35-36 when I'm considered drug free. I wish I would've found this community 5 years ago. The time frame is discouraging but it has to be done. I'll definitely have to discuss the emotional distress this will cause me and my partner. Thanks for explaining everything in detail as best you can. I will do some more reading myself as well. 

 

Thanks,

Reshan

[ChessieCat]

Yes, it is overwhelming which is why I said to just go through it bit by bit.  When I first got to SA I was suffering extreme brain fog so I do understand how hard it is to get the information you need.  You are fortunate that you don't have to read and understand the information and make your decisions almost straight away like I did.

 

And yes, it can be disconcerting when you realise that it is going to take so long, which is why I went into details about why it is better to do it that way.

 

You are not the only one who wishes they had found SA years ago.  Usually the members who join have found SA because they are having difficulties.  On rare occasions we have a new member join before they have even started trying to get off their drug.

 

Post #1 of this topic explains how to get non standard doses:

 

Tips for tapering off paroxetine (Paxil, Seroxat)

 

Q:  Are you currently taking 20mg?  Are you taking Paxil brand or a generic? 

 

If you are taking a generic it is generally better to stick with the same manufacture.  Some members have issues changing.  Something to keep in mind is to ensure that you get your new prescription filled before you run out of tablets.  That way if it happens that you cannot get the same manufacturer you will be able to do a cross over.  See the link given previously which is about going from tablet to liquid as well as changing manufacturer.

 

It would be easier if you can get a prescription for regular 10mg paroxetine tablets (not the CR version).  That way you could take a 10mg tablet and make a liquid from the 20mg tablets you currently have until you have used them all.  If you can get the 10mg tablets then you only need to do a 3/4 + 1/4 and then a 1/2 + 1/2 cross over.

 

If you decide to got to all liquid, you will need to do the next stage as well.

 

I'm in Australia and it's my bedtime.  I will try to get back to you tomorrow with some calculations about how to make a liquid.  I need to be wide awake to do that 😉😴  Good night/day from me

[ChessieCat]

Again, please try not to get overwhelmed.  Just go through step by step.  I find it helpful to write numbers down on paper and try to see the "pattern".  You could draw up a table and write the headings across the top and the relevant numbers below.

 

Please note that if decide to do a Brassmonkey Slide taper, one of the other staff or members will need to help you with this, so please let us know if you want to do that sort of taper.  You can post your questions about that taper method in that topic and others usually see it and help out.

 

Here are some examples of what the amount of water mL (I use a capital "L" to make it easier to distinguish from mg) and the tablet dose mg will give you.  I am also providing an explanation of how it is worked out.  You might not understand it straight away but once you start doing it then it might make more sense.

 

 

Tablet              Water                  Each mL contains mg dose             To get 1mg dose use ? mL liquid             

 

These 2 examples are 1:1 ratios:

 

20mg             20mL                         1                    1                                        1                         1

divide both sides by 20

 

For the above liquid to get a dose of 18mg using the 1:1 ratio you multiply both sides by 18; the "ratio" becomes 18:18.  You would measure and take 18mL. 

 

For 10mg tablets:

 

10mg            10mL                            1                   1                                        1                         1

divide both sides by 10

 

If you want to use more water; in this example double the amount:

 

These 2 examples are 1:2 ratios:

 

20mg             40mL                         1                    2                                        1                         2

divide both sides by 20

 

For the above liquid to get a dose of 18mg using the 1:2 ratio you multiply both sides by 18; the "ratio" becomes 18:36.  You would measure and take 36mL. 

 

For 10mg tablets:

 

10mg            20mL                            1                   2                                        1                         2

divide both sides by 20

 

 

Please see the following for some information about what tools are helpful and some tips:

  

On 5/13/2022 at 6:19 PM, ChessieCat said:

I have a 100mL graduated cylinder and found it difficult to get the exact amount.  If I overfilled it and then tipped some out it would be under the 100mL then if I topped it up a bit it would be over.  So I filled it with water and "finalised" the amount but using the dropped to add/remove water as needed; I was able to add to it by drops of water until it was at the line measure.  It isn't necessary to have one but it helped to make the process easier.

 

Here is the link to show you what I mean (no affiliation):  medicine dropper

 

AND

 

 

[Reshan30]

After reading over all of this, this is way to hard for me to try on my own. This is very confusing to me and I know that I would calculate things incorrectly. This needs to be done by someone that understands & can put this into action which isn't me. Coming off of this medication is going to be harder than I imagined. How on earth do I find someone willing to help me through all of this. This is so stressful when all I want to do is have a successful taper. I'm feeling discouraged because I know I need to start to taper sooner than later especially when it will take years to taper off completely. There's only one person that I know which she's a thyroid specialist & compounding pharmacist but she's only out of pocket but would help me taper off the drug slowly but yet she wants to charge me unnecessary fees trying to give me things that I don't need such as LDN therapy, metabolic detox, adrenal supplements, etc. At this point I don't know what to do. 

[brassmonkey]

Hi Reshan-- When it comes to tapering off of ADs there are very few options. Almost to the doctor, the medical profession does not admit that ADWD exists.  There are a few exceptions, but they are few and far between and almost impossible to find. We have a listing of all the ones we know of that you have been given the link to, that's the best we can do for recommendations for doctors. This is why SA exists, we are a group of fellow travelers trying to help each other through a truly horrible experience. Every moderator here has been or is going through exactly what you are experiencing, along with over 10,000 or more other members. We have been doing this for years and have learned a huge amount about what works and what doesn't. 

 

The staff are in daily contact with the top ADWD experts in the world. Infact several of them are members. Alto just returned from England where she is working with several of these experts helping to write the book on ADWD and establish international programs to help people taper. If you want good advice for ADWD this is the place to get it. No, it is not in person face to face and each member has to rely on themselves to do the actual work, but we are here for help, support and information. Every moderator knows how to do the calculations involve and is very willing to help until a member can do them on their own. We have tons of information on a verity of methods for tapering and can help find the one that is right for each member, and then help them finetune it to their needs.

 

Every member wants a stress free, painless, successful taper. That's our goal too. As you said, "Coming off of this medication is going to be harder than I imagined. " And you are right. I will be blunt, for most members ADWD will be the hardest thing they will experience in their life. But by paying attention, following the steps and learning the skills it is very manageable. There is a huge amount of seemingly complicated information here, but like eating an elephant if you take it one bit at a time it can be sorted through and what doesn't apply can be ignored. We work with over a hundred different medication here, so not all the information applies to each individual.

 

Reading your posts so far it looks like you are in an excellent position to start a taper. Paxil has a reputation for being hard to taper, yes and no. If tapered properly the symptoms decrease along with the dose and become quite mild by the end. If you are relatively symptom free to start with it makes it much easier. If you are starting from 20mg, it si going to take some time to be drug free. The calculator you used is pretty close for the time estimate. I tapered 40mg of Paxil and it too five and a half years. Even though I was in severe poopout at the start, for the last several years the symptoms were quite tolerable to nonexistent.

 

So, let's take a look at that big serving of elephant and decide what bite to start with.

[ChessieCat]

Most people have been brought up to believe that doctors know most things/everything, that doctors are going to do what is best for us (hypocratic oath), that pharmaceutical company products are backed by science, that we should trust the "experts", that we shouldn't tamper with the medication.

 

It is a huge shock when we discover that the above statements are not true.

 

I think you might still be in the stage of disbelief and being overwhelmed.  And this is perfectly normal.  It's a whole new world and there is a lot to try and digest and understand.

 

Both myself and Brassmonkey have suggested that you take it one step at a time.  The beginning of my taper was done by using compounded Pristiq capsules and I used to wonder how members managed to make liquid and work out how much to take etc and use tiny syringes to get their dose.  But then I had to do the same thing.  And it wasn't as hard as I thought it would be.  And other members helped me to work things out.

 

One thing that is reasonably common among members who are tapering is that at times during their taper they have cognitive issues.  I've been there myself; we understand.  If members have difficulties calculating their doses or need help working out how to measure their dose, they post about it and staff and other members help; I did this myself even though I've been a moderator since very early on in my taper.

 

My suggestion would be to start back at the beginning of your topic and slowly go through it and take notes as you read things.  You could divide it up into categories, eg information that you need to understand at the beginning of your taper and things that you want to go back and check later.

 

What you could do is to do some practising with dissolving and measuring.  Do you have access to some artificial sweetener tablets, or some small candy/lollies/sweets that would dissolve in water?  You don't even have to get the equipment straight away, you could use kitchen measuring tools that you already have.  You don't have to work with really tiny amounts to start and when you are practising you won't need to be exact.  It would just be a way for you to work with equipment and calculations and measuring.  And write down notes as you go.  Think of it like creating a recipe for a cake that you want to make.  Or a mixing a cocktail drink.  Think of it as a fun experiment that you are trying and learning something new.  Sometimes there are places that I have to go that I really don't want to and I try to reframe and think of it as an adventure instead of something to be disliked or scared of.

[Reshan30]

Thank you for your response. I'd like to say that I'm not in a state of disbelief believe me I've always questioned the way things are and know that they absolutely do not have our best interest period. It's a disgusting dirty system that needs to be taken down!! When I say I would like help from someone other than myself, I'm referring to those very few physicians that acknowledge how detrimental these drugs are because after all that's what they are "legalized drugs" that mess people's entire system up. I also know that the body has extraordinary abilities to heal on it's own given the right environment. I'm just tired & frustrated at this point and just want to put things in action by having the calculations already done for me and me just having to do it but I understand that that may not be the case for me. I just don't want to mess up and then have things backfire on me when I'm only trying to make a positive change. 

 

Thanks,

Reshan

[Reshan30]

I noticed you said you tapered Paxil? Can you help me one on one? I will compensate you which I don't say that with disrespect but for you to know that I value peoples time and know that everything y 'all do is for the wellbeing of others. Could I give you my number and you help me personally?