Look2God: setback - trazodone & Paxil

[Look2God]

Amid disparaging anguish, I’m looking for experienced advice about how to move forward for relief and healing.

 

Background: After being on Zoloft beginning in 2000 and Paxil since 2004 (failed taper before resuming at 25 mg in 2007, slow wean to 10 mg and held until 2016 - back up to 20 mg before SLOW liquid wean back to 10 mg), I felt well enough (working with Mensah Medical since fall 2018 and a naturopath since May 2020) to begin very slow descent from 10 mg in November 2020. Used liquid to go down 0.02 mL/0.04 mg per day through early February 2022. Was eating VERY healthy (mostly natural/organic, gluten/dairy free).
Noticed sleep issues around beginning of March (waking up 3-4 hours early), OCD symptoms, irritability.
Around Mother’s Day 2022, began losing whole nights of sleep in fairly regular succession. Horrible anxiety and panic.

*I’m still baffled by what went wrong with my careful, supported wean - so disheartening!

After Unisom wasn’t consistently helpful,
PCP prescribed both Ambien (took only 3 times) and Trazodone for sleep. Starting May 16, my first 2 nights on Trazodone at 50 mg - ineffective for sleep, went to 100 mg after one night of 10 mg Ambien/50 mg Trazodone. Stayed at 100 mg for about 1 week before coming down (75 mg one night, then 62.5 — 1.25 pill — for two nights, to 50 mg one night, back to 62.5 mg one night, then 50 mg for 9 nights). Tried adding hydroxyzine a bit - had script for that too - but not helpful enough and too blanked out next day.
 

Notes from being on Trazodone:

”Over the past two nights, I’ve taken 2 Trazodone. It seems to be taking a toll on my body (some constipative, raw stomach, alarming clamped feeling in head and arm/leg/feet muscles) while providing partial sleep (~4 hours last night with some resting after). This morning, I woke up about 4 AM!”

“Continuing to take this Trazodone has felt overwhelming to my body. It recently seems to hinder my rest. It’s super-alarming to have a pounding heart, electrifying grip on my head/body muscles (writhing/jerking for relief),   stomach distress, constipation, and an unpleasant skin warming as I struggle to relax in the night.

The sleep support seems to be dwindling while the intensely unsettling body impact continues. I dread nights because of the experience. I feel scared with wanting relief from Trazodone side effects while hoping my body wouldn’t overreact to sudden change. As my function and coping diminish, I feel at a loss. As much as I want good rest, sleeping meds seem to be counterproductive for me.”

 

On 6/9, started going down from 50 mg  Trazodone by 1/8 pill with 2 nights at every level - was at 25 mg by 6/17 and totally off around July 4. So, I was on Trazodone for around 6 weeks - definitely less than 8 weeks.

 

In the meantime, some of my closest associates were/are convinced that I need some level of Paxil for the rest of my life. Such negative experiences with Trazodone probably indicated that my Paxil dosage was insufficient. So - bewildered and despondent, I resumed 5 mg Paxil on 5/17, increased to 10 mg around 5/26, tried increasing to 20 mg on 6/6 but scaled back to 15 mg on 6/15 due to Trazodone wean, and went back to 20 mg on 7/8 — twice as much as before I started the wean! I so much wish I’d stopped Trazodone earlier (or never started) and not gone up nearly so high on Paxil!

Now off Trazodone and on 20 mg Paxil for about 1 month — sleeping better, BUT …
(alarming tinnitus, burning nerve/muscle pain in limbs/extremities/back - want to writhe out of my skin, gastrointestinal soreness, intense pressure headaches - worse in evenings, nauseating dryness in nose/mouth/ears, twitching urge and restless agitation). Symptoms are persistent, worse at times, and can seem so unbearably awful. I struggle to function, think, process, and socialize.

Psychiatrist wants to add Remeron and remove Paxil later (I’m disinterested), BUT I wonder if it’s somewhat due toTrazodone withdrawal (some Paxil side effects too maybe but never felt this dreadfully rotten with Paxil before) — have begun 0.02/0.04 liquid Paxil wean again (takes 125 days to drop 5 mg).

 

Is this something to bracingly wait out while I wean down on Paxil again (is there a better/safer way to wean Paxil?), or am I unwise not to reinstate Trazodone for a more gradual wean (how would I do that)? Also, am I correct to avoid adding Remeron to the mix?

 

God bless you for reading and considering what support you can offer in response!

 

 

[getofflex]

Hello, and welcome to SA.  We are a volunteer-run community of people who have been or are getting off of psychiatric drugs.

On 8/8/2022 at 9:17 PM, Look2God said:

So - bewildered and despondent, I resumed 5 mg Paxil on 5/17, increased to 10 mg around 5/26, tried increasing to 20 mg on 6/6 but scaled back to 15 mg on 6/15 due to Trazodone wean, and went back to 20 mg on 7/8 — twice as much as before I started the wean! I so much wish I’d stopped Trazodone earlier (or never started) and not gone up nearly so high on Paxil!

How do you feel since reinstating the Paxil?  Has it helped with the symptoms of your withdrawal? 

 

On 8/8/2022 at 9:17 PM, Look2God said:

Psychiatrist wants to add Remeron and remove Paxil later (I’m disinterested),

I don't blame you - I would be very disinterested in this idea, too.  Psychiatrists are trained to use drugs, but this puts people at risk of just getting worse as worse.  The brain doesn't know what to do with all the drugs being thrown at it, plus you could go back into a severe withdrawal of Paxil. 

 

I believe what is going on for you is a combination of factors.  Your brain is in withdrawal from going off the Paxil back in February.  This caused your nervous system to be destabilized and hypersensitive, so that you had an adverse reaction to the Trazodone.  But, since you were on it for 6 weeks, your brain developed a dependency on this, so when you went off Trazodone, your brain had another withdrawal to try and deal with, as well as the adverse reaction to Trazodone.  Then trying the other drugs, like the Ambien, may have compounded things too.  Let me give you some basic info, then a suggestion for what to do.  

 

Can you please give us some specific information about your recent Paxil reductions?  It would help if we had the dates, and the dosages of each reduction.  See my signature for an example.  

 

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.  An even gentler tapering method, which I would suggest for you, is the micro tapering method.  I'll give links to both below: 

 

 Why Taper by 10% of my Dosage  

 

Brass Monkey Slide Method of Micro Tapering

 

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

 

My suggestion for you is to not make any changes to your drug regimen at all for a while.  Don't do any more reduction of the Paxil for a long time. Give your nervous system a chance to adjust to all of the past drug changes and Paxil reductions you have already done.  As you have learned from the links I gave you, these drugs are extremely powerful, and make profound changes to our nervous systems.  It takes a long time for the brain to adjust as we slowly and incrementally lower the dose of the drug.  Your brain really needs some stability right now.  I suggest that you give yourself at least 3 - 6 month hold period of no drug changes, unless you develop a severe adverse reaction.  We strongly suggest on this site that you listen to your body before doing each and every reduction, and don't do it unless and until you feel stable for a couple of weeks.  This link will explain what we mean by stability.  

 

Stability

 

Please keep in touch, and let us know how you are doing. 

Edited August 13, 2022 by getofflex

[Look2God]

Thanks SO much for making the effort to reply!

 

4 hours ago, getofflex said:

How do you feel since reinstating the Paxil?  Has it helped with the symptoms of your withdrawal? 

I do feel rough overall since reinstating Paxil. However, I have improved sleep and appear less unsettled externally. Yet, my body feels like my ~20 mg dose is WAY too high — about twice as much as when I began my previous wean. If I hadn’t been struggling with Trazodone reaction/withdrawal, I probably would have stopped at 5 or 10 mg.
 

4 hours ago, getofflex said:

you had an adverse reaction to the Trazodone.  But, since you were on it for 6 weeks, your brain developed a dependency on this, so when you went off Trazodone, your brain had another withdrawal to try and deal with, as well as the adverse reaction to Trazodone.

This is a BIG question for me — are you confident that I’m okay NOT to reinstate (and more gradually wean) some level of Trazodone to ease withdrawal symptoms (never had ringing in ears and migraine-like headaches with Paxil only before)? I would rather not take any more Trazodone at all - for sure (I despise it). However, would I be naively missing an opportunity window if that’s the only way for any Trazodone withdrawal symptoms to subside?
 

4 hours ago, getofflex said:

Can you please give us some specific information about your recent Paxil reductions?  It would help if we had the dates, and the dosages of each reduction.

On July 31, I went back to using liquid Paxil to decrease by 0.02 mL/0.04 mg per day. So, yesterday’s dosage was 19.48 mg, and today’s is set for 19.44 mg. My symptoms* (combination of too much Paxil and Trazodone aftermath?) feel so intolerably unbearable. I was so hoping to begin a 10% or Brass Monkey slide reduction soon — for relief. I am seriously concerned about coping/functioning with such intense discomfort for 3-6 months. What if one of my main problems is too much Paxil, and I’m becoming more entrenched at a too-high dose without relief? Regarding stability, my symptoms* are relatively the same without major swings for the better - an established pattern that has been present for about a month. While not exactly “tolerable,” my symptom* pattern is predictable.

*alarming tinnitus, burning nerve/muscle pain in limbs/extremities/back - want to writhe out of my skin, gastrointestinal soreness, intense pressure headaches - head feels numb when rubbed, nauseating dryness in nose/mouth/ears, twitching urge and restless agitation

 

I mean to be sincerely grateful while expressing my reflections.

[getofflex]

12 hours ago, Look2God said:

I do feel rough overall since reinstating Paxil. However, I have improved sleep and appear less unsettled externally. Yet, my body feels like my ~20 mg dose is WAY too high — about twice as much as when I began my previous wean. If I hadn’t been struggling with Trazodone reaction/withdrawal, I probably would have stopped at 5 or 10 mg.

Can you expound on what you mean by your body feels the 20 mg dose is way too high?  The best thing you can do now is to keep a daily journal to see if you are having an adverse reaction to Paxil.  Please post your journals in this thread.  Pay special attention to how you feel before and after you take your Paxil dose.  If you are having an adverse reaction, you will feel significantly worse in the several hours after each dose.  

 

Here is an example: 

 

6 AM woke with anxiety

8 am took 2.5 mg lexapro

10 am stomach is upset

10:30 am ate breakfast

11:35 am got a headache, lasted one hour

12:35 ate lunch

4 pm feel a bit better

5 pm took 2.5 mg lexapro

6 pm ate dinner

9:20 pm headache 

10:00 pm took 50 mg Seroquel

10:30 pm feeling dizzy

10:30 pm fell asleep 

2:30 am woke, took 3 mg Ambien

2:45 am fell asleep

4:30 am woke, but got back to sleep 

 

12 hours ago, Look2God said:

This is a BIG question for me — are you confident that I’m okay NOT to reinstate (and more gradually wean) some level of Trazodone to ease withdrawal symptoms (never had ringing in ears and migraine-like headaches with Paxil only before)? I would rather not take any more Trazodone at all - for sure (I despise it). However, would I be naively missing an opportunity window if that’s the only way for any Trazodone withdrawal symptoms to subside?

How is your sleep?  Weren't you taking the trazodone because of withdrawal induced insomnia?  If you are able to get some sleep, I would not reinstate trazodone.  I can't properly advise you on a reinstatement of trazodone, because I don't know when you stopped the trazodone.  What specific date did you stop it?    

 

Here is what we are struggling with:  you have made a number of drug changes in the recent past - you got off Paxil in February, then reinstated in May, you went on and then off trazodone in May and June, you tried Ambien a few times.  You had an adverse reaction to trazodone.  We are dealing with so many things, it is hard to know what is causing what.  Therefore, we want to be extremely cautious about jumping back on yet another drug (trazodone reinstatement).  Reinstatements are risky, and are best reserved for cases where WD is unbearable (the person can't eat, can't sleep, can't work, etc).  Please carefully read this link: 

 

About Reinstating and Stabilizing to Reduce Withdrawal Symptoms

 

The more we jump on, off, and back on drugs, the more our nervous system tends to get kindled and hypersensitive, and then the more difficult and drawn out subsequent withdrawal becomes.  Please read this link: 

 

Kindling

 

12 hours ago, Look2God said:

On July 31, I went back to using liquid Paxil to decrease by 0.02 mL/0.04 mg per day. So, yesterday’s dosage was 19.48 mg, and today’s is set for 19.44 mg. My symptoms* (combination of too much Paxil and Trazodone aftermath?) feel so intolerably unbearable.

 

I need you to please put this information about your tapering in your signature box.  On a computer, click on your name in the upper right hand corner, select account settings, then signature.  Click save after you type it in.  We need to find out if you feel intolerably unbearable because of withdrawal, or because of an adverse reaction to Paxil, or a combination of both.  

 

I think what you need to do now, is the daily journal, and see if what you are dealing with now is an adverse reaction to the Paxil.  

 

Edited August 14, 2022 by getofflex

[manymoretodays]

Hi there Look2God,

I think it's good that you are now off the Trazodone.

Are you familiar with Drugs.com?  It's a site where you can not only look up any drug you are thinking about taking,  you can also check drug interactions.

Bookmark it, on your phone, on your computer, and start to use it.

 

Trazodone is one horrible bear when it comes to drug interactions.  

Take a look:  Drug Interaction Report: trazodone, Paxil

 

It may not be the whole of your difficulties now, but likely played some part.

 

So no, I wouldn't even consider a reinstatement of that if I were you.  The Trazodone.

I'm also seeing in your narratives that you have been totally off Trazodone since July 7th?  Can you add that to your signature please:  Accounts Settings/Signature

Be sure and hit the Save button at the button when you are done.

 

Here's a copy of your present signature:

Zoloft — 2000 - 2004 ………………….……..…… Paxil — ~ 2004 to 2006 (2005 - 2006 slow wean attempt)

Early 2007 - Crashed (some insomnia, dysfunction) ……………………………...…………… Summer 2007 - resume 25 mg Paxil (eventual wean to 10 mg)

2008-2016 — 10 mg Paxil …………………… Summer 2016 - 20 mg (eventual wean to 10 mg)

Fall 2018 - Present — Mensah Medical patient ……………………………………January 2020 - Lexapro (failed transition attempt, suspected “poop out”) ……………………………………………….……………January 2020 - resume 10 mg Paxil …May 2020 - became naturopath patient

November 2020 - February 2022 - decrease by 0.02 mL/0.04 mg liquid Paxil per day (super-healthy diet & many supplements alongside)

March 2022 - sleep, anxiety, OCD concerns …………………………………………….……………………. May 2022 - chronic insomnia, panicky anxiety; tried Unisom, Ambien, hydroxyzine

May 16 to end-June/begin-July — Trazodone 100 mg for 7 days (mostly ineffective & horrible side effects), 75 mg 1 day, 62.5 mg 2 days, 50 mg 1 day, 62.5 mg 1 more day, 50 mg for 9 days, then down by 1/8 pill with pauses at dose levels

Resume Paxil at 5 mg (May 17), then 10 (May 26), jumped to 20 mg (June 8), back to 15 mg, back to 20 mg (July 8th)

Present - back to slow liquid wean b/c body is OVERWHELMED from internal unrest (too much Paxil & Trazodone withdrawal?)

 

You might also add in what you had got down to with the Paxil, dose in mg, last February, note when you came off it too.

You can remove some of the many narrative comments, and symptoms in the signature too.

It's a good first try, and worth saving here in a narrative/reply box,  but leaves out so much of the drug information.

 

What dose of Paxil did you jump off from in February?  What % of each previous dose were you doing your decreases by.  It appears you may have done a purely linear taper.  Do a good read of the Why taper by 10% link, when you are able. 

 

I think it's a good idea to avoid the Remeron too, or any further drugs just now.  It is possible as you get further out from the Trazodone experience, that you might start to improve......so don't obsess about 3-6 months of intense discomfort.  Stay in the day.  Add in your notes/journal any improvements, even if just momentary too.

 

I'm sure this is confusing between the signature and then the NOTES/daily drug and symptom journal too.  

The signature below your posts now, gives us a brief snapshot of your drug history.

The NOTES will go right here in a reply box, that example shown above in getofflex's last post.  And those will help us get a better idea of what might be what.  You're not going to have to do them forever, just try some for a couple of days while not doing any further drug changes or experiments.

 

And best, Love, peace, healing, and growth,

manymoretodays (mmt)

 

  

 

 

Edited August 14, 2022 by manymoretodays

[getofflex]

Are you on any supplements?  If so, which ones, what are the dosages, and when do you take them (time o'clock). 

[Look2God]

@manymoretodays

Thanks for taking an interest in my dilemma. I appreciate the confirmation to avoid both Trazodone reinstatement and adding Remeron — relief. How I so wish I would have factored SA wisdom into my earlier decisions … to do a 10% or micro taper instead (ideally) or more recently to reinstate a MUCH lower (if any) dose of SSRI and avoid Trazodone — much lament!

 

As you suggested, I made some adjustments to my signature. Thanks for your efforts to be upbeat and encouraging.

[manymoretodays]

No problem Look2God, and thanks for some further clarity in your signature.  Good job!

 

Now:

See if you can pull together 24 hours of the Notes/logs/daily drug and symptom diary.

Start with the morning, just put the time on the left, you could mention something about your nights sleep prior to that.

Time on the left then followed by your drug by name, with dosage.

Time on the left then followed by any supplements too, with dosage.

Time on the left then followed by symptoms with some of the descriptions you used in your first post(those were good descriptions)

 

Here's another link on how to do that:

More on drug and symptom logs/Notes/diary

In the first post, open up the quote by clicking the right hand arrow there, and do one or two or 3 days like that for us.  Then post here.

 

Give it your best try.  Consider it some occupational therapy, said with a smile.

I know it can be so very hard to keep your wits about your current status right now.

 

L, P, H, and G,

mmt

Edited August 16, 2022 by manymoretodays
didn't edit, wrong post

[Look2God]

(First attempt at symptom diary)

 

Sunday, August 14, 2022

~6:15 AM - awoke with anxiety

(had slept about 5 hours straight then rested more after awakening)

~9:30 AM - slight increase in internal distress before late breakfast 

~11:50 AM - early lunch / partial Paxil dose (~10 mg) … major surge in headache within 15 minutes (electrical tingling, intensified discomfort)

~2:45 PM - home from church; heightened symptoms continue since lunch Paxil — ringing ears, flushed/jittery head/hands, nerve overwhelm throughout body, raw stomach, dry/irritated nose/mouth

~4:25 - afternoon walk; achy body misery, concentration struggle

~5:30 - supper; stinging/ tingling/ gripping/numbing pain in head (skull & nasal cavity), hands/feet, arms/legs, and body - nauseating and distracting 

~8:30 - evening walk; prickly pain in head, arms, legs 

~9:00 - family time / devotions; slicing soreness in head, arms/hands, legs/feet, back; ringing in ears more noticeable 

~9:45 - tired and starting to doze on couch, lessened head pain, sharp pain in hand/arm, legs

~10:50 - bedtime Paxil dose (~9.4 mg) surge of burning jitteriness in feet, arms, legs, hands; strong ringing in ears

~11:30 - back/neck pain before sleep, more burning jitteriness, head pressure

~5:00 - awaken, use restroom, return to rest

Edited August 16, 2022 by manymoretodays
reduced font size to 14, for ease of reading

[getofflex]

Thanks for keeping notes, they look great!  From what you say, it sounds like you are having an adverse reaction to your Paxil.  Please continue to keep these notes and post them here for a few more days, just to be sure, and see if there are any other patterns going on.  I'm glad you were able to get 5 hours of sleep.  I wonder if it would help it you gradually moved your Paxil doses to earlier in the day, by one hour each day?  That may help your sleep. 

 

So it looks like you are not taking supplements, is this correct?  

 

Please hang in there, we will walk you through this, and help you get your Paxil tapered.  This will get better!  

[Look2God]

5 hours ago, getofflex said:

So it looks like you are not taking supplements, is this correct?  

I do rely on quality supplements as a foundation of my wellness approach. With awareness of the Paxil I have hoped to decrease, they come recommended from 2 sources: Mensah Medical and a naturopathic physician (fluctuates more regularly based on testing).

***Since before my crash from completing a linear wean — instead of a SA-recommended taper, they have been mainstays. ***

 

After awakening: 800 mg SAM-e (before I started the previous wean, this was my breakthrough product for mental wellness) with 500 mg of trimethylglycine (enhances SAM-e efficacy)

 

Before breakfast: ~1/4 tsp of a 100 billion CFU multispecies probiotic supplement 

 

With breakfast: Mensah Medical customized AM compound - 3 capsules

 

With each meal (3x/day): one capsule Bioclinic Naturals PEA

 

With lunch:

*two capsules of Alovea Immun
*one softgel of OmegaFactors UltraPrim “evening primrose oil” (also has omega-6 fatty acids)

 

With supper: Mensah Medical customized PM compound — 6 capsules

 

Before bed:

3 capsules of Integrative Therapeutics’ Pro-Som

2 capsules of Integrative Therapeutics’ Cortisol Manager Allergen Free

1 tablet Now Foods Calcium & Magnesium 2:1 ratio (500 mg/250 mg)

1 Klaire Labs 100 mg 5-HTP

 

5 hours ago, getofflex said:

it sounds like you are having an adverse reaction to your Paxil.  

…

Please hang in there, we will walk you through this, and help you get your Paxil tapered.  This will get better!  

I agree.

…

Thanks for offering support and a glimmer of hope for relief that doesn’t involve added complications from another drug.

[Look2God]

Notes — Monday, August 15

 

~5:00 AM - awaken, use restroom, return to rest

Unsettled body for morning Bible-read, prayer time (report to work ~9:00)

~9:20 - ears ring, medium headache (pressure/gripping), soreness around eyes 

~11:00 (trying to work) - numbing chills in head, arms, legs; ringing ears

~11:15 - prickly pain in hands, feet; ringing in ears especially noticeable, distracting urge to scratch/rub sore head, eyes, arms

~12:45 PM (before lunch) - disorienting internal unrest; cheeks prickly/numb (also hands, arms, head) side ache 

 

~1:00-1:30 (grazing lunch) took ~10 mg Paxil @ ~1:30 … within minutes, surge in internal unrest (head, arms, legs - urge to rub/scratch/itch) possibly amplified ear ringing? Burning/tingling - strong irritation & distracted focus

~2:18 (working) rolling chills, weird feeling throughout body - so uncomfortable; head zaps/ ears ringing

~2:35 - head/eyes felt swelled with numbing pain, then back to zaps, prickly sensations in head

~4:15 (leave work for chiropractic treatment) - numb/tingling hands, arms, head, eyes; ears keep ringing - ongoing malaise

 

6:30 PM (supper) - head achiness/dizziness - like nausea, arm numbness/ache, stomach soreness; (Before supper supplements) —Swelling, pressurized head feeling - like near to explode. Prickly hand sensations

 

7:30 (walk outside) - continued ear ringing, numb pain in head and right arm/hand

 

9:30 (family devotions)  -  same as above plus achy irritation in legs, pin-poke pain in head/eyes, both legs

 

11:15 - 9.36 mg Paxil

Seemed to notice more stinging sensations in right arm and legs/feet, ringing in ears, burning pain in arms/shoulders, legs/knees, and head

 

11:35 and beyond - tingly numb-pain in lips, teeth, fingers; increased agitation around eye sockets, arms tend to twitch, very sore head - want to rub hard for relief

When lying down, it’s like a pulsating electrical field (burning discomfort) from arms, legs, head, and lower trunk; ringing in ears is strong, itchy irritation in nasal cavity

~4:30 AM- awaken, use restroom, back to bed

Edited August 16, 2022 by manymoretodays
reduced font size to 14, for ease of reading

[manymoretodays]

Hi Look2God,

You ARE doing good with the NOTES.

I've just gone in and reduced the font to 14, if you can do that it will be helpful with your next 24 hours.

 

Can we get you to do the next one with the supplements in there too, especially......the 5HTP and SamE.

And oof, those are both serotonergic!  Yowser.  

 

And I'm going to ask you to do an interaction check too, with your 5HTP and SamE and Paxil.  

And then link us to it, or do a copy and paste in a reply.  Here's where you plug in your drugs and those supplements:  Drug Interaction Checker

 

For right now, keep your Paxil doses at the same time, within an hour or less.  We are just gathering information right now.  It's a good thought on getofflex's part and something we can try soon.

 

Have you always split the Paxil?

 

Let's get one more day please.  You're doing great with them.

 

I'm concerned especially about the 5-HTP and Sam-e at the moment and the dose of Paxil!

Here's what we have on them

5-HTP and l-tryptophan

Sam-e

 

I see you have been on them for quite some time though.  Have your doses of supplements changed at all since you've been doing this Mensah thing?  And tell me again when you started with Mensah and naturalists?  I'm pretty sure you said somewhere, but I'm getting short on time.

 

Magnesium and Calcium taken together do cancel out each others calming effect.  So......although we do recommend Magnesium(you've got that link in the first post from getofflex) we do tell people to split those up when they take them, don't take them combined.  You've got the Omega-3 Fish Oil link too.  I think you should find out just how much Omega-3 you are taking.

We often promote single ingredient supplements too.

I'll leave you this link-  I think you might find it helpful;Important topics about test, supplements, treatments, diet

 

I am impressed that you are able to work at all right now.

Many prayers.  Cheering for you Look!

 

Thank you for working with us on getting all your information gathered and sorted too.  You've been super!

Love, peace, healing, and growth,

mmt

 

 

 

 

Edited August 16, 2022 by manymoretodays

[manymoretodays]

Look,

One thing that I would try tonight if I were you...... and if you see this before bedtime, and can gather up some equipment to do it......

Would be to start with a taper on the 5 HTP.

It does need to be tapered.

 

Take a look at the link, especially that first post.

And then I'm seeing some on tapering it here, from that topic, in the end posts.  There may be more in the body of the topic as well.

 

You can make a suspension with the powder in a capsule in an equivalent amount of water to the mg's.

So you could do 100 mg(powder from capsule) and 100 mL water and then reduce by 10 mg or mL, as they will be the same.

You'd need to stir it up or even shake up your suspension well....... before removing 10 mL and then taking the rest.

That gives us a 10% reduction and that of course is good.

We like 10% reductions from the starting dose.

10% and no greater than 25%(and this 25%, just pertaining to your case really, as likely something is going on between the Paxil, 5HTP, and Sam-e combination right now.....too much)

 

You're having so many adverse reactions, and all this serotonergic stimuli(also a adverse reaction) is not helpful at all right now.

 

Here's more on methods of tapering:  Important topics in the Tapering forum and FAQ

Scroll down in the first post to: Methods of Tapering

 

 

 

 

 

Edited August 17, 2022 by manymoretodays
more, always more!

[Look2God]

Thanks for your time and attention!

 

15 hours ago, manymoretodays said:

I'm concerned especially about the 5-HTP and Sam-e at the moment and the dose of Paxil!

…

I see you have been on them for quite some time though.  Have your doses of supplements changed at all since you've been doing this Mensah thing?  And tell me again when you started with Mensah and naturalists?

I regret that my disclosure of my supplements shifted focus onto the 5-HTP and SAM-e. I want to emphasize that I have not observed that they have instigated any issues for me, including when combined with Paxil.
On the contrary, SAM-e especially was a key ingredient to my recovery success … before I even started weaning Paxil incorrectly (used a non-SA method), crashed with insomnia, then adversely used Trazodone and vastly overshot the dose when reinstating Paxil. Also, I have adjusted my 5-HTP dose on/off in the past - without noticing any related concerns.
 

[My current situation strikes me as more likely to result from too-fast-at-the-end/linear taper on Paxil, adverse reaction to and/or withdrawal from Trazodone, reinstating too much Paxil, and a possible adverse reaction to and/or kindling from the Paxil.]

 

As I understand, my DNA test revealed that I do not clear serotonin properly. With the leftover not cleared, new serotonin doesn’t latch properly. SAM-e, niacin, and TMG can help clear receptors, and 5-HTP (at a controlled amount to avoid serotonin syndrome) supplies fresh serotonin beyond the non-reuptaken serotonin blocked by the SSRI.
 

I am willing to wean on 5-HTP if that’s what it takes to indicate gratitude. *Still, I feel so desperate to effectively ease up on the Paxil itself when possible.

 

Yes, my doses have changed based on extensive testing since I started with Mensah in fall 2018 and the naturopath in spring 2020.

 

15 hours ago, manymoretodays said:

Have you always split the Paxil?

No, that’s something I did with this Paxil reinstatement because even 10 mg at a time feels SO intolerable … hard to consider taking the larger, full daily dose (where I’ve regrettably landed) all at once!

 

20 hours ago, manymoretodays said:

And I'm going to ask you to do an interaction check too, with your 5HTP and SamE and Paxil.

No interaction between SAM-e and Paxil, except a food issue with alcohol (a non-issue for me)

https://www.drugs.com/interactions-check.php?drug_list=2563-0,1800-1156

Unsurprisingly, there are warnings about serotonin syndrome and antidepressant duplication. Aware of a concurrent Paxil dose, both Mensah and the naturopath (separately) have purposely suggested adding 5-HTP to supplement during my treatment.

https://www.drugs.com/interactions-check.php?drug_list=1800-1156,1-10727

 

(I tapered the 5-HTP at ~10% less last evening.)

 

Thanks again for any help to effectually experience relief!

[Look2God]

[Sorry - I don’t notice how to reduce font size to 14 (I’m pasting from cell phone’s Notes app into a cell phone webpage)]
 

8/16/22 Notes

~4:30 AM- awaken, use restroom, back to bed

~7:15 - [SAM-e and TMG] dull aches in arms, legs, head (less intense)

~7:50-8:00 [breakfast supplements, including ~25 mg niacin, AM drink has 4 drops of Lugol’s iodine]

~ 8:20 (at work) ears ringing, headache with slight gagging feeling, tingly discomfort/dull pain in arms/hands, shoulders, legs, feet

~10:05 (AM snack & ~ 25 mg niacin) - swollen pain in head, itchy/sore around eyes, ringing ears, achy legs/knees

~10:35 - queasy head discomfort, feeling some nauseous & dizzy

(much of remaining morning — squeezing, nauseating, pressure headache with gaggy throat/nose, electrical pain in arms/hands, legs/feet)

~2:15 (late lunch) maybe more settled before taking Paxil [and lunch supplements, regrettably took an extra Mensah capsule]

~2:30 - took ~10 mg Paxil; unpleasant taste in mouth, electrical pain/ pressure sensation in head — like in a vise; dizzy, disoriented; legs sore

~3:15 - tingling pain in feet, legs, arms, head, hands; ears ringing 

~5:30-6:00 (supper) - sore, dizzy headache and dull-burning pain in hands, legs, feet before supplements [took supper supplements … no significant worsening of symptoms]

~8:00 (evening walk) headache, body pain, ringing ears; frustration while longing for relief from drug effects

~10:30 (bedtime wind down) - steady symptoms, not as bad as sometimes

~10:40 [bedtime Paxil ~9.32 mg dose (a little earlier) + liquidated 5-HTP with ~10% removed] … and time after [other bedtime supplements] - noticed burning/ tingling in arms/hands and legs/feet, headache seemed prickly/pressurized, ringing in ears; nasal cavity irritation; ongoing dull-burning pain in legs, hands, arms 

~3:30 AM- awaken, use restroom, back to bed (struggled to fall back to sleep but tried to rest)

Edited August 19, 2022 by manymoretodays
reduced font size to 14, for ease of reading

[Look2God]

8/17/22 Notes (again, sorry for big font)

 

~3:30 AM- awaken, use restroom, back to bed (struggled to fall back to sleep but tried to rest)

~6:45 - take SAM-e/TMG

(Felt better on way to work and after - body/head aches returned around 8:30)

~10:30 (AM snack ~25 mg niacin) - ringing ears, dull/heavy aches — overpowering and draining — in head, hands, arms, legs, feet … continued pretty much through late lunch

2:00-2:15 (lunch) [took Paxil and lunch supplements] - was feeling rough already; possibly intensified with more dizziness, throbbing in arms, legs/feet. Sensation seemed to maybe intensify in head, arms, tongue, legs/feet. Ringing ears persist.

~2:43 - stomach pain too

~4:00 - symptoms settled down to more tolerable level

~5:00 (chiropractic treatment) 

~6:30 (rest before supper) distasteful mouth, dull/burning body ache (arms, legs), dizzy headache, ear ringing

~6:50 (supper/supplements) - felt painful and weary, worn down from chronic aching

~7:25-9:15 (at church) - hard to concentrate with bodily distress/ misery. Sore head and achy body weighed heavily - like choking my energy and strength.

~10:10 (took PM Paxil - ~ 9.48 mg per getofflex’s advice to suspend reductions at earlier dose + liquidated 5-HTP with ~10% removed) was feeling rotten before but sensations morphed some into more electric-like zaps in head and arms/legs/feet, ringing ears too. Possibly not too much worse but seemed different.

~10:40 - took other bedtime supplements (only 2 ProSom) Noticing raw feeling and distaste in mouth, soreness in neck/throat, itchy nasal cavity & eye sockets, dull burning in head, arms, legs, feet/hands

~5:00 - awaken, restroom, return to rest

 

Edited August 18, 2022 by ChessieCat
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[Look2God]

Aug 18 2022 Notes

(incomplete due to schedule/ availability and weariness)

 

~5:00 - awaken, restroom, return to rest

~6:30 - SAM-e/TMG; ~7:30 - probiotics; ~8-8:15 - breakfast supplements 

~9:10 - Ears ringing, bodily dull ache - head, arms/legs, weird/dry taste in mouth/throat; gaggy/queasy headache (overwhelming, draining heaviness) and jittery hands

~11:15 (working) stinging, jittery overwhelm in various parts of body (head, legs, feet, arms/hands), accompanied by ear ringing 

~12:45 (after snacking) - symptoms subsided somewhat before lunch; slight headache

~1:15-1:35 (lunch) took ~10 mg Paxil and lunch supplements; noticed burning sensation in legs, arms, hands, back; unpleasant, dry taste in mouth; forehead feels sweaty but no sweat

~1:55-2:10 jittery irritation in legs/feet, arms/hands, head; ringing ears; dull burning agitation in head, neck, arms/hands, shoulders/upper back;  mouth/tongue feel strange; body feels like nerves are overloaded, panicky without threat

[gap]

~8:00 (around late supper) - disorienting, overbearing pain in head, arms, neck, legs, and hands (especially right). Hard to describe … burning/smothering nerve-squeezing

[didn’t capture notes beyond]

 

Edited August 21, 2022 by ChessieCat
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[manymoretodays]

On 8/17/2022 at 2:00 PM, Look2God said:

I regret that my disclosure of my supplements shifted focus onto the 5-HTP and SAM-e. I want to emphasize that I have not observed that they have instigated any issues for me, including when combined with Paxil.
On the contrary, SAM-e especially was a key ingredient to my recovery success … before I even started weaning Paxil incorrectly (used a non-SA method), crashed with insomnia, then adversely used Trazodone and vastly overshot the dose when reinstating Paxil. Also, I have adjusted my 5-HTP dose on/off in the past - without noticing any related concerns.
 

[My current situation strikes me as more likely to result from too-fast-at-the-end/linear taper on Paxil, adverse reaction to and/or withdrawal from Trazodone, reinstating too much Paxil, and a possible adverse reaction to and/or kindling from the Paxil.]

 

As I understand, my DNA test revealed that I do not clear serotonin properly. With the leftover not cleared, new serotonin doesn’t latch properly. SAM-e, niacin, and TMG can help clear receptors, and 5-HTP (at a controlled amount to avoid serotonin syndrome) supplies fresh serotonin beyond the non-reuptaken serotonin blocked by the SSRI.
 

I am willing to wean on 5-HTP if that’s what it takes to indicate gratitude. *Still, I feel so desperate to effectively ease up on the Paxil itself when possible.

 

I know, I know.......might be an important focus though.

 

I'm not denying that you may well be into adverse reactions from the Paxil as well as some WD, hypersensitivity or even kindling from your previous drug trials.  And we can address that as soon as possible.

 

Does this mean that you are willing to keep weaning the 5HTP, and off anyway?  Hoping so.  It is one factor, worth decreasing right now....... and...... apparently some who have weaned off 5HTP, while on a SSRI, have managed a faster taper.  So......I might continue down and off that one, over about a weeks time total, and might even reduce by 25% increments until off.

 

I know you are anxious to taper/reduce Paxil.  We are just wanting one change at a time though, to not muddy the waters of observation.

The 3 KI's, simple,slow, stable

And I do also realize that this is not even close to the stable you would like to have.  It is very weary inducing......trooping along when you feel quite horrendous.

Patience required.  Thank you for all your valiant efforts at reporting and observations, .......and honesty.

 

I did read how you felt that Sam-e was instrumental in getting you from A to Z, even while on Paxil, and without consequence or serotonergic symptoms.  And well okay on those tests you had, they are really not helpful when it comes to deprescriping though, or this process we are getting close to undertaking.  

Were you able to read more on what and what has not proved to be helpful validated as fact in this link here, and I quoted one excerpt from our founder, Altostrata.

 

"In "natural" depression, your nervous system is normal and it is operating your body properly. In withdrawal syndrome, your nervous system is struggling to get back to normal operation. Don't try to speed this along with anything that may be stimulating, or you may further unbalance it."

 

Sam-e too, could potentially be stimulating.   Let's see where you are at when you finish the 5HTP taper.  And try and go no further than that right now.  That would be wonderful if there was one thing that actually fixed damaged receptors, after long term SSRI use, and restored all pre drug level functioning.  I'd be wary is all....very wary.  I tried all kinds of stuff too, when I was still medicated........and even tapered too quickly while using it.  My conclusion was that maybe.....just maybe there is a chance in the never been medicated, or the medication virgin.......that all that might help, just might help.  I don't know.  It's not just your serotonin anymore either, you mess with any neurotransmitter.......you basically mess with that fine balance of all of them.  

 

And as you likely know, there has been no evidence to prove the myth that depression or anxiety has anything to do with  the serotonin system.

 

You are in WD, as well as being in a overmedicated(likely) situation.  Things might be different now, in how your nervous system reacts.   Your system is fragile, oh so sensitive. 

 

Keep at the NOTES.....I know, I know.......I thought 3 would do it.  Work hard to get names, and doses in.  Continue to list those key supplements too, name and dose despite your misgivings and disappointment/frustration.

 

So.....if you are willing......hang tight......get all the rest you can this weekend, and prayer/mediation time too.  Be with your Creator as much as possible......ask for comfort, patience, health, and healing.

 

Keep your doses of Paxil a little tighter.  And by that I mean, within 1/2 hour of a set time each day when you take them.

I think you could reasonably go back down to that little bit you had been down to with the night Paxil.  No need to go up.  If that makes sense.....I know you are tired and I am often too, too darn wordy.  I thought I noticed you had re-upped your night Paxil dose just a mini bit.

 

Don't worry then about the large font.  If you can get to a PC at any time, that might help when you do  your notes.  I, personally, have no idea how people can do so much from their mini phone devices.  I have a good one myself, but rarely use it for more than photos and calls, occasionally I'll read only from it, or chance a brief reply.  Anyway.....that's about me.  We've got Altostrata input too now Look2, and that can be very helpful.  So much experience and wisdom there. 

 

Little things you can do while you are weekending.  Epsom salt baths.  Maybe even some weighted blankies too:

https://www.survivingantidepressants.org/topic/2941-weighted-blankets-bed-tents-for-restlessness-akathisia-insomnia-and-anxiety/

 

Sending chill and calm. Best.

 

In my prayers.

L, P, H, and G,

mmt 

 

Edited August 20, 2022 by manymoretodays

[Look2God]

16 hours ago, manymoretodays said:

Does this mean that you are willing to keep weaning the 5HTP, and off anyway?  Hoping so.  It is one factor, worth decreasing right now....... and...... apparently some who have weaned off 5HTP, while on a SSRI, have managed a faster taper.  So......I might continue down and off that one, over about a weeks time total, and might even reduce by 25% increments until off.

Yes, I’m willing to keep weaning the 5HTP until off - decreased another ~10% last night.
 

Expect my notes to be less thorough for yesterday and today.
 

Thanks for your thoughtful feedback!

[Look2God]

*Note: busy weekend — overnight-gathering with extended family from Friday supper through Saturday lunch, then occupied with events surrounding niece’s wedding (Saturday evening through Sunday evening). So, very compromised note-taking

 

Aug 19 2022 Notes (also incomplete)

 

~2:00 - awakened, restroom, back to sleep; reawaken ~5:00, rest more

[Before leaving for work] 800 mg SAMe/ 500 mg TMG, ~1/4 tsp probiotic 

[gap in note-taking]
~10:13 - numb irritation in head, feet, legs, neck, hands … less than sometimes.

~10:20 - AM snack, breakfast supplements (3 Mensah AM capsules)

~11:15 - symptoms seemed to resurface (ear ringing more noticeable, headache)

~1:05 lunch/supplements (2 Alovea Immun capsules, 1 UltraPrim Omega oil capsule), also  ~10 mg Paxil - surge in electrifying headache

~1:45 - buzzing sensation around eyes, cheeks, legs 

~2:30-5:30 (traveling) head sensations like in vise, widespread nerve pain feels sickening and … unnerving; would love to step away from body symptoms and enjoy life! Doesn’t seem to be a matter of counseling techniques to overcome these physical issues

 

[Expecting to be occupied soon … into overnight/tomorrow — extended family getaway … supper Friday through lunch Saturday; so difficult to enjoy with fierce internal torment]

(Resumed very slight liquid Paxil decrease before bed - per “ManyMoreTodays” post, ~80 mg 5HTP liquidated [another 10% down] — also per MMT)

 

Saturday, August 20

[gap - occupied with family]

 

Lunch Paxil ~1:30 PM (taken without food so not too much later) - noticeably more internal agony within 10 minutes. Gripping, electrical soreness in head, arms/hands; bodily/mental unrest that persists. Dry, poking agitation around eyes and forehead.

~2:15 PM (late lunch and supplements — 2 Alovea Immun capsules, 1 UltraPrim Omega oil capsule, ~25 mg niacin)

 

(Afternoon through bed — increased after Paxil dose before-bed [Also took ~70 mg liquidated 5HTP])  The intensity of my head-pressure and body gripping pain has become so intense that it’s nearly unbearable. If I would return to the psychiatrist, he wanted me to add Remeron to the Paxil before considering a Paxil wean. Every time I take a dose of Paxil, I feel like I’m miserably entrenching my body into further physiological dependence. I feel trapped without an open path toward relief.

 

Sunday, August 21

~2:15 woke, use restroom, back to rest.

~7:00 - took 800 mg SAM-e, 500 mg TMG; before/after = feeling rough internally … prickly, pressure pain in nerves, ears ringing noticeably 

[big gap in notes - niece’s wedding (felt so miserable — like body under torturous attack with wracking nerve pain … exacerbated by lunch Paxil dose)]

 

*Willing to consider resuming more consistent notes.

 

On 8/20/2022 at 12:34 PM, manymoretodays said:

So......I might continue down and off that one, over about a weeks time total, and might even reduce by 25% increments until off.

 

Help me understand, please. So, I can go down 10% of 100 mg each day (10 mg less each day) … or 25% of 100 mg each day (25 mg less each day) — either one?

 

 

Edited August 22, 2022 by ChessieCat
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[manymoretodays]

13 hours ago, Look2God said:

Help me understand, please. So, I can go down 10% of 100 mg each day (10 mg less each day) … or 25% of 100 mg each day (25 mg less each day) — either one?

 

I think you reported being down to 70 mg last with your 5HTP.  You might go down next to 50 mg, wait a couple days, and then go down to 25 mg, wait another couple of days.....and then from there off of it.

I'd also get back to thorough notes, glad you are willing........ being sure to note before and after the 5HTP, as well as  before and after Paxil doses and the Sam-e.

If you do notice a significant change in the couple days after making the 5HTP changes, for the worse, then you would not have to continue larger reductions.  So far symptoms seem to be about the same from what I can see.  I don't think you have worsened at all.  What do you think? 

 

13 hours ago, Look2God said:

If I would return to the psychiatrist, he wanted me to add Remeron to the Paxil before considering a Paxil wean. Every time I take a dose of Paxil, I feel like I’m miserably entrenching my body into further physiological dependence. I feel trapped without an open path toward relief.

 

Physiologic dependency is established with the Paxil, restarted over 2 months ago.  We are just trying to mitigate other risky factors now,  those being your serotonergic supplements....... prior to tapering the Paxil.   Not add additional psychopharmacology.

Look at those struggling with Remeron(mirtazapine) here.  Did you plug it in the interactions checker?  EEKS. 

 

You're a trooper, Look2......you've been really busy this past weekend.   I'm sorry you expected the remedication with Paxil to be the magic cure.  I'm glad you came here, and sorry it has not gone more quickly, and in the way you had hoped.

 

 I hope you can find time for self care and some relaxation.  Be sure and note in those NOTES any positives too.  Any non-drug techniques used that helped.  We do really want to see symptoms before and after your Paxil and supplements, but also would like to see how you are progressing with non-drug coping too.  So be sure to note non-drug/non-supplement things you do that help with symptoms too.  Note a few postitives every day please.

 

neuroemotions are high right now for you I imagine.  Including frustration and impatience.

 

Okay.....blessings,

L, P, H, and G,

mmt

 

[Look2God]

Monday, August 22

Awakened (~2:15 AM?) sweaty - had used weighted blanket; restroom and back to bed

Awakened again around 6 - symptoms more subdued, tolerable

~6:25 took 800 mg SAM-e, 500 mg TMG;

more internal unrest afterwards?

~7:25 - took ~25 mg niacin and PEA capsule

~8:00 (breakfast - catered @ work, less healthy than normal) 3 Mensah AM capsules

~9:15 (meeting) - drowsy, stomach discomfort, ears ringing; arms, legs/feet = electrical, numb; head = woozy, disorienting 

~10:45 (snack - vegetables) numbing nerve pain in legs/feet, head, hands; ringing ears; want to squirm to settle awkward, distracting sensations; less intense malaise than sometimes but still discouraging 

~12:15 (healthy lunch - before supplements, Paxil) relative calm with slight unrest in arms/legs, head has mild ache, ears continue ringing

~12:50 (~10 mg Paxil, 2 Alovea Immun capsules, 1 UltraPrim Omega oil capsule) increase in headache sharpness/pain, increase in pain in legs/arms, dry, buzzing distaste in mouth/nose, tongue weirded, unprovoked sense of overwhelm & threat, ears ringing (louder?)

~2:10 (working) surge continues — burning, electrical headache … head = jittery, numb when rubbed; legs/arms/back feel unpleasant, tingly agitation; hard to concentrate

~3:20 (still working) - body and head feels like low-level electrocution with such unpleasant stimulation in head (gripped like vise), arms/hands, legs/feet (more pronounced here) like constant shock of distressing pain

~3:45 (light snack, ~25 mg niacin) not much difference, intensity may be lessening somewhat - still tough

(Extended day at work)

~7:20-8:00 (exercise - push-mowing) tendency to dwell on lament and wish for a clearer path to relief, but it helped to recall Bible promises, pray for others’ needs, and think of Serenity Prayer

~8:30 (supper - delayed so entire family could eat together) 6 Mensah PM capsules and 1 PEA capsule; before/after - squeezing headache and arm-ache … dull, alarming pressure

~10:30 (Before ~50 mg liquidated 5-HTP) -  some squeezing discomfort still in head (some subsided from past 2 hours?); took 5-HTP - headache slightly changed but not lots more intense, arms & legs = fine/relatively settled 

~11:00 (~9.4 mg Paxil)

~11:20 - head feels more electrified (sore around eyes), also arms/legs; ears ringing

~11:35 - headache intensified, also arm/leg jitteriness (right arm numbing), dry distaste in mouth/tongue

~11:50 (1 ProSom, 1 Cortisol Manager, 1 Calcium/Magnesium) used weighted blanket

~2:10 - awaken, restroom, return to bed

~4:15 - awaken, struggle to resume sleep

 

Edited August 23, 2022 by ChessieCat
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[Look2God]

On 8/22/2022 at 12:39 PM, manymoretodays said:

If you do notice a significant change in the couple days after making the 5HTP changes, for the worse, then you would not have to continue larger reductions.  So far symptoms seem to be about the same from what I can see.  I don't think you have worsened at all.  What do you think? 

Unfortunately, my symptoms since beginning to reduce 5-HTP have seemed to steadily progress for the worse, especially in my quality and duration of sleep (and grip-heaviness of afternoon/evening headache & body aches). This was less apparent with my incomplete notes from the weekend.

 

Last night was particularly alarming with sleep lack, and today I carry the memorable sensations of sleep-deprived body pain that I had before — in addition to the typical Paxil surge. It can feel like knives in my head & legs and sharp pressure around my eyes.

 

While I don’t plan to go below last night’s 5-HTP dose tonight, I’m seriously inclined to resume at the 100 mg level; sleep is so precious. Any reflections on the impact either way?

[ChessieCat]

1 hour ago, Look2God said:

While I don’t plan to go below last night’s 5-HTP dose tonight, I’m seriously inclined to resume at the 100 mg level

 

I think from your notes above that you are now taking 50mg?  Just like with psychiatric drugs, when tapering/updosing it is better to make small reductions/increases.  Instead of going back to 100mg if you are now taking 50mg, then it generally better to NOT to go back to the previous dose but to only make a small updose.

[Look2God]

Thanks - what dosage do you consider to be a small updose from 50 mg?

[ChessieCat]

From a quick glance at your notes it seems that you have been reducing by 10% each time.  I don't know how often you have been reducing.

 

You might try increasing to 55mg.

[Look2God]

Tuesday, August 23 Notes 

 

~2:10 - awaken, restroom, return to bed

~4:15 - awaken, struggle to resume sleep ~6:00 (AM prayers, Bible reading) some head, arm numbness 

~7:00 - took 800 mg SAM-e, 500 mg TMG

~7:20 - ~25 mg niacin, 1 PEA capsule; 3 Mensah AM capsules with breakfast on way to work

~7:50 - tired with head and body (especially arms, legs) pain; seems at least partially due to lack of sleep

~10:15 (AM snack & ~25 mg niacin)

~10:35 - similar to rest of AM so far … body-strain pain partially due to lack of sleep; strong pain/drain/numb in head, arms/hands, legs/feet, neck; tingly pain in mouth/tongue; familiar from recent insomnia

~11:00-11:30 (lunch with atypical dairy - 2 Alovea Immun, 1 UltraPrim omega oil capsule) still dealing with similar sensations as above 

~1:00 (before Paxil) - above symptoms, maybe slightly eased? but very noticeable; took ~10 mg Paxil

Very soon - jolt-like pain-grip in arm, head; increase in dizzying ache in head (gagging/nauseating neck/mouth), legs, arms; more burning nerve-agitation I head/limbs, tongue

(at work until ~3 today)

~3:45-5:00 - visit elderly lady (church connection) challenge to focus on conversation but good to interact; intense body and head pain … knife-like, nearly nauseating

(Walk outside after arrive home)

~6:30 (supper - 6 PM Mensah, 1 PEA capsule) continuing, brutal pain in head, arms, legs, hands, feet

~9:00 (home from picking up child at school) lying on couch; knife-like jabbing pain in head, arms, legs, feet, hands; limbs feel unpleasantly warm and prickly; ears still ringing; dismal to experience such ongoing extent of misery 

(Family devotions) - hard to be still with such internal irritation; thanked God for family, safe travels 

~10:20 (before shower and PM “stuff) - my head, arms, legs, hands, and feet feel such itching, burning pain! So weirdly numb and nerve-wracking … literally. Mouth feels dry and numb. Ears ring.

~10:30 - ~60 mg of liquidated 5-HTP; listened to sermon while showering; similar discomfort, maybe some less?

~11:00 - ~9.36mg of Paxil … quite soon felt prickly pain surge in head/face, arms/hands, legs/feet; felt like twitching, squirming, escaping; tongue burning, ears ringing

~11:20 - burning, stinging sensation around body; head throbbing some, face/tongue burning; stomach/hands prickly; Yikes - so intensely disturbing when desiring rest!

~11:30 (1 ProSom, 1 Cortisol Manager, 1 Calcium/Magnesium) used weighted blanket

~2:15 - awoke, restroom, return to rest without weighted blanket

~5:55 - awoke again; less agitation, more rested

Edited August 24, 2022 by manymoretodays
reduced font

[Look2God]

On 8/19/2022 at 10:34 PM, manymoretodays said:

I know you are anxious to taper/reduce Paxil.  We are just wanting one change at a time though, to not muddy the waters of observation.

… 

 

And I do also realize that this is not even close to the stable you would like to have.  It is very weary inducing......trooping along when you feel quite horrendous.

 

…

 

Sam-e too, could potentially be stimulating. 

As I indicated yesterday, I seem to be at a standstill on reducing 5-HTP in order to maintain sleep. 
 

However, my symptoms feel worthy of adjusted focus. From keeping notes, I’m convinced that — along with Paxil being way too overstimulatingly high — my SAM-e level is prompting overstimulation also. (I just doubled the dose to 800 mg in July per naturopath’s recommendation - was on 400 mg before). So, I’m pleading for support to switch my “one change” at this time to Paxil (preferably) or SAM-e.

 

I have access to SAM-e in 400 mg and 200 mg tablets, so I can reduce to 600 mg as a first step. However, from other links on SA, there’s no simple way to gradually reduce SAM-e due to it coming in enteric-coated tablets. So, maybe I should pursue that after Paxil, which has liquid available? (At minimum, decreasing my SAM-e dosage increasing seems far better than changing no thing at this time.)

 

Thanks for your consideration!

[manymoretodays]

Hi Look2,

I had assumed you were still on the liquid Paxil, the 10 mg/5 mL or 2mg/ 1mL concentration. 

Had you changed forms of Paxil when you began reinstating?

(just for further reference)

 

And oh Lordy yes, it is confusing......the whole picture with the serotonergic supplements thrown in, and all the other supplements.

 

So.....you'd be doing the 5HTP again at 60 mg tonight, for your second night.  Can you stay with that for one more night, to see if it has anything to do with your sleep problems?  So many factors in your specifics that it makes ME dizzy.  So.....I do see you saying that since the beginning of 5HTP tapering, or since this weekend you feel your sleep is off more-so than it was prior to.    And then again, it might have been the bigger jump I endorsed, from 70 mg to 50 mg.  Oh, I just don't know.

 

I had hoped we could get you down and off both the 5HTP and Sam-e in a couple of weeks.  We began about a week ago I believe with just the 5HTP.  I would think the Paxil on board now might preclude WD from those 2 supplements a bit........I sure could be wrong.

Let's just do another night, of 60 mg 5HTP, tonight......see how that goes.

Hold steady another day with the Sam-e at the same dose, the 800 mg for tomorrow.

 

A day at a time.

 

I'm just going to line up your 2 days notes below(I'll just copy and paste)......kind of makes it easier to view.  And I'll further confer as well with the other mods/administration. 

 

Monday, August 22

Awakened (~2:15 AM?) sweaty - had used weighted blanket; restroom and back to bed

Awakened again around 6 - symptoms more subdued, tolerable

~6:25 took 800 mg SAM-e, 500 mg TMG;

more internal unrest afterwards?

~7:25 - took ~25 mg niacin and PEA capsule

~8:00 (breakfast - catered @ work, less healthy than normal) 3 Mensah AM capsules

~9:15 (meeting) - drowsy, stomach discomfort, ears ringing; arms, legs/feet = electrical, numb; head = woozy, disorienting 

~10:45 (snack - vegetables) numbing nerve pain in legs/feet, head, hands; ringing ears; want to squirm to settle awkward, distracting sensations; less intense malaise than sometimes but still discouraging 

~12:15 (healthy lunch - before supplements, Paxil) relative calm with slight unrest in arms/legs, head has mild ache, ears continue ringing

~12:50 (~10 mg Paxil, 2 Alovea Immun capsules, 1 UltraPrim Omega oil capsule) increase in headache sharpness/pain, increase in pain in legs/arms, dry, buzzing distaste in mouth/nose, tongue weirded, unprovoked sense of overwhelm & threat, ears ringing (louder?)

~2:10 (working) surge continues — burning, electrical headache … head = jittery, numb when rubbed; legs/arms/back feel unpleasant, tingly agitation; hard to concentrate

~3:20 (still working) - body and head feels like low-level electrocution with such unpleasant stimulation in head (gripped like vise), arms/hands, legs/feet (more pronounced here) like constant shock of distressing pain

~3:45 (light snack, ~25 mg niacin) not much difference, intensity may be lessening somewhat - still tough

(Extended day at work)

~7:20-8:00 (exercise - push-mowing) tendency to dwell on lament and wish for a clearer path to relief, but it helped to recall Bible promises, pray for others’ needs, and think of Serenity Prayer

~8:30 (supper - delayed so entire family could eat together) 6 Mensah PM capsules and 1 PEA capsule; before/after - squeezing headache and arm-ache … dull, alarming pressure

~10:30 (Before ~50 mg liquidated 5-HTP) -  some squeezing discomfort still in head (some subsided from past 2 hours?); took 5-HTP - headache slightly changed but not lots more intense, arms & legs = fine/relatively settled 

~11:00 (~9.4 mg Paxil)

~11:20 - head feels more electrified (sore around eyes), also arms/legs; ears ringing

~11:35 - headache intensified, also arm/leg jitteriness (right arm numbing), dry distaste in mouth/tongue

~11:50 (1 ProSom, 1 Cortisol Manager, 1 Calcium/Magnesium) used weighted blanket

~2:10 - awaken, restroom, return to bed

~4:15 - awaken, struggle to resume sleep

 

Tuesday, August 23 Notes 

 

~2:10 - awaken, restroom, return to bed

~4:15 - awaken, struggle to resume sleep ~6:00 (AM prayers, Bible reading) some head, arm numbness 

~7:00 - took 800 mg SAM-e, 500 mg TMG

~7:20 - ~25 mg niacin, 1 PEA capsule; 3 Mensah AM capsules with breakfast on way to work

~7:50 - tired with head and body (especially arms, legs) pain; seems at least partially due to lack of sleep

~10:15 (AM snack & ~25 mg niacin)

~10:35 - similar to rest of AM so far … body-strain pain partially due to lack of sleep; strong pain/drain/numb in head, arms/hands, legs/feet, neck; tingly pain in mouth/tongue; familiar from recent insomnia

~11:00-11:30 (lunch with atypical dairy - 2 Alovea Immun, 1 UltraPrim omega oil capsule) still dealing with similar sensations as above 

~1:00 (before Paxil) - above symptoms, maybe slightly eased? but very noticeable; took ~10 mg Paxil

Very soon - jolt-like pain-grip in arm, head; increase in dizzying ache in head (gagging/nauseating neck/mouth), legs, arms; more burning nerve-agitation I head/limbs, tongue

(at work until ~3 today)

~3:45-5:00 - visit elderly lady (church connection) challenge to focus on conversation but good to interact; intense body and head pain … knife-like, nearly nauseating

(Walk outside after arrive home)

~6:30 (supper - 6 PM Mensah, 1 PEA capsule) continuing, brutal pain in head, arms, legs, hands, feet

~9:00 (home from picking up child at school) lying on couch; knife-like jabbing pain in head, arms, legs, feet, hands; limbs feel unpleasantly warm and prickly; ears still ringing; dismal to experience such ongoing extent of misery 

(Family devotions) - hard to be still with such internal irritation; thanked God for family, safe travels 

~10:20 (before shower and PM “stuff) - my head, arms, legs, hands, and feet feel such itching, burning pain! So weirdly numb and nerve-wracking … literally. Mouth feels dry and numb. Ears ring.

~10:30 - ~60 mg of liquidated 5-HTP; listened to sermon while showering; similar discomfort, maybe some less?

~11:00 - ~9.36mg of Paxil … quite soon felt prickly pain surge in head/face, arms/hands, legs/feet; felt like twitching, squirming, escaping; tongue burning, ears ringing

~11:20 - burning, stinging sensation around body; head throbbing some, face/tongue burning; stomach/hands prickly; Yikes - so intensely disturbing when desiring rest!

~11:30 (1 ProSom, 1 Cortisol Manager, 1 Calcium/Magnesium) used weighted blanket

~2:15 - awoke, restroom, return to rest without weighted blanket

~5:55 - awoke again; less agitation, more rested

 

Good to see some non-drug coping, the weighted blanket too.  Is the Ca/mg and Cortisol manager stuff essential right now?

And your niacin isn't causing any flushing or anything?  Is it the B3 or the precursor to that, which is Inositol?

I continued amazed at your fortitude Look2, and nice to see how much you are continuing to do. 

 

And best, L, P, H, and G,

mmt

 

 

 

 

 

 

 

 

[Altostrata]

Hello, @Look2God Is the Mensah program supposed to enable you to go off your antidepressant?

 

Have you talked with your Mensah providers and naturopath about whether their regimen is making you sick? That is their responsibility, for which you're paying them. We should not have to unravel this if you're reacting poorly to whatever is in those capsules.

 

One thing we would look for is how you feel after you take a capsule compared to how you felt before taking it, such as

9 hours ago, Look2God said:

my SAM-e level is prompting overstimulation also. (I just doubled the dose to 800 mg in July per naturopath’s recommendation - was on 400 mg before)

 

If the increase in SAM-e caused a more intense adverse reaction, if I were you, I'd cut it down, by perhaps 100mg every 2 days. But I'm not going to spend my volunteer time advising you how to adjust the treatments you're getting from other providers. That's their job. You need to talk with them.

 

Ordinarily, we do advise people NOT to take SAM-e, tryptophan, 5-HTP, or mega-vitamins to substitute for antidepressants because they can cause problems, too. Our approach is NOT aligned with your naturopath's or Mensah's.

[Look2God]

18 hours ago, manymoretodays said:

Had you changed forms of Paxil when you began reinstating?

(just for further reference)

I’m still using 10 mg/5mL liquid Paxil for some of my dose.

 

18 hours ago, manymoretodays said:

So.....you'd be doing the 5HTP again at 60 mg tonight, for your second night.  Can you stay with that for one more night, to see if it has anything to do with your sleep problems?

Yes, I tried to take 60 mg again last night. Sleep seemed better than 2 nights before.

 

18 hours ago, manymoretodays said:

Is the Ca/mg and Cortisol manager stuff essential right now?

And your niacin isn't causing any flushing or anything?  Is it the B3 or the precursor to that, which is Inositol?

I’ve cut back on Cortisol Manager and will likely discontinue soon. 
I have 50 mg niacin (B3 not inositol) tablets, but split them into 2 doses after dealing with flushing before. However, this morning I did get a flushing effect on a partial dose.

 

Thanks for your kind encouragement and any relief suggestions, MMT.

[Look2God]

Wednesday, August 24

~2:15 - awoke, restroom, return to rest without weighted blanket

~5:55 - awoke again; less agitation, more rested

~6:30 - some body soreness in limbs, resurfacing headache 

~6:40 - 800 mg SAM-e/500 mg TMG, ~1/4 tsp probiotic

~6:55 - body feels impacted/stirred in head, limbs, neck (half dose SAM-e = better?)

~8:20 - woozy stimulation in head and body, sore around eyes

~10:45 (AM snack, ~25 mg niacin) squirmy discomfort persists; raw, dull soreness jabbing my legs, hands, back, head. Nose feels dry irritation.

~12:00 (light snack, ~25 mg niacin) - upper back, legs/feet, hands/arms, shoulders, head = wired/geared with squirmy agitation — want to writhe, kick, wiggle, and contort face for relief

~1:00 (lunch) gripping headache, ear ringing, sore/dry eyes/ears, and leg pain

~1:25 (~10 mg Paxil, 2 Immun, 1 UltraPrim omega oil capsule, 1 PEA capsule) 

~4:00 (counseling appointment)

(Walk outside with wife)

~6:45 (supper - 6 PM Mensah capsules, 1 PEA capsule)

~7:30 (church service/fellowship)

~10:00 (devotions)

~10:30 (before 5-HTP) typical soreness and pain as described before

~10:40 (took ~60 mg 5-HTP) not much difference

(Conversation with wife about impact of situation)

~11:20 (~9.32 mg Paxil with help of liquid)

Noticed ears ringing more; like yesterday, prickly pain surge in head/face, arms/hands, legs/feet; feels like addressing Paxil is a priority; again, “burning, stinging sensation around body; head throbbing some, face/tongue burning; stomach/hands prickly; Yikes - so intensely disturbing when desiring rest!” Blowing headache, burning in arms, legs

(1 ProSom, 1 Cortisol Manager, 1 Calcium/Magnesium tablet)

~2:15 - awaken, restroom, back to rest

~5:00 - awaken, pray/rest

 

Edited August 28, 2022 by ChessieCat
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[Altostrata]

Are Mensah and your naturopath working with you to go off your drugs? If so, you will have to take your difficulties to them.

 

Our advice may be counter to what they tell you. Very likely, your supplements are contributing to your symptom pattern.

 

 

[Look2God]

SIncere thanks to all SA contributors who have taken time and heart to consider my challenges.

 

I do not want to be an unreasonable burden to anyone. I was hoping to benefit from your experience-based wisdom to realize relief from Paxil. I regret that my situation involves such complicated elements, including supplements that contribute to confusion. The fact I pursued them before landing here indicates how earnestly I’ve sought a drug-free balance; I mean no disrespect to any of you.  Had I only known in mid-May what you know, I would have avoided reinstating Paxil (so extensively or at all?) and even trying Trazodone!
 

Mensah and the naturopath aren’t working directly with me on the fine details of going off Paxil. Neither provides the Paxil prescription, and tapering itself that is not their area of expertise. 
 

I feel desperate, having consulted with a psychiatrist who reached out to coordinate with the naturopath and Mensah.  However, the psychiatrist does not recognize the concepts you are expressing here and wanted to put me on another/more medication, etc.  The naturopath admittedly lacks training in prescriptions. 
 

If there’s any room in the future to re-engage your support, I’m interested in what it would take to resume.

 

I want to be an appreciative peacemaker. I look to God to fully bless everyone who reads this.

[manymoretodays]

Wow....how sweet.  I was just thinking of you Look2.

 

See what you can do, in lowering, and even off the 5HTP and Sam-e over the next few weeks, or however long it takes.

I think it's only been a little over a week now, with reductions in 5HTP.

If you feel like you need to work directly with Mensah or the naturopath to take a break from their programs, do so.

 

And THEN, we can work with you.

 

You've also got the first couple of posts from getofflex to refer too, when you get back to the Paxil tapering.

 

And of course, you are welcome back.