PupcornNinjaTurtle: my long quest to stop taking Paxil / paroxetine

[PupcornNinjaTurtle]

Hi everyone,

I want to introduce myself. This forum helped me start tapering off of paxil a year ago and I never officially joined until now. Now that I am close to the finish mark, things have gotten harder. It is a long story, so I post a summary first and then a longer version.

 

What I am looking for: sympathy, tips on dealing with current WD symptoms, advice, etc.

 

My history (summary):

May 2017-April 2018: 30 mg paxil

April-September 2018: 15 mg paxil

Sept-Nov 2018: 20 mg paxil

November 2019: switch to 20mg paroxetine (bad reaction to change)

December 2019-July 2021: 20mg Paxil again

June 2021-August 2021: slow transition from 20mg brand paxil to 20mg paroxetine. Went well this time.(motivation was price of drug)

July 2021: discussed with doc that parox has made me feel stupid/less sharp. I have always been considered a smart individual, and my work is very intellectual. He said parox does indeed cause cognitive decline over extended use period. So I started tapering off 20mg paroxetine at approx. -10% a month. Had to combine with suspension which is only sold as brand Paxil. (Doc supported this plan).

July 2021: doc suggested cannabis for insomnia and that has been wonderful. This was because I often found myself needing 0.25mg alprazolam to sleep and he said cannabis was better.

May 2022: reached 10mg paroxetine (from 20mg July 2021). No bad feelings other than noticing increased overall anxiety. Convinced myself I do want to take meds but not paroxetine.

July 2022: Doc suggested change to 10 mg Trintellix. Suggested plan was: week 1: 10mg parox and 5mg trintellix; week 2: 10 mg parox and 10mg trintellix; week 3: 5 mg parox and 10mg trintellix (I disobeyed and went to 7.5mg instead and felt fine); week 4: 2.5mg parox and 10mg trintellix (I disobeyed and went to 5mg of paroxetine and all hell broke loose). Three days into the change from 7.5->5mg paroxetine I started feeling terrible withdrawal.

August 2022: currently taking 10mg trintellix in the morning and 5 mg paroxetine in the evening and afraid to reduce further. Have been needing 0.25 mg alprazolam to sleep because I am afraid of using prescribed cannabis, which is what I normally use for sleeping.

August 2022: 10mg trintellix and 5 mg paroxetine. Alprazolam 0.25mg or cannabis for sleep. Having WD from parox in spite of trintellix. Since 3rd day of going 7.5mg->5mg of parox I have felt crippling headache that did not subside even with 600 mg ibuprofen. This came along with a very stiff neck seemingly out of the blue. I decided it must've been my yoga headstand. But I also felt a bit off - weird racing thoughts, did not feel like myself. Had to take alprazolam 0.25 mg to sleep. The next day I felt extremely nauseous and dizzy along with the stiff neck, ocular pain, and a paradoxical feeling of both light and heavy head, if that makes sense. These symptoms persisted into the next day, which is where I am now.

What I've been trying from reading here: took 2x 120mg magnesium capsules this morning and 2xvegan omega3 capsules. I felt some relief from ocular and neck pain. Also have been using heat pads and sniffing my lavender/eucalyptus oil blend for relief. Tums helped with nausea yesterday. Any tips are welcome. Thank you

PS: I also take between 5-20mg of dextroamphetamine for adhd daily. This started late in life on July 2020 and has proved essential to my surviving in capitalism as a late diagnosed woman with adhd.

 

Long version:

Prescribed brand Paxil for generalyzed anxiety disorder: 10 mg for a week, 20mg second week, 30 mg third week. Adjusted well and main side effects were: constipation, weight gain, increased motion sickness. These seemed worth it compared to my anxiety. Took that from may 2017 to around march 2019, when, aided by prescribing doctor, decided to try to stop gradually. He recommended reduce in half (15 mg) in one go and report back. I did and stayed there for about 5 weeks. I felt physical symptoms such as diarrhea, ocular pain, headaches, general photophobia. Doc said these were normal and would subside and indeed they did after about 5 weeks. At that point doc said to cut in half again (7.5 mg). After a couple of days I felt all the previous symptoms in huge intensity but also despair, dread, bouts of crying, and generally a feeling of losing myself. Doc told me to up it back to 15 mg and stay there, which I did. A few months later I was having trouble sleeping and drinking myself to sleep so I asked for advice and he upped the dose to 20mg, where I stayed until July 2021. In November 2020 I tried switching from paxil to paroxetine and had huge withdrawal symptoms (same dose). Switched back to paxil. July 2021, switched gradually from paxil to paroxetine because it is cheaper. That worked fine. I also then started tapering off from 20mg to 10mg (achieved May 2022, no withdrawal). July 2022, doc suggests transition to trintellix with following plan: week

 

In July 2020 I started seeing a new psychiatrist and long story short he said paroxetine was notoriously difficult to get off of and that we could switch to trintellix if I wanted to continue medication or use fluoxetine as a bridge. In July 2021, aided by websites like this one, I told him I would start a slow tappering off to help me decide and he supported did. I did about -10% a month, including paxil suspension

 

Last week July 2022: started 5 mg Trintellix.

A week later 10 mg Trintellix.

A week later went from 10 to 7.5 mg of paroxetine. Felt ok.

A week later went from 7.5 to 5 mg of paroxetine. On the third day felt crippling headache that did not subside even with 600 mg ibuprofen. This came along with a very stiff neck seemingly out of the blue. I decided it must've been my yoga headstand. But I also felt a bit off - weird racing thoughts, did not feel like myself. Had to take alprazolam 0.25 mg to sleep. The next day I felt extremely nauseous and dizzy along with the stiff neck, ocular pain, and a paradoxical feeling of both light and heavy head, if that makes sense. These symptoms persisted into the next day, which is where I am now.

 

Any advice/tips/stories/support is welcome. Thank you

[Altostrata]

Welcome. @PupcornNinjaTurtle

 

It appears you were going along tapering Paxil, when in July, your prescriber proposed a switch to Trintellix, which has been nothing but trouble. Have you discussed the failure of the switch to Trintellix with this psychiatrist?

 

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

[PupcornNinjaTurtle]

Hi @Altostrata! Thank you for the tip about the signature. I did that and I hope it makes sense. Sorry for many typos in my original post. I was in a very strange mindspace earlier this week.

 

Quote

It appears you were going along tapering Paxil, when in July, your prescriber proposed a switch to Trintellix, which has been nothing but trouble. Have you discussed the failure of the switch to Trintellix with this psychiatrist?

 

Yes, I did on Thursday. I relayed all of this to him and because he is much better than most doctors (psychiatrists in particular I have seen) I was disappointed about how hand wavy he was. He did agree with me it could be WD but did not offer anything except suggesting I go back to 10mg paroxetine, to which I said hell no, since I was ok (ish) with 7.5mg (in retrospect I was feeling more moody but definitely didn't feel as bad as I do now). Then he said to switch back to 7.5 mg. But by the time I talked to him I had been taking Mg for 3+ days and was feeling much better so I did not go back to 7.5mg. I asked if it wasn't an issue that I am currently taking two antidepressants and that at the rate that has worked for me previously it would take me many months to get off of paroxetine. He said no because it won't be *that* long. basically, unhelpful. He is fine with whatever I do.

 

But going back to your point, it didn't occur to either of us that my current WD could be because trintellix is bad (or doesn't work) for me. I guess I was just assuming it was WD of paroxetine in spite of having included another medication. I do think that if i was *not* taking trintellix then this reduction in paroxetine from 10->5mg in less than a month would have had more devastating consequences (and I would not have done it).  But maybe I am just overlooking this possibility? What makes you think that it could be that trintellix is doing harm? 

 

I tried looking for cases like mine (tapering to lower dose, switching to new medication and still having trouble to get off of paroxetine/paxil) but had no luck. If anyone can share anything on this I appreciate!

 

Update: the magnesium helped a lot between 5-7th days of 7.5->5 mg change, but since then I've noticed ups and downs. Since last night my horrible headache and nausea are back...I do notice magnesium has helped a lot. I guess I wasn't expecting symptoms to get worse again.

 

Thank you very much for your input. 

[PupcornNinjaTurtle]

Struggling badly today.

 

Log of symptoms. Note: I never have headaches unless my eye prescription has changed (it hasn't) or under dehydration (I've never been more hydrated). I wonder if I am having migraine due to WD?

08/11/22: switched from 10->7.5mg of paroxetine

08/14-Severe Mood swing

08/15-Fever (possible sinus infection, prescribed azithromycin for 10 days).

08/18/22: switched from 7.5->5mg of paroxetine

08/21- Sauna in the afternoon (this is the most relaxing thing I know of, was feeling great after).

Evening: Absurd headache, back of neck pain/stiffness. 600mg ibuprofen did nothing. took 0.25 mg alprazolam to sleep (bad sleep).

08/22 - Dizzyness, light headedness, still neck pain, NAUSEA. Tums helped. Took 240mg of Mg and felt great improvement in neck/headache. 0.25mg alprazolam for sleep (bad sleep).

08/23- Crying spell without cause in the morning. Felt better but kept heating pad on neck most of the day and needed to lie in the dark often. Took 240mg of Mg in the morning and same at night. And two omega3 capsules (vegan) in the morning. 0.25mg alprazolam for sleep (bad sleep).

08/24- Felt pretty good. Muscle stiffness still there but much better.Took 240mg of Mg in the morning and same at night. And two omega3 capsules (vegan) in the morning and two in the evening. 0.25mg alprazolam for sleep (bad sleep).

08/25- Felt pretty good. Muscle stiffness still there but much better.Took 240mg of Mg in the morning and same at night. And two omega3 capsules (vegan) in the morning and two in the evening. Sauna in the evening. 0.25mg alprazolam for sleep (bad sleep). 

08/26- Felt awesome. I mean abnormally awesome. Some of my old self coming back, like getting high on music (which did not happen with 20mg of paxil). Took 240mg of Mg in the morning and same at night. And two omega3 capsules (vegan) in the morning and two in the evening.0.25mg alprazolam for sleep (bad sleep)

08/27 - neck pain got super bad again. It hurts to move the eyes. 400mg ibuprofen did not do much. Did hot compress, massage. Did cannabis for sleep.

08/28- woke up feeling hungover. Cannabis never does that to me, so that can't be it. Head still hurting, but worse. Nausea back in the afternoon. Went to sauna, which I love. Felt a bit better during and shortly after but an hour later nausea and horrible back of the head headache + eyes hurt when I move them. I put a heating pad, took 400 mg ibuprofen (did nothing), took my magnesium and still it is even hard to type this. If anyone has experiences this (especially if you normally don't have headaches), I am looking for hope!

 

I read somewhere in this forum that people had these terrible headaches and they just randomly went away. Seems to be the same with me except that on the first few days Magnesium seemed to relieve it immediately.

 

Here: Migraine, headache, neck pain/ache and head pressure 

[Altostrata]

I am confused. You were also taking Trintellix 5mg from July 28-August 4, then 10mg Trintellix.

 

On 8/23/2022 at 11:59 AM, PupcornNinjaTurtle said:

July 2022: Doc suggested change to 10 mg Trintellix. Suggested plan was: week 1: 10mg parox and 5mg trintellix; week 2: 10 mg parox and 10mg trintellix; week 3: 5 mg parox and 10mg trintellix (I disobeyed and went to 7.5mg instead and felt fine); week 4: 2.5mg parox and 10mg trintellix (I disobeyed and went to 5mg of paroxetine and all hell broke loose). Three days into the change from 7.5->5mg paroxetine I started feeling terrible withdrawal.

 

It appears you're in the middle of a switch to Trintellix for therapeutic reasons?

 

1 hour ago, PupcornNinjaTurtle said:

08/15-Fever (possible sinus infection, prescribed azithromycin for 10 days).

 

Potential adverse effects from an antibiotic thrown into the mix.

 

You've made a lot of drug changes recently, with an antibiotic, too. I cannot interpret your symptom pattern. I don't know why you think Trintellix is the key to your reducing paroxetine to 5mg, since your symptoms appear to have worsened since you made this change on August 18.

 

As this is a site for going off drugs, we do not assist in drug switches, which is what you're paying the psychiatrist for. It is his responsibility to get you comfortably switched.

 

Please let us know when you want to unpatient yourself and go off antidepressants.

 

[PupcornNinjaTurtle]

Hi,

 

Quote

It appears you're in the middle of a switch to Trintellix for therapeutic reasons?

Yes, I failed to mention this, but back in July 2021 my goal was to get off of AD altogether. I expressed this to my Dr while knowing that: 1) it would have to be a very slow taper based on my history and info I got here and 2) i might not handle that (before AD my anxiety had become very bad). So we discussed that if even a slow reduction (without WD) made my anxiety too strong to cope with, I might go on another medication, but not paroxetine. By this point I was convinced that the side effects and long-term effects of paroxetine were not worth it for me anymore and that if I *must* take something, I would like to take something less difficult to get off of in the future. As the year of tapering passed without WD, I did notice my anxiety becoming increasingly difficult to manage, with more anger, moodiness, and insomnia. So doc suggested since I was at a lower dose of parox at this point (10mg) that I switch to 10mg trintellix. 

 

my goal/hope: I was hoping trintellix would: a) make it a bit less awful to stop paroxetine and b) be easier to quit in the not so distant future. I have life circumstances that it make it particularly difficult to attempt life without meds this year, but next year I would be in a more stable place to attempt.

 

I fully understand that starting another drug (trintellix) opens the possibility for many other troubles but I guess I - naively perhaps - trusted my Dr that this would be a better drug for me at this time and that would not be such a nightmare to quit.

 

In retrospect, looking at my post, I recognize that I wasn't clear as to *why* I started taking trintellix. I hope this clears it up.

 

Quote

You've made a lot of drug changes recently, with an antibiotic, too. I cannot interpret your symptom pattern. I don't know why you think Trintellix is the key to your reducing paroxetine to 5mg, since your symptoms appear to have worsened since you made this change on August 18.

Yes, there have been a lot of drug changes. I've never had adverse reactions to antibiotics though, so unless it is something that worsens WD, I don't think it caused this (but I mentioned for completeness). Regarding trintellix, my original goal was to go off all/any AD, but given that my anxiety was becoming very hard to manage, I accepted the suggestion to switch to trintellix in hopes to quit that as well in the future, hopefully having a less terrible experience than with paroxetine.

 

 

Quote

As this is a site for going off drugs, we do not assist in drug switches, which is what you're paying the psychiatrist for. It is his responsibility to get you comfortably switched.

 

I am truly convinced that what I am experiencing is due to paroxetine WD (not the start of trintellix), and I still want to get off of it. That is the reason I posted on here. I was looking for support on that and the middle-term goal of going off all ADs. 

 

I hope my replies have clarified things. Thank you

 

[Altostrata]

36 minutes ago, PupcornNinjaTurtle said:

As the year of tapering passed without WD, I did notice my anxiety becoming increasingly difficult to manage, with more anger, moodiness, and insomnia.

 

Those probably were withdrawal symptoms.

 

Trintellix is not a common bridge to go off paroxetine, that is usually fluoxetine.

 

Since you're paying a psychiatrist for expert advice and we do not get paid at all for our time, we do not take on complex drug switch cases, nor do we diagnose or treat psychiatric disorders. If a drug switch goes wrong, it's your doctor's responsibility to fix it. You may have developed withdrawal from paroxetine in the middle of this switch -- it's very common that this happens -- but it's your doctor's job to get you comfortable on the second drug.

 

We know it can be difficult to find even a marginally competent prescriber, but we don't provide unpaid backup for doctors. We provide peer support for tapering to go off drugs only. 

[PupcornNinjaTurtle]

Ok, message received. I will just read the stuff without posting then, as I have been doing for a couple of years.