MarliesDutch Dutchie tapering Paroxetine (/Paxil) 14yrs

[MarliesDutch]

Hi all,

 

I’m an almost 39 year old woman from the Netherlands. Going through withdrawl right now. Need support, thanks in advance!!!

 

2007
Started Paroxetine in end 2007 due to an anxiety disorder and emetophobia. Starting was hellish, also because high dose of metocolopramide combined with extreme loss of weight (46kg with 1,78m).

Used 10mg for a year. Tapered in 3 months after one year, no acute withdrawl. 

2009

Summer 2009 anxiety came back (don’t know if that was relapse due to stopping or new triggers for anxiety). Started again on 10mg. Was a rough start. Not many negative side effects during years of use. Used it from 2009 ‘till summer 2021.

Had 2 separate years when I increased to 20mg. Going up and coming down to 10mg without any problems.

Sometimes when I forgot a dose for two days (happened 2 times), noticed mild brainzaps. Gone within a days.

In those years I experienced 4 to max 8 severe panic attacks per year. Used 20mg Oxazepam (Seresta) for those panic attacks.

 

2021
June 2021 wanted to come of Paroxetine due to sexual disorder and stabile life and mind (and negative info in the news about permanent damage).

Tapered from 10mg to 4,5mg in four weeks, no problems.

Wanted to taper from 4,5mg to 1,5mg in four weeks. Got withdrawl at 2,8mg, so stabilized at 3mg. Withdrawl ended in 7 days.

Stabilized at 3mg since, without relapse. Noticed that I got more emotional, but guess that’s a normal thing in life. 
Had lots of therapy in 2022 for cluster C personality disorder. But managed with 3mg. Therapy ended sept ‘22.

 

2023

Plan was to taper from 3mg to 1mg in 6 months. And would taper final mg next year.
January 26th started tapering. In four weeks from 3mg to 2,5mg. Sometimes excessive dreaming, sometimes a crying spell. Withdrawl? Don’t know. But could handle that.

 

Next four weeks wanted to go from 2,5-2,0mg. When I got to 2,2mg after 2-3 weeks, started noticing two brainzaps. Started stabilizing on 2,2mg immediately. Stabilized on 2,2mg for 14 days, but withdrawl symptoms got worse. Ended up at the GP in the middle of the night. Anxiety, crying, depressed.

 

Decided to go back up to 2,5mg cause didn’t have symptoms at that dosage.

In the following 10-11 days (‘till today, 6th of april) I had several okay days. Brighter mind, less symptoms, still problems with waking up often during sleep and some physical symptoms.
 

But also had a few days with many symptoms and complete hell: anxiety, wobbly head, depressed, crying a lot, dispair, hot flashes, shivers, trembling. 
GP —> rather 3 okay days —> 1 hell day —> 2 okay days —> 1 hell day —> 4 okay days —> today is hell again.

 

And I’m so so scared. Desperate. Begged to get hospitalized for support and safe enviroment. But that’s only possible if you’re suidical. I’m not, although I wish I would these days…

 

So many questions now. GP wants to help, but hasn’t got the right knowledge.

 

So:

A) it is normal to have okay and bad days in stabilisation fase? I tought it would be a slow line going up, didn’t expect those bad days. Certainly not after 10 days stabilisation. So scared of further deterioration next days…
 

b) what is an average time to be stable again? 

 

C) is it possible to have an adverse reaction to stabilising on 0,3mg more then the 2,2mg in the two stabilisationweeks prior? 
 

D) what and when could be signs that I have to go back to 3,0mg from end of january (that was my last baseline 8 weeks ago already)?

 

Did some online research last few weeks and now realise I went way to fast. Already thought is was a slow taper… Wish I had this info before…

 

Some reactions would be awesome, really appreciate that!!!

 

 

 

 

[Altostrata]

Welcome, @MarliesDutch

 

Paroxetine is an extraordinarily difficult drug to taper, and at small doses, even more difficult.

 

What was your tapering method?

 

Withdrawal symptoms typically occur in a Windows and Waves Pattern of Stabilization

 

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.

[MarliesDutch]

Hi!

I used these specialy made taperingstrips, there’s one farmacy in the Netherlands who makes these:

 

- 3,0-2,5mg in 4 weeks, just some weird dreams, some crying spells

- 2,5-2,0mg in 4 weeks, but started stabilizing at 2,2mg after two weeks.

 

During the two weeks stabilizing on 2,2mg I got more symptoms. Insomnia, wobly head, muscle tension, anxiety,  pounding heart, zaps, internal shiver. That lead me to the GP.

Decided to go back up to 2,5mg immediately. On 2,5mg for two weeks now.

 

First 1,5 week was ‘okay-ish’ and had 2 realy bad days: anxiety and despair through the roof. Next to insomnia, muscle tension etc. Brainzaps have disappeared, electrical shocks in legs disappeared, wobly head also gone. 

But those 2 realy bad days seem to come out of the blue and that makes me soooo scared! I lost control en trust in my body. Are ups and downs normal?

 

But last wednesday it deteriorated again. Palpitations, sweating, hot flashes, tension, trouble falling asleep, zaps etc. So total panic! I didn’t get why! Prior to wednesday I had 4 okay-ish days. So why this?!

I discovered I mist a dose somewhere this week. Stupid! Could this be the cause? Palpitations, sweating, zaps are gone again. Muscle tension, trembling leggs, insomnia and total loss of appetite still present. And huge cortisol-rush when waking up (goed back to normal in an hour or so).

 

 

What I fear most now:

1) was the first 1,5 okay-ish week, just the brains relief to the higher dose of 2,5mg? And did withdrawl kick in last days as a reaction to the prior 3,0mg?

Or is the missed dose the cause of the last deterioration?

2) Is this seen as acute withdrawl or longer lasting withdrawl? Is that possible even when you’re still on the medicine?

3) Could the ‘up-dosing’ back to 2,5mg have caused kindling? So scared of that after reading many stories here.

 

I guess I need a bit of reassurance I’m

on the right path, that my symptoms are encouraging and I will heal in the next month or so.

 

Here in the Netherland, all the info on tapering, withdrawl, sensitivity and kindling is kinda new. So difficult to get proper info and counseling. 

 

 

After all the info I have now, I see this was way to quick. But at the same time: all the info and experiences here

make me scared…

 

Thanks in advance for any replies!!

[Sebas]

Hi Marlies,

 

"After an okay week, now suffering from withdrawl with massive anxiety, depair, insomnia, total loss of apetite, tembling legs, muscle tension.

Taking about 4x10mg Seresta (oxazepam) to try to cope and sleep.

Having a realy hard time 😰"

 

All the above are well known withdrawal symptoms. In time they will become more managable. Indead try to taper at a slower rate and percentage. With some stabilisation time in between. It's not a race.

 

Take as less Oxazepam as possible!

Using oxazepam together with Paroxetine may increase side effects. Especially when CNS is already upset from changes. You'll end up tapering both paxil and oxazepam.

 

You might try magnesium citrate instead as a calming supplement.

 

Dont take caffein/theine, alcohol, chocolate.

 

Take some stabilisation time 🍀 and try not to panic.

 

Bye Sebas

 

 

[Altostrata]

On 4/8/2023 at 11:21 AM, MarliesDutch said:

I discovered I mist a dose somewhere this week.

 

Yes, this probably is the cause. Paroxetine is very, very finicky.

 

How has your symptom pattern changed over the last 2 weeks? Please add the date you increased to 2.5mg paroxetine in your signature.

[MarliesDutch]

Thanks for the replies @Sebasand @Altostrata Makes me feel seen!

 

- ‘Upped’ to 2,5mg at March 25th after stabilising on 2,2mg for three weeks. 

- Currently on max 20mg Oxazepam a day, taking as less as possible.

- Will order magnesium citraat, thanks for the tip! Can I just take the recommended dose?

- Will not taper any further untill I’m completely recovered from this ‘chapter’… This is way to debilitating to ever go through again.

 

The pattern of my symptoms since March 25th on 2,5mg (after stabilizing on 2,2mg for three weeks prior to that): 

- no more brainzaps, ‘sleepshocks’, ‘wobly head’, trouble falling asleep, muscle tension legs, sweating disappeared.

- current physical symptoms are cortisolrush in the morning incl nausea (30 min.) just after waking up, trembling, weak leggs, moments of palpitations and sweating, pressure/weird feeling in/on my head, not feeling well overall. 

- apetite is very slowly getting better over the last few days, having less diarrea, less internal shivers, less chest pressure, less flu-like head.

- for every physical symptom that’s gone, a new one seams to pop up: since yesterday sort of sideway pressure on and in my head

- would say last week the mental struggle is way more present: severe anxiety, despair, depressive and suicidal thoughts (never had those before), due to lack of positive noticable short-term perspective.
Also experiencing that things are quickly too much, my brain feels ‘fried’ fast. 

 

Read a lot about waves and windows, but do not recognize those. Doesn’t feel like I have had a window yet, and that contributes to the feeling of not improving.

 

Called the GP last night when having a total mental breakdown and as of today getting mental professional help to support me getting through it.

 

Also thinking about getting back to 3mg (was stable on that dose for 1,5 years, last dose of 3mg was end of last january).

Just to get rid of my current symptoms and to have a backup again for the mental issues I’m having right now. Any word on this idea? Do’s and dont’s? 

 

 

And: there might be an autistic component present, but not sure. Testing will take place in maybe 4-5 months. If that’s the case, some ‘pieces fit the puzzle’ I guess.

[MarliesDutch]

Oh, and the psych wants me to try Lorazapam (Temesta) for 1 week in stead of Oxazepam (Seresta); that works longer so I won’t have that many ups and downs during the day.

Also because I’m reaching 3/4 weeks of max 20mg oxa a day (sometimes 5, sometimes 10, sometimes 20).

Lorazepam would take over and would be easier to taper due to longer halflife.

Still hestitant, but something needs to change.

 

 

So that would be 3 questions in total:

- What are your opinions on my symptoms/pattern? Is it somewhat encouraging? 

- What about going back to 3mg (from 2,5mg, last dose of 3,0 was January 26th)?

- What about the switch from Oxazepam to Lorazepam? 

[Kostas]

Hi ,

 

 

 

in my case, whenever going back to my original dose ( 20 mg

 

 

 

seropram) I was ok again after a few weeks..

 

 

 

that happened 4 times , before I was able to be off in the 5th time with a very slow taper lasting 3 years!

 

However from what I am reading here,this is always a gamble about the outcome, since every one is different. 

 

Maybe I was one of the lucky ones ..

Edited April 11, 2023 by Altostrata
removed line breaks

[Altostrata]

12 hours ago, MarliesDutch said:

- Currently on max 20mg Oxazepam a day, taking as less as possible.

 

How much oxazepam do you take each day, at what times and dosages? Please keep daily notes of times o’clock you take your drugs, their dosages, and your symptoms throughout the day. We need to know how you feel before and after taking each drug, and your symptoms in between. Post 24 hours of notes at a time in this topic, in a simple list format with time o’clock on the left and notation (symptom or drug and dosage) on the right.

 

3 hours ago, MarliesDutch said:

Oh, and the psych wants me to try Lorazapam (Temesta) for 1 week in stead of Oxazepam (Seresta); that works longer so I won’t have that many ups and downs during the day....

Also because I’m reaching 3/4 weeks of max 20mg oxa a day (sometimes 5, sometimes 10, sometimes 20).

 

We need to know more about your oxazepam dosing. When did you start it? Please update your signature. 

 

3 hours ago, MarliesDutch said:

So that would be 3 questions in total:

- What are your opinions on my symptoms/pattern? Is it somewhat encouraging? 

- What about going back to 3mg (from 2,5mg, last dose of 3,0 was January 26th)?

- What about the switch from Oxazepam to Lorazepam? 

 

Stabilizing from paroxetine withdrawal syndrome can be difficult. The improvement you've seen from 2.2mg is promising. Increasing to 2.5mg or 3mg may or may not accelerate stabilization. If I were you, I'd try 2.5mg for a month. 

 

Some of your symptoms may be from physical dependence on a benzo, oxazepam. It may not make sense to escalate to lorazepam. The daily symptom notes requested above will help us figure this out.

 

Many people find fish oil and magnesium supplements helpful, see

 

https://survivingantidepressants.org/index.php?/topic/36-king-of-supplements-omega-3-fatty-acids-fish-oil/

 

https://survivingantidepressants.org/topic/15483-magnesium-natures-calcium-channel-blocker/

 

You might try a little bit of one at a time to see how it affects you. Please let us know how you’re doing.

[MarliesDutch]

Hi all,

thanks for the replies, so nice to know someone's with me on this.

I organised all the info from last weeks into a document, as attached as PDF. Not super detailed (no daily timetable), but overall gives a pretty good idea of the process so far. Day, dose, medication, most present symptoms, sleep, GP contact etc. 

 

Making this document (April11), having had the worst week ever I guess. Lot's of moments with helplessness, depressed and even suicidal thoughts, sever anxiety, lost hope it will ever get better, desperate for quick improvement, obsessed with physical signs, obsessed with searching info online, fear of feeling my body.

Very hestitant to trust things that maybe slightly got better, because fear of being knocked down again and anxiety still being very present and 'just around the corner'.

 

Making the document I think there are 2 things happening:

- withdrawl syndrome from tapering 3,0 --> 2,2 --> 2,5 mg Paroxetine

- sudden worsening after forgetting a dose April 3 or 4 (missed one dose completely) and forgetting a dose April 6 (took it next morning)

I think there is no addiction or withdrawl related tot Oxazepam. 

 

What are your thought on this?
A) Do you see improvement (looking with a less dark coloured / more realistic mind than I have right know)?

Would this be acute withdrawl or more persistant withdrawl (looking at the complete timeframe)?

C) Would going back to a slightly higher dose be helpfull? Or make that decision after next weekend (or would waiting any longer make it harder to go up again)?

 

Want to try and avoid going from Oxazepam to Lorazepam (or just incidental, but not 3x a day...). Agree?

 

 

TAPERING DUTCHIE.pdf

[MarliesDutch]

My day so far.

Keeps being a struggle unfortunately:

 

12 april:

00.30 took 10mg oxa en dose PXT

01.00 fell asleep

06.20 woke up, managed cortisolrush, slept another hour

07.30 woke up, little cortisolrush

08.15 out of bed, got dressed

08.45 went to hospital for mammo

09.45 went back home, feel very tired, weak body, slight tremor in body, sometimes minor anxiety in chest with slight heatflush

11.15 had breakfast, less tired, less weakness

11.45 back to hospital for results

12.30 more emotional, called bf, went to communityfarm for bit of activity

13.00 started crosswordpuzzles

13.45 feeling very! warm, sweaty, anxious, emotional, slight tremble continues, little throat ache (had that on and of during tapering)

14.00 working outside makes is possible to feel my body and mind less, is good

 

 

Going to start 0,5 Lorazepam 2/3 a day, need some form of stabilisation or support.

 

(maybe I’m a bit ocd-ish about this ordeal, sorry for that)

[MarliesDutch]

Benzo to help with paroxetine withdrawl

 

Hi all,

going through massive sh*t due to withdrawl from Paroxetine (see profile). Needed some benzo’s to cope, cause withdrawl made me almost suic*dal last week.

 

3-4 weeks going on 5-20mg of Oxa per day. 
Now the psych wants me to use Lorazepam 1,0mg 3x day. That’s a lot more I guess. So want to start with 0,5mg if needed per day.

 

But: I’m in a benzo group on Facebook and everbody says ‘go down as soon as you can’, ‘dont switch to lora’, ‘even worse that AD withdrawl’.

 

So I’m in a sort of freeze right now.

Don’t know what to do.

 

(use of meds, dates and time in PDF I uploaded in my profile and in my other topic).

Edited April 13, 2023 by Shep
added title after merging from another thread

[Sebas]

20 hours ago, MarliesDutch said:

Lot's of moments with helplessness, depressed and even suicidal thoughts, sever anxiety, lost hope it will ever get better, desperate for quick improvement, obsessed with physical signs, obsessed with searching info online, fear of feeling my body.

Very hestitant to trust things that maybe slightly got better, because fear of being knocked down again and anxiety still being very present and 'just around the corner'.

Withdrawal can sometimes cause a state of mind, a way of thinking, like you descrbed above. And then suddenly it can disappear and you end up asking yourself if that was really you thinking all these negative thoughts. Key is to acknowledge you're in a bad wave, accept that you're not going to be able to work or do other normal stuff during some time and ignore negative thoughts. Take naps, watch some t.v., don't go searching the internet just ask you're in the right place here. Avoid stressful events if not necessary.

 

20 hours ago, MarliesDutch said:

sudden worsening after forgetting a dose April 3 or 4 (missed one dose completely) and forgetting a dose April 6 (took it next morning

These together have been the main cause of your current complaints, upsetting CNS in combination with benzo's.

👉 If you forget a dose, then leave it. Take it next time like you would do regular. Don't catch up 12 hours later. Make it an automatism, same time of day, same place, same protocol. Given these have been the main cause, try not to make more changes in what was your normal rhythm. CNS benefits from regularity.

 

20 hours ago, MarliesDutch said:

I think there is no addiction or withdrawl related tot Oxazepam. 

Oxazepam and other pam's are known for causing addiction in short amount of time, hence my general advice to take no more/longer than necessary. Solution will be within re-creating a stable paxil dose in blood with smaller cuts and stabilisation timeframe in future.

 

"Last 2 days (currently April 11ht): appetite gets better, no more diarrhea, knot in stomach gets better, had an okay-afternoon since April
3/4"

Now that's what we refer to as a wave. More to come, be patient, have faith.

 

Bye Sebas

 

 

 

 

[MarliesDutch]

Hi Sebas,

 

19 minutes ago, Sebas said:

Solution will be within re-creating a stable paxil dose in blood with smaller cuts and stabilisation timeframe in future.

do you mean: sit this ride out, patience cause more windows are coming (but please no more waves!) or do you refer to an option to increase the dose paroxetine with 0,1 back to 2,6mg?

 

And I’ll keep posting day-tables

for benzo info and advise.

[Sebas]

A quick look shows me you were doing okay several days start of april. Things went bad after forgetting daily dose. Last days have been becoming better again. So yes stay at current dose as Alto, website president, recommended. 

 

Do not be afraid of incoming waves, just accept and ride them. They will eventually pass and you need to learn to cope. The less you let them scare you, the sooner they will subside. Lots of people on this website have had tons of WD symptoms and are still alive and kicking.

 

Welterusten 😴

 

[Shep]

@MarliesDutch Please note I moved this post from the benzo forum to your intro/update thread.

 

You're already getting feedback here, so let's keep all of your information in one place. 

 

22 hours ago, MarliesDutch said:

Going to start 0,5 Lorazepam 2/3 a day, need some form of stabilisation or support.

 

Please don't start another benzo. 

 

When did you start taking oxazepam? Please list the day, month, and year and place it in your signature. 

[Sebas]

20 hours ago, MarliesDutch said:

Needed some benzo’s to cope, cause withdrawl made me almost suic*dal last week

This suicidal state of mind, which is a known and harsh withdrawal symptom has been caused by biochemical instability due to several shortterm dose changes. In other words, CNS and neurotransmitters are struggling to refind their balance. Introducing new drug changes will probably not contribute to refinding balance.

 

Benzo’s are not a great solution to deal with WD symptoms, they are like trojan horses that create new problems (interaction and addiction). In your situation i would try to persevere at current paxil dose and try to taper oxazepam, monitor by taking daily notes.

[MarliesDutch]

Since yesterdayevening (april 13) started on 0,5mg Lorazepam to subsitute 5-40mg Oxazepam per day.

Want to stick at 2x 0,5mg Lorazepam per day (so not the 3x 1mg they prescribed). Last days:

 

12 april:

00.30 took 10mg oxa en 2,5mg    PXT

01.00 fell asleep

06.20 woke up, managed cortisolrush, slept another hour

07.30 woke up, little cortisolrush

08.15 out of bed, got dressed

08.45 went to hospital for mammo

09.45 went back home, feel very tired, weak body, slight tremor in body, sometimes minor anxiety in chest with slight heatflush

11.15 had breakfast, less tired, less weakness

11.45 back to hospital for results; were good

12.30 more sadness, called bf, went to communityfarm for bit of activity

13.00 started crosswordpuzzles

13.45 feeling very! warm, sweaty, anxious, emotional, slight tremble continues, little throat ache (have that on and of during tapering)

14.00 working outside makes it possible to feel my body and mind less, is good. But also feel exhausted, so difficult to balance.

16.00 went home, feld like crying and having physical anxiety (flu-ish/feverish without actual fever), tight chest, flight-response

16.15 felt more relaxed coming home

16.20 went to toilet first time in 3 days (haven’t eaten much), first dose 0,5mg lorazepam

16.30 on couch in pj’s, quiet room felt bit more calm (not yet due to lorazepam)

18.15 still more calm in mind and body, sometimes little flush of heat and anxiety but goes by quick

19.00 more anxiety in my body, again at 19.25, comes and goes

20.00 some palpitations, warm head, more tired, spend last hours on social media for distraction

20.15 made myself dinner

21.15 feeling flu-ish, warm, again that bit of throat ache

22.30 sudden onset of faster heartrate, pounding heart, warm/flu-like, feeling unwell, shaking leggs, ‘panic without mental panic’, subsided after an hour or so, made me scared

00.00 fell asleep on the couch

00.30 went to bed, took 2,5mg PXT

Bloodpressure and temp both perfect, but not feeling perfect

• morning was bit stressfull, also because last few mornings are thoughest part to ‘get going’
• Afternoon more mental symptoms 
• Evening less mental symptoms, more physical symptoms
• was caught of guard by sudden onset of episode 22.30PM
• Too much activity combined with just 6hrs sleep?

———————————-

 

 

13 april:

01.30 took 10mg oxa because cant fall asleep. Feeling warm, flu-ish and get twitches when falling asleep, so wake up everytime. Didn’t have this symptom before.

02.45 think I still didnt slept. Out of bed, to the couch for some wordpuzzles.

03.20 back to bed, completely frustrated and worn down. Thoughts on how I can end this mess. Took another oxa 10mg and 500mg paracetamol.

04.00 fell asleep

08.15 woke up, fell asleep 

09.15 woke up again, crying

09.30 called to get mental help, cancelled 2 appointments for this afternoon

11.15 out of bed, again trembling hands, watched news, printed some info

12.00 had breakfast, took shower, bit more calm in mind

13.00 conversation psych and counselor, was emotional

14.00 came home, less trembling, little bit warm/feverish feels

14.30 did some chores on the balcony, bit of cleaning, was nice to do, body is a bit more relaxed

14.45 had lunch, watched tv

15.30 took 0,5mg lorazepam, tv continues

17.00-18.00 took a nap (one twitch before falling asleep)

Noticed some same symptoms like yesterday, just before and after sleep: warm, heartrate up, physical anxiety

18.00 on social media, tv, reading, wordpuzzles

19.30 hanging laundry

19.45 started cooking

20.15 ate dinner, watched some tv, wordpuzzles

21.30 boyfriend called

22.30 put garbage outside

23.00 0,5mg lorazepam 

23.30 went to bed, 2,5mg PXT

23.45 some pain/tension in upper leggs

00.15 feel asleep

 

Evening total:

the feeling of physical anxiety slumbers constantly, incl litte throat ache, flu-isch, warm head

• Less ‘fried’ brain and pressure on head today compared to yesterday
• Morning was difficult mentally due to lack of sleep, depresssive thoughts and crying.
• Got better after 14.00. Felt human again for a few hours!! Calm body, calm mind. More of this please!
• Psysical anxiety in evening: new patern in the day?

—————————-

14 april:

 

07.45 woke up with alarmclock, cortisol kicked in, diarrhea, back in bed

08.15 out of bed, got dressed, made breakfast on the go

08.30 0,5mg lorazepam

08.45 visit to GP

09.15 to communityfarm, nice to do some outside chores.

Feel bit sleepy (combi of rough mornings overall and lora first time in morning), sometimes little rush of physical anxiety (more belly centred)

10.30 had breakfast

11.00 back at work

[Shep]

On 4/11/2023 at 2:52 PM, Altostrata said:

Stabilizing from paroxetine withdrawal syndrome can be difficult. The improvement you've seen from 2.2mg is promising. Increasing to 2.5mg or 3mg may or may not accelerate stabilization. If I were you, I'd try 2.5mg for a month. 

 

Some of your symptoms may be from physical dependence on a benzo, oxazepam. It may not make sense to escalate to lorazepam. The daily symptom notes requested above will help us figure this out.

 

 

23 hours ago, Shep said:

Please don't start another benzo. 

 

@MarliesDutch Are you here to get tapering advice? As mentioned, we recommended NOT adding in another benzo and giving us a chance to sort out what was going on first. 

 

If you're going to continue making changes, please work with your doctor, not an online forum. You are setting yourself up for kindling, which is damage to the nervous system. See:

 

Hypersensitivity and Kindling

 

[MarliesDutch]

Sorry for this @Shep...
Feel so stuck between advice here online and my psych who wants me on Lora: 'we cant help you if you don't follow our advice'.
Thing is that the proper knowledge is at this forum, but my psych is the one I can visit these weeks. So stuck.

What would you recommend doing right now? Back to oxa in case of need, like I did last weeks?
Untill you can figure out what's going on? 
Do you have a timeframe when more clearity will come? I'll keep posting daytables in the attachement. Just did.
 

And the prior comment from @Altostrata you're refering to (about trying 2,5mg for a month): already taking that dose sinds March 25. 
Symptoms are getting better, specialy since a day or 3, see attachement: page 1 and specifics in the tables.

 

TAPERING DUTCHIE - noon April 14.pdf

[MarliesDutch]

And can someone tell me what the symptoms of oxa-withdrawl are, so I can think with you?
Cause there's already a lot of info in the attachement.
How are they showing, at what timeframe, after last dosage, how do they present?

[Sebas]

@Shep read my mind. GP's and most psych dont know JS about withdrawal. They only see meds as a (short term) solution. You think visiting your psych is helpful but when given wrong advice you better cancel these visits. Shep, alto and other people on this site have lots and lots more experience and knowledge. Not from books but from their own experience and helping thousands of others.

 

You were quite okay beginning of april so stabilisation cant be far away. Just follow advice and perhaps take a short break from work. Focus on healing.

[MarliesDutch]

Thanks Sebas,

currently only doing some volunteering 2 mornings a week.

Yes, beginning of april was okay untill I forgot a dose.

Since a day or 3 feeling better in the afternoon; bit human again.

And having less symptoms overall… feels I can cope again most of the time.

 

I’ll await answers from @Shep or @Altostrata concerning the chances of having oxa withdrawl.

[Sebas]

4 hours ago, MarliesDutch said:

Since a day or 3 feeling better in the afternoon; bit human again.

Then what do you need benzo for? I think this is a signal you are regaining a stable paxil dose in your blood. And that was the main strategy.

 

About benzo withdrawal. Its difficult to tell wether something is related to either paxil or benzo when both are used and/or tapered together especially when CNS has become unstable. Thats why we suggested no (new) benzo to obtain a good vision on your paxil withdrawal symptoms. These drugs can also interact which makes it even harder to tell one from the other.

 

And then there is possible influence from daily routines like food, drink, hospital (do they use contrast fluid during mammo?) etc. 

 

Bye Sebas

[possum]

Hi, @MarliesDutch — greetings from another emetophobe trying to kick the Paroxetine habit! I am pretty new to all of this and am now at 14.6 mg. When I read how it gets even harder at lower doses I get soooo scared. But, I guess it doesn’t help to “fear ahead” and we'll just take it one day at a time. Just wanted to check in and say hi. 

[MarliesDutch]

Hi @possum!

I had no problems tapering from 10-4,5 mg. Below 4,5 it got difficult.

Went from 4,5 to 2,8 in two weeks and got moderate withdrawl. Stabilized at 3,0 and withdrawl was gone within a weak.

 

This time I went to fast. I thought 3 to 1mg in 6 months (incl hyperbola) would be safe enough. But when it crashed I learned that most safe is 5-10% taper every 4-6 weeks. Didn’t know that before, despite seeking info. That was a very hard lesson to learn. 

 

So if you’re scared: always go for the safest option. 5% in 6 weeks, with sometimes a 6-week break in between. Takes a long time, but that’s so much better then the mess I got myself in. 
 

So yes, it’s possible. But go step by step. And only (!) taper with support from your GP, psych or therapist. And when your life is stable as possible. If not: stabilize and don’t taper untill everything is better again.

You can do it!

[MarliesDutch]

1 hour ago, Sebas said:

And then there is possible influence from daily routines like food, drink, hospital (do they use contrast fluid during mammo?) etc. 

Tried to unravel this myself, but there’s no real clue. There was no contrast used during mammo, ‘just’ radiation.

Stressfull events du increase flu-ish feelings and physical anxiety. Like a hard phonecall this afternoon or trying to catch a horse that escaped, on the other side of the street last tuesday.

I guess this maybe my waves&windows pattern?

- Morning: slow, demotivated, little tremble, emotional in morning.

- Afternoon: okay, hardly withdrawl symptoms, bright mind, content in afternoon. Most apetite of the day at lunchtime.

- Evening: more anxious, tired, flu-ish in evening. Least apetite in evening.

 

Today is the first day in a week I actualy would like to see my boyfriend and let him hugg me. Earlier this week that felt like ‘too much’ I guess.

We don’t live together and he was away this week. Going to see him on monday and could realy use a proper hugg….

[Sebas]

2 hours ago, MarliesDutch said:

Stressfull events du increase flu-ish feelings and physical anxiety. Like a hard phonecall this afternoon or trying to catch a horse that escaped, on the other side of the street last tuesday.

Thats due to hormones and neurotransmitters like cortisol and adrenaline which interact with serotonine.

 

2 hours ago, MarliesDutch said:

I guess this maybe my waves&windows pattern?

- Morning: slow, demotivated, little tremble, emotional in morning.

- Afternoon: okay, hardly withdrawl symptoms, bright mind, content in afternoon. Most apetite of the day at lunchtime.

- Evening: more anxious, tired, flu-ish in evening. Least apetite in evening.

Could be. Windows can last for hours, days or even weeks. Sometimes events during the day can trigger a sudden wave (for example what you had for dinner). 

 

You can get virtual hugs from your fellow members here 😉

[MarliesDutch]

Guys, last days did made the leap to Lorazepam. Will update daily schedule in 4-5 hours from now.

It feels disappointing, but am so stuck between advices and pressure and my ability to cope.

 

I’m not sure what’s going to happen next, but I needed to make a choice. 
Not sure if I’m happy with this choice, but it’s a choice. A step. So I did at least something in stead of staying in freeze mode. 
 

Want to control the situation so badly (my extreme need for control popped back up in this mess…), difficult to ride the waves.

 

Are waves also present with tapering slowly (but to quick) and how long would the process of stabilizing take? Seeing that I made some recovery last weeks?

 

Found this in an article:

[Shep]

On 4/14/2023 at 8:00 AM, MarliesDutch said:

And can someone tell me what the symptoms of oxa-withdrawl are, so I can think with you?

 

The withdrawal symptoms of all benzos are relatively similar. There are some variations with issues such as interdose withdrawal (going into withdrawal in between doses) due to shorter half-lives with some benzos. The Ashton Manual has a great explanation of symptoms:

 

Ashton Manual - Symptoms

 

2 hours ago, MarliesDutch said:

It feels disappointing, but am so stuck between advices and pressure and my ability to cope.

 

You'll need to decide which path to take. Please note we are not doctors or medical professionals here, so if you're going to add in new drugs and create a new drug cocktail, you'll need to work with your doctor. We cannot help you with that. 

 

All we can do is help you space out your drugs to help with any potential drug interactions, help with the math for your taper, and suggest non-drug coping techniques to help with the symptoms. 

 

I would recommend reading this thread, as it gives a good breakdown of how little the medical establishment knows about these drugs:

 

How do you talk to a doctor about tapering and withdrawal?

 

You'll need to set up your game plan for how you want to proceed before we can help. 

 

On 4/14/2023 at 4:59 AM, MarliesDutch said:

Since yesterdayevening (april 13) started on 0,5mg Lorazepam to subsitute 5-40mg Oxazepam per day.

 

Since you were varying your oxazepam from 5 - 40 mg, that may have been causing a lot of your symptoms. 

 

We would have advised getting on the same dose of oxazepam every day and the same time(s) of the day and stabilizing before beginning your taper. 

 

3 hours ago, MarliesDutch said:

Guys, last days did made the leap to Lorazepam. Will update daily schedule in 4-5 hours from now.

 

Work with your doctor until you are stable and ready to taper. And then we can help you. We do not need to see your drug and symptoms journal until you are ready to taper, which likely will be in several weeks to several months after doing this switch. 

[MarliesDutch]

Thanks @Shep!!

Really appreciate the clarity given about what you can and cannot do. 
 

For now: aren’t going to taper Paroxetine for next six months. First get my sh*t together again and stabilize at the 2,5mg I’m on since three weeks. And afterwards another gameplan for taper.

 

And right now sticking to 2 times 0,5mg Lorazepam daily, till things settle down a bit. 
 

Feel some more physical symptoms since yesterday (pressure head, ‘wobbly head’, pressure chest, twitches when falling asleep), but that might be a wave everone talks about. So gonna try to not worry too much and sit it out. 
 

Fingers crossed! 

[Go2zero]

10 minutes ago, MarliesDutch said:

And right now sticking to 2 times 0,5mg Lorazepam daily, till things settle down a bit. 

Be aware that Lorazepam is an extreme difficult drug to get away from. For a lot of people more difficult than paroxetine. And after a few weeks of use you can be fully addicted to it!

 

All benzo's are difficult to taper, but what I have seen are lorazepam and diazepam the most difficult ones. 

 

I do understand how heavy your symptoms are. Lots of the members and moderators have been there. It is very understandable to look for meds or supplements that can help with withdrawal. But unfortunately most make it worse!

 

Stabilising and time are the best healers. There are no wonder drugs/supplements that will help your healing.

 

Also understand that the last 2,5mg is much more difficult to taper, than going from 10 to 2,5 mg. So please give it all the time it needs to stabilise. 

Edited April 15, 2023 by Go2zero

[MarliesDutch]

7 minutes ago, Go2zero said:

Be aware that Lorazepam is an extreme difficult drug to get away from. For a lot of people more difficult than paroxetine. And after a few weeks of use you can be fully addicted to it!

I read and know what you are saying, but at this point I have nothing else to go on. No benzo’s is no option at this point, I wish I could. Trust me.

 

I take the least as possible right know and want to take the shortest amount of time possible.

When I want to taper I’ll seek advice (already know the Ashton Manual and possibility to switch to diaz first and then taper very slowly).

 

And Paroxetine taper: not in the near future anyway.

[Go2zero]

% of 1 pill(20 mg)	Dosage in mg Paxil / Paroxetine/ Seroxat	% blockage serotonin receptor (SERT)
100	20	78
50	10	72
25	5	62
12,5	2,5	48
10	2	44
7,5	1,5	37
5	1	29
4	0,8	25
3	0,6	20
2	0,4	14,5
1,5	0,3	11
1	0,2	8
0,5	0,1	4
0,25	0,05	2
0,1	0,02	0,9
0,05	0,01	0,5

 

See this graph. Then you will understand why tapering in the lower dose regions has to be done so extremely careful. At 2,5 mg paroxetine still 48% of the serotonine receptors are blocked!

 

 

 

The further you go down in dosage, the more extreme you go down in SERT. Therefor it is so important to go slow and not jump to zero before you are nearly at zero. 

 

 

Edited April 15, 2023 by Go2zero

[Go2zero]

9 minutes ago, MarliesDutch said:

No benzo’s is no option at this point, I wish I could. Trust me.

It is your choice of course. But we have seen a lot members here doing the same and making things much worse. You are adding a drug that is most probably even more difficult to stop. 

 

But as Shep also said, we are not doctors. We will not tell you what to do. But there is more than a lot of experience here. 

 

If you go the route of continuing to add/changing meds, you will need to work with your doctors. We will not to be able to assist you then.

 

 

Edited April 15, 2023 by Go2zero

[MarliesDutch]

58 minutes ago, Go2zero said:

% of 1 pill(20 mg)	Dosage in mg Paxil / Paroxetine/ Seroxat	% blockage serotonin receptor (SERT)
100	20	78
50	10	72
25	5	62
12,5	2,5	48
10	2	44
7,5	1,5	37
5	1	29
4	0,8	25
3	0,6	20
2	0,4	14,5
1,5	0,3	11
1	0,2	8
0,5	0,1	4
0,25	0,05	2
0,1	0,02	0,9
0,05	0,01	0,5

See this graph. Then you will understand why tapering in the lower dose regions has to be done so extremely careful. At 2,5 mg paroxetine still 48% of the serotonine receptors are blocked!

 

 

This was exact the info I searched for but couldn’t find! Only had the Citalopram version…

 

Find it devastating actualy… 2,5mg and still 48% blocked receptors…!  
Is that the same as saying that the drug still works for almost 50%?
…. Still just halfway….
 

Thanks for the info… Gonna show my doctor this.