MarliesDutch Dutchie tapering Paroxetine (/Paxil) 14yrs

[MarliesDutch]

3 hours ago, Doctorsrcrap said:

 

why do you want off the benzo first? Isn't paroxetine more activating? Wouldn't the benzo help soften the blow of the AD? 

 

Thanks for your question.

At this point I don’t know if I want to taper Paroxetine in the next few years. 

And it seems ‘off’ to keep using a benzo all that time. 

 

I don’t experience tolerance withdrawal with the benzo yet, so seems risky to keep using it. 

[Doctorsrcrap]

@MarliesDutch

That's fair enough. 

From my understanding paxil is horrible to stop and you could possibly benefit from the cushion the benzo will give you. 

I have a feeling you want to taper the benzo because the idea of doing paxil is scary. But you were so keen to take the benzo that maybe you might aswell use it for its cushioning effects. 

But I could be completely wrong. 

Wait for a mod to guide you as they will know the best path to take. 

The mods are very knowledgeable and I would definitely go with whatever they advice.

Good luck! 

[Shep]

14 hours ago, MarliesDutch said:

Some questions to go with those scenario’s:

1- Which of the two medicines gives a greater/quicker risk of tolerance (and withdrawal to go with that)? 

2- Which medicine is more suitable for holding and slighty updosing if needed? 

3- How can I be sure I pooped-out on Paroxetine? And when experiencing this, is this the same (symptoms) as withdrawal of Paroxetine? Or is it ‘just’ not working anymore? Couldn’t find a lot of info about this.

4- “When tapering Lorazepam, side effects of Paroxetine can come through” (quoting Shep). Are these side effects of the lower dose of Paroxetine I reached when tapering prior? Or the withdrawal coming through? Also when I’m (for example) 1,5 years into Lorazepam tapering? 

 

You're asking a lot of questions that no one can tell you in your particular circumstances. All we can do is provide some "best practices" type of general information. 

 

You may want to read some or all of the information in this thread, as it goes through some of the concepts you're bringing up:

 

Are We There Yet? How Long Is Withdrawal Going To Take?

 

What we know is that preserving sleep is more important than anything and removing the SSRI before the benzo is best for most people most of the time. 

 

You've been on both drugs long enough to be dependent on them both. You'll need to pick out a strategy of getting off that allows you to be as functional as possible. 

 

[MarliesDutch]

All the input is very welcome. 
I’m beginning to see a pattern in my behavior/symptoms. On of the important signs of my waves is the obsessive behavior for info and comforting input ánd being super depressed with suicidal ideation.

Last week, in all my posting…. That was a wave. 
Last Wednesday afternoon the ‘sky cleared’ and emotions got back to normal level. Not free of all symptoms, but those are most debilitating. I can handle some burning, loose stool, headache, pressure on the head, brainfog. But those neuro-emotions… 
I’m somehow glad I see this, gives me a bit of insights for next time.

 

Spend yesterday surfing this website for all the info (from a healthy perspective, not obsessive).

 

Seems I have to choose between these two:

 

- Tapering Lora in appr. 1,5 year. Then let the GABA system stabilize for a year before starting microtapering Paroxetine (if that seems a good idea at that point, so gives me time to think about). I think I haven’t had tolerance withdrawal symptoms from Paroxetine, only while tapering. Not prior. And 2,5mg/48% receptor occupancy seems a lot. 

 

- Tapering Paroxetine, maybe in appr. 4 years (want to take it very slow due to proven sensitivity). After that stabilising the system for a year and starting the Lora afterwards. Means that I will be on Lora for another 4-5 years. Feels off, but I read the reason about which to taper first. Get that. It’s hard to get acceptance for the perspective of having Lora in my system for another 4-5 years (also with risking Lora-tolerance withdrawal symptoms occuring while tapering Paroxetine). 

 

Read in a topic that Lora is more likely to have withdrawal symptoms when tolerance sets in. So want to avoid that.
And read in a topic from Rhiannon that the benzo does not have a ‘brake’ effect anymore at this point, except preventing further crashing when tapering Lora. So don’t know what the advantage is of staying on Lorazepam?

 

Both were topics from 2011, so don’t know if still accurate?

 

[MarliesDutch]

@Sebas, at this point I’m cutting/filing tablets. Which is a hassle and my scale keeps doubting between 0,038 and 0,041, while I need 0,039…

 

So I ordered the Gemini-20, capsules and a crusher.

Does this change in preparation also ask for a slow introduction? Or can I just change tablets for filled capsules?

[Sebas]

2 hours ago, MarliesDutch said:

I’m beginning to see a pattern in my behavior/symptoms. On of the important signs of my waves is the obsessive behavior for info and comforting input ánd being super depressed with suicidal ideation.

That's a very important observation (which we already made). These are mechanisms to 'control' anxiety. I recognize them myself. Sometimes acceptance is key.

 

The depressive feelings are in my opinion caused by fluctuations in serotonine (a.o. neurotransmitter) levels. They can be hard. Write notes that you can read at difficult times.

 

2 hours ago, MarliesDutch said:

And 2,5mg/48% receptor occupancy seems a lot. 

Don't be 'obsessed' with receptor occupancy or timeframes. Focus on taking less than before, minimizing WD symptoms and coping strategies. Focus on possible life goals. I would give the world to be at 2.5 mg. 

 

1 hour ago, MarliesDutch said:

So I ordered the Gemini-20, capsules and a crusher.

Does this change in preparation also ask for a slow introduction? Or can I just change tablets for filled capsules?

Its the same product, however check for excipients in capsules. They are also available with less excipients, vegetarian. Any transition or crossover may cause temporary issues. 

[MarliesDutch]

So just a little update.

Overall, my waves and windows pattern seems to be flattening out a bit. I would say I’m slowly reaching a WD-normal state I guess.

Not symptomfree, but acceptable.

 

Although: since the last reduction and updose on Lora I haven’t been ‘as good’ as the 5-6 weeks prior to that.

My head is less clear, I have less motivation, feeling bad waking up (not the same as the cortisolrush I had before), some tension in my upperleggs, tension/pain in neck, eyes and head (feels different than tensionheadache).

Maybe that’s a Lora-thing?
 

Going to taper my Lora-nighttime dose with 10% as of September 7.

Hope to do that 2 months in a row, bringing the nighttime dose to appr. the same level as the other dosages.

Gives me the opportunity to see what will happen to my sleep, how strongly my body reacts to the taper and what to expect tapering further. 
 

Trying to take it day by day. 
Some days I can stay in the moment and just flow with things, some days I get so sad and frustrated by the idea of years of tapering and symptoms. 
 

Thanks for all the help so far!

 

[Doctorsrcrap]

It looks like you are committed to tapering the Lora first. Please do not panic if you start to get symptoms. You may start to uncover the symptoms from the paxil. 

Whatever you do now you must stick to the choice you make. No more jumping up and down on doses. 

I dint know if it would be possible to get to a more acceptable level of benzo and then start on the paxil whilst still keeping some benzo to preserve sleep. But I'm not sure as I'm not a mod. 

Anyway. Good luck with the taper. I hope all goes well. 

[MarliesDutch]

6 hours ago, Doctorsrcrap said:

Please do not panic if you start to get symptoms. You may start to uncover the symptoms from the paxil. 

Thanks for your reply @DoctorsrcrapMod’s said that before and I asked questions about that because I’m not sure what that means. But haven’t received an answer to that. What do you mean exactly?

 

Are those symptoms of the Paxil withdrawal surfacing again? Or would those have subsided a bit in the background due to months passed (stabile dose 2,5mg since March25)?

 

Or are these symptoms of ‘just’ the lower dose of Paxil that makes me more emotional? 

 

And is that a sure thing going to happen? 

[Doctorsrcrap]

You used a benzo to cover up paxil withdrawal so there's a chance taking away your buffer could reveal the symptoms you covered up with the benzo. But I'm not an expert I could be wrong 

[MarliesDutch]

On 7/31/2023 at 11:19 AM, MarliesDutch said:

Although: since the last reduction and updose on Lora I haven’t been ‘as good’ as the 5-6 weeks prior to that.

My head is less clear, I have less motivation, feeling bad waking up (not the same as the cortisolrush I had before), some tension in my upperleggs, tension/pain in neck, eyes and head (feels different than tensionheadache).

Maybe that’s a Lora-thing?

@Shep, you’re being the expert.

Is this a Lora thing you think? Symptoms seem to be worsening last few days. I’m making daily notes with times and symptoms to see what’s happening.

And what about my conversation with @Doctorsrcrap? Thanks in advance for replying!
 

[Shep]

@MarliesDutch If you're not able to tell the difference between Paxil side effects and benzo withdrawal, I would come off the Paxil first. I've mentioned this several times since you joined the forum. You're making this more difficult than it needs to be. 

 

On 5/4/2012 at 2:34 PM, Altostrata said:

Why taper the antidepressant first rather than the benzo?
When you are taking an antidepressant and a benzo, if you are not having significant adverse effects from the benzo, consider tapering the antidepressant first for these reasons:

• Antidepressants are activating while benzos are sedating. The action of the benzo can soften the suffering from antidepressant withdrawal symptoms.
• Conversely, a concurrent antidepressant will not reduce withdrawal symptoms during a benzo taper. With all due respect, Prof. Heather Ashton's suggestion antidepressants might help is misguided. She later changed it, see http://survivingantidepressants.org/index.php?/topic/1510-ashton-manual-recommendation-of-antidepressants/page__view__findpost__p__14205
• In Dr. Stuart Shipko's e-book Xanax Withdrawal (2012), he addresses the Ashton Manual's apparent recommendation of antidepressants to counter benzo-withdrawal depression, see http://survivingantidepressants.org/index.php?/topic/1510-ashton-manual-recommendation-of-antidepressants/page__view__findpost__p__28759
• Often, benzos are prescribed to mask adverse effects from an antidepressant, such as anxiety, insomnia, and akathisia. When you remove the benzo, the antidepressant's adverse effects come to the forefront. You may then be in such distress, you'll want to go off the antidepressant too fast, risking severe withdrawal symptoms.
• Benzo withdrawal before antidepressant withdrawal increases the risk of a difficult antidepressant withdrawal.
  Going into an antidepressant taper with GABA downregulated by prior benzo withdrawal is a very perilous strategy. Your nervous system will need GABA to deal with antidepressant withdrawal symptoms.
  
  You may more easily control an antidepressant taper. Fast recovery from antidepressant withdrawal will enable you to tackle your benzo taper.
  
  The people who have the worst withdrawal syndrome are those suffering from both benzo withdrawal and antidepressant withdrawal, because two systems -- serotonin and GABA -- that might help them recover are not functioning due to downregulation.
• If you have already done the hard work of getting off a benzo and then suffer severe withdrawal syndrome from the antidepressant, you are faced with the decision of whether or not to get on the benzo merry-go-round again.
  
  Many doctors treat antidepressant withdrawal symptoms with benzos, although that brings in a whole other set of problems, which you know well. Still, many people can't get through withdrawal without an occasional benzo dose. Consider using benzos very, very sparingly.

 

[Doctorsrcrap]

I would listen to shep. She knows what she is talking about. 

I really would think about getting off of paxil first. You only have to look at altos story to know what a terrible drug that is 

[MarliesDutch]

1 hour ago, Shep said:

If you're not able to tell the difference between Paxil side effects and benzo withdrawal, I would come off the Paxil first.

@Shep

I’m so in doubt and making myself crazy. I’m so!! scared to start a further Paxil taper. Before tapering Paxil I had hardly any negative effect from the Paxil. It all began when tapering to fast. So my scared brain tells me to not taper Paxil any further (next years not going of Paxil), and to gently let the Lora go in stead of keeping on Lora for many years to come. It feels like the Lora is making me so depressed and crying. Since end june.

 

 

The thing is that I had 5-6 good weeks before end June and it feels like the windows/waves from Paxil are a lot more stabil/gone (apetite, knot stomach, zaps, wobly head, burn/throatache etc) even when tapering Lora.

 

And that it got worse again by tapering Lora to fast. No more waves/windows but a continue state of depressiveness. Sensations in my body other than I had before. Before it was burning in my chest/throatache/arms. That’s gone but now I feel like my hole body sometimes is flushed and when I eat certain things I get palpitations after. Thoughts seem to ‘loop’ in my brain several times a day. It‘s just a different pattern. Something seems different. Makes me so insecure. 
 

But why am I writing this.

You made a point, I have to

choose and I’m to scared to choose. I’m stuck in fear of tapering Paxil.

 

 

[MarliesDutch]

I just have the idea that things are going to be alright when I taper Lora. 
And that things will keep getting worse when tapering Paxil. And I can’t handle getting worse.

And maybe that’s a lie, but it’s a damn stubborn one… based on a traumatic experience from earlier this year.

 

I’m so sorry for being so in doubt. Don’t want to be this way. Never was before. 

Just a last check, because I think this might be my error: I always thought that time will heal the Paxil withdrawal, despite taking Lora. 
Or can Paxil withdrawal never heal when taking Lora? 

 

[Doctorsrcrap]

At the end of the day it's up to you. Only you can make the decision. 

I guess the question is do you want to be med free at some point or would you like to continue to take an AD? 

[Sebas]

2 hours ago, MarliesDutch said:

based on a traumatic experience from earlier this year

 

Anyone who tapers paxil too fast will experience traumatic wd. There's a bio-/fysiological reason for this.

 

This can be managed though by taking small or micro steps (in range of 1-5% from last dose) with enough time for stabilisation and healthy lifestyle management. 

 

Don't let anxiety - caused by wrong choices in the past - stand in the way of future strategies. 

[MarliesDutch]

I need help! @Shep or @Sebas

I need to know what is going on all of a sudden. I’m worried…

 

Since July first haven’t changed anything in dosage. Started taking own-made capsules almost 3 weeks ago. Works better than cutting pills.
Had an opthalmolgic (?) appointment where they used Cyclogyl to dilate my pupils, last Friday.

Last 2 weeks I noticed I had some more good days, so felt like gently stabilizing on all meds.

But I’m worse since this Monday.

 

 

On Monday; had a great day mentally. Positive, looked at the future etc. After lunch started to feel the old knot in the stomach. Painfull pressure on my stomach. Something I had like a month ago once and during withdrawal in March. So I guessed it was just a symptom. Continued eating that day. No other symptoms.

When I went to bed on Monday I felt so frustrated with the pain in stomach ánd bowel. It was so tense!; couldn’t get any relief and started crying by frustration. Didn’t get why I was so emotional all of a sudden. So, a bit ‘off’, but I guessed it was just a symptom. That night I slept, but a bit restless. Slept appr 7 hours.

 

Tuesday I woke up, seamingly okay and around 10.00 AM diarrhea started. It continued all day long (like 12 times), but less frequent after 17.00PM. No nausea, no fever, no gas, no horrible smell. Didn’t ate all day, just drank water and rehydration salts.

But I noticed higher heartrate during the day, feeling hot/bit burning-sensation and had to pee many times (9x). 

The peeing made me think of my old panic attacks: after a panic attack I would pee 4-5 times. Full blatter, completely transparant urine (without intake that caused that amount). Same as today. The amount of urine didn’t feel right opposed to the frequent diarrhea and max 2 liters of water intake today. Way more output than intake.

 

Late in the afternoon, when the pain in my bowel subsided, it changed to backpain and in the evening to intense pain in my buttocks and leggs. 
Sometimes I have this pain in my leggs, but nothing like today. And not familiair with this kind of backpain.

 

All of this feels atypical I guess. A normal stomachbug or something else (nervous system shutdown)?

 

It’s 02.22 AM right now and I’ve slept for an hour or so. That hour was restless, the pain is intens, I feel

warm/slighty burning, sometimes my heartrate goes up and my thoughts are like ‘popcorn’. So nothing like: I had a rough day, so tired and fell asleep instant.

 

Reading this, what are your thoughts on this? Is this some random kind of worsening withdrawal? Tolerance (concept which I don’t understand quite well…)? I had nothing like this before. Can’t even remember having this sort of diarrhea in my adult life (and I definitely would, because of my emetophobia). 
 

I guess I’m affraid that it has something to do with the meds? 

 

 

 

[Shep]

@MarliesDutch That could be a wave or a stomach bug, as you mentioned. If you feel it's more than that, please get checked out by your doctor. 

[MarliesDutch]

Thanks for answering @Shep,

panic took over I guess. Feeling a bit better today. Went to see my GP this morning. Confirmed it’s probably a stomachbug, which can ramp up withdrawal/anxiety symptoms because ‘the system’ is working hard to fight the bug and recover.

Seems like a reasonable explanation. 

My head spins out of control when something happens that’s not familiar or I have no control over. 

But to keep things positive: I have had more good days last weeks, so happy with that! 
 

[Sebas]

On 8/16/2023 at 2:51 AM, MarliesDutch said:

After lunch started to feel the old knot in the stomach. Painfull pressure on my stomach.

Many things we eat or drink can influence ssri. F.e. chocolate, caffein, herbs, alcohol, etc.

 

In the future try not to visit your GP everytime something like this happens.

Learn to cope with these "normal withdrawal symptoms".

 

Acknowledge and accept there's a (sudden) wave, lay down and rest your CNS, try to analyse for yourself. Learn to recognize triggers.

 

From these experiences you will be forced to handle anxiety and panic. This journey will become your training for the future. 

 

As you experienced for yourself, more good days had come nonetheless.

[MarliesDutch]

Well… I guess all took a turn for the worse. 
 

Since stabilizing and a little updose on Lora end of June, I keep getting worse. I keep track of my days in an excel sheet and it’s getting only worse since.

 

I’ve got pain and tension in my leggs, no apetite, losing weight and depression and suicidal ideation are going through the roof. Especially since I had severe diarrhea last week. I keep getting worse.

Yesterdag I had the worse mental day since april.

 

At this point I’m no longer capable of going through with all this. Something has to change medicationwise.

In the long run I still want to taper, but more gently than last year. But something needs to happen quick. I’m done. Can’t do it anymore.
 

Tried every non-drug way of coping, mindfulness, ACT, breathing with Moonbird, keep doing daily tasks, keep reaching out to friends, walking, adding Nutridrink etc etc. I know this is withdrawl, I know this will get better in the long run. But I’m done. I want out of this mess.

 

Credits to all the people who can ride this out for years. I just can’t do it anymore and feel ashamed to admit it, to write this here. But this is my situation. I have to take care of myself by changing something in the meds. 

Any suggestions of what might be safest option? 
- Paroxetine 2,5mg to 2,6mg to see if it alleviates symptoms?

- Paroxetine to old dose of 3,0mg?

- Lora to Dia, because depression and suicidal ideation gotten worse since lowering and updose end of june (ánd stabilising since)?

- crosstaper Paroxetine/Fluoxetine?

- combining Paroxetine with little Fluoxetine and very gently taper Paroxetine out of the combo?

 

I need to live and try something soon. 
Stabilise and going off again in a way more slow taper.

 

@Shep @Altostrata

[Shep]

4 hours ago, MarliesDutch said:

adding Nutridrink

 

What are the ingredients in Nutridrink? When did you add it? How is your diet? 

 

And one more question - is the stomach bug you mentioned earlier healed or are you still dealing with that health issue? 

 

The reason I'm asking so many questions about diet and stomach issues is because many issues with withdrawal may be tied to our gut health. The drugs are horrible for gut health, so all of this is important. 

[MarliesDutch]

Thank you for thinking with me @Shep. I wanted to insert a picture of all the vitamins etc as well, but ‘my attachments are full’ and I don’t know how to delete the older ones.

If official dietary food/drink for people in hospital, with severe GI issues or underweight.

I didn’t take it for a long time (because eating and weight were sort of stable), took it just last week 2 days, but can’t really link it to my mental issues last 2 months.

 

I still can’t tell if last week, the stomachbug was indeed a stomachbug. It was atypical and since then my depression/suic/crying/leggpain have worsened.
 

I keep an excel for tracking my symptoms and wellbeing and it’s worse since end june. There is a definite change in pattern since then.
Would like to add the excel for visuals and details, but ‘my attachments are full’. Maybe I could send them in a PM? 

Symptoms changed since end June:

- some got less: burning sensations, palpitations, morning cortisol

- some got worse: loose stool, less clear mind, more depressed, more suicidal thoughts, tensed/pain upper leggs, more tired, falling asleep on couch, way more crying, front of my head above my eyes feels ‘full’, overall it takes more effort to keep things going.

 

The change in meds at that time was:

- 20 june: coming down on Lora from 0.50-0.25-0.50 to 0.25-0.25-0.50

- 1 july: updose to 0.375-0.375-0.50

That is the only noticable factor in my excel.

 

[Altostrata]

Please do not tag me, @MarliesDutch Thank you.

[MarliesDutch]

40 minutes ago, Altostrata said:

Please do not tag me, @MarliesDutch Thank you.

I’m sorry, I wasn’t aware that I couldn’t.

Appologies.

[Sebas]

On 8/23/2023 at 1:43 PM, Shep said:

On 8/23/2023 at 9:08 AM, MarliesDutch said:

adding Nutridrink

 

What are the ingredients in Nutridrink? When did you add it? How is your diet? 

 

Stop drinking this asap. Do not underestimate the effect of several of these ingredients on WD. It's a complete list of triggers and red flags.  

[Sebas]

On 8/23/2023 at 9:08 AM, MarliesDutch said:

Any suggestions of what might be safest option? 
- Paroxetine 2,5mg to 2,6mg to see if it alleviates symptoms?

- Paroxetine to old dose of 3,0mg?

- Lora to Dia, because depression and suicidal ideation gotten worse since lowering and updose end of june (ánd stabilising since)?

- crosstaper Paroxetine/Fluoxetine?

- combining Paroxetine with little Fluoxetine and very gently taper Paroxetine out of the combo?

 

Be more careful of what you eat and drink. Keep a solid diet. All the above alternatives will only destabilise your CNS furthermore. Keep notes and see what triggers your symptoms, then adjust.

[Go2zero]

14 hours ago, Sebas said:

Stop drinking this asap. Do not underestimate the effect of several of these ingredients on WD. It's a complete list of triggers and red flags.  

Completely agree. Nutridrink is full of sugar and artificial additives. This has nothing to do with health. Just a so called ready to use health product from a big marketing company...

 

Take care of a real healthy diet. Organic and fresh products (easy to get one the Netherlands). Stay away from all processed products and product with sugars.

[Sebas]

On 8/16/2023 at 6:35 PM, MarliesDutch said:

But to keep things positive: I have had more good days last weeks, so happy with that! 

 

On 8/16/2023 at 2:51 AM, MarliesDutch said:

Last 2 weeks I noticed I had some more good days

 

On 8/16/2023 at 2:51 AM, MarliesDutch said:

On Monday; had a great day mentally. Positive, looked at the future etc

I see a pattern of recovery (windows) that you don't seem to see yourself. 

 

I also see sudden withdrawal worsening as a direct result of med changes (updose juli) and sudden diet changes to cope with symptoms.

 

Do not underestimate any small dose changes (even updose) to a CNS which is already destabilised and working hard to regain stability. With every new change you are actually not helping yourself. It's actually (subconsciously) sabotizing yourself. This you need to work on mindset wise.

 

On 8/23/2023 at 9:08 AM, MarliesDutch said:

I want out of this mess.

 

On 8/23/2023 at 9:08 AM, MarliesDutch said:

Something has to change medicationwise.

In the long run I still want to taper, but more gently than last year. But something needs to happen quick

 

Thousand of people on this site want out of this. But there's no quick way, no forcing, no sabotizing. Focus on good strategy, healty lifestyle and mindset changes. 

 

[MarliesDutch]

Hi all,

 

back here after a few months, ‘cause I could use some thinking brains.

Updated my signature, cause there are some adjustments since then.

 

End of August I decided something had to change. Couldn’t cope anymore. Was in total despair, despite doing different things of non-drug ways of coping. 

 

25th of August decided together with the psych to try and updose Paroxetine again to my old dose of 3mg (last January before WD), but also to slightly updose Lorazepam as a temporary backup. 
Both in an attempt to reach more stability before tapering anything (and to get away from being suicidal…).

 

After 5 days of 1,25 —> 1,5mg Lora daily, felt emotional relief. Less despair and suicidal thoughts. Like taking a deep breath again and going forward. Pfew. 

About a week later, went from 2,5mg Paroxetine to 2,6mg Paroxetine. Experienced some updosing symptoms at the end of week 1 (anxiety, crying, pressure chest, fluffy stool, bit of throat ache) but disappeared after 4 days.

 

Three weeks later updosed to 2,7mg. Experienced some updosing symptoms at the end of week 2 (morning anxiety, fluffy stool, more crying, little pressure chest, tired) disappeared again after 6 days. They where bit more intense then prior updose.

 

Could say that updosing made overall WD slightly better (eg. normal stool again!). Thank god…

 

Four weeks after starting 2,7mg, updosed to 2,8mg. Experienced some emotional symptoms in week 2 (down, crying, irritated) that subsided.

But in week 3 woke up with cortisol spikes in morning, some days more anxiety (mentally and/or physically), more days with depression and crying, sometimes internal shivers, and last few days -sense of- palpitations (pressure chest and neck, warm head, but around 70bpm, sometimes max 80bpm), “full head” (sensitivity for environment) and little throat ache.

 

Feels a bit off that these symptoms turn up in week 3, would have expected to turn up earlier. Currently already at the end of week 4 since updosing to 2,8mg. Feels like physical symptoms get worse.

 

So I’m a bit confused right now. Maybe you have some questions or good ideas to figure this out together.

 

1️⃣ Is this just a late updosing thing, about to pass? —> how many more weeks before I can say “this is not normale updosing effect anymore?”

2️⃣ Is this an adverse effect from updosing to high? —> do I need to go back down to 2,7mg and in what timeframe?

3️⃣ Is this Lora tollerance kicking in after 2 months on this dose and overall 7-8 months of benzo use? 
 

 

Some background on nr 1 and 2: the current physical symptoms look like symptoms I had during WD since march, but in a milder form (more like the post acute symptoms, not the acute symptoms like zaps/insomnia/loss apetite). 

 

Some background on nr 3: since starting Lora in april I had two mentally okay months (and physical symptoms also got a little better, but didn’t go away). During those two months tapered Lora from 3mg daily to 1mg daily. Emotional symptoms kicked in hard and updosed back to 1,25mg, without any relief next two months. Was very depressed, had suicidal ideation and was in despair. That lasted for two months.
End of August updosed to 1,5mg daily and felt relief after 6 days. Emotional symptoms got very manageable, but marking 2,5 months right now and emotional symptoms returned in mild form, not every day, but present again. 

Can’t tell if the 2-month-cycle is a coincidence or maybe tolerance?


And because I experience both physical and mental symptoms right now, don’t know what to make of it and what steps to take (or none at all).

It is manageable, but hard and want to try and keep it that way!

[LotusRising]

@MarliesDutch

 

 A couple of thoughts.

 

It looks as though you updosed the lorazepam and started feeling better in August. You then started to increase the paroxetine and most notably started feeling effects of the increases around October? Is that correct?

 

It's possible that although you started feeling better from the lorazepam updose, you then updosed the paroxetine, and are just now feeling the cumulative effects of the paroxetine updoses as they come to steady state. It looks like you also added in B-vitamins - are you aware that some people find these stimulating? 

 

See:

 

How are you dosing the lorazepam? 

 

Any new stressors?

 

[MarliesDutch]

Hi @LotusRising, thank you for replying!

- Correct that Lora gave some relief and now I seemingly notice a cumulative effect of the Paroxetine (didn’t know there is something like a cumulative effect when updosing slowly). I thought that Paroxetine reached steady state earlier. Also thought that the higher the dose, the less effect an updose would give (due to the hyperbolic curve). But the opposite seems to happen.

 

- Not taking any B vitamins although deficiency, waiting till situation settles down. 

 

[LotusRising]

43 minutes ago, MarliesDutch said:

Also thought that the higher the dose, the less effect an updose would give (due to the hyperbolic curve)

Not at these lower doses, where receptor occupancy is greater - these drugs are strong at lower doses.

 

44 minutes ago, MarliesDutch said:

Not taking any B vitamins although deficiency, waiting till situation settles down. 

From your signature, it looked as though you took them in October. It's probably good you're waiting on this.

 

Do you dose the ativan once a day, or split dosing? Is there a daily pattern to your symptoms?

[MarliesDutch]

3 hours ago, LotusRising said:

Do you dose the ativan once a day, or split dosing? Is there a daily pattern to your symptoms?

I take Lora 3x a day; 0,5mg at 08.15, 15.45 and 23.15. Not experiencing any interdose withdrawal or something.

Mostly the symptoms are more present in the morning and less in te evening. Has been since the beginning.

 

 

And as we speak: since this evening I experience a more burning sensation in chestarea, warm head, faster heartrate and I’m very warm, bit sweaty and it’s hard to fall asleap (hardly had any sleepingproblems last months). I feel pretty crappy so to say. 
Didn’t had this yesterday (or not in this proportion anyway). 
 

I’m getting worried about the worsening over the last week. 

[LotusRising]

 

What time do you take your paroxetine?