Sonoma: Withdrawal or going crazy?

[Sonoma]

Dear all on this forum. I am glad I found this resource and community since I have been struggling with OCD and social anxiety disorder (SAD) as well as anti depressants for most of my life. I have a decent job and generally function well, however on the inside things are not in order and I accept the fact that I have mental issues which need addressing mainly OCD and SAD. I have been in therapy on and off since I started working back in 2000. I have also been on Paxil on and off since around that time as you can see from my timeline with the drug.

 

In October of 2023 I increased my dose of Paxil from 20mg to 30mg since the 20mg was not doing anything I felt for my OCD and SAD. The higher dose did not seem to have any effect either and in February 2024 I decided to get off the drug. I tapered my Paxil down from 30mg to zero over approximately 6-8 weeks as per the directions of my Psychiatrist. The first weeks were fine with no symptoms however when I tapered my last 5mg over the course of 2 weeks I started to experience weird (withdrawal?) symptoms. 

 

First of all, I am not sure these are withdrawal symptoms and I hope the community here can provide insight into whether this could be Paxil related, or possibly is completely unrelated, and general insight into my withdrawal process. My symptoms from mid March 2024, around the time I tapered Paxil down from last 5mg to zero, until now are: hearing issues (loud high pitch tone in right ear, ear fullness and very sensitive to sounds, sound distortion), depersonalization (like I am not grounded, not attached to reality), smell disorder (phantom smells and smell distortion similar to when I had Covid in 2020). Needless to say that these symptoms are highly concerning to me and are impacting my daily life to a high degree. I am praying that these issues will resolve with time. 

 

My Psychiatrist at the end of the Paxil taper (March 2024) put me on Buspirone (5mg three times a day) to alleviate anxiety related to my symptoms. In April I tapered the Buspirone down over 1.5 week since I was getting highly suspicious of all medication. On April 20th (2024) my Psychiatrist reinstated 10mg of Fluoxetine (I believe is Prozac) to see if it would resolve the symptoms. This has not had an effect on my symptoms so far.

 

Thank you for your support and I wish everyone good health and good fortune.

 

TIMELINE with PAXIL

001 - 2004: 20mg Paxil for OCD
2007 - 2009: 20mg Paxil for OCD and SAD
2014 - 2016: 10mg Paxil for OCD and SAD
2019 - JAN2023: 10mg Paxil for OCD and SAD
JAN2023 - OCT2023: 20mg Paxil for OCD and SAD
OCT2023 - JAN2024: 30mg Paxil (since 20mg didn't seem do anything)
FEB2024 - MAR2024: tapered Paxil from 30mg to zero over 6 weeks
FEB2024 to now: weird (withdrawal) symptoms - hearing (loud high pitch tone in right ear, ear fullness and very sensitive to sounds, sound distortion), depersonalization (like I am not grounded, not attached to reality), smell disorder (phantom smells and smell distortion similar to when I had Covid in 2020)

Edited April 28 by Emonda
Name to title

[Onmyway]

Hi @Sonoma

These do sound like withdrawal symptoms to me but except for the depersonalization sound mild (I. E. bearable). It could be much much worse. I'm saying this not to dismiss the discomfort but to reassure you because I wonder if the worry about these may be more distressing than the symptoms themselves. I'm familiar with OCD and GAD and the tendency to laser focus onto uncertainty and negative feelings. Depersonalization is hard though. 

 

The best option to deal with withdrawal from paxil is to reinstate paxil, in general, not play Russian roulette with random drugs as many psychiatrists do. You may try to see if a tiny dose of paxil may relieve some of the symptoms - 0.5mg? Do you have some sitting around? This would be a tiny sliver. Just 0.5mg. I did not make a mistake and mean 5mg. Do not take MORE. more in not better in this case. Take it with the prozac for a week and see if it makes a difference. 

 

Usually reinstatement works best if you do it as soon as possible so this might not work. But that is the only thing we know other than 'grin and bear it. ' we also recommend magnesium and omega 3. magnesium has a calming effect. 

[Catwoman73]

Hi @Sonoma!  Welcome!

 

Definitely not crazy.  I came off of Paxil cold turkey many years ago, and had similar symptoms, plus the brain zaps.  Not fun. 

 

You have also likely 'pooped out' on Paxil, which is why you felt it wasn't really doing much for you, even after dosage increases.  This seems to happen with all antidepressants- they just stop working.  Unfortunately though, OMW is right- the best treatment for your withdrawal is to reinstate a small dose of Paxil-very small, to see how your body reacts.  And then you have to wait a week or so to see if it makes a difference.  Unfortunately, everything happens at a snail's pace when withdrawing from these drugs, but we're here to support you along the way!

[Sonoma]

Thank you very much for the insightful responses and support. It means a lot to me. I am hanging on and telling myself that this is all temporary, but it is hard to keep my sanity especially with the combination of weird symptoms (hearing issues one ear, smell distortion, and probably worse of all; the derealization and depersonalization that feels like I am on a bad trip and just want to snap out of it and feel normal and grounded again. 

 

The symptoms are weird but seem all sensory related so perhaps indeed part of a withdrawal syndrom. Thank you again for your words of support. I have started taking a tiny fraction of one quarter of a 20mg Paxil tablet(s) I still have around and will combine that daily with my reinstated 10mg of Prozac to see if it eleviates the symptoms. For the rest I am praying that this is temporary and that I will pull through eventually. How long do these withdrawal symptoms usually last for people until they come out on the other side?

 

Thanks again and wishing you the best of health.

 

 

[Sebas]

On 4/29/2024 at 1:02 PM, Sonoma said:

. I have started taking a tiny fraction of one quarter of a 20mg Paxil tablet(s) I still have around and will combine that daily with my reinstated 10mg of Prozac to see if it eleviates the symptoms. For the rest I am praying that this is temporary and that I will pull through eventually. How long do these withdrawal symptoms usually last for people until they come out on the other side?

Hi @Sonoma sorry to read that you were given such extremely bad advice by psychiatrist. Indeed you had gone into poopout and should have just slowly tapered down.

 

It may take a while before you become stabile again. Paxil (withdrawal) is really very powerful even in poopout.

 

Here's some questions;

In 2004, 2009 and 2016 how did you taper paxil?

 

At what exaxt date (april 24) you reinstated 10mg of prozac? 

 

Bye Sebas

[Sonoma]

Sebas, thanks for your response and great to see you're from Amsterdam. I am originally from Delft in the Netherlands. Indeed seems like I got some bad advice regarding the Paxil and it was consistent with advice I received on three previous occasions when I tapered Paxil from 20mg to zero. Must say though that I never had bad experiences during those tapers, which were done over a relative short period of time (2 weeks). This time though is quite different and I feel very out of it. Last week I had a couple of good days, so hopefully it will trend upwards. I reinstated Prozac on April 21st on the recommendation of my Psychiatrist and I started taking a little tiny shaving of Paxil beginning last week on the advice of this forum. Perhaps for now what my brain most needs is to stabilize. I wonder if anything can be said about how long these symptoms roughly last, but I understand that is probably quite specific and personal. Keep well and thanks again for the response.

[Sebas]

2 hours ago, Sonoma said:

Must say though that I never had bad experiences during those tapers, which were done over a relative short period of time (2 weeks

Thats actually a quite positive reference. 

 

2 hours ago, Sonoma said:

This time though is quite different and I feel very out of it.

Probably the combination of an already upset CNS (from poopout), then too fast taper en reintroduction of new drugs.

 

2 hours ago, Sonoma said:

. I reinstated Prozac on April 21st on the recommendation of my Psychiatrist and I started taking a little tiny shaving of Paxil beginning last week on the advice of this forum

It takes apprx. 6-8 weeks for prozac to kick in. You may suddenly get new waves by then. Under normal circumstances i would be happier if you reinstated paxil. Your history however (rather easy taper from paxil) provides some perspective. A cross over to fluoxetine can be quite to extremely challenging. 

 

2 hours ago, Sonoma said:

Last week I had a couple of good days, so hopefully it will trend upwards

Thats actually quite amazing, it's called a window.

 

Keep us informed how you're doing regularly. Whatever you do, don't panic or take sudden actions without consulting first.

[Sonoma]

Thanks again for the valuable insights. You mention that it would "under normal circumstances" have been better to reinstate Paxil. Since it is now 6 weeks ago that I tapered to zero Paxil, and about 2 weeks since I reinstated 10mg Prozac, I guess I would have to accept that this is the path my Psychiatrist chose and I followed, and that I should stick to it. Would you agree with this reasoning? I am hessitant to make any new changes at this point since it seems that my brain has gone through a lot and needs to stabilize. Am I correct that the Prozac will kick in at a certain point and that hopefully the withdrawal symptoms from Paxil will decrease with time? Also, should I continue to take the tiny amount of Paxil (0.5mg) for the foreseeable future, or can that be dropped? It was advised by forum members, but perhaps that was intended to see if the withdrawal symptoms would go away (i.e., if not, I can stop taking it).  Thanks again.

[Sebas]

14 hours ago, Sonoma said:

Since it is now 6 weeks ago that I tapered to zero Paxil, and about 2 weeks since I reinstated 10mg Prozac, I guess I would have to accept that this is the path my Psychiatrist chose and I followed, and that I should stick to it. Would you agree with this reasoning?

Given the knowledge that your last paxil tapers were very easy (in comparison to the standard) i would agree. Were you drugfree in between those periods? 

 

14 hours ago, Sonoma said:

Am I correct that the Prozac will kick in at a certain point and that hopefully the withdrawal symptoms from Paxil will decrease with time?

That would be best case scenario. Other people have had big challenges from sudden switch paxil-prozac, it's very personal.

 

14 hours ago, Sonoma said:

Also, should I continue to take the tiny amount of Paxil (0.5mg) for the foreseeable future, or can that be dropped?

 

Yes, continue this for a while. I would advice though to measure more precisely with the help of a micro scale you can buy online. That requires some calculation cause the pil weighs more then the net amount of paxil. If you need 0.5mgai from a 10mgai paxil tablet that means you need to shave 5% of the gross (bruto) weight of the pil. This will create more accurate druglevels and contribute to stability.

 

Take the drugs at the same time every day, don't switch from morning to afternoon to evening for example. Also in the next months don't use the following: alcohol, caffein/theine, chocolate, other meds or supplements.

 

For now,

Bye Sebas

 

[Sebas]

30 minutes ago, Sebas said:

Yes, continue this for a while. I would advice though to measure more precisely with the help of a micro scale you can buy online. That requires some calculation cause the pil weighs more then the net amount of paxil. If you need 0.5mgai from a 10mgai paxil tablet that means you need to shave 5% of the gross (bruto) weight of the pil. This will create more accurate druglevels and contribute to stability.

 

Or, you could dissolve 10mg in 20ml of water, leave this for a couple of hours in a small amber glass container in the fridge, stirr and then subtract 1 ml and mix with orange juice. Refresh every 3-4 days. Ask for a 20ml and a 1 or 2 ml syringe at the pharmacist office. 

 

You can also just continue protocol like you are doing right now but than you have to accept that this is less precisely. 

[Sonoma]

Sebas, thank you very much for the insights. Between Paxil I was indeed off meds. 

 

I will continue on the path that I am, hoping that the Prozac will kick in and the Paxil withdrawal symptoms will subside. 

 

Will keep you posted.

 

Best wishes!