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PaxilRomana: Rare side affect from paroxetine, not sure where to go from here.


PaxilRomana

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I am getting Tardive-Dyskinesia from Paxil, I am not sure what to do, I just want to be stable for the next ten weeks then begin the process of tapering. But since Paxil was causing Dyskinesia and I was at a low dose my provider had me stop it cold turkey saying that it would not be too hard. But I feel absolutely awful now and am really panicking. I tried 5 mg lexapro and 100mg 5 htp yesterday and I still feel quite awful. I would like to slowly taper Paxil but my concern with that is that the chance of dyskenisia being a permanent side effect is higher the longer I am on the medication. What should I do? (I am still getting the dyskinesia from Lexapro this morning but maybe it's placebo). Earlier when I tried going off paxil cold turkey before realizing it was causing the Dyskinesia I was unable to. I have a very important financial/career life thing for the next 9 weeks that I need to be stable for so that is a huge consideration aswell.




History:  

10 mg paxil 2018-2022

Strattera up titrating from 25mg to 75mg + Paxil 10 mg 2022-2023 

(summer)

2023 August stopped Strattera

2023 September stopped Paxil

2023 November  lexapro 5 mg + Strattera 25 mg

2023 December switched to effexor 

2024 Feb Effexor up titrating to max dosage of 112.5 mg 

2024 March switch to Prozac 30 mg

2024 Late April switch to strattera 25 mg + paxil 10 mg

2024 Mid May switch to guanfacine 1 mg + paxil 10 mg

2024 Early June stop guanfacine 1 mg

2024 June multiple attempts of cold turkey paxil to no avail

 

 

Edited by Emonda
Name to title

 

2018-2022: 5-60 mg Paxil usually 10 2023 Jan-Summer: Strattera up titrating from 25 mg to 75 mg + 10 mg Paxil. August 2023: Stopped Strattera. September 2023: Stopped Paxil. November 2023: 5 mg Lexapro + 25 mg Strattera. December 2023: Switched to 37.5 mg Effexor. March 2024: Effexor up titrating to max dosage of 112.5 mg. April 2024: Switch to 30 mg Prozac. Early May 2024: Switch to 25 mg Strattera + 10 mg Paxil. Mid May 2024: Switch to 1 mg Guanfacine + 10 mg Paxil. June 2024: Two attempts of cold turkey Paxil to no avail (one with a taper of a few days). June 20, 2024: Third attempt at c/t withdrawal got bad. June 22, 2024: 5 mg Lexapro + 100 mg HTP. June 23, 2024: 3.5 mg Paxil. June 24, 2024: 11 mg Paxil. Plan Going Forward: Try 2.5 mg Paxil for a week and adjust from there.

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  • Administrator

Welcome @PaxilRomana,

 

You've made a lot of changes in a short period of time.

 

16 hours ago, PaxilRomana said:

But I feel absolutely awful now and am really panicking.

 

Things will improve with time and patience.

 

Please read this list and see if you can identify with the WD symptoms listed: Daily Checklist of Antidepressant Withdrawal Symptoms (PDF).

 

16 hours ago, PaxilRomana said:

my provider had me stop it cold turkey saying that it would not be too hard.

 

There are ~20,000 members on this site that would suggest otherwise.

 

16 hours ago, PaxilRomana said:

Earlier when I tried going off paxil cold turkey before realizing it was causing the Dyskinesia I was unable to

 

The way to taper, is as slow as a snail. Why taper by 10% of my dosage? The reductions should get smaller and smaller each month, for example: 10mg, 9mg, 8.1mg, 7.3mg etc. Importantly, if you develop unpleasant side effects from tapering, halt the taper, give yourself time to settle, and once stable, taper more slowly and by smaller amounts moving forward.

 

16 hours ago, PaxilRomana said:

I would like to slowly taper Paxil but my concern with that is that the chance of dyskenisia being a permanent side effect is higher the longer I am on the medication. What should I do?

 

Given you've made so many changes in a short period of time. It may be best just to sit tight and let your body recover. Think in terms of months, not weeks.

 

It has been my own experience that unwanted side effects have abated or gone as I have slowly tapered. Things that I'd worry were permanent have not been permanent.

 

These links are worth a read:

Windows and waves pattern of stabilization

Emotional Spirals

Non-drug coping strategies

Melatonin for sleep

We don't suggest many supplements, but two that many of us find helpful are magnesium and omega-3 fish oil. Here are the links for info about those. Add one at a time and start with a low dose to see how it affects you. 

Magnesium

Omega-3 fatty acids (fish oil)

Avoid alcohol.

Don't change the manufacturer of your AD.

This is your own Introduction topic.  Each member has only ONE Introduction topic.  Your own Introduction topic is the best place to ask questions and the place to journal your progress.  This keeps your history in one place and means you do not have to repeat your story. 

Once again, welcome to S.A.

Emonda

Please don't send me PMs. I am not a doctor. My comments are based on my personal experience with ADs and tapering. Consult your doctor about your own medical decisions.

Start of taper: Jan ’22 Vortioxetine 15mg, 

End year 1: 4.5mg, 

End year 2: 2.38mg, 

Year 3: 19 Jan 2.33mg, 26 Jan 2.28mg, 2 Feb 2.24mg, 8 Feb 2.19mg, 29 Feb 2.15mg, 7 Mar 2.10mg, 14 Mar 2.06mg, 21 Mar 1.99mg, 10 Apr 1.95mg, 17 Apr 1.91mg, 24 Apr 1.87mg, 1 May 1.83mg, 23 May 1.80mg, 30 May 1.76mg, 8 Jun 1.72mg, 13 Jun 1.66mg, 3 Jul 1.62mg, 10 Jul 1.58mg, 17 Jul 1.54mg

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Okay I appreciate the advice. I have read the article on re-instating and kindling and reinstated at about 3.5 mg (very rough estimate as I cut the pill). I’m thinking about diluting Paxil in water and tapering that way. How much do these liquid dilutions from compounding pharmacies usually cost? So should I try keeping it at around 2.5 based on the kindling article. Also the thing with dyskinesia is that it seems like stopping the med earlier would help me avoid it being life long:

As mentioned previously, SSRIs are associated with TD. Fluoxetine, in particular, can lead to TD or symptoms similar to TD, and these symptoms have been reported for up to 1 year after discontinuation and withdrawal from the medication.”

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5472076/

The possibility of acquiring this condition increases the longer these drugs are taken.

https://www.alternativetomeds.com/blog/long-term-effects-of-paxil/#tardive

 

“I stress the importance of monitoring the patient at every visit just to check in with them, to see if they’re developing it. Early intervention is critical. Even though we talk about tardive dyskinesia in terms of years for the onset, from studies we know that it can be answered, can be from several weeks to years. If it’s identified early, then you can either stop the agent or try something different. But the longer the patient has stayed on antipsychotic medication, and TD has developed several years later, then TD may not be irreversible. The impact on the patient is huge. That’s the most critically critical thing that we need to keep in mind.”

(I know this talks about antipsychotics but what I think this illustrates is that the sooner I stop the better)

https://www.psychiatrictimes.com/view/prevention-and-early-detection-of-tardive-dyskinesia

 

2018-2022: 5-60 mg Paxil usually 10 2023 Jan-Summer: Strattera up titrating from 25 mg to 75 mg + 10 mg Paxil. August 2023: Stopped Strattera. September 2023: Stopped Paxil. November 2023: 5 mg Lexapro + 25 mg Strattera. December 2023: Switched to 37.5 mg Effexor. March 2024: Effexor up titrating to max dosage of 112.5 mg. April 2024: Switch to 30 mg Prozac. Early May 2024: Switch to 25 mg Strattera + 10 mg Paxil. Mid May 2024: Switch to 1 mg Guanfacine + 10 mg Paxil. June 2024: Two attempts of cold turkey Paxil to no avail (one with a taper of a few days). June 20, 2024: Third attempt at c/t withdrawal got bad. June 22, 2024: 5 mg Lexapro + 100 mg HTP. June 23, 2024: 3.5 mg Paxil. June 24, 2024: 11 mg Paxil. Plan Going Forward: Try 2.5 mg Paxil for a week and adjust from there.

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I feel for me the main symptoms of withdrawal are feeling physically ill (hard to describe just an awful feeling), extremely low motivation, akathisia, difficulty focusing, anhedonia, dizziness, headaches, blurry vision, very impulsive (more than usual) (I am normally impulsive thanks to ADHD this takes it to a 10 hopefully that helps explain some of the strange or silly decisions I made regarding dosing recently). I looked some of the info you sent and elsewhere on the site to figure out how to taper making my own liquid formulation. It seems it is stable only for 24 hours which is unfortunate. I also found out the liquids are usually quite expensive, but I'll speak to my doctor about the price to be sure. 

 

-Marcos

 

2018-2022: 5-60 mg Paxil usually 10 2023 Jan-Summer: Strattera up titrating from 25 mg to 75 mg + 10 mg Paxil. August 2023: Stopped Strattera. September 2023: Stopped Paxil. November 2023: 5 mg Lexapro + 25 mg Strattera. December 2023: Switched to 37.5 mg Effexor. March 2024: Effexor up titrating to max dosage of 112.5 mg. April 2024: Switch to 30 mg Prozac. Early May 2024: Switch to 25 mg Strattera + 10 mg Paxil. Mid May 2024: Switch to 1 mg Guanfacine + 10 mg Paxil. June 2024: Two attempts of cold turkey Paxil to no avail (one with a taper of a few days). June 20, 2024: Third attempt at c/t withdrawal got bad. June 22, 2024: 5 mg Lexapro + 100 mg HTP. June 23, 2024: 3.5 mg Paxil. June 24, 2024: 11 mg Paxil. Plan Going Forward: Try 2.5 mg Paxil for a week and adjust from there.

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Took a 10 mg this morning I’ve decided just to go back at full dose, to stabilize myself. 

 

2018-2022: 5-60 mg Paxil usually 10 2023 Jan-Summer: Strattera up titrating from 25 mg to 75 mg + 10 mg Paxil. August 2023: Stopped Strattera. September 2023: Stopped Paxil. November 2023: 5 mg Lexapro + 25 mg Strattera. December 2023: Switched to 37.5 mg Effexor. March 2024: Effexor up titrating to max dosage of 112.5 mg. April 2024: Switch to 30 mg Prozac. Early May 2024: Switch to 25 mg Strattera + 10 mg Paxil. Mid May 2024: Switch to 1 mg Guanfacine + 10 mg Paxil. June 2024: Two attempts of cold turkey Paxil to no avail (one with a taper of a few days). June 20, 2024: Third attempt at c/t withdrawal got bad. June 22, 2024: 5 mg Lexapro + 100 mg HTP. June 23, 2024: 3.5 mg Paxil. June 24, 2024: 11 mg Paxil. Plan Going Forward: Try 2.5 mg Paxil for a week and adjust from there.

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After re-reading kindling article, I am going to try 1 mg the following days and see if it stabilizes me. If it doesn't then I will try moving up from there. Or what do you guys recommend for reinstatement? Sorry for all the messages. Just a recap on

Stopped Paxil Wednesday.

Saturday I took 5mg Lexapro, Sunday  evening 3.5 mg Paxil. Monday morning 10 mg paxil

 

2018-2022: 5-60 mg Paxil usually 10 2023 Jan-Summer: Strattera up titrating from 25 mg to 75 mg + 10 mg Paxil. August 2023: Stopped Strattera. September 2023: Stopped Paxil. November 2023: 5 mg Lexapro + 25 mg Strattera. December 2023: Switched to 37.5 mg Effexor. March 2024: Effexor up titrating to max dosage of 112.5 mg. April 2024: Switch to 30 mg Prozac. Early May 2024: Switch to 25 mg Strattera + 10 mg Paxil. Mid May 2024: Switch to 1 mg Guanfacine + 10 mg Paxil. June 2024: Two attempts of cold turkey Paxil to no avail (one with a taper of a few days). June 20, 2024: Third attempt at c/t withdrawal got bad. June 22, 2024: 5 mg Lexapro + 100 mg HTP. June 23, 2024: 3.5 mg Paxil. June 24, 2024: 11 mg Paxil. Plan Going Forward: Try 2.5 mg Paxil for a week and adjust from there.

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  • Emonda changed the title to PaxilRomana: Rare side affect from paroxetine, not sure where to go from here.
  • Administrator

So the moderators can best help you, please complete your drug signature by following these instructions. Adding a signature ensures your drug history appears at the bottom of every post, making it more efficient for those trying to assist.

This link should go directly to your own signature: Account Settings – Create or Edit a signature

 

Your history in your first post says you have been taking 10mg of Paxil since late April. However, when I read the post directly above this, it says you took 5mg of Lex on Saturday, 3.5mg of Paxil on Sunday and 10mg of Paxil on Monday. This is all very unhelpful for your body. You can't chop and change like this.

Keep It Simple, Slow, and Stable

Please create your signature so we can try to work this out. The signature needs to show all the changes / dates / doses.

Please don't send me PMs. I am not a doctor. My comments are based on my personal experience with ADs and tapering. Consult your doctor about your own medical decisions.

Start of taper: Jan ’22 Vortioxetine 15mg, 

End year 1: 4.5mg, 

End year 2: 2.38mg, 

Year 3: 19 Jan 2.33mg, 26 Jan 2.28mg, 2 Feb 2.24mg, 8 Feb 2.19mg, 29 Feb 2.15mg, 7 Mar 2.10mg, 14 Mar 2.06mg, 21 Mar 1.99mg, 10 Apr 1.95mg, 17 Apr 1.91mg, 24 Apr 1.87mg, 1 May 1.83mg, 23 May 1.80mg, 30 May 1.76mg, 8 Jun 1.72mg, 13 Jun 1.66mg, 3 Jul 1.62mg, 10 Jul 1.58mg, 17 Jul 1.54mg

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Fixed my signature I've done alot of med stuff over the years but I can't remember it all so I kept only the important ones. 

 

 

 

2018-2022: 5-60 mg Paxil usually 10 2023 Jan-Summer: Strattera up titrating from 25 mg to 75 mg + 10 mg Paxil. August 2023: Stopped Strattera. September 2023: Stopped Paxil. November 2023: 5 mg Lexapro + 25 mg Strattera. December 2023: Switched to 37.5 mg Effexor. March 2024: Effexor up titrating to max dosage of 112.5 mg. April 2024: Switch to 30 mg Prozac. Early May 2024: Switch to 25 mg Strattera + 10 mg Paxil. Mid May 2024: Switch to 1 mg Guanfacine + 10 mg Paxil. June 2024: Two attempts of cold turkey Paxil to no avail (one with a taper of a few days). June 20, 2024: Third attempt at c/t withdrawal got bad. June 22, 2024: 5 mg Lexapro + 100 mg HTP. June 23, 2024: 3.5 mg Paxil. June 24, 2024: 11 mg Paxil. Plan Going Forward: Try 2.5 mg Paxil for a week and adjust from there.

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Welcome to SA @PaxilRomana

Since there are so many changes could you please explain for each of those changes what made you stop the drug, then what happened and why did you start a new drug. 
Did you experience withdrawal stopping Paxil in September 23? Why did you start Lexapro in November? Why the switch to Effexor in December and then Prozac in April? 
Any of these drugs could be causing you withdrawal. 
Please do not change or add anything. You need to stabilize on one dose of one drug. The accuracy of the dose is equally important. It cannot be eyeballed with a pill cutter. Many use a scale like Gem 20 on Amazon or make their own liquid. Paxil is usually good for 3 days in the fridge. One 10 mg would give you 3 days dose and then the leftover liquid would be discarded. 
Once we get more background, we will see if 2.5 mg is reasonable. Stay with that dose for now. Do not go up or down. Your cns has taken a beating with changes. This will not be a quick fix. Patience and acceptance are key. 

2016-twice weekly for a couple months-oxazepam 10 mg sleep/ 2020-22-once a week 3.75-7.5 mg for sleep/20 yr+ Paroxetine/ Dec2018-May 2022 20 mg/ May 2022 30mg/2022.07.28-2022.08.24 30mg to 0mg/ August 24-29 2022 10mg Prozac/2022.11.28-2022.12.04- 5mg Paroxetine/Dec 5&6/22 10mg Paroxetine/ Dec 8&9/22 10mg Prozac/ 2022.12.07 to 2023.07.01 5mg Paroxetine

TAPER 23.07.02-58mgpw/4.9mgai/ 23.07.21-4.8 mg/23.07.28-4.73 mg/23.08.04-4.65 mg/21.09.23-4.58 mg/27.10.23-4.56 mg/5.12.23-4.54 mg/2.1.24-4.52 mg/9.1.24-4.51 mg/17.1.24-4.49 mg/26.1.24-4.47 mg/6.2.24-4.46 mg/19.2.24-4.44mg /4.4.24-4.43mg/28.4.24-4.4mg/5.5.24-4.39 mg/19.5.24-4.36 mg/2.7.24-4.34 mg/9.7.24-4.32 mg

8am-probiotics/9am-paroxetine, 200mg mag bisglycinate/ 1000mg Vitamin D/5pm-75 mg DGL/200mg calcium citrate/0.25 mcg melatonin nightly

"... your strength will be in keeping calm..."-Isaiah 30:15

I am not a medical professional just your peer. The suggestions I give are based on personal experience and/or the well documented experience of others.

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  • Administrator

Thank you very much for jumping in @LostInCanada.

 

PaxilRomana, can you please help us with the answers to the questions asked?

 

1 hour ago, LostInCanada said:

Your cns has taken a beating with changes. This will not be a quick fix. Patience and acceptance are key. 

 

100% agreed.

Please don't send me PMs. I am not a doctor. My comments are based on my personal experience with ADs and tapering. Consult your doctor about your own medical decisions.

Start of taper: Jan ’22 Vortioxetine 15mg, 

End year 1: 4.5mg, 

End year 2: 2.38mg, 

Year 3: 19 Jan 2.33mg, 26 Jan 2.28mg, 2 Feb 2.24mg, 8 Feb 2.19mg, 29 Feb 2.15mg, 7 Mar 2.10mg, 14 Mar 2.06mg, 21 Mar 1.99mg, 10 Apr 1.95mg, 17 Apr 1.91mg, 24 Apr 1.87mg, 1 May 1.83mg, 23 May 1.80mg, 30 May 1.76mg, 8 Jun 1.72mg, 13 Jun 1.66mg, 3 Jul 1.62mg, 10 Jul 1.58mg, 17 Jul 1.54mg

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