Emmanuel76: From France : Paroxetine / Paxil withdrawal or relapse...need help about reinstate

[Emmanuel76]

Hello/Bonjour (if any french people it would be great to talk in french as it is not easy to explain most correctly my situation). Just discovered this amazing website through an article on the National Library Of Medecine from Adele Framer. This patient website is such a great place to learn...just read many articles...never heard about Tapper Withdrawal Poop Out and other words...i would need your advice as im in a very difficult situation, as every one who write a message here i guess, at least when its in a middle of a sudden insomnia.

 

Im sorry to detail my story : im 48, having OCD since 2000, took Clomipramine a couple years then switched to Paroxetine/Paxil 15 years ago. I did managed my OCD with this med with 20mg dosage for a couple of years trying here and there to stop when i felt no effect of improvement but still OCD...but ultimately went back to it until june 2020 i stopped it with my doctor in 2 months diminishing doses week by week...august 2020 no Paxil anymore...it was OK, still OCD but no "withdrawal effect"....january 2021 Covid...1 week and just small fatigue but massive fear/anxiety...OCD came back on fire, i was totally despaired with huge compulsion (lack of meds or brain inflammation ?)...my psychiatrist who saved my life with my first major ocd crisis in 2000 told me i should have never stopped Paxil, OCD people like me have a genetical brain dysfunction and they need meds period. He gave me an antipsychotic + Lexomil + Paxil 20mg...went back on track i kept only Paxil 20mg from June 2021 to June 2024.

 

i decided in May 2024 to decrease slowly my Paxil 20mg due to a stagnation of my OCD situation, i wrongly thought (not knowing this website advices...) that since it was not doing any good it could not do any wrong to stop this bad chemical substance...i wish i knew your forum and didnt stop in 2 months, diminishing on my own the 20mg every week...1 pill then 1/2 pill then every other day...

 

No Paxil since August 2024.

 

since October its a sudden nightmare with full OCD on fire, huge sadness, no motivation, very emotional/sudden tears, what looks like depression for me (never been depressed, just have compulsions from my OCD which gives me anxiety but not depression) and sudden huge insomnia (that i never had in my life except during my "post Covid crisis") which scares me.

 

I know that my doctor is less qualified than you on this forum because you lived it...My question :

 

• Is it relapse or withdrawal from Paxil ?

• how can we explain a period of calm of 2 months with no issue aftee stopping Paxil and a sudden collapse in just a couple days ?

• Should I take it back now at low dose like 5mg as i read on the forum to Tapper very slowly in a year or 2 or 10...

 

I dont know if the expression exists in english but this is "ma bouteille à la mer" as we say in french in a middle of insomnia.

 

Merci pour votre aide !

Emmanuel
 

 

 

Edited October 14, 2024 by Emonda
Name to title

[Emonda]

Bonjour @Emmanuel76

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

Can you please show in detail the dates / doses of each of your reductions since May 2024. This will be important for us to read.

 

Whilst we wait to see your signature, you should have a read of these two links:

About Reinstating and Stabilizing to Reduce Withdrawal Symptoms

Kindling

For future reference:

Never skip doses to taper

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. This process involves a degree of trial and error, as there is no way of predicting how an individual will respond. 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. The experience of others suggests that the lower you go in dose, the slower you need to go with tapering.

7 hours ago, Emmanuel76 said:

since October its a sudden nightmare with full OCD on fire, huge sadness, no motivation, very emotional/sudden tears, what looks like depression for me (never been depressed, just have compulsions from my OCD which gives me anxiety but not depression) and sudden huge insomnia (that i never had in my life except during my "post Covid crisis") which scares me.

Those that taper too quickly often develop very unpleasant withdrawal symptoms. This Daily Checklist of Antidepressant Withdrawal Symptoms (PDF) is a helpful summary of what many experience.

7 hours ago, Emmanuel76 said:

is it relapse or withdrawal from Paxil ?

What you describe above sounds like WD symptoms from stopping Paxil too quickly.

7 hours ago, Emmanuel76 said:

how can we explain a period of calm of 2 months with no issue aftee stopping Paxil and a sudden collapse in just a couple days

People can develop WD symptoms at varying periods of time. It is normally quite quick with Paxil, I believe...but I have certainly read of WD symptoms taking some months to kick in.

7 hours ago, Emmanuel76 said:

Should I take it back now at low dose like 5mg

Don't reinstate anything until you provide your drug signature and a Moderator/LostinCanada provides some guidance on an amount (LostinCanada has considerable wisdom/personal experience reinstating the same AD).

Reinstating at too high a dose is not recommended at all!

 

Mon nom Est, Emonda (I don't speak French...clearly 😊)

[Emmanuel76]

Thanks a lot Emonda, i edited my profile i read your links. Just having someone who answers that quickly is already a great news. I'll wait for the "experts" feedback. Bonne journée !

[LostInCanada]

Bonjour @Emmanuel76 Welcome to SA.

18 hours ago, Emmanuel76 said:

Is it relapse or withdrawal from Paxil ?

This is definitely withdrawal. 

18 hours ago, Emmanuel76 said:

how can we explain a period of calm of 2 months with no issue aftee stopping Paxil and a sudden collapse in just a couple days ?

Many times our body is so happy to not have the drug in our system. Unfortunately we our dependent on the drug and it takes a while for our central nervous system to react. For me, the worst came at the 3 month mark.

18 hours ago, Emmanuel76 said:

Should I take it back now at low dose like 5mg as i read on the forum to Tapper very slowly in a year or 2 or 10...

Reinstatement would be the best chance of getting stable. Were you thinking of making your own liquid? That would be preferable to dry cutting since I would recommend a reinstatement dose of 1 mg. 

It is important to stay with the same manufacturer you were using for your paroxetine. It can take a couple months before reaching stability but fairly quickly you should feel relief of some symptoms. 

The dose can slowly be increased if necessary but less is more. We want to prevent kindling especially because you have been on and off a few times.

 

 

[LostInCanada]

 

 

[LostInCanada]

Please read the link. When making your own liquid, accuracy is important. You want to use a full 10 mg pill or 20 mg pill or weigh part of a pill.

Paroxetine is soluble but the fillers they use are not. Some crush the pill between 2 spoons before adding to water to help with the dissolving. It is good to allow it to sit for about 30 minutes at room temperature as well. Keep the solution up to 3 days in the fridge. Discard leftover solution. Always stir the solution before extracting the amount needed. For a 10 mg pill, it is recommended to use 20 ml of water. With that ratio you would take 2 ml of solution. 

 

 

 

[littlebird]

Je suis désolé, mon français est mauvais.  Les écoles américaines sont terribles. 😅  Bienvenue!

 

40 minutes ago, LostInCanada said:

When making your own liquid, accuracy is important.

It is, I've gotten a lot of luck with being very strict with my exact ml when adding liquid - it helped to get a small beaker with measurements on the side to double check.

 

19 hours ago, Emmanuel76 said:

sudden huge insomnia (that i never had in my life except during my "post Covid crisis") which scares me.

This can affect every other mental health factor, I am so sorry you're dealing with this. I'm not an expert in this, but I've read a lot of studies about covid, and I'm wondering if you're experiencing a reactivation of the virus from the med changes and stress. 

 

Please prioritize taking care of yourself - choosing soothing activities, letting yourself take time to relax for bed, etc. It really is important when things are getting hard. Hoping you are feeling, and sleeping, better soon!

[Emonda]

Thanks for adding your signature, @Emmanuel76.

 

LostinCanada has given you some good info and a helpful suggestion regarding reinstatement.

 

Thank you, LostinCanada & littlebird for jumping in ❤️

[LostInCanada]

@Emmanuel76 I love Paris in the fall. I hope you are able to enjoy some gentle, calming walks in the parks around your beautiful city. ♥️🍂

1 hour ago, littlebird said:

Please prioritize taking care of yourself - choosing soothing activities,

This is so important.

[Emmanuel76]

Thanks a lot @LostInCanada and everyone for answering so quickly.

 

Just tried Melatonine yesterday night 1h before bedtime 1,9mg and i slept better.

 

To be honest im scared to become a chemist in my kitchen with this liquid experimentation (that i guess any doctor will strongly not recommand following the official pharmaceutical guidelines) but do i have a choice...?

i'm so sad to put this substance in my brain again...feel like a huge defeat.

 

from your experience/other people feedback...waiting with no medication that the brain regulates/heals by itself for months/years has little to no chance to work but just suffering ?

 

from your experience again, if the doctor i see today ask me to start at 5mg or 10mg, the risk is high for what you calm kidling ?

 

i guess my questions are kind of naive due to high anxiety.

 

Bonne journée and great wishes from Paris !

[Emonda]

3 minutes ago, Emmanuel76 said:

just tried Melatonine yesterday night 1h before bedtime 1,9mg and i slept better.

 

Good news that you slept better.

 

4 minutes ago, Emmanuel76 said:

To be honest im scared to become a chemist in my kitchen with this liquid experimentation

 

These are the steps that many of us have taken to taper successfully.

 

You can have a chemist compound various doses for you; however, that will significantly increase the cost. Also, from memory, LostinCanada initially paid her chemist to do this for her, but then she felt something was off. She purchased a digital scale and found the doses she was paying for were not accurate...hence she now does it herself (sorry LostinCanada if I'm confusing you with someone else).

 

7 minutes ago, Emmanuel76 said:

but do i have a choice

 

A commercial liquid of your AD is available; however, changing from a tablet to a commercial liquid can cause some people significant problems. It's best to make as few changes as possible.

 

I'd pay close attention to what LostinCanada has said.

 

10 minutes ago, Emmanuel76 said:

from your experience/other people feedback...waiting with no medication that the brain regulates/heals by itself for months/years has little to no chance to work but just suffering ?

 

Do you mean just riding it out? If so, you may well suffer badly for several years. I'm not trying to discourage you; instead, make sure you are aware of the potential time frame versus carefully reinstating and then tapering slowly.

 

11 minutes ago, Emmanuel76 said:

from your experience again, if the doctor i see today ask me to start at 5mg or 10mg, the risk is high for what you calm kidling ?

 

Yes, too high a dose to reinstate. I made this mistake with Escitalopram ten years ago...I won't make that mistake again.

 

It is far safer to start low and see how you go.

 

14 minutes ago, Emmanuel76 said:

i guess my questions are kind of naive due to high anxiety.

 

All good questions, and I completely understand the high anxiety.

 

jusqu'à la prochaine fois (hopefully that says, "until next time").

 

Emonda

[Emmanuel76]

Thank you so much @Emonda for your kind words and quick answers, i trust you people feedbacks as it comes from "survivors"....now i got to talk with my doctor...20 years more or less with AD in my brain and gut i guess i can not get away as easily as i thought it would it is be...

 

Hope to be able one day to help people here as you all do.

 

The french sentence is correct btw !!

[LostInCanada]

5 hours ago, Emmanuel76 said:

scared to become a chemist in my kitchen

This is understandable. Unfortunately it is what we must do to as the medical community has left us with no real choice.

5 hours ago, Emmanuel76 said:

if the doctor i see today ask me to start at 5mg or 10mg, the risk is high for what you calm kidling ?

Yes there is a real risk of kindling and making your body react negatively to the drug.

If the doctor is not understanding or cooperative, many just let the doctor think they are following their advice so they can get the prescription. Then they either cut and weigh  the pills or make liquid. 

Make sure the pharmacy always gives you the same manufacturer you are used to.

5 hours ago, Emmanuel76 said:

waiting with no medication that the brain regulates/heals by itself for months/years has little to no chance to work but just suffering ?

The suffering can get very bad. Reinstating helps with the healing and lessens the suffering. Also reinstating gives you time to work on non drug methods to deal with the issues that led you to taking the drugs. CBT, mindfulness, breathing techniques, relaxation techniques, etc

 

5 hours ago, Emonda said:

LostinCanada initially paid her chemist to do this for her, but then she felt something was off. She purchased a digital scale and found the doses she was paying for were not accurate.

I did not have success with a compounding pharmacist. Doing it myself was much better for me. 

5 hours ago, Emmanuel76 said:

Bonne journée and great wishes from Paris !

❤️🍂

[Emmanuel76]

@LostInCanada i dont know how to quote a specific part of your answer but its very helpful to have an honest answer which is basically "no you can not wait with no med until one day the brain gets better on its own"...be out of a tunnel of drugs and going back in it seems very frustrating.

 

My doctor just gave me phone numbers of 2 psychiatrists to have a prescription and advices (i'll try to ask about this very very low first dosage to see their reaction...), i ll call them tomorrow. If its too long my doctor said he will prescribe me 20 mg Paroxetine...and then my chemist job will start to take 1mg...

 

I may ask again for your help and advice...

 

Merci encore énormément à tous/toutes !!

[LostInCanada]

10 minutes ago, Emmanuel76 said:

If its too long my doctor said he will prescribe me 20 mg Paroxetine...and then my chemist job will start to take 1mg...

Sounds like a plan. You need to buy syringes(no needle) and whatever you need to measure water accurately. It is also recommended to use glass jars to make the liquid in. 

We are here to help with any questions. ❤️

[Emmanuel76]

@LostInCanada thanks you so much for your time.