PaxilNightMares: Vivid Dreams when withdrawing from Paxil

[PaxilNightMares]

First I'd like to say it's hard to get help from professionals with the in depth understanding of risks that SSRIs such as Paxil present. I was told almost 20 years ago by my PCP that it was non-habit forming and non-addictive and had few side effects and I would be able to stop after around a year without an issue. I took it for Panic Disorder. I was having Panic attacks because I was going through a whole host of things. But I asked for CBT instead of just medication several times without any further assistance along those lines. The first night I was on it I woke up in a panic on my dining room floor and was rocking back and forth feeling like my head was detached from my body yelling at the top of my lungs in the middle of the night "What's wrong with me...What's wrong with me?" And not knowing who I was or where I was at first. My head felt like it was burning, literally flames coming from the top of my head. I called my doctor and told him what happened. I told him I had a very bad reaction to it. He said, you will get used to it within 3 to 4 weeks. I still asked for CBT but none was ordered or referred. I took it for a year along with a whole host of side effects. The one that most complain about was the inability to be able to perform romantically with my wife. It was a problem and was for a while. I was frustrated and I wasn't the only one. I was not told this would happen to the extent that it did. So when I decided to come off, I think it was due to this issue along with gaining too much weight. I was unable to exercise with endurance, and I was tired all the time. Also my heart rate was faster than normal. Palinopsia was also an issue. All these things I was not told. I can also remember bruising easily. All these were signs that it was toxic for my body and mind from what I read (bruising easily especially). Due to my doctor not responding to my requests to get CBT and he didn't tell me the risks of coming off cold turkey, that's what I did. After about a day or two that I can remember I started feeling very odd. I felt like I was in a dream state. I remember walking around in circles and being confused, crying and thinking didn't. Mind you, I took the Paxil for "Panic Disorder", NOT DEPRESSION. So it was not a return of my original issues. I'd never felt like that in my life and I have never felt like that again since the withdrawal. I also remember having horrible vivid dreams. These dreams seemed so real, I was thinking I was awake. I do remember them being disturbing. Things are very hazy around that time. I didn't know all this until recently when I was doing research about stuff. Has anyone experienced horrible dreams that seem so real that they felt like they were awake during withdraw? I was told by a well known Psychiatrist that this is due to REM rebound. And the agitation would seem to come out in the dreams during withdraw because the pineal gland has been inhibited for a long time. Also I didn't know that Paxil / Paroxetine is the worst for withdrawal or “ADS” out of all the SSRIs due to the short half life. Also Paxil inhibits its own metabolizing enzyme CYP2D6 from the PY450 Cytochrome list of enzymes. I didn't know that. I've read several books since the beginning of the year on this. Has anyone else experienced this dreamy/unreal feeling during withdrawal? And the very real feeling vivid nightmares and dreams that plays with your mind?

[Catwoman73]

Hi @PaxilNightMares, and welcome to SA!  We are a community of volunteers providing peers support in the tapering of psychiatric medications and their associated withdrawal syndromes. 

 

I know KenA has already sent you a warning, but if you could kindly complete your drug signature, we would greatly appreciate it.  Your drug signature gives us an at-a-glance picture of your drug history, allowing us to know how to help you without reading pages of posts.  To do this, click the following link, fill in the box, and click save.  That's it!  You can have a peek at my signature at the bottom of this post to see the general format. 

 

Your Drug Signature

 

Regarding your question about that detached/unreal feeling (known as derealization/depersonalization)- this is a very normal withdrawal symptom that we see all the time around here.  Vivid dreams are as well.  So you are not alone!  Please see the following list of typical withdrawal symptoms as a reference, and info on DR/DP:

 

Daily Checklist of Antidepressant Withdrawal Symptoms (PDF) 

Derealization or Depersonalization

 

How long ago did you stop your Paxil?   And are you managing to live your life and function despite your symptoms?  If you quit within the last three months-ish, and are struggling to get through your days, you may wish to consider a low dose reinstatement (very low dose- more is NOT better!) to see if you can reduce the severity of your symptoms.  Once you stabilize, you could taper more slowly- here at SA, we recommend tapering by no more than 10% of your current dose, no more often than every 4 weeks (so, as an example, 10mg-9mg- 8.1mg, 7.3mg and so on).  This is called hyperbolic tapering, and does a fine job for most people at keeping withdrawal symptoms to a minimum.  Read more here about both reinstatement, and hyperbolic tapering:

 

Why taper by 10% of my dosage?

About Reinstating and Stabilizing to Reduce Withdrawal Symptoms

 How long does it take to stabilize after reinstating or updosing?

 Hypersensitivity and kindling

 

If it has been longer than three months, or you are coping OK and don't feel the need or want to reinstate, I want to assure you that you will heal.  We are all healing, all the time, even when it doesn't feel like it.  It can take some time though- the nervous system is a notoriously slow healer.  You will have to be very patient!

 

Are We There Yet? How Long is Withdrawal Going to Take?

 "Is it always going to be like this?"

 

There are a handful of things you can do to help with healing.  Most are fairly intuitive.  Eat a balanced, whole foods diet, stay well hydrated, engage in gentle exercise (intense exercise can be very activating for some of us- just like you have discovered), and get adequate rest/sleep.  Avoid all neurologically active substances, including caffeine, nicotine, alcohol and recreational drugs- these can be like pouring gasoline on a fire for your symptoms.  Also, do not add any further psychiatric drugs into the mix- when the nervous system is destabilized like yours is, the effects of these drugs are not predictable, and they can make you much worse rather than better.  We only recommend two supplements here at SA- magnesium and omega-3 fatty acids.  Do be mindful though- it is very common for those in withdrawal to become hypersensitive to all sorts of things, including medications, supplements and even foods!  So if you choose to try any supplement, even those we recommend, start at a very low dose to see how you fare.  If you tolerate them ok, you can increase dosages slowly over time.  It is also a good idea to only add one thing at a time, so you know what is causing you problems, should side effects arise.

 

As you heal, you will notice that you go through periods where you feel ok, and periods where you feel terrible. This is an absolutely normal part of the healing process that we refer to as the windows and waves pattern of stabilization.  This is a good sign that you are healing, so do not be discouraged by setbacks- it's all part of the process!

 

Windows and waves pattern of stabilization

 

You may wish to try keeping a symptom journal.  Track each of your symptoms every day, rating them on a scale of 1-10 for severity.  This can help you identify your windows and waves (as they can be subtle in the early stages), and will help you see how far you've come over time.  If you choose to track your foods, supplements and activities as well, you may find that there are a handful of things that trigger symptoms for you.  It's very helpful to take note of your triggers, and avoid those things- it makes the journey just a bit more smooth and predictable.  For me, I am extremely sensitive to coffee (even decaf), chamomile, refined sugar, intense exercise, stress, and magnesium (it's supposed to relax you, but gives me brain zaps and insomnia instead). 

 

Dealing with the emotional and cognitive symptoms of withdrawal can be incredibly challenging.  It's really important to start developing some non-drug coping mechanisms early in the process to help carry you through.  We have lots of threads on this topic- I'll link some below.  For me, a daily mindfulness practice has been very helpful.  Guided meditation and yoga Nidra are great for calming the nervous system and facilitating sleep.  Seek out CBT on your own- you don't need a referral for that!  CBT is great for helping you learn to see the negative thought patterns behind the negative emotions, to challenge and transform those thought patterns.  Deep breathing really does help with calming the nervous system as well.  And distraction really is your best friend- stay busy with things that bring you joy.  I do lots of cooking, writing and artistic projects to keep myself distracted. 

 

 Non-drug techniques to cope with emotional symptoms

 Easing your way into meditation for a stressed-out nervous system

Music for self-care: calms hyperalertness, anxiety, aids relaxation and sleep

Ways to cope with daily anxiety

"Change the channel" - dealing with cognitive symptoms

Dealing With Emotional Spirals

The importance of recognizing you're feeling good

 

You may wish to try a very low dose of melatonin as well for sleep.  Do note the VERY low effective doses of melatonin- this is another case where more is not always better!

 

Melatonin for sleep

 

In summary, if you have quit your Paxil within the last three months or so, you may wish to consider a low dose reinstatement.  There's no guarantee that it will work, but if you're really suffering, it's worth a shot.  If you stopped further back than that, or do not wish to try to reinstate, there are lots of things you can do to help with your healing process.  Control what you can with the above techniques, and learn to accept that there will be rough times.  It will all be worth it in the end!   We're here to support you along the way!

 

This is your introduction topic- each member gets one intro topic, so please post updates and questions here, on this thread.  But do explore the rest of the forum- there's lots of good info here!  And I always recommend reading and commenting on the intro threads of other active members here- withdrawal can be a very lonely journey, and it really does help to build a community of people who understand exactly what you are experiencing.  By engaging with others here, you can build that community quite easily.  

 

I look forward to following your journey, and helping in any way I can! ❤️‍🩹