Pasquale: First post. Need some helpful advice

[Pasquale]

 

 

I am fearful of medications as well as upon my initial introduction (2016) to multiple drugs over a short period - had a horrible start up and experience on them and and spiralled multiple times was put on lor@az…initially 2016 to take as needed with no information on the dangers… also le*apr, then switched to a tricyclic shortly after which was a nightmare, then sertr@line…and r3meron after all this nightmare of multiple off and ons I became super scared of all medication changes obviously. Finally got into an anxiety program with an actual psychiatrist- whom switch me to Clon@z .025 twice a day and settled at 40mg P@x. I was much better obviously not perfect due to side effects but good… decided it was time to come off the benz0 first 2023-2024 successful. Then started the p@x taper and now come my current situation 

Brief backstory of situation. 
tapered a b3nz0 last year and finished that end of last year I am sure I am technically still healing from that.  But I was feeling good! Cl0n@z semi low dose for a few years. 
Started taper of p@x in Feb - org dose 40mg for about 5ish years- was doing 5mg drops. For the most part had some mild withdrawal symptoms that were manageable and symptoms throughout. Got to 20mg Sept 12 about a 3-4 weeks started to feel pretty bad with all symptoms getting worse, I gave it some time and with Pdoc advice updosed back to 25 on NOV 9. With the odd window- I almost feel like it’s worse at times and I can figure out if I continue to taper NOW using the 10% harm reduction taper on a liquid

 

… feels like initial start up. Mind racing, anxiety, intrusive thoughts, hypervigilance, thinking I’m going crazy, overthinking, mood all over the place, list goes on. How long does one usually wait after up-dosing to hopefully stabilize or did I updose to little or to much. Sorry for the longer rant 🤦‍♂️

I do have some windows but waves are definitely like super intense at times and obviously very uncomfortable and debilitating. I have 11 month old and 5 year old and a wife who mean everything to me.  
 

I did do CBT before, I am aware of a lot of techniques/helpful things ie mindfulness, breath work, keeping busy, diet, exercise etc etc. I know that obsessing and researching and overthinking leads me here to try and find some relief. I don’t know if it’s just WD and to continue to wait it out or to stick through and just start to drop again to see if that helps or to updose even more 🤦‍♂️ I’ve read though many articles and I know there is no right or wrong but just looking for a bit of clarity in this Wave of distress and discomfort!!! ❤️

Edited December 7, 2024 by Emonda
Name to title

[Jane318]

Greetings @Pasquale and welcome to SA.  

 

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.  Please list all drugs, doses, and dates in chronological order.  Please use conventional spelling for drugs names.  The abbreviations and symbols are confusing make it difficult for us to see efficiently what is going on.  Also please list any supplements or other over the counter drugs you take on a regular basis.  

 

I am so sorry you are suffering right now. Please know you will stabilize with time and patience.

 

As you know, here at SA, we recommend the hyperbolic taper method, Why taper by 10% of my dosage?  From your narrative, it appears you were tapering no faster than rate we recommend - 10% of prior dose no more frequently than every 4 weeks, but  it is not unusual that some people need to go even more slow.  Some people also interject holding periods occasionally, and there may be interactions with other drugs you are taking.  Once we have your drug signature, we will try to assist you further.  In the meantime, recommend you hold at current dose - I would not resume tapering until you are stable.  

 

I am glad you are familiar with strategies for managing symptoms - this is so important.

 

This is your introduction topic.  Each member gets one intro topic- please post updates and questions here, in this thread.

 

Best wishes.  

[Jane318]

On 12/6/2024 at 5:25 PM, Pasquale said:

How long does one usually wait after up-dosing to hopefully stabilize or did I updose to little or to much.

Recommend you read:

About Reinstating and Stabilizing to Reduce Withdrawal Symptoms

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

Hypersensitivity and kindling

 

From your narrative, it  appears you were on 20 mg for about two months and then updosed to 25 mg.  That was more than we would have advised.  We typically advise an intitial updose of about 10%, so would have suggested 21 or 22 mg to avoid the risk of kindling.  Did your symptoms noticeably worsen immediately upon updosing?

[Pasquale]

They didn’t get horribly worse but have got progressively worse… it’s almost like it caught up with me from the very quick taper… obviously PDOC recommends stabilizing closer to my original dose I’m just so torn…. I’ve had all these symptoms initially LONG ago before obviously stabilizing on my original dose of pax..

I’m aware and can deal with the anxious feelings and thoughts… it’s just the hopelessness and brick wall feeling- super overwhelmed feeling that pushes it over the edge..

“””side note””” Pdoc did give me a script for liquid now to make dosing easier

 

[Jane318]

9 hours ago, Pasquale said:

They didn’t get horribly worse but have got progressively worse… it’s almost like it caught up with me from the very quick taper

Looking at your drug signature, your taper was NOT unduly fast, fortunately.  This is good news.  However, you did make bigger cuts than we recommend, you cut by equal amounts each time, and this taper followed right on the heels of your prior year taper off clonazepam.  Given this, with your prior history of ssris and benzos, you likely would have benefited from an even slower taper, with more gradual cuts and periodic holding periods.  Evidence from many case histories here indicates that the more drugs and times going off of them, the harder it becomes to get off them in the future.  And Paxil is reputed to be very difficult to get off of.

 

At SA, we recommend a hyperbolic taper (Why taper by 10% of my dosage?)  The reductions get smaller and smaller, 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, such as discussed here:  The Brassmonkey Slide Method of Micro-tapering. 

 

Since you did not have an immediate adverse reaction when you updosed to 25 mg, I would tend to agree with you that withdrawal symptoms sort of caught up with you.  Unless things get much worse quickly, especially right after taking your dose (indicating a kindling response) I would stay at 25 mg if I were you for as long as it takes to stabilize.  This could take several months.

 

9 hours ago, Pasquale said:

I’m aware and can deal with the anxious feelings and thoughts… it’s just the hopelessness and brick wall feeling- super overwhelmed feeling that pushes it over the edge..

I can relate.  I can also assure you that this will get better with time.  I commend you for all you are doing to do the hard work to get off these drugs!  You will succeed, this is a temporary trial. An awful one yes, but you will feel better soon.

 

You are knowledgeable of many coping strategies.  You might perhaps benefit from this video, which I just viewed yesterday:  Psychiatric Drug Withdrawal - How can I survive/manage these withdrawal symptoms? https://www.youtube.com/watch?v=bf-0yVDBKlg&ab_channel=AndersS%C3%B8rensen.

 

You may also want to read/view: 

What is withdrawal syndrome.

Brain Remodelling 

Video:  Healing From Antidepressants - Patterns of Recovery

 

10 hours ago, Pasquale said:

“””side note””” Pdoc did give me a script for liquid now to make dosing easier

Great!  This will help a lot.  Again, you want to hold where you are at until you are stable.   But in preparation for tapering again, you may want to read:  Tips for tapering off Paxil (paroxetine)

 

As you hold and while tapering, it is very normal to have periods where you feel better, and periods where you feel terrible.  This is what we call the windows and waves pattern of stabilization.  This is actually a good sign of healing!  Read more about windows and waves here:   The Windows and Waves Pattern of Stabilization

 

It’s important to keep tabs on your symptoms.  This will help you identify your windows and waves and reveal your progress, which is encouragement we need!  You can use the following list of typical withdrawal symptoms to track the severity of your symptoms over time:  Daily Checklist of Antidepressant Withdrawal Symptoms (PDF).  Once you begin to taper again, this can help guide you in knowing when / how much to cut.

 

You may choose to also track your foods and activities to identify things that trigger symptoms as well. 

 

There are a few things you can do to help your nervous system heal.   Eat a balanced, whole foods diet, stay well hydrated, engage in gentle exercise, and get adequate rest/sleep.  Avoid all neurologically active substances, like caffeine, alcohol, nicotine and recreational drugs- these are like pouring gasoline on a fire for your symptoms.  Of course, avoid adding any further psychiatric medications to deal with your withdrawal from psych meds- the effects of these meds on a destabilized nervous system is unpredictable, and taking something else could make you worse.

 

 

We recommend only two supplements here - magnesium (glycinate is a good form) and omega 3 (fish oil). Many people find these to be calming to the nervous system.

Magnesium, nature's calcium channel blocker 

Omega-3 fatty acids (fish oil) 

If you decide to try a supplement, even those we recommend here, add in one at a time and at a low dose in case you do experience problems.  If you tolerate it well, you can increase the dosage slowly over time.  

 

Please keep us posted - 

I look forward to following your journey, and helping out in any way I can.

[Jane318]

Greetings @Pasquale - How are you doing?  I hope you are seeing signs of improvement / stabilizing at your current dose.  Wishing you the best for the holidays.