blueskies17: should i even consider being ssri free?

[blueskies17]

Hi everyone. I joined this site today in hopes of receiving some opinions! I have been on Paxil 40 mg for a little over 2 years for generalized anxiety disorder (absolutely no depression...I realize how lucky that is). It is my first time using medication.

 

Here's the clincher...I feel GREAT!!! What a problem to have, right? Almost no anxiety, no side effects, I sleep great, I have no personality changes, and generally loving life. I feel like Paxil saved my life at a point where I almost had to quit my job because if GAD. I am under the care of a psychiatrist, and I used to see a therapist but we stopped after a few months because I really had no more issues to discuss.

 

So here's the question, should I consider stopping? I am aware of the issues surrounding Paxil withdrawal, and my phychiatrist and I are aware of proper tapering. I trust her judgement, but when it comes to the topic of quitting, she says it's really up to me.

 

I know I would be risking bad withdrawal and maybe even relapse if I started tapering/quit my Paxil. Is it even worth it to me to try quitting on what is basically just an experiment to see if I can go without? I am scared of sacrificing my currently awesome mental health to obtain a "medication free" status...why is that even something I want?

 

I feel like my situation is unusual around the internet and am hoping to find some people who know what I'm feeling ????. Thank you!!

[mammaP]

Hi Blueskies, welcome to SA. I am SO glad that you joined us before starting to taper. Your doctor probab;y has the best will in the world but sad to say they rarely know about tapering the drugs they prescribe. This is not their fault, they are taught by the drug companies! 

 

It is good that you are feeling well and not having side effects. Often people find that after a couple of years the drug reaches what we call poop out, when it stops working or turns paradoxical and causes symptoms of the illness it is supposed to be helping. You are still well and happy so that is great. The key to tapering is to go very slowly.  I will post some links for you so that you can read them and gain an understanding of tapering before starting. Most people are shocked that a taper could take many months or even years but if that is what it takes to stay well and carry on with life then it is well worth it.  

 

First, could you fill out your signature for us? You can find instructions here.... 

 

http://survivingantidepressants.org/index.php?/topic/12364-please-put-your-withdrawal-history-in-your-signature/

 

Before starting to taper

 

http://survivingantidepressants.org/index.php?/topic/1008-before-you-begin-tapering-what-you-need-to-know/

 

Tapering paxil 

 

http://survivingantidepressants.org/index.php?/topic/405-tips-for-tapering-off-paxil-paroxetine/

 

Any questions, just ask 

[blueskies17]

Your doctor probab;y has the best will in the world but sad to say they rarely know about tapering the drugs they prescribe. This is not their fault, they are taught by the drug companies! 

 

...

 

Any questions, just ask :-D

 

Thank you so much MammaP! It is interesting to see this site's advice on tapering, it's slower than my Dr was taking about...she wanted to go down 5 mg at a time over a few months. Good to know I have the freedom to go even slower! To be honest I didn't even know if I could safely cut pills in half till today.

 

After reading the linked posts, I'm still undecided. One of the major reasons I went on meds in the first place was bad health anxiety, which I see mentioned as a possible reason to not start a tapering yet. While I'm not having full on hypochondriac episodes, even the level at which I'm thinking about possible tapering today does give me pause!!!

 

At first I was speaking with the doc about just cutting back to 30mgs and stay at that for a while, but she did warn me that if a return to 40 mg is needed, sometimes it will not work as well as it initially did! Way to muddy the waters, right?

 

For now I'm just taking it month by month, since I'm not feeling any poop out I can relax into the idea that I have plenty of time to make a decision!

[MollyN]

Hi blueskies - just popping by to say hi and that I too very much enjoyed life on Paxil. It certainly buoyed me up emotionally and I had many marvellous years on it and it carried me through the worst effects of domestic violence and through the other side of divorce with 4 young children.  

 

It was only when I tried to stop taking it - that I realised my dear friend paxil was a false friend indeed - I remember feeling surprisingly betrayed that a drug I'd enjoyed and gained so much benefit from was actually had me in a stranglehold.  Once I realised how I responded when I didn't take it (I believe the first withdrawal a doctor recommended was one 20mg one day, the next day 10mg crappy advice!) that's when the gloss of the drug fell away for me; I no longer felt uplifted and 'carried' instead I felt increasingly trapped and beholden to a drug I no longer needed, but couldn't seem to stop taking.

 

I suppose, my thoughts now regarding new trauma that may (will likely) happen in my life, are that withdrawal is teaching me alternative ways to deal with my pain, stress, worry and concerns. I no longer believe that if I feel bad emotionally that a drug will help me feel better, instead I would turn to all the techniques that are available to us to deal with the difficulties that are a 'normal' part of the human condition. Which is not to say I don't struggle - and some days still I remember fondly the soft paxil cushion - but it offers no answer for me anymore, just ultimately more pain. 

 

I hope you enjoy reading some stories here, I love my life now without paxil in it - it's a little more raw - but it's all mine!! xxmolly

[blueskies17]

Hi blueskies - just popping by to say hi and that I too very much enjoyed life on Paxil. It certainly buoyed me up emotionally and I had many marvellous years on it and it carried me through the worst effects of domestic violence and through the other side of divorce with 4 young children.  

 

It was only when I tried to stop taking it - that I realised my dear friend paxil was a false friend indeed - I remember feeling surprisingly betrayed that a drug I'd enjoyed and gained so much benefit from was actually had me in a stranglehold.  

 

Hi Molly!  Thank you so much for replying, your support and story means a lot to me.  I'm so glad you are mostly out on the other side - sounds like you're been though enough!

 

I just wrote a long reply and basically personal blog post...but my computer ate it, waaah  But basically I'm getting all emotional because I'm scared...and I know the best thing to do right now is go distract myself for a while, but I will check in later.  

 

I hope you (and anyone else reading) is having a pleasant day 

[blueskies17]

okay I had some lunch and now have a cup of tea brewing, so here it goes.

 

By considering tapering off of Paxil, I feel like I'm poking a sleeping bear.  A big, angry bear, being poked with a very pointy stick. My anxiety was so out of control prior to trying meds, the only reason I didn't lose my job was because I telecommute (easy enough to cry during work if no one can see it...ugh), and because my life is otherwise generally easy.  I acknowledge that I had it all going for me, but the nature of my anxiety was totally irrational, and totally out of control (I'm sure lots of you can relate).

 

My little brother is going through almost exactly the same thing right now (no meds yet), and I feel for him so bad.  I'm sure this is one of the reasons why I've been thinking about my own plan as well.

 

One of the reasons I'm interested in tapering is because I want DATA.  Science is sort of letting us down when it comes to these meds.  Sure, I could stay on Paxil for the next 70+ years (god willing I live that long!), but there's no telling it will poop out, it will develop weird side effects or other issues....or if underneath the medication I am perfectly capable of living without meds.  I have learned a lot since Paxil chilled me out enough to give CBT a real try, and I've been adjusting some parts of my home life as well.  I even managed to lose 20 lbs using weight watchers which must help in some way.

 

\My psych is one of those who recommends trying SSRI's for 1+  year for first "occurrence" and then long term for the second "occurrence".  By that logic, I should try tapering off at least once before I decide to say on it indefinitely. By joining this group, I'm learning how to best set myself up for tapering success, because I don't want to just feel withdrawal symptoms (like rebound anxiety) and throw in the towel prematurely.

 

This all sounds fine and reasonable, but I am SO SCARED.  I've spent the last 24 hours obsessing over it (in a way that feels icky but "normal" for me...not anxiety relapse just yet!). 

 

I'm telling myself over and over that I have a lot of time to make this decision...my psych said ideally she would start taper in late spring/summer so we can take advantage of the sunshine and activity.  So I've been doing a lot of reading here, and thinking about things I can do to set myself up - start a gentle exercise routine, get in the groove of eating healthy, reduce caffeine, and work on my health anxiety issues that are cropping up.  Maybe even check my work schedules and see if I can get some days off on dosage change weeks!!

 

....if I decide to go for it, anyways.  LOL!  Oh, life. 

[StarJ]

Hi Blue,

 

It seems by all accounts the longer you stay on, the harder it is to get off.

 

I wish I could go back in time to where you are now and get off, ( after only a couple of years).

 

Chances are greatly that you will succeed!

 

Good luck!

[Gridley]

You might want to read Brassmonkey's thread.  He was on 40 mg Paxil and it "pooped out," necessitating his taper.  He's almost finished now.

[ChessieCat]

Hi blueskies and welcome to SA,

 

Here is the link to Brassmonkey: Talking about myself

 

Here are some other helpful links:

 

Why taper by 10% of my dosage?

 

How do you talk to a doctor about tapering and withdrawal?

What should I expect from my doctor about withdrawal symptoms?

 

These helped me to understand SA's recommended taper of no more than 10% of the previous dose followed by a hold of about 4 weeks to allow the brain to adapt to not getting as much of the drug:

 

Brain Remodelling

Video:  Healing From Antidepressants - Patterns of Recovery

 

It is also a good idea to get some tools under your belt for both during your taper and afterwards.  Claire Weekes is excellent.  She was a doctor who suffered from anxiety (in her day known as nervous illness) and she learnt and taught ways of managing it.

1. Acceptance
2. Acceptance and Mindfulness
3. Claire Weekes' Method of Recovering from a Sensitized Nervous System
4. "Change the channel" -- dealing with cognitive symptoms
5. Change cognitive framing - Redirect - Another Way
6. Cognitive Behavior Therapy (CBT) for anxiety, depression
7. Cognitive Behavior Therapy lessons
8. Non-drug techniques

[MollyN]

Hi! I love all the sound of all the positive changes you've already made with the CBT, home circumstances and weight loss!  I had to laugh right out loud at your wanting to taper for 'data' - that's so foreign to me, I'm all about the 'feeeeling' lol.

 

StarJ is right, it's great that you've been on paxil for a relatively short time. Although for me 40mg seems a high dose - although I'm no specialist so I wouldn't really know. Maybe an interim measure might be to start to reduce it down, using this website's 10% of current dose taper.

 

What do you think you're going to do? I can hear the back and forth in your thinking - it's very human and entirely understandable xxxmolly

[blueskies17]

Thanks for checking in Molly, you're such a sweetie 

 

Right now I'm leaning towards starting a taper once the weather warms up (it has been cold and gray and ugh here for weeks!), which is also what my doc suggested (um...in every visit for the past 2 years, LOL.  Maybe I should have gotten the hint last summer?).  It really seems like the perfect time, right?  You all are right that I haven't been on for long (2 years), and even the "official" documents I read from researchers suggest 1-2 years on Paxil for the first "occurrence" (I will never not put that word in quotes...I had anxiety occurring for basically my whole life, it's pretty hilarious to assume it just pops up like that word implies).

 

I think the plan I'm formulating right now will be based on not the goal of "elimination" but "get down 10 mg slowly and see how I feel".  So right now I'm on 40mg.  Doc suggested ordering 30mg tablets + 10mg tablets and cutting the 10 in half first.  I may cut the 10 in quarters first to start the first few weeks on a 37.5mg dose, then dropping to the 35mg...then eventually to 30 for an extended time and see how I feel.  

 

Apparently 40 mg is a pretty moderate dose (60 is the max apparently).  When I started meds, I went from 10 mg lexapro right to the 40mg Paxil (yeah, I know this was bad.  This is the main reason I started seeing a psych instead of my PCP for these medicines). Needless to say I felt TERRIBLE for the first month before it all stabilized into the good that it is now.  Since I never experienced life at 20mg, or 30mg, I'm pretty curious.

 

Of course, I would like to eventually come off entirely, but I'm putting that at the back of my mind for now.

 

I'm pretty happy because even though I was having ruminations about this (and fear) for basically 24 hours, I was able to get a good night's sleep without taking a Xanax....just annoying my poor sweet boyfriend.  Used lots of deep breathing and read though my Anxiety CBT workbook again to reassure myself that I CAN HANDLE whatever happens.

 

Now I better go get to work and stop checking this site all day like a woman obsessed

 

I found a good quote last night that I really have to reflect on, because I royally suck at patience (if you can't tell, ha!):

 

"Adopt the pace of nature: her secret is patience." - Ralph Waldo Emerson

[blueskies17]

 

Hi blueskies and welcome to SA,

 

Here is the link to Brassmonkey: Talking about myself

 

Here are some other helpful links:

 

.....

 

 

 

 

Thanks Chessie!  I found some time to go through these links and they are really good.  They are helping me reinforce my almost-decision to start a taper.  

 

In particular I liked the discussion of tapering and withdrawal being a good "practice" time to use all your techniques to calm yourself.  Since one of my old issues was health anxiety, there's a decent chance any withdrawal effects will be a bit of a trigger, but in this situation I KNOW it's just withdrawal and not another health problem.  It's still scary to think that something bad could happen, but I have a ton of techniques to chill out and deal.  I also liked the Claire Weekes techniques, they are similar to a lot of things I've heard in the past few years but it's very nice and concise.  I will definitely try to implement those if anxiety hits (before or during withdrawal, even on paxil I'm not 100% cured, afterall).  And who's to say, I could get lucky and feel very little wd.

 

I think I got overwhelmed thinking about the WHOLE taper, all the way to the end.  It's calming to only think of getting to 30mg right now, which seems achievable.  The rest and everything that comes with it can wait for later.  This also plays into the idea I posted earlier about needing to practice patience.  

 

I also may have bought that fancy pill splitter on amazon....(this one)  The idea of cutting/crushing/dissolving my own doses is a little scary, so I thought a tool that could bring some accuracy to my first tapers would be nice.  (aww, a taper gift!! LOL)

 

right now I'm feeling good, like I can do this!!  It will probably get uncomfortable, but I can deal.  But I could gain a lot from this, both information about how my body/brain works, practice with CBT, and if I get lucky maybe I could get over my weight loss plateau (one can wish, right?)

 

PS my boyfriend is more concerned about me withdrawing from caffeine in the next few weeks than the drop to 30mg, haha!  I can tell the poor guy is not thrilled with my idea to taper because he saw the huge difference starting Paxil made, and he feels like I have NO mental related side effects from it.  He is being very supportive despite that, though.  I think he would prefer this to a random poop out at an inopportune time, though (me too).   

 

I am planning on discussing with my parents and brother this weekend, and am planning a date with a good friend of mine who has also been through the antidepressant wringer with both herself and a family member of her own.  Hopefully those go well.

 

then maybe after that....pulling the trigger and picking a date to start the taper?!?!