Mourad: Tapering from over 20 years of Paxil

[Mourad]

I'm bouncing back from two weeks of bad withdrawal, with intense headaches, poor coordination, and unsteady gait. I've started tapering early July 2016 from 10 mg Paxil daily for over twenty years for depression and GAD; I'm at 1,5ml (=3mg) now (I meant) 0,15 ml/0,3 mg. The last reduction hit me hard, so I'm taking more time, once again.

 

Looking back, there seem to be three distinct phases of withdrawal for me. In the beginning, I suffered a lot of physical symptoms like nausea, dizziness, disorientation, sweating, and nightmares. About half way through, waves and waves of emotion were crashing over me. Now, at the tail end, it's a kind of weird cocktail, with plenty more of both to go! 

 

I've been supplementing with feverfew, GABA, phenibut, ginger, huperzine A, and B12. They all help to some extent, especially the feverfew, ginger, and GABA, but there's no magic bullet. 

 

The challenge for me remains to allow for the time and space for my brain to adjust. Just to allow the process to run its course. With just about every reduction, I have thought, well, the next one can be quicker and bigger. With the nasty implication, of course, of should be quicker and bigger. As if it is all some sort of competition, or battle of will power and discipline. The big obstacle here is my own sense of impatience and judgment. Constantly, I need to re-learn to surrender to the material reality of my brain, an organ that naturally requires the time that it requires. Now, at 1,5 ml (3 mg) 0,15 ml/0,3 mg, the temptation again is to rush, to jump, to have it over with. But it really doesn't work like that. 

Edited June 4, 2017 by scallywag
tags; previous edit corrected dose error see Post #6

[Madeleine]

Yes, you are right that it doesn't work rushing, and at lower doses it's often necessary to taper slower.

[snostorm]

I rushed.  And I paid and am still paying.  Really wish I didnt.

[Frogie]

I'm bouncing back from two weeks of bad withdrawal, with intense headaches, poor coordination, and unsteady gait. I've started tapering early July 2016 from 10 mg Paxil daily for over twenty years for depression and GAD; I'm at 1,5ml (=3mg) now. The last reduction hit me hard, so I'm taking more time, once again.

 

Looking back, there seem to be three distinct phases of withdrawal for me. In the beginning, I suffered a lot of physical symptoms like nausea, dizziness, disorientation, sweating, and nightmares. About half way through, waves and waves of emotion were crashing over me. Now, at the tail end, it's a kind of weird cocktail, with plenty more of both to go!

 

I've been supplementing with feverfew, GABA, phenibut, ginger, huperzine A, and B12. They all help to some extent, especially the feverfew, ginger, and GABA, but there's no magic bullet.

 

The challenge for me remains to allow for the time and space for my brain to adjust. Just to allow the process to run its course. With just about every reduction, I have thought, well, the next one can be quicker and bigger. With the nasty implication, of course, of should be quicker and bigger. As if it is all some sort of competition, or battle of will power and discipline. The big obstacle here is my own sense of impatience and judgment. Constantly, I need to re-learn to surrender to the material reality of my brain, an organ that naturally requires the time that it requires. Now, at 1,5 ml (3 mg), the temptation again is to rush, to jump, to have it over with. But it really doesn't work like that.

 

Hi Mourad:

 

I noticed that when you taper you get nausea.

 

That is my only symptom. And I'm so nauseous that I've had to updose twice to try and get rid of it.

 

I can't take ginger, my body doesn't like it at all.

 

Do you have any other suggestions?

 

What do you take GABA for if you don't mind me asking?

 

I really appreciate you answering me.

 

Take care,

Frogie xx

[Mourad]

@snostorm I'm so sorry this happened to it. It's so seductive to rush, to get rid of it; it's so difficult to resist and pace oneself. I really hope you will bounce back soon.

 

@frogie the nausea can be intense indeed, sorry you're suffering from this in particular. Did you try different forms of ginger? There are capsules, oil, crystals, or tea. I take the capsules. Maybe there's a form you are able to stomach? I've also intermittently taken the antihistamine cinnarizine for nausea; it's usually sold for car sickness. It works for me, but the problem is that it messes with both serotonine and dopamine, so it's not a long-term solution. Maybe accupuncture or the acupressure wristbands that are sold for car-sickness? I hope you will find something that works for you, and I wish you the best of luck.

 

I take GABA Calm from Source Naturals to help relax. The effects are mild but noticeable, and I tolerate the tablets well. 

[Mourad]

I can't believe how much wisdom, experience, and knowledge there is on this site.

 

By the way, I wrote above that I'm stalling on 1,5 ml/3 mg -- but I meant 0,15 ml/0,3 mg (mod note: this has been corrected). I guess that goes to show how a brain on withdrawal works! (Not that I'm very numerically savvy on the best of days, can't blame withdrawal for everything!)

 

But yeah, even on that minute amount, the withdrawal symptoms are worse than they've ever been since starting tapering. Amazing but true.

Edited April 12, 2017 by ChessieCat

[mammaP]

Hi Mourad, welcome to SA.  Unfortunately your taper has been faster than we would recommend and your nervous system is struggling. I tapered effexor for a year and thought it was a very slow taper but ended up with withdrawal too, so I know how it feels! 

 

You could updose slightly, that could help enormously and it wouldn't have to be much, a tiny amount could help. It might be better than suffering while your brain tries to catch up. When you have stabilised you should hold for a while to give your brain a break then restart the taper.  This topic covers reinstating and updosing to relieve withdrawal symptoms. 

 

http://survivingantidepressants.org/index.php?/topic/7562-about-reinstating-and-stabilizing-to-reduce-withdrawal-symptoms/

 

We recommend tapering no more than 10% of the current dose with 4 weeks or more between cuts. Tapers need to slow down at lower doses, as you have discovered withdrawal is felt most at the lower doses. 

 

http://survivingantidepressants.org/index.php?/topic/1024-why-taper-by-10-of-my-dosage/

 

Tapering paxil 

 

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

 

What is withdrawal syndrome 

 

http://survivingantidepressants.org/index.php?/topic/603-what-is-withdrawal-syndrome/

 

There is a lot to read there, if you have any more questions, just ask. 

[Mourad]

Thanks for this, mammaP.

 

Yes, I think my tapering speed has caught up with me. I thought I wás slow, but it needed to be slower. I've been struggling with how really slow slow should be. Patience is difficult for me.

 

I've considered updosing a little bit, but it now appears that the worst withdrawal symptoms, after roughly two weeks, are lessening considerably. So I'll keep steady at this dose, and then take extreme care with the final steps. 

[mammaP]

It would be good to hold for a few months to give your nervous system a break. I am glad that you are feeling better, You will probably find that you have some windows and waves while stabilising. Don't be disheartened if you get a return of symptoms for a while. It will not last and you will stabilise. 

 

http://survivingantidepressants.org/index.php?/topic/82-the-windows-and-waves-pattern-of-stabilization/

[Mourad]

So, I tried to take the next step, but that backfired pretty badly. I reduced from 0,15 ml/0,3 mg to 0,1 ml/0,2 mg. I assumed that should be possible, and smaller steps are hard to determine, even using the suspension.

 

After a day, I suddenly suffered extreme nausea, disorientation, agitation, dread, and melancholy. I quickly reinstated, and hope I'll re-stabilize in a few days. Quite a shock! This only confirms the experience of so many on this site: the final steps are the hardest.

 

I guess I'll need to rethink how and when to do this. I wonder what my doctor will say! Then again, she thought the 10 mg I'd been taken for 20 years was already a 'homeopathic dose', so I'm not sure I want to know what she thinks about the potency of 0,15 ml. On the other hand, she's happy to humor me and let me do this at my own pace, even though I think she doesn't quite take it all very seriously. We'll see. 

 

If anyone has insights to offer on how to manage these final, minute reductions, please let me know.

[miT]

I would stay on your current dose until the windows clearly outweigh the waves. Also thanks for warning me. I won’t jump at 1mg anymore.

[scallywag]

So, I tried to take the next step, but that backfired pretty badly. I reduced from 0,15 ml/0,3 mg to 0,1 ml/0,2 mg. I assumed that should be possible, and smaller steps are hard to determine, even using the suspension.

 

...

Mourad, after you've stabilized you might try smaller decreases. For example, decrease from 0,15 ml/0,3 mg to 0,135 ml/0,27 mg, a 10% reduction.

 

The nice thing about a liquid is that you can dilute it to get more accurate with smaller doses. Let us know if you'd like assistance with the calculations and/or dilution ratios.

[Mourad]

Dear scallywag,

That's a fantastic idea, thanks! If you could, I would love some assistance with the calculation and dilution ratio.

Thanks! Mourad

[Mourad]

I've taken my last dose July 15. So far, so good. In any event, things haven't gotten worse. I realise that that doesn't mean much; it may well go wrong again in the near future or later. But, of course, that may also possibly nót happen -- something I sometimes forget because of all the heartbreaking accounts on SA. It's easy to forget there must be countless other stories of easier withdrawal that won't necessarily appear on a site like this. For now, all I know is that there will be waves, there will be windows, and each day, and each night, might be different. All bets are off. 

 

The windows and waves seem changed. It used to be almost like science-fiction or mythology, like stepping in and out a different world. Now, it's more like bad and good days. At times, it's one day up, down the next; sometimes it's a series of several good days, interrupted by a bad one. The bad days usually mean a 4-hour night (rather than a 6-hour one), intestinal discomfort, and a singularly morose, foul, desperate mood. Mornings are worst; it gets much better as the day proceeds. Praise the Lord that the endless nausea has now largely dissipated.

 

Sleep remains a hassle. But, then, on Seroxat, I easily slept ten hours a night, with two-hour naps in the daytime. I guess some adjustment wouldn't be bad! Maybe this will get a little better if I can just bring myself to accept this new sleep pattern rather than keep fighting it. We'll see ...

 

[scallywag]

Thanks for letting us know how things have been going for you since "jumping to 0", Mourad!  Good to read that you're managing well.

[Mourad]

After my last dose on July 15, things were steadily getting better, but November has been one big bad wave so far. Just horrible. My waves used to be much shorter. While many of the other symptoms have waned, what remains, and with a vengeance, are the insomnia and nasty cycles of (neuro)emotions.

Most nights, I'm only able to sleep four hours; some nights are even worse, with brief and intermittent sleep, interrupted by cycles of emotional upheaval. I was okay for a while but the exhaustion gets to you in the end. I'm incredibly weak and vulnerable. The Seriphos, melatonine, aspirine, and lactium  -- all suggestions I got from SA -- don't seem to do much anymore. Will try acupuncture, which has been good for me in the past. 

Also, I get caught by weird emotional storms with nary a provocation, shifting more or less arbitrary from hurt to rage to fear and back. Most of the time I'm entirely lost, but every now and then I'm able to recognise the feelings are so disproportionate and unreal they're not really 'me.'

 

I'm getting so tired of talking to people who don't really understand this. My doctor tries but is entirely clueless. I haven't found it easy to find a shrink or therapist who understand long-term usage of paroxetine and discontinuation. But I'll keep on trying. I really need to talk to someone who gets it. 

 

Of course, every now and then there is the suggestion of a window: a moment when everything is completely fine and normal, I feel entirely like myself again, and just go about my day. Those moments are far and few between right now, but marvels. 

[ChessieCat]

Here are some links which may be helpful:

 

Acupuncture - Posts #6 & #8 (not detox or stimulation)

 

dealing-with-emotional-spirals

 

Non-drug techniques to cope with emotional symptoms

 

Irritability, Anger, Rage

 

Sleep problems - that awful withdrawal insomnia

 

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

What should I expect from my doctor about withdrawal symptoms?

 

Video:  Healing From Antidepressants - Patterns of Recovery

 

 

From What is Happening in Your Brain:

 

"Basically- you have a building where the MAJOR steel structures are [...] to be rebuilt at different times - ALL while people are coming and going in the building and attempting to work.

It would be like if the World Trade Center Towers hadn't completely fallen - but had crumbled inside in different places.. Imagine if you were [...] to rebuild the tower - WHILE people were coming and going and [...] to work in the building!  You'd have to set up a temporary elevator - but when you needed to fix part of that area, you'd have to tear down that elevator and set up a temporary elevator somewhere else. And so on. You'd have to build, work around, then tear down, then build again, then work around, then build... ALL while people are coming and going, ALL while the furniture is being replaced, ALL while the walls are getting repainted... ALL while [...] is going on INSIDE the building. No doubt it would be chaotic. That is EXACTLY what is happening with windows and waves.  The windows are where the body has "got it right" for a day or so - but then the building shifts and the brain works on something else - and it's chaos again while another temporary pathway is set up to reroute function until repairs are made. "

[Mourad]

A very belated thank you, ChessieCat. I’d already reviewed most of the material, but not all, and it helps. Still on vitamin C, magnesium, ashawaganda, and Seriphos to try get the cortisol under control.

 

Last November was a particularly low point, but I have gotten better since, partly helped by acupuncture. But the last four to five weeks my sleep has gotten steadily worse again, and now, particularly the last week, it’s at its very worst ever. If I take 10 mg of temazepam, I can get 3 to 4 hours of sleep (but I’m only prescribed the temazepam to use twice a week to prevent habituation). If I don’t take anything, I hardly sleep at all. 

 

It’s the weirdest thing: I feel fine in the evening, also for the first half hour or so in bed, and then I’m visited by wave after wave of anxiety, unrest, and tension. The feelings seem entirely autonomous, with little relation to what’s actually happening in my life: indeed, they don’t feel like "my’" emotions at all. I usually get a little very light and restless sleep towards the morning. It doesn’t really feel like sleeping, but sometimes I remember a dream, so there’s that. The tension stays with me for most of the day, then usually dissipates in the late afternoon or early evening. I guess this sounds like a cortisol cycle completely thrown out of whack! 

 

If this goes on, I’m a little afraid I won’t be able to cope. I’m sure my GP will trot out the old “Well, you must need it so why don’t you …“   Meanwhile, she’s entirely unwilling to do anything more about the insomnia than prescribe temazepam. If I have to call in sick when I can’t function anymore, I’m sure the company doctor (a devious thing we have here in the Netherlands), will probably advise much the same to get me on my feet again. And I’m afraid that by that time I’ll be so exhausted, disoriented, and emotionally unstable I’ll agree, just to get rid of the whole issue. So I hope I’ll remain able to remember that heavy insomnia doesn’t necessarily indicate the return of the “original condition,” and that the feelings of anxiety and unrest I’m experiencing while lying in bed awake don’t feel like “my” feelings to begin with.

 

In any event, discontinuation is unpredictable. Next week may be entirely different. 

 

[Mourad]

It just goes on and on.

Earlier, a few weeks of the best sleep in one and half year. It was amazing.

But the last week, a pretty intense relapse. Now I get at most one or two hours of sleep each night, then wake up high-strung and anxious. I can’t get back to sleep unless I use phenibut, which carries the risk of habituation. My mood generally improves slowly through the day; the evenings are fine. Repeat.

Trying to get the cortisol under control using the usual: ashwaganda, Seriphos, pharmagaba, zinc. Nothing really works.

It’s over a year after taking my last small drop of paroxetine. When will it end? I know, it’s impossible to say.

 

[Mourad]

Some twenty months after my last drop of paroxetine, a new wave.

 

It’s a nasty one, with intense insomnia and anxiety.

 

Of course, always in the back of my mind, the fear that my old anxiety disorder is back. On the other hand, the simple reality of long-term withdrawal. I’m reading brassmonkey’s thread on duration frequently to help with acceptance (that thread is pure gold). I need to be reminded constantly! And I continue to be amazed by the whole drawn-out process: waning and returning, repeating and varying. It’s always more or less the same, yet at the same time it somehow feels so different and new at every turn.

 

Before this wave hits, I was doing so much better. A sleep study showed that part of my insomnia was apnea-related after all (I only did the study to rule that out!). A little device conditioning one to sleep on your side rather than back helped a great deal. So did ample pre- and probiotics (supposed to help with cortisol). I was sleeping so much longer and deeper. Deep sleep makes a whole lot of difference.

 

But then, a promising relationship suddenly turned unbearably complicated — and I was getting next to no sleep. Five weeks on, and I’m a wreck. I try to manage with phenibut and zoplicon, and they sometimes work a little bit, and sometimes they don’t. A lot of painkillers.

 

Week five of the latest wave. Are we there yet? Are we?

[Vasherr]

Hi, @Mourad,

 

I am sure a lot of people would like to know how are You feeling lately, I know I would.

 

Please let us know!

 

Wishing You a lifelong window!

V.