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DaveB: Trying to stop a roller coaster year

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DaveB
On 7/23/2017 at 5:24 PM, RachelSusan said:

Hi Utah49,

I'm very sorry to read your story, it sounds like are currently going through a lot.   I have been through something similar and wanted to add my suggestions because I hate to see you suffer needlessly. Just remember though, they are only suggestions, and you have been getting a lot of different suggestions.  So perhaps mull them all over and come up with the best plan for you.

 

I went off an anti-depressant cold turkey, ouch! Then I reinstated, still ouch. At that time I was prescribed gabapentin which is similar to Pregabalin.  Here's where the similarities come in.  I tried to go off the gabapentin with my first drop being 30% of the dose.  Oh what a flippin' nightmare. I had to reinstate.  It felt somewhat like WD but with a heavy dose of the flu, and tremors. Ok, you get the idea, it was bad. I hear you about the cost of the Pregabalin. Is it possible to maybe afford it for another two or three months only and perhaps do a taper during that time? Or perhaps don't decide right away, just do a small taper with what you have left and see how you feel?  If you get a reaction then you know how difficult it will be for you, and at that time you may look at extending your prescription a little differently. I have learned that whatever I do, I must do it very slowly otherwise the symptoms are horrible. I do hear you though about the financial pressure, what an awful choice to have to make. Whatever you decide to do, please know we are rooting for you, no judgement, just support.

 

Thank you so much for your post, and for all of you who have taken the time to comment, even if it is just to tell me I am crazy (don't worry, I agree with you!) So far my anxiety has definitely been increased since dropping to 300mgs, however last night I had a window where I felt pretty much completely normal. Not sure when the last time that was, unfortunately woke up again today with extreme anxiety (kind of weird since I take the 300mgs of pregabalin at night, so wouldn't night be the worst, before another dose?)

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DaveB

I have been reading a lot on this site about kindling, how do I know if the SSRIs I have attempted to reinstate are "kindling" or if they are just something I need to adjust to and stabalize before tapering slowly? If something is kindling or making you worse, is it best to get off it as soon as possible?

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manymoretodays

My best guess is that the interdose withdrawal is part of your discomfort now.........compounded by greater than 6 mos. of frequent medication changes, medications, dosages, etc.  I'm not even going to speculate on "kindling".  You don't really know.......that's all I know.  I mean maybe you do.  And hopefully in retrospect you will understand more........as far as you, and your medication history.

 

So now you are considering another, essentially CT?  I think that there is probably a better way.

 

What's your day to day been like?

 

You are not crazy.  Your poor nervous system is in a very precarious state right now.  If nothing else you might consider just staying exactly where you are right now........no changes.........I mean if I were you I would...........either that, or liquifying the Pregabalin and splitting your total daily dose out throughout the day.........one of the mods can probably help you further with that as I am not quite sure how many times a day might work best.  I had thought you were working on the Pregabalin first........as far as tapering goes.

 

Good for you to recognize a brief window and that one occurred. 

 

Best,

mmt

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DaveB
3 hours ago, manymoretodays said:

My best guess is that the interdose withdrawal is part of your discomfort now.........compounded by greater than 6 mos. of frequent medication changes, medications, dosages, etc.  I'm not even going to speculate on "kindling".  You don't really know.......that's all I know.  I mean maybe you do.  And hopefully in retrospect you will understand more........as far as you, and your medication history.

 

So now you are considering another, essentially CT?  I think that there is probably a better way.

 

What's your day to day been like?

 

You are not crazy.  Your poor nervous system is in a very precarious state right now.  If nothing else you might consider just staying exactly where you are right now........no changes.........I mean if I were you I would...........either that, or liquifying the Pregabalin and splitting your total daily dose out throughout the day.........one of the mods can probably help you further with that as I am not quite sure how many times a day might work best.  I had thought you were working on the Pregabalin first........as far as tapering goes.

 

Good for you to recognize a brief window and that one occurred. 

 

Best,

mmt

 

I am certainly not considering another cold turkey, I was just wondering about kindling. It seems people who get more anxiety when they start an SSRI either eventually level out like Finn or TikkiTikki, or they get to a point where they find they are "kindling" and have to go off all meds or find some success with something like Mirtazapine or a Tricylic for a bit to stabilize, then taper. I was just wondering how you know which camp you are falling into, what constitutes a "negative reaction" or "kindling" and what is "start-up" anxiety you just need to work through until you get stable enough to taper again.  

 

Thank you for asking, my days have been pretty hard, though I did have that really nice window on Sunday and a pretty good one of Friday night as well. I am really trying my best, but frustrating my wife as I find it really hard to get out of bed to start my day. I don't know if this is because of the big 300mg pregabalin dose at night, or if it is just because I am dreading another anxiety filled day, either way, everyday is a grind and after 6 moths it is getting really hard. I would give anything to go back in time and make different decisions so I could still be the happy, productive, care-free guy who so stupidly quit Zoloft cold-turkey last November. If I had just found this site and tapered properly, how different my life would be right now. Or heck, even found this site in January when I attempted to reinstate the Zoloft so I would have known not to reinstate at my original 50mg dose, and known I had to give my nervous system time to stabilize, instead of jumping from different meds. 

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manymoretodays

Sounds good then Utah.  You are reading and getting familiar with the site.  I don't think anyone here would recommend that kind of cross taper with Mirt or a Tricyclic.  Sometimes that stuff happens though to many of us........as yet, not really informed, other than our uninformed/uneducated(on withdrawal)doctors,  as we are trying to get off meds.  I always say, "don't do as I did"........ except with my final medication........ I finally did a decent taper.   And yes........some brutal years of just surviving are now behind me.  B)  That's the thing........you don't have to be the same way.

 

I had done some scattered reading at Mad in America and Beyond Meds.......... and the book "Anatomy of an Epidemic" really influenced me alot..........and my whole belief system around medication changed years before I got here to survivingantidepressants.  Somewhere along the line I began listening to myself and my own intuition.

 

There is a video here somewhere about how to talk to family members about what is happening.  It can be tough for them as well.  And it does sound like you have a busy household at this time.  I will look later........if time.......maybe someone linked it in your beginning posts?  Just so you can get some ideas of how to talk about what's going on with you, to those who matter most in your life now.

 

I'm kind of excited as maybe we can get together a support group of some kind in our area sometime soon.........as it sounds like we might not be too far away.  I think others in the area have at least visited this site too......started intros, etc.    In the relationship section here........there is a location post.......for this very thing.........trying to get some live person support groups going in different areas.  So......pay attention.

 

Okay then.  :)

 

Best,

 

mmt

 

 

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DaveB
On 7/21/2017 at 0:18 AM, Altostrata said:

Rebound anxiety is unlikely with SSRIs. Rebound anxiety occurs when sedating drugs, such as Lyrica or benzos, wear off.

 

So in your opinion should I continue to take all of my 20mg Paxil dose in the morning, or split it 10mgs and 10mgs?   

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Altostrata

We've never discussed splitting your Paxil dose. Why would you want to do that?

 

One thing we do emphasize: Never change more than one drug at a time, or the situation can become impossibly confusing.

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DaveB
13 hours ago, Altostrata said:

We've never discussed splitting your Paxil dose. Why would you want to do that?

 

One thing we do emphasize: Never change more than one drug at a time, or the situation can become impossibly confusing.

 

Sorry I was just wondering if since Paxil has a shorter half-life if you would recommend taking it twice a day like you do benzos and such. Maybe the shorter half-life isn't big enough to make a difference, or it is different for SSRIs?

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scallywag

Paxil's half-life is 21 hours and therefore is usually dosed once per day. Studies have found that pregabalin can have a half-life as short as 6 hours, and is therefore prescribed with multiple doses/day.

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DaveB

After reading on this site about the effects of caffeine on a sensitive CNS, I quit drinking the one soda a day I had been. What about caffeine withdrawal from stopping, will this not make my symptoms worse?

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DaveB
5 hours ago, scallywag said:

Paxil's half-life is 21 hours and therefore is usually dosed once per day. Studies have found that pregabalin can have a half-life as short as 6 hours, and is therefore prescribed with multiple doses/day.

 

Yes I just noticed that Paxil has a shorter half-life than other SSRIs I have taken, and was wondering if it is better dosed twice a day. 

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scallywag

It's fine to take it once a day. Splitting the dose may add an unnecessary task to your day and unnecessarily complicate your symptoms  situation.  Remember the goal here is to keep medications stable; please read

3KIS: Keep it slow. Keep it simple. Keep it stable.

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TryingToHoldOn

Listen to the mods!  Go into credit card debt or take out a loan for the lyrica - no joke.  The mods are trying to save you from the worst of WD.  Believe them when they say it can get much, much, much worse.  

 

I fast tapered 2 meds: sertraline which I took for 2.5 years & I was wrongly put on Latuda for 5.5 months.  The cold turkeyed of a mood stabilizer (lamictal) which I was on for 3 months.  I'm in hell. 

 

Right now you're feeling extremely uncomfortable with all your symptoms, you're still able to function (I.e. Work).  That ability can be gone in an instance if you make the wrong move.  Please, please be judicious.  Everyone is just trying to help you from further harm.  I can hear the panic from your posts, but you're not thinking clearly.  Let the experts help you.  They will save you from a lot of unnecessary pain.   

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DaveB
On 7/23/2017 at 5:24 PM, RachelSusan said:

Hi Utah49,

I'm very sorry to read your story, it sounds like are currently going through a lot.   I have been through something similar and wanted to add my suggestions because I hate to see you suffer needlessly. Just remember though, they are only suggestions, and you have been getting a lot of different suggestions.  So perhaps mull them all over and come up with the best plan for you.

 

I went off an anti-depressant cold turkey, ouch! Then I reinstated, still ouch.

 

On 7/24/2017 at 10:46 AM, JanCarol said:

Hey Utah - Found myself re-reading this and thought of you.

On 7/23/2017 at 4:33 PM, manymoretodays said:

I hope we haven't overwhelmed you with responses and you are doing okay today.  I also used to get needleless syringes to measure my liquified Trileptal at Costco as well.  I had to go to the pick-up counter and just ask.  They never even charged me.

 

Best,

mmt

 

 

On 7/19/2017 at 3:23 PM, bubble said:

They say the best things in life are free but I'm afraid this free consultation service has expired. I gave my opinion a few times and now I'm off to assist somebody else in distress. Wishing you all the best with your tapering journey.

 

On 7/19/2017 at 9:19 AM, scallywag said:

Gabapentin is available as a generic. It was the drug that Lyrica was developed to "replace," i.e. the patent on Neurontin (gabapentin) was expiring so Parke-Davis/Pfizer invested in R&D for a new drug.

 

On 7/20/2017 at 11:19 AM, Altostrata said:

If I were you, I would not attempt cross-taper, I would directly taper from Lyrica.

 

First off, thank you all so much for your responses, support, and advice. It has been invaluable to me at this point in my recovery process. I keep plugging away, every day is a grind, but I keep getting up. I try to "float" through the anxiety, not get caught up in "what happened to me?" "how do I fix it?" "when will I feel better?" but it is hard. 

 

So I am now 7 weeks into my "reinstatement" of Paxil. I still don't really feel any better, maybe some symptoms have reduced (shaky hands, burning eyes, intrusive thoughts) but the anxiety is still ever present and feels maybe worse than before. I also seem to be more irritable, maybe more spaced out, sensitive to noise. I generally feel better after about 7PM, but I can still get pretty bad "waves" of anxiety after that. Does that mean my "reinstatement" has failed, if so, where does that leave me as far as options? Or is it just my Pregabalin interdose withdrawal and now fast taper interfering with what would normally have been a successful "reinstatement"? According to my doctors taper schedule, I took my last dose of 300mgs of pregabalin last night and am supposed to be done, but honestly I am really scared. Have I only been sleeping better because of the pregabalin? Will I now fall into a pit of unfunctionality (not that I a really functional now) and become disabled like many on this thread have insinuated? I have only taken the pregabalin for 2 months, will getting off really be a huge deal? So many questions and no way to get answers is frustrating, I don't know the right solution and to be honest am scared of all paths to take. Stay on pregabalin (maybe even updose to 450 since these 10 days have been really hard) and do a proper taper (which may bankrupt my family)? Go off the pregabalin and risk who knows what? What (if anything) has the Paxil reinstatement done, has it helped? has it hurt? Shouldn't I know one way or the other by now? 

 

P.S. I miss Bubble and Karen, they have been awesome to me and it looks like I have offended them and for that I am truly sorry!

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ChessieCat
4 hours ago, Utah49er said:

P.S. I miss Bubble and Karen, they have been awesome to me and it looks like I have offended them and for that I am truly sorry!

 

All the mods on this site are human beings and are volunteers who are also going through their own withdrawal and life issues.  Moderating on this site can be very stressful and draining.  The mods need to look after themselves and make their own wellbeing their top priority.

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DaveB

So after a really tough 10 days, let's  say I wanted to declare this rapid Lyrica  taper a "failed experiment," would you suggest updosing back to 600? 450? I like the idea of trying to take it 4 times a day to minimize interpose withdrawl, and 150 is half of my 300 so that is easy, but I also like the idea of trying to limit my updose.

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JanCarol

Thanks for that Chessie, I was going to say something similar, that yes, Bubble and Karen are lovely people, but after you have chosen such a dangerous course, they couldn't stay and watch.   You "out-stubborned" them.  We each have limited resources, and repeatedly citing evidence to support a reasonable course of action is exhausting when that reasonable course of action is ignored, even disputed.

 

We have no way of knowing, now that you have done what you have done, how much of your symptoms are changes to Paxil or changes to Lyrica.

 

It's the changes that make things happen, not this drug or that one.  You just had 2 months of major changes.

 

Paxil is not going to cover Lyrica withdrawal.  Lyrica is not going to cover Paxil withdrawal.

 

You didn't hear what I was telling you about how bad this can get.  I'm hoping it won't for you, but it can get a lot worse. 

 

I'm trying to remember why you were doubling the Paxil?  The Lyrica was given to you to deal with Paxil side effects, as far as I can tell  It's never good medicine to drug the side effects of a drug - and so - by doubling your Paxil, you have doubled your need for Lyrica.  And then cut the Lyrica in half.

 

If I were you, I would bite the bullet, buy the Lyrica, go back to your previous dose.  And hold.  These are all changes, and they should settle for 1-3 months before you start tapering.  

 

If you refuse to buy the Lyrica, then I would hold here for 3-6 months.  Which will still require you to buy more Lyrica.

When you do taper, please reconsider and taper by 10% of your previous dose.

 

I hope you see the sun today!
 

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DaveB
55 minutes ago, JanCarol said:

Thanks for that Chessie, I was going to say something similar, that yes, Bubble and Karen are lovely people, but after you have chosen such a dangerous course, they couldn't stay and watch.   You "out-stubborned" them.  We each have limited resources, and repeatedly citing evidence to support a reasonable course of action is exhausting when that reasonable course of action is ignored, even disputed.

 

We have no way of knowing, now that you have done what you have done, how much of your symptoms are changes to Paxil or changes to Lyrica.

 

It's the changes that make things happen, not this drug or that one.  You just had 2 months of major changes.

 

Paxil is not going to cover Lyrica withdrawal.  Lyrica is not going to cover Paxil withdrawal.

 

You didn't hear what I was telling you about how bad this can get.  I'm hoping it won't for you, but it can get a lot worse. 

 

I'm trying to remember why you were doubling the Paxil?  The Lyrica was given to you to deal with Paxil side effects, as far as I can tell  It's never good medicine to drug the side effects of a drug - and so - by doubling your Paxil, you have doubled your need for Lyrica.  And then cut the Lyrica in half.

 

If I were you, I would bite the bullet, buy the Lyrica, go back to your previous dose.  And hold.  These are all changes, and they should settle for 1-3 months before you start tapering.  

 

If you refuse to buy the Lyrica, then I would hold here for 3-6 months.  Which will still require you to buy more Lyrica.

When you do taper, please reconsider and taper by 10% of your previous dose.

 

I hope you see the sun today!
 

 

Um...I think you have me confused with someone else. I was not prescribed Lyrica to cover up Paxil side effects, nor did I double the Paxil, other than before I found this site listening to my doctor, who upped me from 10-20mgs. I was on 600mgs of Lyrica before my doctor added Paxil, so I never upped my Lyrica dose to deal with a doubles Paxil dose. I am certainly not going through any kind of Paxil withdrawl am I? Wouldn't I have had to stop or reduce Paxil at some point for that? Not sure what to do with that comment, other than to take it that it is very clear you were not of fan of my trying to reduce Lyrica due to cost.

 

I guess my question still remains for anyone else who wants to weigh in.

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JanCarol

See Utah, you're working on running me off, too.

 

So your doctor doubled your Paxil dose.  I got my information from reading your signature.  Is it accurate?  It looks like the Lyrica was added to help with Lexapro withdrawal (after the Klonopin was discontinued).  

 

No, I don't have much sympathy for your efforts to "control your costs" - these are dangerous drugs, and if you can afford it, you should respect them, and continue with a slow taper.  I have friends and family in the US who are $$,$$$ in debt to hospitals because of these drugs, and cannot afford food and are in danger of losing shelter.  Does that apply to you?  (I was an accountant, and have hoped that I could appeal to your business sense). What is the dollar value of 1-2 years in extreme distress, followed by 5-10 years of ill health and sensitivity?  $500 a month is a small price to pay for preventing that, if you can afford it. 

 

I can think of a hundred people that, if they could, and $10,000 would have prevented their withdrawal - they would jump on that opportunity in a heartbeat, selling their car, their house, their dog - whatever it took to prevent withdrawal.  You only have to sell one car to pay for a year of Lyrica.   I know people whose withdrawal has cost them their relationships, family, friends, job, house, career - everything.  Are you sure you want to risk that to save some money?  Even if it's only a 10% chance of that happening?

 

You can get symptoms from quitting Lexapro. You can get symptoms from changing doses in Lexapro (that was only 3 months ago, your symptoms could also be complicated by that).  Lexapro is one of the most difficult drugs to withdraw from.   You can get symptoms from quitting Klonopin cold turkey.  You can get symptoms from increases in Lyrica.  You can get symptoms from cutting Lyrica by 50%.  You can get symptoms from starting up Paxil, and you can definitely get symptoms from doubling your Paxil.  All of these changes have happened in the last 3 months, and the doubling of Paxil and halving of Lyrica have happened in the past month.  So what is causing your symptoms?  Answer:  all of the above.  Add to it the stresses of your life that I don't understand or know about (this is the internet, after all) - and that can double your symptoms.

 

The more you fiddle your doses (or your doctor does) the more you will suffer symptoms.  Instead of fiddling with doses - look to fiddle with your life.  Eliminate stress, learn Non Drug Techniques for Coping with Emotional Symptoms, cut your losses on the things which are draining your vital force in your life, or adding stress and pressure.  Learn to sleep well.  

 

I won't argue with you further.  Like Bubble, you've heard my best suggestion.  Arguing with mods is a warning offence.  I had hopes that I could drive home how serious is the the course you have chosen.  I will no longer harbour that delusion, and will not accept the stress of an argument, because I won't take any drugs to numb the consequences of these stresses.  

 

I do hope you see the sun today.

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DaveB
13 hours ago, JanCarol said:

See Utah, you're working on running me off, too.

 

Sorry, I am certainly not trying to run anyone off and I apologize if it came off that way. I am agreeing with all of you, you, bubble, alto, my tapering strategy of Lyrica for cost is not worth the risk as just my 50% drop had been quite painful. 

 

I was just just looking for guidance as to if I should updose back to the 600 I was taking 10 days ago, try to stay here at 300, despite the fact I have felt significantly worse, or split the difference at 450 and see how I do there. Sorry, I am not trying to argue, I am just new to this whole thing, frustrated, and scared to be honest. Maybe that comes off as intense, but it isn't aimed at any of you, just my situation.

 

thanks for your responses!

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ChessieCat

Have you read these topics?

 

Stabilising After a Reduction - What Does That Mean?

Windows and Waves Pattern of Stabilization

Withdrawal Normal Description

About reinstating and stabilizing to reduce withdrawal symptoms

Keep it Simple, Slow and Stable

 

It is also a good idea, when taking multiple drugs of any type, to use Drug Interactions Checker

 

You will see in the reinstatement topic that small increases are suggested followed by a hold at that dose unless your symptoms worsen.  However, as JC said above because of the large number of changes that you have made during the last months it is very hard to work out what is causing what and therefore hard to know what might help.  Even if all you had done was double the Paxil and the reduce Pregabalin in a short period of time then we wouldn't be able to tell if the increase in Paxil dose is causing any issues (side effects) or if the Pregabalin reduction (withdrawal) is causing problems or even if drug interaction is happening.

 

If you are able to put up with how you are feeling, it would be better to not change anything.  If you want to try an increase in Pregabalin make sure you have read the reinstatement topic Post #1 very carefully, even twice, so you understand it and that a small increase is suggested.  Also Keep notes on paper about your drug dosages and daily symptom pattern

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JanCarol

Okay Utah - I see better what you are asking.

 

I've got mods looking into it and get back to you soon.

 

As for your kindling question, yes, you're a good candidate for kindling.  Everything about your history said to me:  danger.  You wouldn't believe how casual doctors are with these drugs, and then we get the fallout here at SA (and we can only catch a small percentage of it).  On, off, switch - they do this all the time, and the people pay with years of their lives.

 

If you can, hold where you are and maybe a reinstatement won't be needed.  If you have to, add 100 mg to see if it helps, until we get a mod consensus.

 

Also pregabalin has a very short half life.  It is important that you take it 2x daily, this should also help with your withdrawals.  This is not a doubling of the dose, but a splitting of the dose into 2 daily portions.  I believe Alto recommended that some time ago.

 

I'm relieved that you have decided to buy the stuff - as it only gets harder from here if you "tough out" a rough taper plan.  I have hopes that we can get you stabilised so that you can lead a more normal life.  It does get better - I'm sorry you are suffering, truly I am.

 

I'm out most of this week, but if you quote me directly, I'll see your posts and try and stop by.  Other mods have been notified of your question.

 

I hope you see the sun today!  (really, it's excellent for mood, even if it's just 10 min of sunlight per day!)

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JanCarol

How are you holding Utah?  I haven't forgotten about you - I'm just having trouble getting a second opinion.

 

Chessie said you can updose if you need to, recommending a small dose.  I was considering what would happen if you went directly up to 450 since your drop was so recent.  But that is still in the "thinking about" basket.  I lay out a more conservative course below.

 

It's been about 2 weeks since your last drop, what form are your capsules?  150 mg?  

 

Because the first thing you should do is take a split dose:  some in the morning and some at night.

 

If you have round-the-clock problems, the doses should be equal.  If, however, the pregabalin makes you drowsy or dizzy, or affects your work, you might consider taking a smaller dose in the morning.

 

So - if you are on 300 mg, you might consider 100 mg in am, and 200 mg in pm.  See how that goes (give it 5 days).  If that's not helping (give it 5 days), then add 50 mg to pm.  If that's not helping, add 50 mg to am.  I reckon by then, you should be starting to stabilise from you precipitous drop.

 

Lyrica has an awfully short half life.  Some people dose up to 4x a day.  Let's see if we can get you by on 2.  

 

1.  Split your dose between am and pm.  (Alto recommended that pages ago)  Give it 5 days.

2.  If still suffering, add 50 mg to pm dose.  Give it 5 days.

3.  If suffering is still unbearable, add 50 mg to am dose.  

 

Let us know each step of the way how your symptoms are - because these tiny adjustments (I've given you about 3 weeks of work here) can tell us a lot.  If the split dose gives you 50% improvement, for example, we'll know we're on the right track.

 

Then, when you get to a stable place - HOLD.  When you are tempted to taper - HOLD some more.  When you are groaning about your pharmacy bill - HOLD some more!  Hold for at least 6 months in a stable place.  That's - 6 months after your symptoms settle.  

 

Then we can talk about tapering.

 

I hope you see the sun today!

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Altostrata

Yes, it does seem that cutting your dosage from 600mg pregabalin to 300mg pregabalin was too much for you.

 

JanCarol suggests a reasonable schedule. You'd move a partial dose earlier in the day. As Plan B, I would be inclined, like JanCarol, to try a slight updose rather than go back to 600mg.

 

On 7/29/2017 at 10:39 AM, Utah49er said:

So I am now 7 weeks into my "reinstatement" of Paxil. I still don't really feel any better, maybe some symptoms have reduced (shaky hands, burning eyes, intrusive thoughts) but the anxiety is still ever present and feels maybe worse than before. I also seem to be more irritable, maybe more spaced out, sensitive to noise.

 

Some symptoms have reduced. That is a good thing. Could be the other symptoms have been aggravated by changes in pregabalin.

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TryingToHoldOn

Just checking in.

 

How are you doing?

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DaveB

Well, here it goes. I was on Zoloft for 8 years following a year of intense anxiety after my 1st son was born. I generally felt good on Zoloft, though I would have blips in which I would up or lower my dose and I would balance back out. For the majority of the 8 years I was on 50mgs (the "lowest" dose according to my doctor). Well almost exactly a year ago I was doing so well, and figured since I was on the "lowest" dose I would simply stop taking it. Felt a little weird (light-headed, tearing up for no reason, spacey) for about 3 weeks, then I felt normal. Had a great holiday season with my family and so happy to be off meds and doing well. I started to feel a little bit of an anxiety blip at the end of February and figured I would be proactive and resume my 50 mgs of Zoloft for the rest of the winter, then get off again in the spring or summer...then disaster struck. I woke up the next morning with my mind racing, feeling like adrenal glands had been switched to overdrive, and 10 months later, I still haven't been able to turn them down. From the 1st night of taking the Zoloft I have not had a day without a huge wave on anxiety hitting me at some point. For most of these 10 months I have been waking at 4-5 AM with anxiety bordering or exceeding panic. Since I was prescribed the Zyprexa, I still wake feeling "keyed up" but it is not as bad and not as early (usually don't wake til 7 or 7:30AM). 

 

I was on the Zoloft for 6 weeks, being told that it can increase anxiety at the start, but then it will subside and I will go back to normal. When that didn't happen at 6 weeks I was told Lexapro works faster and is better for anxiety anyway...so I started it. One week at 5mgs then 10mgs for 7 weeks. When that didn't help I decided "enough of these meds, I have never had anxiety this bad, I will just get off." Well unfortunately my month off of Lexapro was no better, still waking early, still having extreme anxiety, wondering what the heck had happened to me. I was talked into giving Paxil a try by my doctor saying "it was the least activating" of the SSRIs and it could actually help me sleep...I didn't and I really felt no different on it than the other two. After two months of Paxil and feeling no better the doctor decided I just hadn't got to a "therapeutic" dose of Paxil for my severe anxiety, so he recommended going up to 40 and then if no improvement 60 on Paxil, in the meantime he gave me Zyprexa to help sleep and morning panic. To be honest I have been better since August, I am assuming the Zyprexa is calming down my overactive nervous system, but I am far from "stable." I went to 60 MGs of Paxil and felt a little better than I did at 40 for a week or two (probably placebo) then back to how I have felt since August (which admittedly is much better than Spring and Early Summer). Since I don't think the Paxil is helping, and actually may be "activating" and counteracting the Zyprexa (I hate even typing Zyprexa, I NEVER thought I would ever take an anti-psychotic, but here I am, and unfortunately I have to admit it has helped) I want to go lower and off the Paxil. From looking over this site it seems I have attempted what you would call a "reinstatement" of Paxil, that clearly hasn't worked. Seems I have four choices and would welcome and recommendations you could give. 

 

1. Stay at 50mgs of Paxil with the 2.5mgs of Zyprexa hoping I will "stabilize" even though I haven't yet in my two months at both 40mgs and 60mgs of Paxil.

2. Realize the Paxil has never helped me and could in fact be "activating" and further hurting my chances to let my brain heal from my Zoloft CT and simply quit.

3. Go back up to 60mgs of Paxil and stay there until I "stabilize" even though I am two-months at this dose with no sign of leveling out. 

4. Slowly wean myself off the Paxil, even though I am not stable as it is just a likely it is doing as much harm as good. 

 

I have read on this site that I shouldn't get off the Zyprexa until after dealing with the Paxil as it is a "brakes" medication and could help with whatever has happened to me this year. I really hate that I am taking Zyprexa and honestly the side-effect profile terrifies me, I have already gained about 15 lbs, but noticed this quickly and have been able to maintain my weight at 205 at 6'2", so it isn't a HUGE problem...yet. 

 

I welcome any thoughts, opinions, and insights. I have been very impressed with this site and am learning a lot about what has happened to me and what may be the best course of action moving forward. 

Edited by baroquep

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Gridley

Hello, Dave B, and welcome to SurvivingAntidepressants.org (SA),

 

You have had a great many changes in dosage and drugs in the last weeks and months, including at least one cold turkey.  This is all destabilizing to the central nervous system and causing the withdrawal symptoms you have experienced.  SA recommends tapering no more than 10% per month with a 3-4 week hold after that taper to allow your brain to stabilize.  I have attached two links below that will explain further.

 

Please add to your signature the cold turkey of Lexapro.

   

Because you have made so many changes, my recommendation would be to make no more changes at all at this point and see if you can stabilize on your current doses of Zyprexa and Paxil.  It can take longer than two months to stabilize.  After you have stabilized (which means not an absence of withdrawal symptom but rather that they are tolerable), it will be tie to begin thinking about tapering--but not before. Please let your system stabilize on your current dosages before contemplating any more changes.  I recognize the desire to do something, but holding is doing something--it allowing your CNS to stabilize.

 

To get  familiarized with the protocols followed by SA, I am linking a couple of topics so that you have a better understanding of what is recommended here and the steps that you can take to minimize your withdrawal.  

 

What is Withdrawal Syndrome?

Why taper by 10% of my dosage?

 

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DaveB

Ok, should I hold at 50mgs of Paxil, or go back to 60mgs? I have actually found the morning anxiety to be slightly less on 50mgs, but still having multiple anxiety bouts during the day. Do I just hold indefinitely even if I don't feel my anxiety is improving?

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ChessieCat

Hi Dave and welcome to SA from me too.

 

Thank you for completing a drug signature.  It is nice and clearly laid out.  It would be helpful if you could add dates where ever possible, at least for when you have been taking Paxil.  For earlier this year just adding in early, mid or late month will be enough if you don't know the dates.

 

Tips for tapering off Paxil (paroxetine)

 

Because you have made so many changes during this year both in drugs and doses, it is difficult to know what is causing your current symptoms.  It could be withdrawal from either or both the 2 previous drugs or side effects of the current drug or a combination of all of these.  The brain likes stability and any changes in drug and dose has a cumulative effect.  I think it would be better to stay at your current dose and give your brain the time it needs to stabilise.  These drugs are strong and going back up to 60mg from 50mgs is a very big jump.

 

Keep it Simple, Slow and Stable


Keep Notes on Paper

Rate Symptoms Daily to Check Patterns and Progress

 

Dr Joseph Glenmullen's WD Symptoms Checklist

 

It's important to learn and use Non-drug techniques to cope.  What can happen when we experience things like anxiety is that we become scared of the feelings in our body, because we don't understand what is happening, and this can then add more feelings in our body.  Claire Weekes calls it the second fear, or fear of the fear.

 

Audio:  First Aid for Panic (4 minutes)
 

 

Some people find Magnesium helps to reduce their anxiety.  I found that it does for me and when I have stopped taking magnesium my anxiety returns and when I go back on it takes the edge off the anxiety.

 

These helped me to understand SA's recommendations:

 

Brain Remodelling


Video:  Healing From Antidepressants - Patterns of Recovery

 

This is your own Intro topic where you can ask questions and journal your progress.

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DaveB

Thank you for your advice, you guys are awesome and this is the 1st place where I have found anything that makes any sense of what has happened to me. 4th day of 50mgs of Paxil...from reading the stuff you guys posted, it seems my jump was quite large from 60-50mgs. I didn't know any better and I only have access to 20s and 10s. Am I going to get slammed by a wave because of this? I am actually sleeping a little later and better since the switch to 50, is that probably not going to continue? Anxiety in the day is pretty much the same. I am asking questions that probably don't have answers haha, I guess just wondering based on the majority of people what I should expect. 

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DaveB

Yesterday, and a pretty typical day.

 

7:30 AM - Wake up, slept a little later as I have on 50mgs, feeling a little less "keyed up" with anxiety than usual in the mornings (which is usually the worst time of day).

9:00 AM - Take Garden of Life Men's Multivitamin, Sports Research Omega 3 Fish Oil (2074 total Omega 3s), 250 mgs Naturemade Magnesium Citrate, 2000IU Nature Made Vitamin D

10:00 AM - Noon - Feeling pretty good, borderline "normal"

Noon - 4PM - Pretty strong off and on waves of anxiety.

4PM - 9PM - Anxiety still present but receding.

9PM - 11PM - Feeling pretty good, borderline "normal"

11PM - 50mgs Paxil, 2.5mgs Zyprexa.

11:30PM - Bed

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Gridley

Hi, DaveB,

 

Anxiety is a very common symptom of withdrawal.  Check out the links in ChessieCat's earlier post on handling anxiety.  Dr. Claire Weekes' techniques have been helpful to me.

 

It's impossible tp predict when a wave will hit or why.  If you find yourself in a wave, these links are helpful:

 

Non-drug techniques to cope with emotional symptoms

Acceptance and Mindfulness

 

You may also want to try supplementing Magnesium and/or Omega 3 which seem to be helpful in relaxing and healing the central nervous system. You can read more about these supplements below.  I have found the Magnesium Glycinate form of Magnesium to help with anxiety.

 

Magnesium

Omega-3 Fish Oil

 

Best,

Gridley

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DaveB

I see people posting about their benzos and “rebound anxiety.” Due to this they are advised to take benzos 2-3 times per day. Could I be experiencing something similar with Zyprexa where I should be dosing it 2-3 times a day, or does Zyprexa not really work that way?

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Gridley

DaveB,

 

Olanzapine has a fairly long half-life; in people who are not elderly, it ranges from 32-37 hours (longer for those over 65)  -- from http://www.medicines.org.uk/emc/medicine/61.  By contrast, Benzos that are dosed 2-3 times a day, have a much shorter half life, e.g. Ativan 12 hours, Xanax 11.2 hours.  As we advised previously, I would hold steady, make no changes, and let your CNS settle down.

 

 

 

 

 

 

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DaveB
On 11/20/2017 at 6:53 AM, Gridley said:

DaveB,

 

Olanzapine has a fairly long half-life; in people who are not elderly, it ranges from 32-37 hours (longer for those over 65)  -- from http://www.medicines.org.uk/emc/medicine/61.  By contrast, Benzos that are dosed 2-3 times a day, have a much shorter half life, e.g. Ativan 12 hours, Xanax 11.2 hours.  As we advised previously, I would hold steady, make no changes, and let your CNS settle down.

 

 

 

 

 

 

Sounds good, can it really take longer than the 2 months I have given at these doses to stabilize? Given enough time does everyone stabilize or is there a point at which you conclude it is not going to happen? Are there early signs of stabilization I can look for and hold onto during the waves?

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