Clearmind: Severe and distressing paroxetine withdrawal

[Clearmind]

I started taking Paroxetine 20mg in 2012. Prescribed by my GP for what was then mild anxiety and low mood. I decided to come off of the paroxetine in Januay 2016. Had enough of being an asexual zombie. The drugs did little for me anyways.

 

Started a slow taper and got down to 10mg once weekly by September 2017. If I didn't dose for longer than a week I would get agitated and angry. 10mg was enough to make me calm for a week or so....

 

On 24th September 2017 I decided complete withdrawal would be impossible and that maybe I would be better off going back on the paroxetine full-time. I started taking 10mg daily without a doctor's supervision. Five days later I became suicidal for the first time in my life...bearing in mind before this I had always been pretty much emotionally stable. I went to A & E suffering severe agitation/depersonalisation and several other worrying symptoms such as intrusive thoughts about attacking loved ones (something which I would never do or ever think about before). I was given diazepam to get me through the next few days. I vowed never to touch SSRIs again.

 

I have not taken any paroxetine since the crisis on 29th September. The last 2 weeks have been the worst 2 weeks of my life. I went to see a psychiatrist privately - he diagnosed me with bi-polar and prescribed me Seroquel (quetiapine). I am NOT bi-polar, my brain has been destroyed by paroxetine. My daily symptoms are: psychomotor agitation, intrusive thoughts about violence, feeling empty, no emotion at all, electric shock sensations all through my body, panic, crying etc

 

I know the sensible thing would probably be to go on prozac for a while, but after almost throwing myself in front of a bus after just a few days on paroxetine, to me, it's not worth the risk. I just want to ride this out and hopefully get better. I want to be in control of my thoughts and emotions again. At the moment my thoughts and emotions are controlling me. This is not a problem I had before paroxetine. I'm just worried that I'll remain this nervous wreck forever.

 

Can anyone relate to this? Especially the intrusive thoughts, which is what worries me most.

 

Does it get better?

 

Regards,

 

Clearmind

Edited October 12, 2017 by baroquep

[ChessieCat]

Hi Clearmind and welcome to SA,

 

1 hour ago, Clearmind said:

I am NOT bi-polar

 

I am really glad that you realise that the bi-polar diagnosis is incorrect and yes it is the drug that has caused changes in your brain.  SA recommends a slow taper of 10% of the previous dose, holding for about 4 weeks, to allow your brain to adapt to not getting as much of the drug.  When you returned to taking 10mg daily, your brain had already made some adaptations and 10mg was too much.

 

What you are experiencing are withdrawal symptoms from coming off paroxetine too quickly.  The only known way of relieving withdrawal symptoms is by taking the same drug that your brain has adapted to.  This is because we have become physiologically dependent, not physically dependent like caffeine or nicotine.  Changing to a different drug can cause issues because you will probably continue to experience at least some withdrawal symptoms from the old drug and might get start up/side effects/adverse reaction to the new drug.  You will not know what is causing any issues.  It depends on your tapering what dose might help reduce the symptoms without being too much to give you a bad reaction.  Once we have more details we will be able to suggest a dose that you could try.

 

Please follow these instructions:

 

 A request: Would you summarize your history in a signature - ALL drugs, doses, dates, and discontinuations & reinstatements, in the last 12-24 months particularly?

• Please leave out symptoms and diagnoses.
• A list is easier to understand than one or multiple paragraphs. 

• Any drugs prior to 24 months ago can just be listed with start and stop years.
• Please use actual dates or approximate dates (mid-June, Late October) rather than relative time frames (last week, 3 months ago)
• Spell out months, e.g. "October" or "Oct."; 9/1/2016 can be interpreted as Jan. 9, 2016 or Sept. 1, 2016.
• Link to Account Settings – Create or Edit a signature.

 

My own situation may help you to understand how these drugs change our brain.  I attempted to reduce my Pristiq from 100mg to 50mg and suffered extreme cog fog for 3 weeks.  At the end of the 3 weeks I was unable to type.  Being a professional typist for 40+ years I knew that something was very wrong.  Thankfully I had joined SA just a few days before this happened and they had suggested that I increase my dose.  I took extra Pristiq and after about 4 hours I was able to type again and my head was clearing.  Since then I have been tapering as recommended and I am now down to 18mg.  As my dose reduced I have been feeling more like how I was before I started taking an antidepressant continuously for 25 years.

 

I will give you some links to check out. Especially read Post #1 of the reinstatement topic:

 

About reinstating and stabilizing to reduce withdrawal symptoms

Why taper by 10% of my dosage?

 

Dr Joseph Glenmullen's WD Symptoms Checklist

 

Tips for tapering off Paxil (paroxetine)

 

These really helped me to understand SA's recommendations:

 

Brain Remodelling

Video:  Healing From Antidepressants - Patterns of Recovery

 

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

[Clearmind]

8 hours ago, ChessieCat said:

What you are experiencing are withdrawal symptoms from coming off paroxetine too quickly.  The only known way of relieving withdrawal symptoms is by taking the same drug that your brain has adapted to.  This is because we have become physiologically dependent, not physically dependent like caffeine or nicotine.  Changing to a different drug can cause issues because you will probably continue to experience at least some withdrawal symptoms from the old drug and might get start up/side effects/adverse reaction to the new drug. 

 Hi ChessieCat,

 

I have included my history with Paroxetine in the signature. I have booked an appointment to see a doctor today to ask for some paroxetine. Do you think it would be safe to cut a piece off a 10mg pill and see if my symptoms ease a bit? I have read previous posts about the brain becoming sensitized during withdrawal, which probably explains what happened when I reinstated at 10mg?. I would rather not touch the stuff again but a little may be needed every few days to reduce severity of my symptoms. What is your advice?

 

Thanks,

 

Clearmind

[ChessieCat]

Thank you for completing your signature.  It is very clear and extremely helpful to be able to see exactly how you have been tapering.

 

Because your dose Jan 2017 - September 2017: 10mg every 7 - 10 days my suggestion would be to try only 1mg (one milligram) of paroxetine EVERY DAY.  These drugs are strong and a very tiny dose may be enough to reduce the withdrawal symptoms.

 

It takes about 4 days for the drug to get to a steady state in the blood and a bit longer for it to register in the brain.   If you don't have a bad reaction and your symptoms begin to improve and are tolerable you would stay on that dose for maybe 3-4 months to allow yourself to stabilise.  You will need to throw out the calendar and listen to your body.  Because of the way you tapered by skipping days, you might find that you need 5-6 months.  If you find after about a week that symptoms are not improving at all, then you may need to increase you dose by another 1mg and take 2mg instead.  It is better to start at a low dose and increase by a small amount if needed than to start with too high a dose.  Please keep notes of the symptoms which improve/worsen so that if problems arise you can post your notes here and we can assess your situation.

 

Keep Notes on Paper

Rate Symptoms Daily to Check Patterns and Progress

 

Windows and Waves Pattern of Stabilization

 

I suggest you check out these topics before seeing your doctor:

 

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

What should I expect from my doctor about withdrawal symptoms?

[ChessieCat]

Please note that I said take 1mg EVERY DAY.  Please do not skip days.  Your brain likes consistency.  Skipping Days vs Every Day Dosing Graph

 

To get your dose you can make a liquid from your tablet:

 

From Post #1 of Tips for tapering off Paxil (paroxetine):

 

Make your own liquid
You can make your own liquid with water. See How to make a liquid from tablets or capsules

[Clearmind]

3 hours ago, ChessieCat said:

Please note that I said take 1mg EVERY DAY.  Please do not skip days.  Your brain likes consistency.  Skipping Days vs Every Day Dosing Graph

 

To get your dose you can make a liquid from your tablet:

 

From Post #1 of Tips for tapering off Paxil (paroxetine):

 

Make your own liquid
You can make your own liquid with water. See How to make a liquid from tablets or capsules

 

Unfortunately my GP was unable to help with this and said I would have to see a psychiatrist for this sort of taper. This means I have no Paroxetine at the moment. Still having waves of symptoms. I have Clonazepam for when the agitation/panic becomes too intense.

 

I guess for now I'll have to ride it out a bit longer and hope things improve on their own.

[Suttisan]

Please keep us posted, I've had pretty much exactly the same experience after stopping Effexor 4 months ago. 

[ChessieCat]

9 hours ago, Clearmind said:

Unfortunately my GP was unable to help with this and said I would have to see a psychiatrist for this sort of taper.

 

Sometimes we need to be assertive, and creative in how we get a drug, for our own well being's sake.  Are you able to contact your psychiatrist and get a prescription for paroxetine immediately without seeing them?  If you aren't currently seeing a psychiatrist you could see your GP again and tell them that you think you might need to go back on the drug because you are feeling so bad.  Word it in a way that they assume you are going back on it.  The sooner reinstatement is done the more chance there is of it being successful.

 

If it were me I would not be taking the Clonazepam.  It is a benzo and is very addictive and can cause rebound anxiety as they wear off.  Adding a different drug into the mix is going to muddy the waters because if you have issues you will not know if it is withdrawal from the paroxetine or side effects or possibly a bad reaction from the Clonazepam.

[Clearmind]

15 hours ago, ChessieCat said:

 

Sometimes we need to be assertive, and creative in how we get a drug, for our own well being's sake.  Are you able to contact your psychiatrist and get a prescription for paroxetine immediately without seeing them?  If you aren't currently seeing a psychiatrist you could see your GP again and tell them that you think you might need to go back on the drug because you are feeling so bad.  Word it in a way that they assume you are going back on it.  The sooner reinstatement is done the more chance there is of it being successful.

 

If it were me I would not be taking the Clonazepam.  It is a benzo and is very addictive and can cause rebound anxiety as they wear off.  Adding a different drug into the mix is going to muddy the waters because if you have issues you will not know if it is withdrawal from the paroxetine or side effects or possibly a bad reaction from the Clonazepam.

 

22 hours ago, Suttisan said:

Please keep us posted, I've had pretty much exactly the same experience after stopping Effexor 4 months ago. 

 

Hi ChessieCat,

 

In hindsight I should have got the prescription, however as you can imagine I am absolutely terrified of putting that stuff in body again, even at a dose of 1mg. The breakdown I suffered when I reinstated was too painful and has quite frankly put me off medication for life. I have gone 15 days without the paroxetine and although I'm suffering from waves of anxiety, panic, depression, intrusive thoughts etc I think I can keep on it top of it without the need to reinstate.

 

I saw a therapist today for my OCD/intrusive thoughts, and that was very helpful. I plan on continuing with therapy to get me through this withdrawal. Hopefully won't need to touch medication ever again.

 

If I knew SSRIs were capable of reducing me to this I would never have taken them. They are so dangerous. People need to be educate about the risks.

 

Thanks for your advice and support,

 

I will keep this thread updated.

 

Regards,

 

Clearmind

[ChessieCat]

7 hours ago, Clearmind said:

I think I can keep on it top of it without the need to reinstate.

 

I need to tell you, so that you can make an informed decision, that your withdrawal symptoms might get worse and could possibly last for months or even years.  Many members who have made the decision not to reinstate when they were able to now say that if they could go back in time that they would reinstate.  The ones who arrived months later so missed the chance to reinstate are sorry that they didn't find the site sooner.  Some SA members have ended up having to quit their job, some have had to move in with a relative, some have become house bound and a few bed bound after they have gone off their drug too quickly.

 

Getting off psychiatric drugs has absolutely nothing to do with how strong you are as a person and whether you can withstand the withdrawal symptoms.  That is why I told you about my experience with not being able to type and then taking extra Pristiq and being about to type about 4 hours later.  Because I had a bench mark I knew for a fact that it was the drug.  It was almost 2 years ago when I updosed and it was late on a Sunday night and I can still remember the relief and amazement when the head fog cleared and I could type.  I had spent 3 weeks having to focus completely on every little thing I was doing.

 

If it were me I would be contacting the doctor and requesting the script.  You could say you were a bit confused and stressed at the time and that you realise that you need to go back on the drug.

 

I understand your reluctance to go back on.  We all want to get off the drug/s we are taking but unfortunately when we started the drug are brain adapted to the presence of the drug.  When we take the drug away too quickly the brain struggles to regain homoeostasis which is why we experience withdrawal symptoms.  Did you check out the Glenmullen Withdrawal Symptom Checklist to see the wide variety of symptoms?  A few days after I reduced from 100mg to 50mg Pristiq I had an upset stomach for several days which I thought was a stomach bug.  Once I joined SA I realised that in all probability it was a withdrawal symptom.  Before starting Pristiq several years ago I cold turkeyed citalopram and felt really great for a few months.  Then I got very sick for about 2 and 1/2 weeks which I thought was the flu and I lost about 8kgs during that time.  After learning about AD WD I understood that it was most likely withdrawal.

 

Learning CBT is good and can be helpful whilst getting off these drugs and for afterwards but as nz11 (who in this post made a very crazy cat welcome to me - he had previously had a cat avatar too) said to me:

 

On 28/10/2015 at 7:21 PM, nz11 said:

Personally i think when it comes to ssri withdrawal CBT is like herding cats but thats just my opinion.

[Clearmind]

20 hours ago, ChessieCat said:

 

If it were me I would be contacting the doctor and requesting the script.  You could say you were a bit confused and stressed at the time and tha

Hi ChessieCat,

 

Managed to get a prescription for 10mg Paroxetine tablets today. Cut the pill in 4 with a pill cutter and just took 2.5mg. Is that too high? Shall i dose the same amount tomorrow? Turning the pill in to is a bit confusing to me. Advice appreciated

 

Clearmind

[Clearmind]

Is it more advisable to take an 8th of a tablet from tomorrow (1.25mg) from tomorrow at the same time?

[Clearmind]

A quick update: I reinstated paroxetine for 2 days at dose of roughly 2mg but found that it made my akathisia and intrusive thoughts worse (a dangerous combination of symptoms). I decided it was probably too late for reinstatement so ditched paroxetine altogether.

 

For the last 4 nights I have been taking quetiapine xr 150mg and am slowly seeing some benefit. I believe my mood is more stable and thinking more rational. No akathisia at present. I will persevere with quetiapine because i need to be on antipsychotic/mood stabiliser, as the paroxetine situation sent me in to hypomania.

 

I am aware quetiapine withdrawal is probably worse, but will have to cross that bridge later, and not make the same mistakes when tapering.

[baroquep]

Hi Clearmind, Am a little concerned about substituting quetiapine for Prozac and have to wonder if reinstating at 2mg was just too high a dose for your central nervous system to manage, especially after you having such a bad reaction after trying to reinstate a daily dose of 10mg after alternating doses between January 2016 and September 2017.  Basically you were putting yourself into withdrawal on and off over the course of almost two years and why you have been experiencing so much difficulty discontinuing Paxil.  It is one of the more difficult antidepressants to discontinue under the best of circumstances and am not surprised by your reaction to it.   

 

I don't want to play devils advocate but have to wonder if maybe reinstating Paxil at 2mg, regardless of whether it was too high a dose, it somehow managed to level out in your central nervous system and you are only now noticing some benefit.  it takes approximately four days for a steady dose to get into the system and another couple of days for the brain to register a change and wonder if the benefit you are now experiencing was in fact from the reinstatement of Paxil rather than the anti-psychotic.  

 

what are the benefits that you are noticing?  

[Clearmind]

16 minutes ago, baroquep said:

Hi Clearmind, Am a little concerned about substituting quetiapine for Prozac and have to wonder if reinstating at 2mg was just too high a dose for your central nervous system to manage, especially after you having such a bad reaction after trying to reinstate a daily dose of 10mg after alternating doses between January 2016 and September 2017.  Basically you were putting yourself into withdrawal on and off over the course of almost two years and why you have been experiencing so much difficulty discontinuing Paxil.  It is one of the more difficult antidepressants to discontinue under the best of circumstances and am not surprised by your reaction to it.   

 

I don't want to play devils advocate but have to wonder if maybe reinstating Paxil at 2mg, regardless of whether it was too high a dose, it somehow managed to level out in your central nervous system and you are only now noticing some benefit.  it takes approximately four days for a steady dose to get into the system and another couple of days for the brain to register a change and wonder if the benefit you are now experiencing was in fact from the reinstatement of Paxil rather than the anti-psychotic.  

 

what are the benefits that you are noticing?  

Hi ChessieCat,

 

From my personal experience with Paxil, I think trying to reinstate at this point was counterproductive. Even at 2mg for 2 consecutive days i began to feel agitated and dangerous. You are right in that I put myself into a state of withdrawal on and off for almost two years. That is the problem. My brain doesn't know what to make of paroxetine anymore. If I took a small dose (eg 2mg or 1mg) for a third consecutive day I believe the agitation would have increased and become intolerable.

 

I am still in a state of paroxetine withdrawal, that is true. The quetiapine is working to basically zombify me and make the withdrawal less intense. Over the last two days I felt little agitation -  quetiapine is major tranquiliser as you know. Yesterday I had some minor waves of depression and panic and today I have had practically none. My mood today overall at 6s and 7s.

 

Using a powerful antipsychotic to stabilise the nervous system may not be the most sensible method, but if it works it works. If I feel relaxation and calm tonight after taking my quetiapine, I can only conclude that the quetiapine is helping. This is what I felt last night after dosing and it continued in to the next day (today)

 

I may be wrong and my mood me destabilise over the next few days. Only time will tell.

[baroquep]

At the end of the day, we have to trust our instincts and do what we have to do for our health and well-being.  I hope you continue to see improvements.

[Clearmind]

Just an update. I've been on Seroquel XR for 8 nights now. The paroxetine withdrawal is not as severe. I'm able to sleep easily and no longer have akathisia. Still get waves of intrusive thoughts but I'm learning to see them for what they are and am no longer terrified of them.

[Martina23]

Clearmind, I had also in my withdrawal intrusive thoughts.

[Clearmind]

5 minutes ago, Martina23 said:

Clearmind, I had also in my withdrawal intrusive thoughts.

What sort of intrusive thoughts, if you don't mind my asking?

 

Mine began as extreme health anxiety, then suicidal intrusive thoughts, then causing harm to others. It caught my by surprise. Started to question my sanity and whether I was an evil person. Violent intrusive thoughts are hands-down the worst thing I have ever had to deal with.

[Martina23]

I had also - thoughts of harming me and others. I got them after stopping Lyrica. So you are not the only one.

[Clearmind]

That's interesting because i also stopped Lyrica roughly a week before the problems began. Was on 75mg twice daily but had managed to cut down to once daily

[Martina23]

I got them three weeks after stopping Lyrica, but it was the only medicament I took at that time.

[Clearmind]

52 minutes ago, Martina23 said:

I got them three weeks after stopping Lyrica, but it was the only medicament I took at that time.

Do you feel like you'll never be able to see yourself as a good person again? That's how I feel, even though the depression is lifting. It feels like an evil side of me has been awoken which i'm going to have to live with forever.

[Martina23]

I dont know. Before I felt I was afraid that I would lose control and do someone something. And I felt a bit like a monster when these thoughts came but now there are only a fleeting annoyance for me (it is almost three years after my cold turkey), I don t feel like a monster anymore, but I would wish they are away altogether.

[Clearmind]

On 27/10/2017 at 8:17 AM, Martina23 said:

I dont know. Before I felt I was afraid that I would lose control and do someone something. And I felt a bit like a monster when these thoughts came but now there are only a fleeting annoyance for me (it is almost three years after my cold turkey), I don t feel like a monster anymore, but I would wish they are away altogether.

How long did it take for you to stop worrying that you would actually harm someone?

[Clearmind]

Doing better than I was when I first found you guys but still facing challenges. Had to cut the Seroquel XR down to 150mg a night due to heart palpitations. Have not touched paroxetine for 3 weeks now. If I could go back in time I would have tapered slow and steady but it's too late for that. Psychiatric meds have fried my brain...at times I feel like I have dementia at 28. Hope everyone is well, or at least slightly better.

[Clearmind]

In the last 4 days I have had barely any symptoms. No dark depressive moods and barely any intrusive thoughts. Not sure whether my brain is healing or whether it's down to the new medication filling the void. Either way I pray this lasts. Life is beginning to become bearable again.

[ChessieCat]

Just remember not to panic if any symptoms return.  Some members have panicked and updosed because they felt they had to do something.

 

Keep notes on paper so that you can see improvement which you may not feel.

 

Please update your signature:  Account Settings – Create or Edit a signature

[Clearmind]

On 11/11/2017 at 1:34 AM, ChessieCat said:

Just remember not to panic if any symptoms return.  Some members have panicked and updosed because they felt they had to do something.

 

These past two days I have experienced intense rage similar to what I have experienced before in withdrawal. The anger is irrational, I know that. But it's hard to shake off.....

[baroquep]

Hi Clearmind, I too find that I sometimes deal with completely irrational emotions and know how difficult they can be to manage ... hoping you find something helpful in one of the links below.

 

Neuro Emotions
Irritability, Anger, Rage

Non-drug techniques to cope with emotional symptoms

[Clearmind]

On 25/11/2017 at 12:50 AM, baroquep said:

Hi Clearmind, I too find that I sometimes deal with completely irrational emotions and know how difficult they can be to manage ... hoping you find something helpful in one of the links below.

 

Neuro Emotions
Irritability, Anger, Rage

Non-drug techniques to cope with emotional symptoms

Thanks for the links.

[Clearmind]

Just an update for anyone who is interested....

 

I have completely stopped taking paroxetine at the beginning of October and have been on 150mg Quetiapine since October 14th. Still get intrusive thoughts about losing control and harming loved ones. They are not as bad now but I am still bothered by them. I also suffer from depressive states everyday..these states usually last less than an hour.

 

I'm not even sure if the quetiapine is making me feel better or worse. It's hard to see it sometimes but I am definitely in a better place than I was when I signed up to this site. Hope you guys are seeing improvements too.

[Martina23]

On 28.10.2017 at 3:50 PM, Clearmind said:

How long did it take for you to stop worrying that you would actually harm someone?

That is a good question. After 1 year off the thoughts started to be less intensive, somewhere in the background. But even now I have it sometimes that I worry to do someone something, but it comes mostly if I take something what my body doesnt like, for example anesthetics by the dentist, coffee or tee or too much glutamate or something which my body is sensitive on (since the withdrawal started I have hypersensitivity on every chemical and some foods)

[nz11]

On ‎10‎/‎13‎/‎2017 at 10:35 AM, Clearmind said:

I have not taken any paroxetine since the crisis on 29th September. The last 2 weeks have been the worst 2 weeks of my life. I went to see a psychiatrist privately - he diagnosed me with bi-polar and prescribed me Seroquel (quetiapine). I am NOT bi-polar, my brain has been destroyed by paroxetine.

I am so sorry these people did this.

 

 

[Clearmind]

I am a little bit better than I was all those months ago but my brain still feels very fragile and damaged. My moods don't make a lot of sense, I get very depressed sometimes. Intrusive thoughts not as bad, but do still affect me sometimes at night.

 

I'm on 150mg quetiapine daily.. I get 10 hours of sleep a night.

[Clearmind]

I'm started another antidepressant. I'm on Clomipramine now. Started at 10mg for the first 2 weeks and now I'm up to 20mg. I didn't want to take another serotonin boosting medication and tried to put it for as long as possible. The problem is I have been on Anti-depressants (mainly paroxetine) for most of my adult life. My brain has been rewired...I need meds to not feel miserable....Feeling better at the moment.