wynninio: Paxil advice

[wynninio]

Hello everyone,

 

Glad to find this forum as I have been lost without advice and the GP is clueless. I am also a health care professional myself. So I was started on Seroxat/Paxil in 2001( 20mg ) and have been on it for over 16 years. Altering doses but hovered around 10mg on the liquid form for majority.

 

I then decided this year to taper and went too fast. I went from 10mg to 2mg in around 4 months. I then kind of crashed only a few weeks ago. I then upped my dose to 8mg and have been on that dose for 5 weeks. I still feel crap and all the initial ssri side effects of when I originally started. Horrific. 

 

My question is how long do I wait at 8mg to feel better or at least balance? My plan is to wait until week 8 and if no improvement up my dose to 12mg but its taking me in the wrong direction. I want to come off this drug.

 

Any help or advice would be greatly appreciated?? 

Edited September 27, 2017 by baroquep

[Altostrata]

Welcome, wynninio.

 

How has your symptom pattern changed since you increased to 8mg Paxll? What are the "initial ssri side effects" you feel? When do they occur relative to when you take Paxil each day?

[wynninio]

Thanks for your reply.

 

The symptoms seemed to increase to intense anxiety, nausea, sleep disruption, lack of appetite, no motivation, unable to work after upping the dose.  Since then the symptoms have calmed down but i'm still left with good and bad days, nausea, sleep disruption, no appetite and mild anxiety and thought it would have balanced by now after 5 weeks. I was wondering wether upping my dose would be effective to get me more functional again and then taper or do I sit it out?

 

The symptoms initially were straight away after taking the meds but I'm now seeming to feel better after taking the meds at night but feel rough early morning and mornings are a real struggle. What do you think? 

[Altostrata]

If those are familiar Paxil side effects to you from your pre-withdrawal days, it could be that 8mg is too much for you.

 

Or are the Paxil start-up symptoms and your withdrawal symptoms the same? It sounds like things changed when you reinstated.

 

Going on and off drugs can make your nervous system hypersensitive to drugs, supplements, even some foods. A dosage that you were used to before might cause new upsets.

 

If I were you, I might try 7mg. Keep daily notes on paper of your symptoms, when you take your drugs, and their dosages.

 

If you feel a bit better, you'll know that you're going in the right direction.

[wynninio]

Hi, Thanks for your advice. The symptoms definitely got worse when I went to 8mg. The withdrawl symptoms were not as bad as these. I only know from google that I appear to be having all the classic side effects of starting a ssri. 

I think you may be right as hypersensitivity maybe the culprit here. So you think increasing my dose would make things worse? I just assumed that an increase in dose would help stabilise me quicker and then I can taper when  ready? 

 

People have mentioned that because the drug is already in my system that upping dose would have minimal side effects but not sure thats the case?

 

thanks again 😊

[baroquep]

Hi Wynninio, When a person has become hypersensitive to these drugs, more is definitely not better.  Even in small doses, these drugs are very powerful.  As Alto mentioned, you might want to reduce your dose from 8mg to 7mg and see if that alleviates the increased symptoms.  It takes approximately four days for your body to register the change in dose, so please make sure that you keep daily notes on paper of your symptoms, when you take your drugs, and their dosages and let us know how you are doing.  Also see the attached link and pay particular attention to the text I've copied from the link below.

 

About Reinstating and Stabilizing to Reduce Withdrawal Symptoms

 

Additional reasons to reinstate only a partial dose
Reinstating at a low dose reduces the risk of severe adverse reactions in case reinstatement does not work.

• Experiencing withdrawal may have sensitized you to drugs and a larger dose will cause an adverse reaction.
• These drugs are vastly more powerful than they need to be; often reinstatement at half dosage AT MOST is sufficient and many people do well with a lot less. You want to be taking only the lowest EFFECTIVE dose. 
• Your receptors may have adjusted somewhat (upregulated) during the time you were tapering or had withdrawal symptoms.
• If you can stabilize on a lower dose, you have less to taper when you finally do go off.
• If you had adverse reactions while you were taking the drug, a low dose may not trigger the adverse reactions but still reduce withdrawal symptoms. Adverse reactions tend to be dosage-related: The higher the dose, the worse the reaction.

 

 

Edited September 29, 2017 by baroquep

[wynninio]

Hi,

 

Thanks for the information. Very interesting. I can feel my body trying to rebslance itself and obviously when you are in the worst of it you just want a quicker route. I will see what the next couple of weeks bring and let you know.

 

Thank you for the support. 

[baroquep]

Slow and steady wins the race ... 

 

Keep it Simple, Slow and Stable

Stabilising After a Reduction - What Does That Mean?

[wynninio]

Thanks all. So the lesson here is to wait and lower my dose if anything and not increase?? It's great information as I wrongly thought that upping my dose would stabilise me quicker and alleviate symptoms but after reading the forum posts it appears updosing should be a last resort. 

 

Any other advice or links is greatly appreciated. 😊

[wynninio]

Hi everyone,

 

Has anyone had adverse reactions when changing the time of day when they take their medication? I changed from the evening to the morning for three days and this seemed to send me in to a few days of the old strong reactions I had initially. I crashed 8 weeks ago  when down to 1ml paxil and have been rebuilding since then. I stupidly upped my dose to 8mg initially as I had not found this form or advice. Lesson learned. 

 

So in short has anyone had reactions when changing their time of day when taking their meds or is this just because Im in a period of recent recovery?

 

Any advice appreciated. 

[ChessieCat]

When changing dose time it is best to move it forward/back by 1 hour each day so that it is less of a shock to your CNS.

[wynninio]

Oh wow, I have totally under estimated the impact. I probably shifted 12/13 hours. what an idiot. Oh well lesson learned.

 

Thank you for the information it's much appreciated. 

[megb]

Wynninio, I am also on Paxil and tapering off. Are you still on 8mg? Did you ever drop to 7 to see how your body reacts? And just as you, I learned the hard way that every small change can impact our systems. 

 

Meg

[wynninio]

1 hour ago, megb said:

Wynninio, I am also on Paxil and tapering off. Are you still on 8mg? Did you ever drop to 7 to see how your body reacts? And just as you, I learned the hard way that every small change can impact our systems. 

 

Meg

 

Hi Meg, I stayed on 8mg just to give my system a rest and not adjust too much. The adverse symptoms are slowly dying down so it makes sense to stay put for a while and then review. How are you getting on? 

[baroquep]

On 2017-09-30 at 1:59 PM, wynninio said:

So the lesson here is to wait and lower my dose if anything and not increase??

 

Hi there, this was one of the lessons I learned fairly early on after running into trouble a couple of times.  Long holds are our friend and to make as few changes as possible.  For me, I would rather suffer through a bit of discomfort and do a longer hold rather than up-dose.  To me, up-dosing, would mean that my CNS has to make an additional adjustment to accommodate the up-dose.  For me anyway, you may find that something else works for you, but in my situation, I feel it's best to "stress" the CNS only once with a change (at the time of decrease) and to only up-dose when it's an absolute necessity.  

[megb]

That is a wise decision to stabilize before making any other changes, well done you! I'm getting on well at the moment, which is a huge blessing. This is my 3rd taper and most successful so far. I've gone from 20 to 10mg in almost two years. In my calculations I will be done in another 7 years. I plan to hold my current dose for 6 months total. 

 

Luckily, I am sleeping great and have a wonderful support system Keep trucking along!! Time and patience is key (not easy though!)

 

Meg

[wynninio]

Hi Meg,

 

Yes I managed to get down to 2.5mg and was fairly stable. I went at a quick pace too and was still ok and I have been on 16 years. So there is definitely hope. This is my first withdrawal episode experienced and as such I have taken time out of work. I work as a critical care paramedic so stress is part of the job  . Do whatever you are comfortable with. I am still healing and getting better but have learned so much from this forum. 

 

I have realised the importance of patience and stability. Maybe its the metaphor for life   

 

Keep on truckin. 

[MollyN]

Hi wynninio, my goodness, you're doing a great job maintaining your dose and not making any further changes - you're dead right, stabilising is your best taper friend right now. Plenty of us read about stabilising, but then kind of fail when it comes to putting it into practice, especially when we're in distress and desperate for relief.

 

Are you still on a break from work? Love your attitude to self-care!!! xxxmollyn

 

 

 

 

[wynninio]

21 minutes ago, MollyN said:

Hi wynninio, my goodness, you're doing a great job maintaining your dose and not making any further changes - you're dead right, stabilising is your best taper friend right now. Plenty of us read about stabilising, but then kind of fail when it comes to putting it into practice, especially when we're in distress and desperate for relief.

 

Are you still on a break from work? Love your attitude to self-care!!! xxxmollyn

 

 

 

 

 

Hi Molly,  oh Auckland I stayed in Ponsonby for a few months in 2001  I also travelled around NZ. I love NZ. Yeh my ego got in the way and I was pushing to just get off the drug. This has been 9 weeks of hell all because I did not have the knowledge. I went from 2mg to 8mg and suffered adverse effects due to the hypersensitivity. I am still not right and taking my time to heal but it has been tough. I have only had 5 weeks from work so far and i get full pay for six months so I am putting my self first for a change  . I so want to be off this drug but I have learnt that slow and steady wins the race. Did you often find relief by lowering your dose rather than upping?

[MollyN]

Paxil is such a nightmare, honestly, I was astounded by how powerful it was. 2, 4, 8mg: those seemed such small figures, alas no. I'm delighted to hear you have 6mths break up your sleeve - that's wonderful (and hard won I'm sure over your years of service).

 

If you feel like you might be stabilising on the 8mg now, then perhaps stay on it for the 4 weeks as per the suggested taper. Otherwise, there is the option to drop to 7.5mg perhaps, then hold there. Really you'll be guided by how you feel, and don't forget the windows and waves of recovery we experience, so if you find yourself feeling quite good, followed by a period of feeling horrible, that's quite normal (although not much fun!). Here's a discussion of this experience if you'd like to learn more. The Windows and Waves Pattern of Stabilization

 

 

Personally, I took big cuts in the drug in the early days - 15 to 10mg was horrendous - I don't need to describe it to you! When I dropped from 10 to 5mg, it was appalling. Alto suggested updosing to 6ml - just that one little milligram made the world of difference and within hours I was back to paxil normal. When I tapered at 10% of the last dose I did really really well, barely noticed a thing.

 

So glad you enjoyed it here, travel is such a blast! Ponsonby is where the cool cats hang, I'm in the less salubrious, but much quieter west of the city  You're welcome anytime! xxxmollyn

[wynninio]

Hello All,

 

I'm very grateful for this forum and advice. A quick question. I started withdrawing from 2mg paxil in August and had not found this forum then so felt so bad that I upped my dose to 8mg. I am now close to 10 weeks at 8mg and it has been a rough ride. Early weeks were unbearable anxiety, sleep loss, weight loss etc. I am now feeling marginally better but still stuck with low mood, waves and windows type emotions along with when will this end type scenarios.

 

Do I up dose to 9mg to see if that helps?

Do I down dose to 7mg to see if that helps?

Do I ride it out and hope it passes?

 

Any help would be greatly appreciated as at times I feel lost.

 

Regards, 

 

[MollyN]

Hi wynninio,

 

I've just merged the new thread you started into your original one, it's easier if we keep it to one journal per person so any questions, advice, details are in the one place, hope you don't mind.

 

It sounds like you're not feeling great, sadly that's to be expected when we withdraw from paxil quickly - it's one heck of a drug. I'm glad that you have experienced some let up in those initial strong symptoms and that you've got an understanding of the windows and waves pattern. You will heal, but it does take time and careful tapering from here on in.

 

You mention having held nearly 10 weeks at 8mg, you may consider starting your reduction taper of 10% of that dose, or alternatively you could consider that you are stabilising after a period of change and that to give your brain time to adjust properly, this might be a time to stay where you are, especially considering you are finding those acute symptoms are lessening. I do know it's hard and we all want to feel better sooner rather than later, but honestly, the slower you can manage to do all this, the more successful your taper will be. 

 

During this time of stabilisation and tapering, it's a great time to develop and enhance your self-care toolkit. I found the stuff that worked to reduce my anger/fear/anxiety (for me: qi gong, EFT tapping, simple yoga poses) by trial and error and desperation! I'll add some links below to discussions on here around what different people found useful, it's so individual. I guess it's about trying things when you are feeling distressed or low that get you through the day. 

 

Non-drug techniques to cope with emotional symptoms

Magnesium

Omega-3 fish oil

 

Here's also a discussion on Emotional Spirals that might be helpful. Looking forward to hearing your thoughts.

 

Big hugs xxxmollyn

 

[wynninio]

Hi Molly,

 

No problem at all. Thanks for the advice   Yeh I feel it's the frustration of time frames that is my biggest concern so you start looking at quick fixes and maybe its the realisation that it will just take as long as it takes. 

 

Hugs 

[MollyN]

You got it in one!! Absolutely agree with you! For me it was quick fixes that got me into this pickle with drugs in the first place: wanting to feel better, wanting not to feel upset or stressed or unable to cope.

 

I wish so much I could have been offered rest, care and many cups of tea, wrapped in a soft blanket on the couch rather than a prescription for a drug that would hold me in its grasp for years to come. Now, when I feel bad, I know it's only up to me to deal with that. So I try and use the soothing techniques I've learnt during the chaos of withdrawal. I often do them poorly, but something about the attempt seems to take the edge off enough to see the light. I do so wish you all best during this special time when you can focus on yourself and caring for yourself, since you obviously have spent a great deal of time caring for others.

 

xxxmollyn

[wynninio]

Hi Molly,

 

yeh I understand. The lesson I have learned here has been the chemical reactions in my body that I was never truly aware of. I separate the two between my true organic emotions and the med induced emotions. Lines can become a bit blurred obviously but trying to keep the two under check can help when in the midst of a storm. Thank-you for your kind words.

 

Hugs xxxx

[MollyN]

I could learn a lot from you!  I'm still rubbish at distinguishing between these two! xxx

[nz11]

Any update?

Have you stabilised on the 8mg

[wynninio]

14 hours ago, nz11 said:

Any update?

Have you stabilised on the 8mg

 

Hello mate,

 

Well what a journey. I am four months in and still struggling. Nowhere near as bad as the initial few weeks. I now seem to be trapped in the windows and waves which are currently at about 50/50 so one week window and one week wave. The waves are much less intense but when in a wave i suffer from nausea, low mood, lethargy and the fear (Will I always be like this) Ive taken complete time away from work. (very stressful job with bully boss and no support) and tried to show myself some compassion and TLC. I never realised how strong this drug was, totally underestimated. Thank God I learned about windows and waves on here or I would have been so scared.  How are you doing? What's your story with paxil?

 

Also in hindsight I would have stabilised at 3mg and not 8mg but I had not found this forum then. I'm looking at the six month mark, so March to see where I am at and what the next steps are. Its been really tough but time is the healer so they say.

 

Best wishes

[nz11]

Thanks for taking the time to update Wyn.

I see you are remaining positive and that's something during this rollercoaster ride.

I was a little like you long term paxil user then tapered from 20 to 5 all hell broke loose and I thought things couldn't get worse so I jumped off. 7 years later still recovering!

 

Look forward to reading the march update.

Hang in there.

nz11 

[wynninio]

So it took over six months to recover from the crash and horrendous side effects. So I start my journey again. I'm currently on 8mg paxil and have decided to try 5% reductions every four weeks. Today is day one. Wish me luck and I will keep you updated

 

I may also write a post about my theory on repressed emotions caused by the use of SSRI's and that some of the side effects are also a mixture of never actually fully expressing emotions as they are meant to be expressed. I'll save that for a rainy day.

 

Hope everyone is safe and taking it slowly. Big love. 

[Carmie]

Hi wynninio, ,

 

Yes, please keep us updated. 5% is the way to go after a big crash.

 

I’m so glad you’ve come out of the crash.

 

Take it slow and if you need to hold more than four weeks. Sometimes the tapering sneaks up on us even after four weeks. 

 

Tapering from 10mg to 2mg in about seven months or so  is really quick. I’m soooo glad you’ve come out of the crash.

 

Wishing you all the best in this slower taper xx

 

 

[Songbird]

Glad to see you have recovered.  Your taper plan looks good.  Remember you can always hold a bit longer if you need to.  I believe SSRIs repress a lot of things -  emotions and thoughts and the difficult parts of ourselves.  Then when we taper off them, these parts can bounce back and hit us quite strongly.