Marconius: down to 10 mg Paxil, hitting some bumps in the road

[Marconius]

Hi,

 

I've been on SSRI's now for about 20 years except for a few years in the middle.  First it was Prozac with BuSpar, and over the last 10 years Paxil with Klonopin.  I'm in search of who I am off of these meds, and I'm sick of the side-effects (mainly sexual side effects of Paxil for me).  I successfully tapered off of Klonopin over 1 year from 0.5 mg (finished that in May of '16), and I've been tapering off of Paxil for the last year and a half from 30 mg. to my current dose of 10 mg.  This is my second deliberate attempt to get off of SSRI's.  The first attempt was done very quickly in 2012 (over about a month) and it was a disastrous fall into extreme anxiety resulting in voluntary hospitalization for five nights in a locked unit.  In 2014 I was switched from Paxil to a different drug altogether (Lamictal), and that was also a terrible event because the doctor had me go off of the Paxil too quickly, resulting in a quick descent into anxiety, then the worst soul-crushing depression I've ever experienced.  I was out of work for 5 weeks.  I'm happy to share more details later, but for now I'll focus on the here and now.

 

So back to the current withdrawal attempt.  I was down to 10 mg of Paxil in November, 2017, and I told my psychiatrist that I wanted to continue the slow taper.  He prescribed liquid Paxil at the equivalent of 9 mg for 2 weeks, then 8 mg, but when I went to pick it up I was told it would be over $150.  Yikes!  The pharmacist recommended I look into having it compounded elsewhere to save money.  After searching for a compounding facility, calling my doc and writing him a letter, I finally got the prescription for a compounded version of Paroxetine for $70 / month, plus $5 shipping.  A couple weeks later it arrived, and I was very happy to continue my slow, controlled taper.  That was around Dec. 22, 2017.

 

That's when things went wrong.

 

After a couple days I started feeling a bit cantankerous, fidgety, and my appetite increased.  I had just re-started working out, and this adrenaline rush fueled my anger and appetite.  You know that feeling when you've run out of fuel and you've got that hungry, angry feeling inside?  I was feeling like this almost all the time.  About five days after starting the compounded Paxil I had an incident at work where I lost my temper.  I apologized and things smoothed over, but I'm pretty convinced that something wasn't right with the compounded medication.  Maybe it was measured wrong; maybe the bitter cold affected it in shipping.  I don't know, but I strongly doubt it was 9 mg. Paxil.  So I went back to the 10 mg., and that's when I've been on for the last 5 nights.  But my mind and body are both very much off-kilter.  My anxiety's increased and the insatiable hunger continues.  I have a high-metabolism which is even higher under this stress, so I can't seem to satiate my appetite.  I'm hoping that after a few more days things will even out, and I plan on staying at 10 mg. for at least a couple weeks before I start a taper again.  I've since picked up the prescription for the liquid Paxil; I decided that when I continue the taper, I want to make sure I'm very confident of the accuracy of the medication.  I don't trust the compounded version now.

 

Thanks for reading.  Any encouragement would be much appreciated as I re-stabilize.

Edited May 20, 2022 by Shep
updated title with new username

[Olympia]

Hello Marconius,

What a shame they messed up your compounded Paxil! I hope you will feel better soon. 

Edited May 20, 2022 by Shep
updated with new username.

[Marconius]

On 1/4/2018 at 5:35 AM, Olympia said:

Hello Marconius,

What a shame they messed up your compounded Paxil! I hope you will feel better soon. 

Thanks Olyimpia, I appreciate it.  I am doing better now.  It's been about 8 days back on the 10 mg, and I'm less anxious and irritable; the rage has dissipated, as has my insatiable appetite.  These were all classic Paxil discontinuation syndrome symptoms for me, so I'm fairly sure the compounded medication was less than 9 mg.  I'm going to hang at 10 mg for a while before resuming a taper with the liquid Paxil.  I'm gearing up for some changes in my life involving both work and possibly living situation, so it's probably not the greatest idea to taper during this time.  But I plan on taking a year or so to taper off the last 10 mg, and I don't want to wait too long to do that.  So I'm a bit torn, but for now, I stay at 10.

Edited May 20, 2022 by Shep
updated with member's new username

[manymoretodays]

Hi Marconius,

 

Welcome to survivingantidepressants.  This page now acts as your journal/introduction........a place for you to ask questions, as well as record your tapering, symptoms, progress, etc.

 

Could you do a signature for us please:  http://survivingantidepressants.org/topic/12364-please-put-your-withdrawal-history-in-your-signature/

Go to your user name at the top right of the screen and down to Account settings to signature.

 

Include the last 12-24 months

Leave out diagnoses

Date each entry with the name of the month, day, and year.

 

This will be helpful to us and give us easy access to your history.

 

I'm wondering if you started your new preparation of Paxil with a 10% decrease?  Rather than starting it at the usual 10mg. dose?  Sometimes changes in formulation, can cause a difference as well.  I don't think that's the case with a compounded medication though.  Possibly?   I'm just wondering if you started it at 10mg. and stayed there, BEFORE decreasing 10%, would that have made a difference?

 

And you are going to go back to a liquid Paxil now?  What form of Paxil were you on before the liquid, and then compounded?

 

Or you may be right, that "it was a classic case of Paxil withdrawal" for you.  You may want to decrease at less than 10% next time.  Many do that without as pronounced withdrawal symptoms.  So that's something to consider.

 

Some other things you might find useful are:

 

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

 

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

 

Please don't hesitate to go to our Symptoms and Self Care section as well.  On the Home page.  Under Forums.  Especially take a look at some of the "pinned topics" at the top, that may be helpful in dealing with your current withdrawal symptoms.

 

And don't hesitate to ask questions or comment on other threads as well.

 

Love, peace, healing/in recovery, and growth,

 

manymoretodays

 

Edited May 20, 2022 by Shep
updated with member's new username

[Marconius]

Rough couple days.  Feel down, and I'm trying to reason my way out of it, but it's not working so well.  Feel a bit overwhelmed with life; anxious, out of sorts.  I've been on the 9 mg Paxil now for about 10 days (?).  Is it really possible that decreasing by just 1 mg could give me discontinuation symptoms?

[AliG]

Would you mind filling in your drug history?  It appears below each of your posts  : then we can see your situation at a glance.

 

Please put your withdrawal history in your signature

 

When we have a little more information, we will be in a better place to help.

 

Welcome to SA,

Ali

[Marconius]

I'm back after months away, and I finally filled out my drug history.  Thanks for the posts back in January.  I'm doing alright.  Down to 1.5 mL Paxil liquid (3 mg Paxil).

I've been meeting with a talk therapist for the last couple months which has been a good support for me.

Truth is I'm struggling emotionally this month.  I'm in sales, and this month has been slow, and I don't think the pollen is helping.  From what I understand that increases cytokines which increases inflammation.

I'm going to stay at this level of Paxil for the coming weeks / month or two if necessary before making the next small taper.

[Petunia]

Hi Marconius,

 

Welcome back, its good you have decided to hold, slowing down when there are increased symptoms is what we recommend. Whether the wave of increased symptoms is caused by external stress, or tapering too fast, its what we usually suggest. Also, some people find they need to slow down their taper as the dose gets lower, see: 

 

Why taper? Paper demonstrates importance of gradual change in plasma concentration

 

Micro-taper instead of 10% or 5% decreases
Decreasing your dosage by very tiny amounts more often might be more tolerable than 5% or 10% decreases. Know your symptom pattern first so you can estimate how often you can reduce.

 

The Brassmonkey Slide Method of Micro-tapering 

One way you can micro-taper.

 

I'm glad you have a helpful therapist, emotional support while going through difficulties is so important.

 

Unfortunately, your signature is still not showing up, please would you try again. Here are instructions: Please put your withdrawal history in your signature

 

 

Edited May 20, 2022 by Shep
updated with member's new username

[Marconius]

Thank you Petunia.  I'm in no rush.  Continuing this journey slowly.  My signature should show up now.

[Marconius]

I've went down to 2.5 mg Paxil on July 1, and will go down to 2 mg in the next week or so.  Doing alright for the most part.  I plan on finishing my taper over the next 5-6 months.  There are some rough days for sure, but I expect that and try and keep my focus narrow when I get overwhelmed.

[ChessieCat]

On 6/20/2018 at 8:11 AM, Marconius said:

I'm in no rush.  Continuing this journey slowly.

 

Why taper by 10% of my dosage?

 

Your last reduction from 3mg to 2.5mg was more than a 10% drop (17% actually).  3mg x 0.9 = 2.7mg.  You might want to consider holding for longer.  A 10% taper of 2.5mg is 2.25mg.  Going from 2.5mg to 2mg would be a 20% reduction.  Many members find that the lower their dose gets the slower they need to go by reducing by less and/or holding longer.  

 

You stated that you are in no rush, so why are you planning to be finished your taper in the next 5-6 months?  It would be much better to listen to your body and taper according to it rather than following a calendar.  I think it is better to get off with minimal discomfort.  If you try to go too quickly you may end up having to updose and/or hold for longer and this can result in your taper being longer than if you follow the 10% four weekly taper recommendation.

 

 

Edited May 20, 2022 by Shep
updated with member's new username

[Marconius]

ChessieCat,

 

Thank you for your feedback... I appreciate it!    The 5-6 month plan is just a sketch, not set in stone.  I've paused in my taper as needed in response to how I feel.  I'm happy to have gone from 30 mg to 2.5 over almost 2 years, and I'm looking forward to being ssri-free.  I'll re-read the justification for a 10% or less taper when at such a low dose.  It does seem counter-intuitive that at such a low dose the body would be more sensitive to small reductions, but how I feel will ultimately guide me.

[Carmie]

Hi Marconius, 

 

How are you doing?💚

Edited May 20, 2022 by Shep
updated with member's new username

[Marconius]

Hi Carmie,

 

Thanks for asking, and sorry for the delayed response.

I made it down to 1.6 mg by Dec. 1, '18.  My psychiatrist suggested that it's such a small dose that I could stop taking it, but we agreed to a more accelerated taper, which proved to be a mistake.  By Jan. 1, '19 I was down to 0.6 mg and things quickly unraveled.  My anxiety grew, mixed in with depression.  It became very difficult to function, and I took some time off of work.  I tried increasing the dose a little, but I couldn't get stabilized.  I then tried a different approach - Ketamine treatments at a clinic.  It was quite a bizarre experience, and although it seemed to work at first, it didn't have any lasting effects.

After two weeks missing work, I went to my psychiatrist and went back up to 10 mg Paxil, and he prescribed Klonopin to use as needed.  The original plan was to quickly go back up to 30 mg, but I didn't want all my tapering efforts after 2 1/2 years to be in vain, so I called back the doc and told him I wanted to try staying at 10 mg, and I've been on that dose now for about 6 weeks.  Doing a lot better than I was.  I missed a total of 3 weeks of work, and I've been back now for more than a month.  Overall I'm doing well, although I have my rough days, especially on days off when I don't have as much structure.

I'm not in a rush to try tapering again... I just want stability, and the 10 mg Paxil is low enough a dose that I don't seem to have much in the way of side effects.

[Carmie]

Hi Marconius, 

 

I’m glad you’re slowly feeling stable again, and yay that you didn’t go to 30mg of Paxil. That would take so much longer to get off, and it may have even made your symptoms worse. 

 

Please be careful with the Klonopin as your brain can become addicted to that really quickly. Are you taking any? If so, how much?

 

Yes, please wait until you stabilise before you even decide to taper. Taper really slowly, as you already know, I’m tapering by 3% at the moment. I can’t tolerate anymore than about 4% to 5% myself. If once you stabilise you are ready to taper again why not try tapering by a smaller percentage than you were doing before, at least going really slowly off these meds is better than staying on them. I’m always happy with any forward movement, no matter how small. 

 

There is no no such thing as a small dose when it comes to these powerful mind alternating drugs. The accelerated taper your psychiatrist suggested was not prudent as you now realise.  One person on here is down to 0.000something or even another zero and they are still feeling every drop. That’s the exception though, I’ll probably jump off at 0.0something or maybe a bit lower. 

 

Take care, sending hugs🤗

 

 

Edited May 20, 2022 by Shep
updated with member's new username

[Marconius]

Carmie,

 

Yes, I'm glad that I stopped at 10mg Paxil.  I feel no different than I did at 30 mg except that I don't have the side effects of 30 mg.

 

Klonopin... I take 1/2 of a 0.5 mg tablet as needed.  I was using it to help sleep for a while, but now I sleep fine without it.  I'm finding I'm using it 3-4 times a week.  I take it when my mind starts getting overwhelmed with thoughts and stimuli.  First I try deep breathing, and if that fails I'll take 1/2 tablet which helps calm me down.  I'm making an effort to minimize the use of Klonopin as much as possible.

 

I agree... slow is the way to go.  I'm in no rush, and I'm staying at 10 mg for a good while so I'm very stable.  Should I taper again, I'm all for doing something like a 3-5% at a time taper.

 

Thanks for your support, and sending you hugs back!

 

[Carmie]

Hi Merconius,

 

Glad to hear that if you start tapering the Paxil again you’ll go slow. 

 

Your brain is probably already addicted to the klonopin if you’re taking it 3 or 4 times a week. You will have to taper it slowly if you decide to come off it too. Are you getting withdrawals from it inbetween doses? 

 

Take care💚

Edited May 20, 2022 by Shep
updated with member's new username

[Marconius]

Hi everyone,

 

I've tried and failed a few times to come off of Paxil.  Each attempt has been a painful learning experience of what not to do.  In 2012 after suffering Paxil's sexual side effects and emotional blunting, I tapered off of it over about two months, which was a disaster.  I ended up in a horrible state of high anxiety and restlessness every waking hour which eventually landed me in the hospital for six nights.  I had no choice but to go back on the Paxil (30mg).  Adding BuSpar helped some with the sexual side effects.

 

In 2014, my psychiatrist diagnosed me with Bipolar 2 and had me do a quick taper off of Paxil and onto Lamictal.  She assured me that because we would be ramping up the new medication as we tapered the Paxil, all should go smoothly.  But it didn't.  I plunged into the worst depression I could have ever imagined - deeper and darker than anything I had previously experienced.  I was hanging on by a thread; the doctor added Brintillex, but that didn't help.  I switched back to Paxil and stopped taking the other meds, and I switched doctors.

 

A slow taper was the way to go, so from about mid-2016 to Jan 2019, I tapered off the Paxil at a rate of about 10% of the previous does.  When I got down to about 1mg, my psychiatrist suggested that this was a good jumping-off point because I was on such a low dose.  So I finished the rest of the taper quickly over the next few weeks.  Unfortunately, I fell into a pretty deep depression with a lot of anxiety.  I tried some unconventional treatments that didn't work, and I ultimately had to go back on the Paxil.  I went up to 10 mg which brought me back to my "normal" functioning self.  I should have listened to other users' experiences and continued tapering, even when I was at just 1mg.

 

I really want off of this drug, and I'm trying another taper yet again.  I've been tapering from mid-2019 to present (May 2022), reducing the Paxil at a rate of 10% from the previous dose about once a month.  Over the last 6 months, I reduced the rate to about 5% every 3 weeks.  As of March 22, 2022, I was down to 1.7mg.  I've been experiencing withdrawal symptoms of mild nausea, mild-moderate anxiety, mild diarrhea, increased Tinnitus, lower appetite, and slightly blurrier vision than usual.  I've decided to stop tapering and hold at 1.7mg to let my body and mind adjust.  It's been about two months at this dose, and I'm concerned because I'm feeling more anxiety than I expected, and my appetite is often low.  I've had some trouble with sleep lately as well.  I'm worried because this is how I felt in late 2018 before things turned very South in early 2019.  The difference this time is that I'm listening to my body and pausing the taper whereas in '18/'19, I kept tapering regardless.

 

I just started acupuncture, and I'm doing my best to be gentle on myself and get enough nourishment despite the nausea.  I'm still very functional (work full time and do some socializing), but I am starting to feel overwhelmed.  I hope my mind evens out soon.

 

Thanks for reading, and I look forward to being a part of this community.

 

-Marconius

[Shep]

On 5/18/2022 at 11:51 AM, Marconius said:

I just started acupuncture, and I'm doing my best to be gentle on myself and get enough nourishment despite the nausea.  I'm still very functional (work full time and do some socializing), but I am starting to feel overwhelmed.  I hope my mind evens out soon.

 

Welcome back, Marconius.

 

Did you start to feel worse after you began acupuncture or were you already feeling worse before? The reason I ask is because some people feel that acupuncture is too stimulating. Please see:

 

Acupuncture

 

Or it could just be a wave and you'll be better off holding for a few weeks and seeing if things stabilize.

 

 

[Marconius]

As a matter of fact, I did feel worse the day after acupuncture!  I thought it was a coincidence, but my anxiety became worse with an elevated heart rate (110-120 bpm) and elevated respirations for much of the day.  This discomfort, combined with my recent withdrawal anxiety and nausea over the last few weeks, pushed me to up my dose slightly this past Wednesday night as I sought relief.  I raised the Paxil from 1.71mg to 1.85mg (where I had been in February).  That night I slept better than I have for a long time, and the next morning I woke feeling rested.  No nausea, and I felt good most of the day.  Toward the end of the day, I had some tightness in my chest with increased respirations and a little anxiety, but not too bad.

 

Today I'm feeling calm and fairly balanced.  I'm hoping to continue to stabilize at 1.85mg for some time (not sure how long), then continue the slow taper.

[ChessieCat]

I can see that Shep gave you the link to the acupuncture topic.  It seems that some acupuncturists think that the person needs detox treatment.  Also, what a person tapering/in withdrawal needs is calming treatment and not stimulating.  If you decide to have acupuncture in the future I suggest that you mention this.  Please see the two posts noted below:

 

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

[Marconius]

I appreciate it, ChessieCat.  I canceled my next acupuncture treatment and had a nice conversation with the doctor.  His approach was to activate the parasympathetic nervous system to counteract the sympathetic, but apparently my system's too sensitive.  He appreciated my feedback.

[Marconius]

I had mostly a window from Wednesday through Saturday, then I was back to a wave on Sunday and today.   Heightened anxiety with tingling around my scalp, shoulders, and arms.  Elevated heart rate, low appetite, irritability, and a feeling of heaviness.  Ugh.  When in my window, I was really trying to embrace it, and I visualized looking out a large, open window at a beautiful lush, green landscape.  Last night I hardly slept a wink, and today was a real struggle, but I got to work and made a sale.  I thought about raising the Paxil up to 2mg from 1.85, but I'm going to try and ride the wave and stay where I'm at.

[Shep]

14 hours ago, Marconius said:

I thought about raising the Paxil up to 2mg from 1.85, but I'm going to try and ride the wave and stay where I'm at.

 

Holding where you're at sounds like a great idea. If you did need to updose, I wouldn't go back to 2 mg. You haven't been at 2 mg for months (from your signature, it looks like it might have been sometime in 2021).

 

When you're in windows, please be sure you're not overdoing it. A lot of us have that problem - we feel so good, we start to do things like going off restricted diets, doing too much exercise, not being as good at sleep hygiene, etc. Windows and waves are like an obstacle course.

 

Please let us know how you're doing over the coming days. Hopefully you'll get some relief from the hold and get back into a window. Congratulations on making a sale at work. It shows you can still get a lot done even while surfing the waves.

[Marconius]

Thank you @Shep.  What you said about taking it easy when in windows rings true to me.  Back in February & March when I was feeling pretty consistently good, I returned to the gym twice a week, about 2-2.5 hours each time, full body workout & cardio.  It felt good, but then I became constantly hungry and realized I wasn't eating enough for the extra calories burned.  I became too stressed out and had to take a break from working out.  I need to learn to balance things better.  I need to focus on eating well and enough and getting light to moderate exercise.

 

No sleep now for two nights in a row.  I just realized that I haven't been consistent with supplements (fish oil, magnesium, & probiotic).  Come to think of it, I haven't taken them for the last few days.  That's easy to improve, and I'll work on being consistent with that.

 

Thanks again for the advice, and I hope to report back in a few days with good news.

[Shep]

@MarconiusThanks for taking an honest assessment of what's been going on in the background. I would keep to that strict supplement schedule and what you wrote about balancing things together is spot on.

 

Yes, please do report back in a few days. I bet you'll feel a lot better once you're back on the supplements and doing more self care.

[Marconius]

@Shep I'm feeling very uneasy.  I had the day off and was anxious all day.  Low appetite continues.  Elevated heart rate; haven't slept the last two nights.  I'm not concerned about backtracking to 2mg Paxil.  It's where I was at in December, and it's only an 8% increase from where I'm at now.  I wish I were stronger, but I need to be functional for my job and for family obligations.  Thoughts?

[ChessieCat]

37 minutes ago, Marconius said:

I'm not concerned about backtracking to 2mg Paxil.  It's where I was at in December, and it's only an 8% increase from where I'm at now.

 

BEFORE updosing I suggest that you re-read what Shep wrote above.  You might find that if you wait a few weeks that things will settle down again.  It definitely sounds like you overdid things.  We have members who report that when they over-exert themselves that their symptoms increase.

 

About updosing:

 

It's been 5 or 6 months on 1.85mg Paxil.  During that time on the lower dose your brain will have made adaptations to the lower dose and taking 2mg might be too much.  The effect of changing/taking/going on and off psychiatric drugs is cumulative and you have a long history of various drugs.

 

SA urges caution when updosing and it is suggested to only make a small increase.  It is better to increase gradually by small amounts than to risk taking too much.  I have seen members on SA who have taken too high a dose and ended up making things worse.  Some have had their relationship break down, some have had to leave work, some have ended up changing to a different drug or adding a new one (which then needs to be tapered) and changing or adding does not always work.  Some have had to move in with a relative or friend.

 

It takes about 4 days for a dose to get to full level in the blood and a bit longer for it to register in the brain.  If you decide to updose you will need to be patient and try not to panic.  When we panic we can make bad decisions.

[Marconius]

Thank you, @ChessieCat.  I've been at or below 1.85mg for 3.5 months.  I hear what you and Shep are saying, and it makes sense.  I feel the pressure to keep it together so that I don't crash hard like I did in 2019; back then I kept tapering down below 1mg even though I felt like crap.  Instead I should have paused the taper and held.  I ended up going back to my psychiatrist who wanted to put me back to 30mg.  Instead I went up to 10mg, and I found level ground again.  In hindsight, I wish I had gone up to no more than 5mg.

So, I'm finding myself with quite intense anxiety and insomnia now.  I don't want a repeat crash like I did in '19 which caused me to lose three weeks of work.

I'm at 23mg pill weight (1.85mg Paxil).  Perhaps I go up to 24mg pill weight (1.92mg Paxil)?

 

I feel like a chemical puppet.

 

Thanks for the video link...watching it now.

[ChessieCat]

13 hours ago, Marconius said:

I just realized that I haven't been consistent with supplements (fish oil, magnesium, & probiotic).  Come to think of it, I haven't taken them for the last few days.

 

If it was me I'd be concentrating on the non-Paxil things first.  You might not need to make an increase.

[Shep]

9 hours ago, Marconius said:

I'm at 23mg pill weight (1.85mg Paxil).  Perhaps I go up to 24mg pill weight (1.92mg Paxil)?

 

8 hours ago, ChessieCat said:

If it was me I'd be concentrating on the non-Paxil things first.  You might not need to make an increase.

 

@MarconiusWhat CC wrote makes sense. You mentioned you had stopped fish oil, magnesium, & the probiotic over the past few days. Since you're adding those back in, that's a change. I wouldn't change your drug dose at the same time. Only one change at a time. See the first post in this thread:

 

The rule of 3KIS: Keep it simple. Keep it slow. Keep it stable.

[Marconius]

Thank you @Shep and @ChessieCat.  I took the fish oil, magnesium, probiotic, and multivitamin this a.m. and will take them consistently each day going forward.  It's a 100mg magnesium pill.  Is this too much?  I poured out half of it this a.m. thinking that 50mg might be better.  I've seen many different opinions about this.

[Shep]

15 hours ago, Marconius said:

It's a 100mg magnesium pill.  Is this too much?  I poured out half of it this a.m. thinking that 50mg might be better.  I've seen many different opinions about this.

 

Everyone is different. You'll have to gauge the amount that's right for you. Some people like to dissolve magnesium in water and sip on it throughout the day. More tips can be found here: 

 

Magnesium, nature's calcium channel blocker

 

Glad you're giving the supplements a chance before increasing the Paxil. Please let us know how you're doing over the coming days.

[Marconius]

Thank you, Shep!   Good news: I'm able to sleep again 🙂  Two night's ago I slept about half the night and last night I slept all through the night.  I appreciate sleep so much more after a bout of insomnia!!

I'm taking my supplements each day.  My anxiety was more manageable yesterday, and today I'm feeling pretty well so far.  Yesterday I switched to decaf coffee for my usual one cup of coffee a day.  I figured than an anxious brain doesn't need a stimulant.

I appreciate all of the advice and support, and I'm feeling good about holding at 1.85mg Paxil.  We'll see how the next few days go, but I think I've got this.

[Shep]

Excellent update, Marconius. 

[Marconius]

After a brief reprieve of symptoms for maybe two days, I'm struggling again.  Low appetite, low mood, tense, feeling heavy, having a hard time concentrating.  I'm almost certain I'm going to updose tonight, likely to 2mg Paxil from 1.85.  I wish I could say I'm strong enough to deal with all of these symptoms, but I don't feel I am.  I need relief, and I really hope I get it by updosing.