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teePeer1: Very confused and upset

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teePeer1

(mod note)link to teePeer1's benzo forum thread:  https://www.survivingantidepressants.org/topic/19092-how-to-taper-the-used-as-needed-benzo-or-sparing-benzo-use/

 

 

Dear all,

I gradually tapered to 10 mg of paxil from 40 and also tapered off benzo (3mg to 0) both slowly over a period of months. Long story short, I thought I was near the fonish line. However, when I taperedd to 10 mg from 15 mg paxil and stopped a doze of less than .25 benzos things got rough after two weeks. My issues are mostly related to night:severe anxiety, hyper alertness, pounding heart. It was so bad a couple of nights that I resorted to taking a small dose of lexatonil. Now I am afraid of what strategy to follow next. My experience with psychiatrists have been pretty bad during my taper and I am afraid if I go back they will put me on more meds. Should I go back to 15 mg paxil from 10 and is it safe to use half a tablet of benzo at night to brave through the night? (Though i am afraid of benzo withdrawals too) I would appreciate any suggestions on how to stabilize my situation at this stage and dosage?

Edited by manymoretodays
link to benzo topic

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Gridley

Hello, teePeer1, and welcome to SA.  I am sorry you're having these symptoms.  They are likely a combination of benzo withdrawal and the fact that you tapered from 15mg Paxil to 10mg, a drop of over 30%.

 

At Surviving Antidepressants, it is recommended that a person taper by no more than 10% of their current dose with at least a four week hold in-between decreases.  The 10% taper recommendation is a harm reduction approach to going off psychiatric drugs.  Some people may have to taper at a more conservative rate as they are sensitive to even the smallest drops.
 
To give members the best information, we ask them to summarize their medication history in a signature -- drugs, doses, dates, and discontinuations & reinstatements, in the last 12-24 months particularly.
  • 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. 
  • Please leave out symptoms and diagnoses. 
  • A list is easier to understand than one or multiple paragraphs. 
  • Link to Account Settings – Create or Edit a signature.

How long ago did you drop from 15mg to 10mg Paxil?  Often a reinstatement of 1-2 mg of the drug (on top of your 10mg) is enough to help withdrawal symptoms.  To get a small consistent

 dose you'll need to either weigh crushed tablets or make a liquid.
 
You can become dependent on benzos after two weeks' use.  Rather than go back on the benzos after you've gotten off them, you might consider Melatonin for sleep.  Start with a very small dose, 1/4-1/2mg.

 

You might also want to consider incorporating a technique or two that you can practice on a day-to-day basis to help you manage some of the more difficult withdrawal symptoms.  You can find a few ideas at the links below:

 

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 and you can read more about these supplements below:
Start them one at a time at a low dose.
 
This is your introduction topic -- the place for you to ask questions, record symptoms, share your progress, and connect with other members of the SA community. I hope you'll find the information in the SA forums helpful for your situation. I'm sorry that you are in the position that you need the information, but I am glad that you found us.
 
 

 

 

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teePeer1

Dear All, 

In 2017, I had a terrible reaction to a c/t from Prozac. I was on it intermittently for 2+ years but discontinuation left me with a terrible case of hypnic jerks and severe insomnia. In the early part of 2016, I was put on an off a LOT of medicines. However, from August 2017 onwards I gradually and successfully weaned myself off many medications. I am on 15 mg of Paxil now. (the only medicine I am taking).  My only issue so far is irregular heartbeats right before sleep (but I still manage to sleep well most nights). I have also started exercising and losing weight. My goal is to safely taper off Paxil as well. However, when I tried reducing to 10 mg from 15 mg, I had shock-like symptoms at night and had to go back to 15 mg. My question is how many months should I take to taper off Paxil? Does the 10% reduction be monthly? What are some of the things I can do to ensure my nervous system does not get messed up again? I will greatly appreciate any help.

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ChessieCat

Hi teePeer, I've moved the new Intro topic you created and merged it with the original Intro topic you created.  Each member has only 1 Intro topic where they can ask questions and journal their progress.  Please do not create any more Intro topics.  Thank you.

 

Gridley has given you links to information which answers the questions in your new post.  Please read them.

 

 

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manymoretodays

Hi teePeer1,

Dear All,

I am currently on 10 mg of Paxil and occasionally use lexotanil (6-7 times a month in very small doses). My basic issue is an SSRI induced sleep disorder and hypnic jerks (with ocassional bouts of depression that makes me weepy). But My jerks are  MY CORE ISSUE.  They occur cyclically (mostly at sleep onset) and worsen during my periods. Sometimes, they keep startling and waking me all night. I have made good progress in a year but I still have to use lexotanil (a benzo) as needed. On 20 mg of paxil, I did not need to use a benzo for two months, but since I want to taper off my AD eventually the jerks returned when I reduced paxil. My jerks  are, however, less vicious than before but some nights are still terrible (snorting, heart palpitations, sweating...) However, in this situation in which I use a benzo 6-7 times a month (0.25 mg to 1.25 mg depending on how bad my jerks are), how should I taper off a benzo? Or should I wait to get off Paxil first? I understand benzos are very addictive and this can backfire or I can get kindling effect so I am very confused how to move further. I want to move forward cautiously. And would very much appreciate an advice from fellow sufferers. I tried Vitamin B 12 and melatonin (these supplements don't suit me. I also use probiotics for my intestinal issues that occurred because of tapering)

(mod note:  posted 2 hours ago, copied here, as well as moved to Hypnic jerks when falling asleep)

 

Could you update your signature for us and add some dates:

Paxil 10 mg currently reduced over 12 months (Initial dose 40 mg 30 July 2018)

Lexatonil 1.25 mg or even less (6-7 times a month)

That will make it clearer as to your present medications.  For example:  note the date that you began Paxil 10 mg, as well as when you began the Lexatonil.  Thank you.

Go to Account Settings to do this.

This may help too:  Please put your withdrawal history in your signature

There's a bit more detail as to what we need to see in a signature in the above link.

Thank you.

 

What will also be of help to us will be if you could do some drug and symptom logs for us.  Keep it simple.  Note the day.  Then time on the left, drug name, and dosage on the right.  Include symptoms,supplements, and sleep on the right hand side as well.

Here's more on that, with a sample of logs/notes.  Drug and symptom logs

Post that right on your page here.  This is different from your signature, which you will see below your post and others, unless viewing from a phone device.

 

And welcome back.  It looks like you have been gone, off site for a bit.  It's really, truly helpful for us as moderators to be able to see a bit more of your daily patterns as related to your drug use.......before making any suggestions. 

The signature just gives us all, an idea of your history, and present medications and doses.  Also very helpful.

This page serves as your main introduction/journal.  You've introduced yourself to the community here, and it is the best place for you to ask questions regarding your personal situation and withdrawal.  That way your pertinent information all remains in one place.

 

Thanks again.....in advance.

Love, peace, healing, and growth,

mmt

 

 

Edited by manymoretodays
additional, spelling

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Shep

teePeer, I've responded to your question about tapering off your periodic benzo over in your benzo thread. I really think you should consider a much slower Paxil reduction. This likely will reduce your need to resort to a benzo. 

 

You may even want to consider updosing a small amount of the Paxil to see if that will help. Please don't make any more changes until we have a chance to discuss that, though.

 

You've been a member of this site for 8 months but you've only posted 5 times. We simply don't have enough information to be able to help you yet.  

 

Please let us know the rate you are tapering and list the dates of your reductions for the past 6 months, if you have that information. 

 

On 2/22/2018 at 9:28 PM, teePeer1 said:

I gradually tapered to 10 mg of paxil from 40 and also tapered off benzo (3mg to 0) both slowly over a period of months.

 

When did you taper off a benzo? Please list the dates you were on it, as well as the name of the benzo. Please place this information in your signature. A direct link to your signature is here:

 

Account - Settings - Create or Edit Your Signature

 

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teePeer1

Dear Shep,

I am currently on "need basis " on benzo. I take half a tablet of lexotanil or even less on nights when I am unable to sleep because of hypnic jerks or anxiety. I try to avoid it like the plague but give up some days. This time, 6-7 nights because of hypnic jerks issues. I did a slow taper of paxil from 40 mg to 10 mg. I was very sick after my cold turkey from Prozac. Now, today, I visited my doctor and he suggests I reinstate Paxil to from 10 mg to 20 mg if I do not want to take benzos (he thinks that increasing the AD will make it easier for me to give up benzos). I am in a fix. I asked him if going from 10 to 15 will be okay and he said no, the therapeutic dose for Paxil is 10. I feel crushed because I worked so hard to come this far. You also suggested an updosing. What should I do in this situation? I will be grateful for some input. 

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teePeer1

Also, I have added the info in the signature. In short MOST of my AD withdrawal issues have been sleep-related both in the past and present. And they have been well.... very severe. 

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Shep
33 minutes ago, teePeer1 said:

I am currently on "need basis " on benzo. I take half a tablet of lexotanil or even less on nights when I am unable to sleep because of hypnic jerks or anxiety. I try to avoid it like the plague but give up some days. This time, 6-7 nights because of hypnic jerks issues.

 

Thanks for the additional information, teePeer.

 

Please tread carefully with the benzo - it only takes 2 - 4 weeks to become dependent. You've taken it 6-7 nights, so you really need to decide if you are going to stay on it and then taper off it after your Paxil taper or if you'd rather stop using the benzo now. You may already be dependent, but with your antidepressant symptoms so severe, it's going to make it hard to tell. So let's try to figure out the Paxil updose.

 

33 minutes ago, teePeer1 said:

Now, today, I visited my doctor and he suggests I reinstate Paxil to from 10 mg to 20 mg if I do not want to take benzos (he thinks that increasing the AD will make it easier for me to give up benzos). I am in a fix. I asked him if going from 10 to 15 will be okay and he said no, the therapeutic dose for Paxil is 10.

 

Your doctor is misinformed. A "therapeutic dose' is meaningless for antidepressants - it's made up by the pharmaceutical companies. There are no tests to see what your serotonin level is, so how do they even come up with that number? This ties into the complete myth of the chemical imbalance.

 

Going from 10 mg to 20 mg is too high a dose. This is from the thread About reinstating and stabilizing to reduce withdrawal symptoms  , but it also relates to updosing.

 

On 10/8/2012 at 7:17 PM, Altostrata said:

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.
  • You can always adjust the dosage upward if you find you need to.

 

I'm going to ask the moderators who are more familiar with Paxil than I am what they would recommend as far as an updose is concerned. It will no doubt be a lot less than what your doctor is recommending, so please don't worry that this will undo all the progress you've made. 

 

Once a Paxil-wise moderator has a chance to review your information, they can better advise you. 

 

While you're waiting, please have a read of some information that explains more about withdrawal:

 

How psychiatric drugs remodel your brain

 

Healing from antidepressants. Patterns of recovery video (4 minutes)

 

Also, please check out some of the great non-drug coping techniques that may be helpful:

 

Non-drug techniques to cope with emotional symptoms

 

 

 

 

Edited by Shep
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teePeer1

Thanks Shep and SkyBlue, how much should I updose? Is 5 mg a safe updose?

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Gridley

5mg is far too much, for the reasons given in Shep's quotation of Alto's post.  These drugs are strong, and when updosing/reinstating it is better to start with a small amount and increase if symptoms remain unbearable.  If you take too high a dose,  it may be too much for your brain.  Again, please read Shep's quotation of Alto's post above.

 

I would suggest an updose of 1mg.   Remember, it takes about 4 days for a dose change to get to full state in the blood and a bit longer for it to register in the brain.

 

Instructions about how to make a nonstandard dose of Paxil is in the following link:

 

Tips for tapering off Paxil (paroxetine)

 

 

 


 

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manymoretodays

Hi teePeer1,

When do you do the decrease to 10 mg of Paxil?

 

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.
  • You can always adjust the dosage upward if you find you need to.

 

How long should you give reinstatement?

  • It takes at least 4 days for your body to fully register the addition of a neuroactive drug. Unless you have an immediate bad reaction, observe your symptom pattern for about a week to see if the reinstatement is helping. If you have an immediate bad reaction, reduce or stop taking the drug.
  • After reinstatement, the amount of time needed to alleviate withdrawal symptoms (stabilizing) varies according to the individual. Relief can be felt immediately, after some weeks, or after some months.
  • Once you feel withdrawal symptoms are reduced after reinstatement, give your nervous system time to stabilize before attempting dosage reduction. Think in terms of months, not days.
  • Be patient after you reinstate. Reinstatement may not immediately eliminate all withdrawal symptoms. You may still experience waves of symptoms, which usually lessen as time goes on. Do not attempt to taper again until you feel symptom-free, or at least until your withdrawal symptoms are mild and tolerable.

The dose needed for effective reinstatement varies according to the individual.

As you have had several years now of medication/drug usage, no doubt you may be sensitive at this point.  I extracted some of the information for you from the reinstatement link above.  Do go and take a look at this link, especially the first post there..........as well as the links given to you by Gridley back in February.  If you just scroll up on this page you can find them.  The why taper by 10% and links to making a liquid or using a scale, as well as the Tips to tapering Paxil should prove to be invaluable to you now.

It is important when updosing or with any dosing to be consistent with your dosing, both in timing and measurement of the dose.  And then to be patient as well.......giving an updose at least 4 days and then a week or more as far as stabilizing goes.  And we are talking withdrawal stable.  As.......no doubt, your CNS(central nervous system) is presently in a bit of disarray, from previous disruptions.

 

I'd stick with the 1 mg, as I see Gridley has suggested.  Best to go with the lowest dose possible as it's the most harm reduction method(easier on your nervous system).

 

Best,

Love, peace, healing, and growth,

mmt

Edited by manymoretodays

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teePeer1

Dear many more todays, I have been on 10 mg paxil  since end of August 2017. I tried reducing to 8, got really bad palpitations (for which I took benzo) and within 3 days returned to 10 mg paxil. For two weeks, I was fine but I get real bad issues at night for which AGAIN I had to use benzo. (with a start and stop approach). I do not want to become addicted to a benzo on top of an AD. I would like to only be on an AD for a while. But with 10 mg, I am having jerks at night (which is one of my biggest withdrawal symptoms from my c/t experience with Prozac that Paxil mitigated  and "cured" a good deal). Now, today, my doctor suggested up your dose to 20 mg and you will be fine. I am very afraid of such a big increase and discouraged because i have made good progress on my taper from 40 mg paxil. (though my psychiatrist who I somewhat trust because he cured my c/t prozac withdrawal says I should updose by 10 and I will feel better?

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teePeer1

sorry end 2018* 2.5 months basically not 2017! *correction*

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manymoretodays
2 minutes ago, teePeer1 said:

Now, today, my doctor suggested up your dose to 20 mg and you will be fine. I am very afraid of such a big increase and discouraged because i have made good progress on my taper from 40 mg paxil. (though my psychiatrist who I somewhat trust because he cured my c/t prozac withdrawal says I should updose by 10 and I will feel better?

 

Most doctors know very little about withdrawal, unfortunately, teePeer1.  And that is why this site exists.

I think we'd all love to be out golfing or enjoying the weather.......not dealing with the aftermath of the over-medication age in psychiatry.

 

If I were you I would try the 1 mg updose.  Work on getting what you need for accurate measurement.  E-bay or Amazon are often great.  Try not to sit around procrastinating.  It's good to empower youself and take charge when it comes to your own mental/physical/spiritual health.

 

No need to waste breath on educating your Dr, if he/she is not interested and/or is somewhat pompous.  Seriously, I don't think this bozo has cured your W/D(and pardon me doctor, maybe he/she is okay).........quite the contrary if you ask me.......

 

Do take a look at the links offered.  Ask questions here on your thread as needed. 

Best, Love, peace, healing, and growth,

mmt

 

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teePeer1

Hi,

Visiting the site after long. I am on 5 mg of paxil at the moment. Tapered slowly from 60 mg. My withdrawals symptoms have been palpitations and bodily twitchings. Most of my weird symptoms disappear after a few weeks but when they recur it is either a sleep disturbance or some kind of twitching. I held on 5 mg for four months. Going to 4.5mg wiyh home made liquid now. My question is with smaller doses how long should the hold be? Is it okay to hold at a dose for 4 months especially if you are in the smaller taper doses or is holding on for such long periods not a good idea? Thank you. I would very much appreciate a response and suggestion.

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Gridley

Welcome to SA, teePeer1.

 

We recommend tapering by no more than 10% of your current dose every four weeks.  Every four weeks is the minimum time between cuts.  Holding for longer is fine.

 

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

 

I don't know what your previous taper rate from 60mg was, but going from 5mg to 4.5mg is 10% and is perfectly acceptable.

 

Regarding how long to hold, as I said, four weeks is the minimum.  There's nothing wrong with holding for longer, and in fact it can be very beneficial as it allows your central nervous system plenty of time to adapt to the new lower dose.  At the lower doses it is important to go slowly, either with longer holds or smaller cuts or both.  In determining how long to hold it is important to listen to your body and guide yourself by how you're feeling.  Your conservative approach of long holds is a good idea, and a four-month hold is fine.

 

The reason for tapering slowly and holding is to allow your body to adapt and to minimize withdrawal symptoms.

 

 
 
When we take medications, the CNS (central nervous system) responds by making changes over the months and years we take the drug(s). When the medication is discontinued, the CNS has to undo all the changes it made. Rebuilding the neurotransmitter production and reactivating the receptor and transporter cells takes time -- during that rebuilding process symptoms occur.  
 
These explain it really well:

 

 

   On 8/30/2011 at 2:28 PM,  Rhiannon said: 
When we stop taking the drug, we have a brain that has designed itself so that it works in the presence of the drug; now it can't work properly without the drug because it's designed itself so that the drug is part of its chemistry and structure. It's like a plant that has grown on a trellis; you can't just yank out the trellis and expect the plant to be okay. When the drug is removed, the remodeling process has to take place in reverse. SO--it's not a matter of just getting the drug out of your system and moving on. If it were that simple, none of us would be here. It's a matter of, as I describe it, having to grow a new brain. I believe this growing-a-new-brain happens throughout the taper process if the taper is slow enough. (If it's too fast, then there's not a lot of time for actually rebalancing things, and basically the brain is just pedaling fast trying to keep us alive.) It also continues to happen, probably for longer than the symptoms actually last, throughout the time of recovery after we are completely off the drug, which is why recovery takes so long.

This is your Introduction topic, where you can ask questions and connect with other members.  We're glad you found your way here.

 

 

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Altostrata
3 hours ago, teePeer1 said:

Hi,

Visiting the site after long. I am on 5 mg of paxil at the moment. Tapered slowly from 60 mg. My withdrawals symptoms have been palpitations and bodily twitchings. Most of my weird symptoms disappear after a few weeks but when they recur it is either a sleep disturbance or some kind of twitching. I held on 5 mg for four months. Going to 4.5mg wiyh home made liquid now. My question is with smaller doses how long should the hold be? Is it okay to hold at a dose for 4 months especially if you are in the smaller taper doses or is holding on for such long periods not a good idea? Thank you. I would very much appreciate a response and suggestion.

 

teePeer, I merged your new Intro topic with your existing one. Only one Introductions topic to a member. Please put all your updates here.

 

Have those withdrawal symptoms gone away? Taper again only when you're sure you've stabilized from the last reduction. You can hold at a dosage as long as you think necessary.

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teePeer1

Thank you for the responses. This website has been such a source of comfort on some many difficult days.

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