zouxi: on Paxil for 16 years - trying to withdraw

[zouxi]

hello,

 

I am new on this forum. I have been on paxil (in my country it is called seroxat) for more than 16 years (was prescribed for panic attacks) 20mg for almost the entire time (been on 40mg a couple of weeks only then back to 20mg). Since more than 10 years i feel awesome, zero panic attack episode, well being and no anxiety whatsoever. I tried to quit cold turkey several times with no success, every time it was hell. I am planning to do the slow withdrawal technique, i have a couple of questions though:

 

1- The 10% reduction method seems plausible , however the major drawback is the time needed to become free from the drug. I was thinking about another schedule:

 what about reducing as follows ( it seems to me that the lower the dose, the more the withdrawal symptoms appear. When i was on 40mg for probably 3 months, i reduced my dose directly to 20 mg with no symptoms whatsoever, that's a huge 100% 50%* drop):

*1st month: 15mg

*2nd month: 10mg

* 3rd month: 7.5mg

*4th month: 5mg

*5th month: 3.75mg

*6th month: 2.5mg

*7th month: 1.875mg

*8th month: 1.25mg

*9th month: 0.625mg 

then jump off

 

any thoughts?

 

 

 

Edited March 22, 2018 by ChessieCat
* corrected reduction percentage

[ChessieCat]

Hi zouxi and welcome to SA,

 

I don't think there would be 1 member on this website who doesn't want to get off their drug/s as quickly as possible.  However, SA recommends a harm reduction method of tapering which means taking the drug away slowly allowing the brain to adapt to not getting as much of the drug.  This generally means that people experience only minor withdrawal and can live their life as best as possible whilst getting off the drug.

 

I'm going to give you lots of links to check out.  Please don't feel overwhelmed, just work your way through them one at a time as you feel able.

 

SA recommends tapering by no more than 10% of the previous dose followed by a hold at that dose for about 4 weeks to allow the brain to adapt to not getting as much of the drug.  This is because psychiatric drugs create a physiological dependence, not physical like caffeine or nicotine.

 

Patience is needed to get off these drugs.  We suggest throwing out the calendar and listening to your body and your symptoms.  If after 4 weeks you don't feel stable, are unwell or life circumstances are a bit more stressful than usual (for example the Christmas period, winter time, or job change) it is better to stay at that dose for a bit longer until things settle down.

 

We ask all members to create a drug signature.  Please update it whenever you make a change.  Please keep it nice and simple.  We only need details for the last 2 years.  Date, drug and dose only, no symptoms or diagnoses.  The other years can just be an overview.  

 

This is the preferred format which is helpful for the mods.  Thank you.

 

A request: Would you summarize your history in a signature - ALL drugs, doses, dates, and discontinuations & reinstatements, in the last 2 years particularly?

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

• Any drugs prior to 2 years 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.Before you begin tapering what you need to know

 

Why taper by 10% of my dosage?

 

Before you begin tapering what you need to know

 

Why taper by 10% of my dosage?

 

Tips for tapering off Paxil (paroxetine)

 

Dr Joseph Glenmullen's Withdrawal Symptoms

 

Windows and Waves Pattern of Stabilization

 

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

What should I expect from my doctor about withdrawal symptoms?

 

Brain Remodelling

Video:  Healing From Antidepressants - Patterns of Recovery

 

Keep it Simple, Slow and Stable

Keep Notes on Paper

 

Rate Symptoms Daily to Check Patterns and Progress

Tapering Calculator - Online

 

The only supplements which SA recommends are Magnesium and Omega-3 Fish Oil.  Try a small amount one at a time to see how you react.  It is best to make only 1 change at a time.  It is also better not to start taking a complex vitamin because if you experience issues you will not know what exactly is causing it.  B vitamins can be stimulating especially B6.  hypersensitive-to-b-vitamin-or-b-vitamin-complex  If trying anything new, start with a small amount to see how you react and build up to the recommended amount.  

 

Even with a careful and slow taper you will most likely experience times of discomfort.  It is best to learn and use Non-drug techniques to cope

 

There are many existing topics and discussions on this site.  You can use the site search function on the main page of the site at the top right, or use a search engine and include survivingantidepressants.org in your search string.

 

As I said, lots of information, but I really want you to have what you need so you can have a successful taper.

 

This is your own Intro topic where you can ask questions and journal your progress.  We suggest that members visit each others Intro topics so that can support and encourage each other.

[zouxi]

waw, thank you indeed! very insightful post and lots of detailed info. The 10% reduction method will will take like eternity to finish (around 2 years) which is the only drawback , beside the hassle of calibrating the does when they become a minuscule amount .

 

can i find any excel sheet where i can insert my data and get the exact figures for my next dose?

 

Thank you again and sorry for my bad English as i am not a native speaker.

[zouxi]

final note: we don't have liquid paxil in my country and the smallest available dose/tablet is 20mg (we don't have the 10mg, we have the 12.5mg CR though, which is not suitable for withdrawal as i learned). It makes cutting the tablet into tiny pieces a very hard work, if not impossible.

 

Can i dissolve the paxil tablet into water and use it or should i get a mmg scale and crush the tablets into powder and take them that way?

 

Thank you.

[ChessieCat]

You are welcome.

 

I can understand your frustration at the length of time it will take.  I was hoping to be off Pristiq by my 60th birthday at the end of last year.  I won't be off until the last half of 2020.  But as my dose got lower I started to feel like my old self before antidepressants (25 years).  Tapering fades into the background.  I'd rather get of slowly with minimal withdrawal symptoms.

 

The easiest way to calculate a 10% reduction is to multiple the dose you are currently taking by 0.9.

 

As an example 20mg x 0.9 = 18mg.  And to cross check you multiply 20mg x 0.1 = 2mg, 20mg - 2mg = 18mg.  The next reduction would be 18mg x 0.9 = 16.2mg.  If you decide to round a number off to make it easier to measure always round up.  So you could measure 16.25mg.  Remember to calculate the next reduction on 16.25mg not 16.2mg.

 

Tapering Calculator - Online

 

On 27/05/2011 at 10:52 AM, Altostrata said:

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

 

On 27/05/2011 at 10:52 AM, Altostrata said:

Cutting up tablets
To reduce your dosage, cut regular Paxil tablets up with a pill cutter, available at any drug store.

If you get your prescription filled with the 10mg tablets, you may be able to cut them in half or quarters to reduce by 5mg or 2.5mg at a time.

Paxil CR tablets are enteric-coated and not designed to be split. Switch to regular Paxil if you wish to cut up the tablets.

Precisely weighing tablet pieces or crushed tablets with an electronic digital scale
You may wish to precisely measure your dosage with an electronic scale that measures milligrams. These are available for under $30 US. See Using a digital scale to measure doses

 

 

Edited March 22, 2018 by ChessieCat

[zouxi]

Hello,

 

I have been on paxil for 17 years now, my current dosage is 20mg (since 2008). I met my psychiatrist yesterday who said that i don't need the drug anymore (he is right, as i feel extremely well with no anxiety or PA since 12 years). He proposed that i taper the following way:

 

-15 mg for one month

-10 mg for one month

-5 mg for one month

-5 mg every other day for one month

-5 mg every five days for one month then stop.

 

He said that paroxetine has a half life of 21-24 hours and taking the drug every other day is a good idea since it remains in my system. He said that in his experience, this gradual method worked with around 99% of his patients during his career.

 

Do you think the above schedule is feasible?

 

Thank you.

[ChessieCat]

No, the proposed schedule is not a good idea.  You could end up with very bad withdrawal symptoms.  This may include insomnia, which is a very common withdrawal symptom.  If you start having difficulty sleeping it makes other withdrawal symptoms so much harder to cope with.

 

Please read this:  CT and Fast Tapers

 

Many medical professionals do not understand tapering and withdrawal from psychiatric drugs, which is why this site exists.

Skipping days to taper is not recommended.  The brain likes consistency.  Skipping Days vs Every Day Dosing Graph

 

How to get the dose you need:  Tips for tapering off Paxil (paroxetine)

 

Please read the information given previously.  SA recommends tapering by no more than 10% of the current dose with a hold of about 4 weeks to allow the brain to adapt to not getting as much of the drug.

 

Many members find that the lower their dose gets the slower they need to go by reducing less and/or holding for longer:  Why taper paper: dose-occupancy curves
 

When to end the taper and jump to zero?

 

Here's some additional information which might help you to understand what is happening:

 

Recovery isn't linear it happens in a Windows and Waves Pattern

 

Withdrawal Normal Description

When we take a psychiatric drug, we are adding chemical/s to the brain.  The brain then has to change to adapt to getting the chemical/s.  It might have to change something to do with A and then once that change has been made it affects B so another change has to be made and so on down the line.  It is a chain reaction, a domino effect.

 

The same thing happens when we take the drug away.  That's why it's possible to experience such a vast array of withdrawal symptoms, and they can change, and be of different intensity.

 

Please read this:  CT and Fast Tapers

 

These explain it really well:

 

Video:  Healing From Antidepressants - Patterns of Recovery

 

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.

 

AND

 

On 12/3/2015 at 10:41 AM, apace41 said:

Basically- you have a building where the MAJOR steel structures are trying to be rebuilt at different times - ALL while people are coming and going in the building and attempting to work.

It would be like if the World Trade Center Towers hadn't completely fallen - but had crumbled inside in different places.. Imagine if you were trying to rebuild the tower - WHILE people were coming and going and trying to work in the building!  You'd have to set up a temporary elevator - but when you needed to fix part of that area, you'd have to tear down that elevator and set up a temporary elevator somewhere else. And so on. You'd have to build, work around, then tear down, then build again, then work around, then build... ALL while people are coming and going, ALL while the furniture is being replaced, ALL while the walls are getting repainted... ALL while life is going on INSIDE the building. No doubt it would be chaotic. That is EXACTLY what is happening with windows and waves.  The windows are where the body has "got it right" for a day or so - but then the building shifts and the brain works on something else - and it's chaos again while another temporary pathway is set up to reroute function until repairs are made.  

 

Edited January 31, 2019 by Gridley
inserted "not"

[Carmie]

Hi zouxi, 

 

How are you doing? As ChessieCat said the taper you had proposed is way too quick, I hope you’re tapering slower. Doctors have no idea of how horrific these withdrawals can get if we taper too quickly. 

 

Please let us know how you’re doing💚

 

 

[zouxi]

Hi all,

I managed to reach 10mg (from 20mg at the start of the taper, 40mg was my highest dose) with minimal withdrawal symptoms, so i am now on 10mg and willing to stick to this dose for a while as i am having a lot of challenges in my life. I will resume tapering once things settle down a bit.

 

However, i tried to take my 10mg dose in the morning instead of the evening (it helps my gastric motility as i have sibo/ibs), but after a week or so i had difficulty sleeping at night.

 

Did anyone experience this? Can i take paxil in the morming instead of evening?

 

Thanksm

[ChessieCat]

On 3/22/2018 at 6:43 PM, ChessieCat said:

We ask all members to create a drug signature.  Please update it whenever you make a change.  Please keep it nice and simple.  We only need details for the last 2 years.  Date, drug and dose only, no symptoms or diagnoses.  The other years can just be an overview.  

 

Please create your drug signature as previously requested and then post advising that you have done this so that we are notified of it (signature creation/editing does not notify us).

 

Instructions:  Withdrawal History Signature

[ChessieCat]

2 hours ago, zouxi said:

However, i tried to take my 10mg dose in the morning instead of the evening

 

When changing dose time we generally suggest to move the dose by 1 hour each day because it is gentler on the system.

 

Q:  Was changing your dose time the only this that changed at this time?

 

If there were any other changes then it is difficult to know what caused the sleep issues. 

 

2 hours ago, zouxi said:

i am having a lot of challenges in my life.

 

It might be due to something related to the above and just happened to coincide with the change in dose taking time.

 

2 hours ago, zouxi said:

Can i take paxil in the morming instead of evening?

 

Generally antidepressants are taken in the morning because they can be activating.  However there are some people who find that their antidepressant makes them sleepy so they might find it better to take it at night time.