jolena: I am starting tapering of Paxil after 19 years of use

[jolena]

I am using Paxil for 19 years now and decided together with my doctor to bring the dose down and eventually stop altogether. Everything is stable in my life, and the summer is coming in Alaska. I went from 60mg to 40mg in a few months, but I experience flu like symptoms now. After looking on the web I found this site with success stories about slowly tapering. I am going up to 50mg now and as soon as I am stable will start tapering.

[ChessieCat]

Hi jolena and welcome to SA,

 

I am really pleased that you are aware that tapering is the best way to get off a psychiatric drug.  You might find that instead of going from 40mg back up to 50mg that a small increase of 1mg or 2mg may be enough.  This is because your brain will have already made some adaptation since you have been on the lower dose and going back up to 50mg may be too high.  It is better to increase by a small amount and increase again by a small amount if needed rather than take too high a dose.  Please carefully read Post #1 of this topic which is relevant to updosing as well as reinstating:  About reinstating and stabilizing to reduce withdrawal symptoms

 

It takes about 4 days for a dose change to get to full level in the blood and a bit longer for it to register in the brain.  If you have only taken 50mg once or twice it would be okay to reduce down to 41mg or 42mg from your next dose.

 

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

 

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.

 

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

 

Stabilising After a Reduction - What Does That Mean?

Withdrawal Normal Description

 

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.

[jolena]

Wow, thank you ChessieCat!  I will read it all and go to 42g paxil per today April 9 2018.

 

[brassmonkey]

Hi Jolena-- welcome to SA.  CC has give you a lot of good information so I won't repeat any of it. But I will point out that, although the cuts you made were very large, which is probably the root to your feeling bad, doing the recommended taper would have put you at about 40mgai within the same time frame.  The small updose to 42mgai should help to calm the symptoms that you're feeling.  I would also suggest that you hold at this level for an extended time, in the several month range to let your body adapt to the lower dose.  Then when things have stabilized you can continue your taper.

 

Getting off of a high dose of Paxil after so many years of use is going to take a while, but it can be done.  I was on 40mgai for 18 years when  started my taper, I am now drug free and love'n life.  Once you get stable we have a lot of ideas on how to proceed and succeed.

 

Brassmonkey

[jolena]

Thank you for your reaction. It is so good to hear that you came off the paxil after so many years.

I ordered the book of dr Glenmullen to learn more about the symptoms.

Over the years I have gone up and down on the paxil according to season and stress levels in my life. I live in Alaska with dark long winters and had two bad winters and two good winters.

I learned that the more alert on my symptoms I am the better I can manage my dosage without having nervous breakdowns. 

This time I did not recognize the flu like symptoms as withdrawal symptoms though.  I will look carefully at the symptoms in Glenmullen's book to recognize when I am totally stable. Till then I will stay at 42g. I ordered a precision scale to measure exactly.

[Altostrata]

Hello, Jolena. Please read Tips for tapering off Paxil (paroxetine)

 

Paxil comes in a liquid form for easy tapering. In your situation, you might want to take a combination of capsules and liquid. Your doctor would have to prescribe both.

[maree]

Hi Jolena. Looks like we're starting on a similar type of drug tapering journey at the same time. This looks like a very supportive forum. Although due to my cptsd I haven't in the past been any good at sitting still and reading heaps either on a forum or in books. All the very best on you journey.  I posted this below a few minutes ago:                                                                                                                                                                                                                                                                                                                                                                            Hi and thanks for letting me join this forum. I'm 55 yrs old and have been on paxil for 20 years, due to a breakdown back then from stuffing down the abusive childhood I had. Over the last 3 years I have been tapering off the paxil from 60mgs per day to 30 mgs per day. It seemed to be ok (although I did blame myself for low moods etc and maybe not realized this was the tapering....don't know for sure?) Then on April 2nd (2018) I cut a corner  sliver off one of my daily tabs and since then I have had some big mood swings, irritability, impatience with people, bigger blues and more trouble co-ordinating my time and to do list. I don't work as I have CPTSD (Complex Post Traumatic Stress Dissorder). I attend online recovery groups for adults who have come from alcoholic and dysfunctional homes. I would love to hear from anyone who either can tell me if it's normal to have all these bad mood swings and also anyone who is in similar position as me with cptsd. Thanks. P.s Also I lost an online friend (for the time being I hope) because I was irritable and impatient. I've apologised. Has anyone else lost friends due to tapering? I'm going to do a much smaller taper next time and work hard on being concious of how I come across. 

[jolena]

Thank you Altostrata,

I will ask my doctor next time!

[jolena]

Thank you Maree, 

I recognize your worry about losing a friend. I just entered this website and a common charactertrait we all have seems to have is overthinking. We overthink everything and I mean everything. I am for the last few days thinking about if I said anything wrong to a friend who I would meet on Monday and who cancelled. 

When I am on a too low dose or when I was menopausal I would always tell my familymembers exactly what I thought of them. I was not mean, but lost all tact and was full on confrontational. I solved this by going on a higher dose. When I had moodswings again I would tell my husband, son and daughter: you better listen today because I am in a very bad mood. They would then leave me alone till it was over. 

But friends are not family and they don't ask, 'are you oke, mom?', but they avoid you. 

So you are not alone in this and I had cognitive behavioral therapy to learn to deal with this. 

You also must never assume that you know what somebody else thinks, just because you don't know what they think. 

I am sorry to hear you have CPTSD. I hope you are doing better soon.

[maree]

Thankyou for your reply Jolena. It was helpful to read how you manage your own mood swings. And thankyou for your wishes for me to get better. I wish the same for you. Maree p.s I am only just learning how to navigate this wonderful looking forum and was just pleased I actually found your reply ha ha

[jolena]

I have trouble navigating the site too! But I am learning. All the best.