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Laurame: Withdrawing from Paxil, on Zoloft but want to go off that too


Laurame

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Hello, I have recently found this site and it's been a tremendous relief to see other people going through similar things. Withdrawal and anxiety can be such isolating experiences, especially when your doctor or psychiatrist doesn't seem to have any concrete knowledge of the way it works for many people.

 

I began taking 30mg of Paxil in 2004 during an episode of major depression and anxiety. It helped me regain my stability and in addition to the medication I spent many years in psychotherapy. I considered going off the drug many times but even skipping one dose made me feel physically ill and my psychiatrist also warned me that because I had suffered a previous episode of depression, I was likely to relapse. 

 

In the fall of 2017, my partner and I decided we wanted to try having a baby and on the advice of my doctor, I began weaning off Paxil, decreasing the dose by 7.5 g each month. I know realize that was probably way too fast but I didn't have any serious problems until I stopped it completely. My doctor's recommendation was to switch to 50mg Zoloft/Sertraline but I wanted to see if I could go without drugs. I lasted a month. At first it was mainly physical symptoms: nausea, dizzines, diahrrea, muscle pain, headaches but then anxiety set in and I ended up in the ER. I began taking 50mg of Zoloft/Sertraline in February buteven after several weeks didn't notice much improvement. They increased my dose to 100 and then 150mg but the anxiety persisted and I got terrible diahrrea and began losing weight at an alarming rate. I went back down to 50mg and continue there. In February, March and part of April (?) I was taking .5mg of Lorazepam each morning and evening to function and sleep but have stopped that. I only take it very occasionally when I really need a good night's sleep or feel a panic attack coming. 

 

I have had good weeks and bad weeks and the idea of "windows and waves" really resonates with me. I have a couple weeks where I feel like myself and then the anxiety returns and hangs around for a week or two. I've been taking care of myself as well as possible: exercise, meditation, diet, time with friends, and that helps but it seems like the only thing that is really going to make a difference is time. 

 

I have a couple of questions for my fellow SA members'. Do you recommend magnesium citrate? I'm not taking any supplements because I'm trying to get my nutrients from food and I also don't want to get my hopes up that if I just find the right combination of vitamins and minerals and powders that I will be cure. 

 

Secondly, I've been taking Zoloft for almost 5 months now and I can't say that I have noticed any huge benefit. It doesn't seem to be helping with the anxiety at all. I don't want to double my withdrawal misery but I also don't want to stay on it too long and make it harder for myself later. I've been contemplating halving my dose and seeing what happens. During the time I was increasing and lowering my dose by 50mg over these previous months, I didn't notice any significant changes in my mood or mental state, FYI. Any thoughts?

2014 Was first prescribed  30mg of Paxil/Paroxetine for an episode of major depression and anxiety. 

October 2017 Decided that I wanted to try to become pregnant and on the advice of my doctor began weaning in October to 22.5 mg, November 15mg, December 7.5mg, January 2018 0mg

February 2018 After recovering from the nausea, dizziness, headaches, back pain, diahhrea and irritability, I began having extreme anxiety. Doctor put me on 50mg of Zoloft/Sertraline and .5mg of Lorazepam in the morning and evening.

March -April 2018 Zoloft seemed to have no effect on the anxiety so I increased first to 100mg and then to 150mg with no benefit and increased gastrointestinal problems. Decreased to 100 and then 50 mg.

May 2018 Slowly cut down on Lorazepam after two months and now only take occasionally for sleep/panic.

July 2018 Sleep problems returned, began taking .5mg Lorazepam almost nightly

August 2018 Reinstated 5mg of Paroxetine after going into a deep depression with extreme fatigue, depersonalization and suicidal feelings

September 2018 Increased to 10mg Paroxetine, also taking .25mg of Lorazepam and .75mg melatonin for sleep

 

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  • ChessieCat changed the title to Laurame: Withdrawing from Paxil, on Zoloft but want to go off that too
  • Moderator Emeritus

Hello Laurame, welcome to SA.  Thanks for creating your signature already. 

 

It seems that the sertraline has not done a very good job of covering paroxetine withdrawal.  However, it sounds like your symptoms have been improving over time.  What symptoms are you having currently?  Is it just anxiety?  How severe are your symptoms?

 

It's great that you've been looking after yourself really well, that will make a big difference, as well as time.  Unfortunately there is no cure, but many people do find magnesium citrate helpful.  See our topic about magnesium:  magnesium natures calcium channel blocker

 

The sertraline you are currently taking will still need to be tapered very slowly, as I'm sure you don't want to add even more withdrawal symptoms from sertraline withdrawal.  Some people do find higher doses of ADs easier to taper, which may be why you've been able to jump between 150mg, 100mg, and 50mg.  I would be very cautious about reducing below 50mg.  Here is some more information about tapering you may find helpful:

why taper by 10% of my dosage?

before you begin tapering - what you need to know

tips for tapering off zoloft (sertraline)

 

I would suggest taking a cautious approach to tapering, and only start reducing dose once you're feeling fairly stable. 

Stabilizing - what does that mean?

the windows and waves pattern of stabilization

 

Please post your updates and questions here in your introduction topic.


 

 

2001–2002 paroxetine

2003  citalopram

2004-2008  paroxetine (various failed tapers) 
2008  paroxetine slow taper down to

2016  Aug off paroxetine
2016  citalopram May 20mg  Oct 15mg … slow taper down
2018  citalopram 13 Feb 4.6mg 15 Mar 4.4mg 29 Apr 4.2mg 6 Jul 4.1mg 17 Aug 4.0mg  18 Nov 3.8mg
2019  15 Mar 3.6mg  21 May 3.4mg  26 Dec 3.2mg 

2020  19 Feb 3.0mg 19 Jul 2.9mg 16 Sep 2.8mg 25 Oct 2.7mg 23 Oct 2.6mg 24 Dec 2.5mg

2021   29 Aug 2.4mg   15 Nov 2.3mg

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Hi Songbird, 

 

Thanks for your reply. Yes, my sense is that the Zoloft hasn't really helped with any of the withdrawal symptoms but it's hard to know. Maybe I would feel worse if I weren't taking it. 

 

After the initial physical symptoms, the main symptoms for me have been anxiety and occasional insomnia. The anxiety starts the moment I wake up in the morning and sometimes fades by the afternoon. I'm usually able to fall asleep at night but have periods where I wake at 4am or 6am. Some of these periods seems to be related to my menstruation and perhaps are provoked by hormone fluctuations. 

 

I also have periods of one or two weeks where I feel mostly fine. At first those were very deceiving, as I thought I was "cured" but I've since read about the windows and waves concept and see that's not the case. In general, I'm able to manage my anxiety, or at least live with it, through meditation, breathing and self-care. I'm taking Zoloft but have phased out the Ativan/Lorazepam and only take it very occasionally when I really need to sleep. I am definitely making small forward progress. 

 

The motivation for going off medication was to get pregnant, so perhaps that is giving me some urgency about the Zoloft. I've been taking it for 5 months and sort of want to start phasing it out before I become "addicted". For some reason I have the idea in my head that after 6 months of taking it, it will be harder. I guess it's also the idea that I'm going through all of this hell only to become dependent on a different drug....Does that make sense?

 

In any case, thanks for your words and support. I will check out the links you posted. 

 

2014 Was first prescribed  30mg of Paxil/Paroxetine for an episode of major depression and anxiety. 

October 2017 Decided that I wanted to try to become pregnant and on the advice of my doctor began weaning in October to 22.5 mg, November 15mg, December 7.5mg, January 2018 0mg

February 2018 After recovering from the nausea, dizziness, headaches, back pain, diahhrea and irritability, I began having extreme anxiety. Doctor put me on 50mg of Zoloft/Sertraline and .5mg of Lorazepam in the morning and evening.

March -April 2018 Zoloft seemed to have no effect on the anxiety so I increased first to 100mg and then to 150mg with no benefit and increased gastrointestinal problems. Decreased to 100 and then 50 mg.

May 2018 Slowly cut down on Lorazepam after two months and now only take occasionally for sleep/panic.

July 2018 Sleep problems returned, began taking .5mg Lorazepam almost nightly

August 2018 Reinstated 5mg of Paroxetine after going into a deep depression with extreme fatigue, depersonalization and suicidal feelings

September 2018 Increased to 10mg Paroxetine, also taking .25mg of Lorazepam and .75mg melatonin for sleep

 

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  • Moderator Emeritus

It all makes sense, and it looks like overall you are doing pretty well.  After five months of Zoloft, your system will already have made adjustments that necessitate a slow taper off.  However, you have the added complication that the previous paroxetine withdrawal has sensitised your system.  Your system is still trying to recover from paroxetine withdrawal - rushing the sertraline taper while in that sensitive state would be even higher risk.  It will be safer to "hasten slowly" as they say.

2001–2002 paroxetine

2003  citalopram

2004-2008  paroxetine (various failed tapers) 
2008  paroxetine slow taper down to

2016  Aug off paroxetine
2016  citalopram May 20mg  Oct 15mg … slow taper down
2018  citalopram 13 Feb 4.6mg 15 Mar 4.4mg 29 Apr 4.2mg 6 Jul 4.1mg 17 Aug 4.0mg  18 Nov 3.8mg
2019  15 Mar 3.6mg  21 May 3.4mg  26 Dec 3.2mg 

2020  19 Feb 3.0mg 19 Jul 2.9mg 16 Sep 2.8mg 25 Oct 2.7mg 23 Oct 2.6mg 24 Dec 2.5mg

2021   29 Aug 2.4mg   15 Nov 2.3mg

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You're probably right. Especially because at the moment I'm not feeling especially stable from the paroxetine withdrawal. Over the last few days I've taken 1mg of Lorazepam twice to sleep and today I took .5 mg because I was in such a state of heightened anxiety. I hadn't taken any in about a month but it felt necessary in order for me to continue functioning. I'm trying not to get into the mindset that this is a failure or beat myself up about it. I'm trying to look for signs that I'm making small, forward progress but it just feels so excruciatingly slow and exhausting sometimes. 

 

I also started menstruating two days ago and it seems like my menstruation provokes a spike in anxiety. Has anyone else had that experience? I suppose even if that's the case there's not much I can do about it except prepare myself each month. 

 

I've started taking Magnesium Citrate after dinner and I'm hoping that will help a bit with my sleep. 

2014 Was first prescribed  30mg of Paxil/Paroxetine for an episode of major depression and anxiety. 

October 2017 Decided that I wanted to try to become pregnant and on the advice of my doctor began weaning in October to 22.5 mg, November 15mg, December 7.5mg, January 2018 0mg

February 2018 After recovering from the nausea, dizziness, headaches, back pain, diahhrea and irritability, I began having extreme anxiety. Doctor put me on 50mg of Zoloft/Sertraline and .5mg of Lorazepam in the morning and evening.

March -April 2018 Zoloft seemed to have no effect on the anxiety so I increased first to 100mg and then to 150mg with no benefit and increased gastrointestinal problems. Decreased to 100 and then 50 mg.

May 2018 Slowly cut down on Lorazepam after two months and now only take occasionally for sleep/panic.

July 2018 Sleep problems returned, began taking .5mg Lorazepam almost nightly

August 2018 Reinstated 5mg of Paroxetine after going into a deep depression with extreme fatigue, depersonalization and suicidal feelings

September 2018 Increased to 10mg Paroxetine, also taking .25mg of Lorazepam and .75mg melatonin for sleep

 

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  • 1 month later...

It's been almost 8 months since I weaned off Paxil and I find myself in a desperate state. My initial wean was probably too fast (reducing from 30mg by 7.5 each month over 3 months) and resulted in intense physical symptoms the first month (nausea, body aches, stomach upset) that then gave way to daily morning anxiety and bouts of insomnia.

 

I started taking Zoloft (Sertraline) 50mg one month after finishing with Paxil and after experimenting with higher dosage, have come down to and stuck with 50mg until now. I have not found that it has helped with the anxiety or the insomnia. Initially I was having good weeks here and there but now it's been a while since I can remember the last string of days without anxiety. Now it's more of a question of a string of some good hours, usually in the evening when my anxiety tends to dissipate.  I've also been trying to control my symptoms through diet, exercise, meditation and psychotherapy. 

 

Recently I traveled home to the United States for three weeks' vacation (I live in Spain). I don't know if it was the change in routine or other emotional triggers but by the end I was having great difficulty sleeping and feeling both anxious and low on a regular basis. I was also increasingly relying on Ativan (Lorazepam) for sleep, which is not ideal. I had been using it only occasionally but in the last 20 days I have taken it 12 times , usually .25mg or .5mg at a time.  Upon returning home, I tried taking 3mg of melatonin for sleep and to help with the jetlag for a few nights which put me into a depressive stupor, with no energy or desire to do anything and the sensation that my limbs weighted 100 pounds. I now realize that was too high a dose and have stopped it completely. 

 

The last few nights I have slept only a few hours and I'm feeling on the verge of collapse. I just don't know how I can go on in this state. My psychiatrist suggested switching to Effexor but I really think the problem is withdrawal and that changing to a different SSRI or SNRI won't help. So that leaves me considering reinstatement of Paxil. Based on what I've read in other posts, it would be best to start with a low dose like 5mg. Does it make a difference that I've been taking Zoloft all this time? How should I reduce that while adding the Paxil back?

 

I hate the idea of going back on it but I also feel like I need to know my limits and what I can withstand. As my sister, who has been very supportive, said to me "There must be a tipping point at which this distress stops." 

2014 Was first prescribed  30mg of Paxil/Paroxetine for an episode of major depression and anxiety. 

October 2017 Decided that I wanted to try to become pregnant and on the advice of my doctor began weaning in October to 22.5 mg, November 15mg, December 7.5mg, January 2018 0mg

February 2018 After recovering from the nausea, dizziness, headaches, back pain, diahhrea and irritability, I began having extreme anxiety. Doctor put me on 50mg of Zoloft/Sertraline and .5mg of Lorazepam in the morning and evening.

March -April 2018 Zoloft seemed to have no effect on the anxiety so I increased first to 100mg and then to 150mg with no benefit and increased gastrointestinal problems. Decreased to 100 and then 50 mg.

May 2018 Slowly cut down on Lorazepam after two months and now only take occasionally for sleep/panic.

July 2018 Sleep problems returned, began taking .5mg Lorazepam almost nightly

August 2018 Reinstated 5mg of Paroxetine after going into a deep depression with extreme fatigue, depersonalization and suicidal feelings

September 2018 Increased to 10mg Paroxetine, also taking .25mg of Lorazepam and .75mg melatonin for sleep

 

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 I was prescribed 30mg Paxil in 2004 for depression and anxiety. I continued taking it until last year when I decided I wanted to get pregnant and my doctor suggested weaning off it and going on 50mg of Zoloft instead. I reduced my dose by 7.5 mg from October to January until I stopped taking it completely. For the first month I experienced nausea, dizziness, irritability, headaches and muscle pain and after that I I began experiencing severe anxiety and began taking 50mg Zoloft in February as well as .5 mg of Lorazepam in the AM and PM. I later weaned off the Lorazepam and only took it occasionally for sleeplessness and extreme anxiety. I have also been using diet, exercise, meditation and psychotherapy to control the symptoms. 

 

It's been almost 8 months and though I have had a windows of feeling good, usually lasting a week or so, recently I've been feeling quite bad. I live in Spain and I went on a visit home to the United States for 3 weeks, which disrupted my normal routines and triggered some strong emotions. During my last week there I slept very poorly and had to rely on .25 or .5 mg of Lorazepam at night to get any sleep. I typically don't have trouble falling asleep but then sometimes wake only an hour later and am awake for several hours before being able to sleep again. 

 

I continued to have morning anxiety, usually dissipating in the afternoon, and also started to feel in a low mood, which hadn't really happened yet during withdrawal. Perhaps it's a result of the Lorazepam. When I returned to Spain I tried taking 3mg of melatonin to help with the sleep but this put me into a depressive stupor for several days. I had zero energy or will to do anything and my limbs felt like they weighed 1,000 pounds. I know realize this was perhaps a high dose and stopped taking it. Yesterday I felt okay but I barely slept last night, maybe 2 hours or so between 4 and 7 am. I'm a wreck again today. Exhausted, lethargic, brain fog. 

 

I'm beginning to feel like I can't go on. I thought I was seeing some improvement before my trip but now I feel worse than ever before. As a result, I'm considering reinstating on a low dose of Paxil, like 5mg. Is that too high? I have received 10mg tablets from my GP so I don't know how complicated it would be for me to cut them into smaller doses. Also, what do I do about the Zoloft? I was thinking of halving my dose to 25mg while I start up on the Paxil for a week or two to see how it goes. 

 

My psychiatrist cautioned that it could be ineffective and wants me to start on Effexor instead because it's an SNRI rather than an SSRI but I feel like my problem is withdrawal and so an additional drug isn't necessarily going to have any effect on that. 

 

Any thoughts on this? Advice about dose? I don't really want to go back on Paxil at all and  I'm scared to do anything that might upset my nervous system more but I'm also exhausted and don't know if I have any fight left in me. 

2014 Was first prescribed  30mg of Paxil/Paroxetine for an episode of major depression and anxiety. 

October 2017 Decided that I wanted to try to become pregnant and on the advice of my doctor began weaning in October to 22.5 mg, November 15mg, December 7.5mg, January 2018 0mg

February 2018 After recovering from the nausea, dizziness, headaches, back pain, diahhrea and irritability, I began having extreme anxiety. Doctor put me on 50mg of Zoloft/Sertraline and .5mg of Lorazepam in the morning and evening.

March -April 2018 Zoloft seemed to have no effect on the anxiety so I increased first to 100mg and then to 150mg with no benefit and increased gastrointestinal problems. Decreased to 100 and then 50 mg.

May 2018 Slowly cut down on Lorazepam after two months and now only take occasionally for sleep/panic.

July 2018 Sleep problems returned, began taking .5mg Lorazepam almost nightly

August 2018 Reinstated 5mg of Paroxetine after going into a deep depression with extreme fatigue, depersonalization and suicidal feelings

September 2018 Increased to 10mg Paroxetine, also taking .25mg of Lorazepam and .75mg melatonin for sleep

 

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  • Administrator
10 hours ago, Laurame said:

I started taking Zoloft (Sertraline) 50mg one month after finishing with Paxil and after experimenting with higher dosage, have come down to and stuck with 50mg until now. I have not found that it has helped with the anxiety or the insomnia.

 

Hello, Laurame.

 

Exactly how often do you take lorazepam now? Did you get any withdrawal symptoms when you reduced it?

 

Did the Zoloft help with any Paxil withdrawal symptoms?

 

What time of day do you take Zoloft? What is your daily symptom pattern? Please keep daily notes on paper about your symptoms, when you take your drugs, and their dosages. Use a simple list format with time of day on the left and notation (symptom, drug and dosage) on the right.

 

When you traveled, did you take any of your drugs off-schedule because of the time zone difference?

 

This is not medical advice. Discuss any decisions about your medical care with a knowledgeable medical practitioner.

"It has become appallingly obvious that our technology has surpassed our humanity." -- Albert Einstein

All postings © copyrighted.

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Hi Altostrata,

 

I took Lorazepam morning and evening from February to the beginning of May. Then I phased out the am dose and noticed an increase in morning anxiety that eventually decreased. Later in May I phased out the evening Lorazepam but I've been taking it on and off to sleep since then. I've gone for a couple of weeks at a time without taking it and haven't noticed withdrawal symptoms, or at least distinct symptoms from the anti-depressant withdrawal. I have been relying on it on closer to a daily basis in the last two weeks do to my terrible sleep and increasing desperation, usually taking either .25mg or .5mg but once or twice having to take a full 1 mg. 

 

I do not feel that the Zoloft has helped with any of the Paxil withdrawal symptoms. I take it in the morning, around 9am. My symptoms depend on the day, sometimes I wake up with morning anxiety that lasts until the afternoon, sometimes I don't. Sometimes I am able to get a good 5 or 6 hours sleep sometimes I sleep just a few hours here and there. In July I started experiencing a hotness and tingling in my chest and an exhaustion in my limbs, also usually in the morning. 

 

I hadn't really experienced low mood until recently. In New York I had very fractured sleep and started to feel anxious at night and have some dark thoughts, in addition to just being awake. I began taking 3mg of melatonin the night before I returned to Barcelona and for several days felt completely leaden, barely able to participate in life and very low with increasingly dark thoughts. I don't know if jetlag is a factor or the usual blues I get after saying goodbye to friends and family. 

 

I continue to take my drugs at the same time but of course there was a 6 hour time difference between here and there so I was taking my drugs at 9am EST which would have been 3pm here. 

 

2014 Was first prescribed  30mg of Paxil/Paroxetine for an episode of major depression and anxiety. 

October 2017 Decided that I wanted to try to become pregnant and on the advice of my doctor began weaning in October to 22.5 mg, November 15mg, December 7.5mg, January 2018 0mg

February 2018 After recovering from the nausea, dizziness, headaches, back pain, diahhrea and irritability, I began having extreme anxiety. Doctor put me on 50mg of Zoloft/Sertraline and .5mg of Lorazepam in the morning and evening.

March -April 2018 Zoloft seemed to have no effect on the anxiety so I increased first to 100mg and then to 150mg with no benefit and increased gastrointestinal problems. Decreased to 100 and then 50 mg.

May 2018 Slowly cut down on Lorazepam after two months and now only take occasionally for sleep/panic.

July 2018 Sleep problems returned, began taking .5mg Lorazepam almost nightly

August 2018 Reinstated 5mg of Paroxetine after going into a deep depression with extreme fatigue, depersonalization and suicidal feelings

September 2018 Increased to 10mg Paroxetine, also taking .25mg of Lorazepam and .75mg melatonin for sleep

 

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  • Administrator

Do you feel better or worse before and after you take Zoloft every day? Do you ordinarily take it at 3pm Barcelona time? How long have you been taking it at that time?

This is not medical advice. Discuss any decisions about your medical care with a knowledgeable medical practitioner.

"It has become appallingly obvious that our technology has surpassed our humanity." -- Albert Einstein

All postings © copyrighted.

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I visited my primary cmenare doctor today (my psychiatrist is out of the country) and got a prescription for 10mg of Paxil. I was planning on taking 5mg tomorrow morning, along with 25mg of the Zoloft. Do you think that's a good idea? 

 

As I mentioned, the psychiatrist wants me to try Effexor. Would that be an option that is more likely to improve my situation? I proposed the reinstatement of Paxil to my primary care doctor and she thought it sounded reasonable but I don't think she has any experience with it specifically. 

2014 Was first prescribed  30mg of Paxil/Paroxetine for an episode of major depression and anxiety. 

October 2017 Decided that I wanted to try to become pregnant and on the advice of my doctor began weaning in October to 22.5 mg, November 15mg, December 7.5mg, January 2018 0mg

February 2018 After recovering from the nausea, dizziness, headaches, back pain, diahhrea and irritability, I began having extreme anxiety. Doctor put me on 50mg of Zoloft/Sertraline and .5mg of Lorazepam in the morning and evening.

March -April 2018 Zoloft seemed to have no effect on the anxiety so I increased first to 100mg and then to 150mg with no benefit and increased gastrointestinal problems. Decreased to 100 and then 50 mg.

May 2018 Slowly cut down on Lorazepam after two months and now only take occasionally for sleep/panic.

July 2018 Sleep problems returned, began taking .5mg Lorazepam almost nightly

August 2018 Reinstated 5mg of Paroxetine after going into a deep depression with extreme fatigue, depersonalization and suicidal feelings

September 2018 Increased to 10mg Paroxetine, also taking .25mg of Lorazepam and .75mg melatonin for sleep

 

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I ordinarily take it at 9am Barcelona time but in the US I took it at 9am US time which would be 3pm here. I don't usually feel any different after I take it. I've been on it for 7 months and even tried increasing the dose to 100 and 150mg but didn't notice any improvement. The Lorazepam is the only thing that seems to have any noticeable effects. 

2014 Was first prescribed  30mg of Paxil/Paroxetine for an episode of major depression and anxiety. 

October 2017 Decided that I wanted to try to become pregnant and on the advice of my doctor began weaning in October to 22.5 mg, November 15mg, December 7.5mg, January 2018 0mg

February 2018 After recovering from the nausea, dizziness, headaches, back pain, diahhrea and irritability, I began having extreme anxiety. Doctor put me on 50mg of Zoloft/Sertraline and .5mg of Lorazepam in the morning and evening.

March -April 2018 Zoloft seemed to have no effect on the anxiety so I increased first to 100mg and then to 150mg with no benefit and increased gastrointestinal problems. Decreased to 100 and then 50 mg.

May 2018 Slowly cut down on Lorazepam after two months and now only take occasionally for sleep/panic.

July 2018 Sleep problems returned, began taking .5mg Lorazepam almost nightly

August 2018 Reinstated 5mg of Paroxetine after going into a deep depression with extreme fatigue, depersonalization and suicidal feelings

September 2018 Increased to 10mg Paroxetine, also taking .25mg of Lorazepam and .75mg melatonin for sleep

 

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  • Administrator

I don't think substituting Effexor is a good idea.

 

It could be you can adjust the Zoloft dose without bringing in Paxil again. Please answer these questions:

3 minutes ago, Altostrata said:

Do you feel better or worse before and after you take Zoloft every day? Do you ordinarily take it at 3pm Barcelona time? How long have you been taking it at that time?

 

This is not medical advice. Discuss any decisions about your medical care with a knowledgeable medical practitioner.

"It has become appallingly obvious that our technology has surpassed our humanity." -- Albert Einstein

All postings © copyrighted.

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  • Administrator
1 minute ago, Laurame said:

I ordinarily take it at 9am Barcelona time but in the US I took it at 9am US time which would be 3pm here.

 

Effectively, you skipped a dose of Zoloft on your first day in the US. This could cause symptoms during your trip and for weeks afterward.

This is not medical advice. Discuss any decisions about your medical care with a knowledgeable medical practitioner.

"It has become appallingly obvious that our technology has surpassed our humanity." -- Albert Einstein

All postings © copyrighted.

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Do you think so? I feel like I am suffering from a some depression as a result of emotional issues stirred up during my trip and the Zoloft is not doing anything to help. If you're right, then it's just a matter of waiting to restabilize? I just feel really, really low and hopeless and don't know how long I can really continue like this which is why I am considering reinstatement. Most of my trip my symptoms were similar to the ones I have at home but these last few days have been different and really bad. 

 

I've even thought about seeing if I could get checked in to an inpatient facility somewhere because I don't know how to go on like this. Do you have any advice? Is reinstatement a risky move? I hoped it might lessen some of these awful withdrawal symptoms. 

2014 Was first prescribed  30mg of Paxil/Paroxetine for an episode of major depression and anxiety. 

October 2017 Decided that I wanted to try to become pregnant and on the advice of my doctor began weaning in October to 22.5 mg, November 15mg, December 7.5mg, January 2018 0mg

February 2018 After recovering from the nausea, dizziness, headaches, back pain, diahhrea and irritability, I began having extreme anxiety. Doctor put me on 50mg of Zoloft/Sertraline and .5mg of Lorazepam in the morning and evening.

March -April 2018 Zoloft seemed to have no effect on the anxiety so I increased first to 100mg and then to 150mg with no benefit and increased gastrointestinal problems. Decreased to 100 and then 50 mg.

May 2018 Slowly cut down on Lorazepam after two months and now only take occasionally for sleep/panic.

July 2018 Sleep problems returned, began taking .5mg Lorazepam almost nightly

August 2018 Reinstated 5mg of Paroxetine after going into a deep depression with extreme fatigue, depersonalization and suicidal feelings

September 2018 Increased to 10mg Paroxetine, also taking .25mg of Lorazepam and .75mg melatonin for sleep

 

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  • 2 weeks later...

A week ago I decided to try reinstating 5mg of Paroxetine after falling into a severe depression that left me almost physically incapacitated and wishing I was dead. I haven't noticed any negative reaction except continued insomnia and some drowsiness midmorning, about 2 or 3 hours after taking the pill and the usual side effects of dry mouth and headaches. I have noticed a small reduction in the anxiety and the extremely dark thoughts but I still feel deeply depressed. Obviously this is a very short time in the context of medication and it reasonably could be weeks before I know how the reinstatement is affecting me. My psychiatrist has suggested going up to 10mg. Is it too soon for that? 

 

Also I was taking 50mg of Zoloft which I have reduced to 25mg. So I'm currently taking 25mg Zoloft and 5mg Paxil.  Any advice is deeply appreciated. It has been very disorienting to go from the anxiety and insomnia that I've been working so hard to manage over the last 8 months to this feeling of complete apathy, detachment, hopelessness and self-recrimination. 

2014 Was first prescribed  30mg of Paxil/Paroxetine for an episode of major depression and anxiety. 

October 2017 Decided that I wanted to try to become pregnant and on the advice of my doctor began weaning in October to 22.5 mg, November 15mg, December 7.5mg, January 2018 0mg

February 2018 After recovering from the nausea, dizziness, headaches, back pain, diahhrea and irritability, I began having extreme anxiety. Doctor put me on 50mg of Zoloft/Sertraline and .5mg of Lorazepam in the morning and evening.

March -April 2018 Zoloft seemed to have no effect on the anxiety so I increased first to 100mg and then to 150mg with no benefit and increased gastrointestinal problems. Decreased to 100 and then 50 mg.

May 2018 Slowly cut down on Lorazepam after two months and now only take occasionally for sleep/panic.

July 2018 Sleep problems returned, began taking .5mg Lorazepam almost nightly

August 2018 Reinstated 5mg of Paroxetine after going into a deep depression with extreme fatigue, depersonalization and suicidal feelings

September 2018 Increased to 10mg Paroxetine, also taking .25mg of Lorazepam and .75mg melatonin for sleep

 

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  • Moderator Emeritus

Can you list all the symptoms you had before paxil reinstatement with a severity level, e.g. anxiety 8/10, insomnia 7/10 and so on.  That way symptom comparisons can be made over time.

 

On 9/5/2018 at 1:53 AM, Laurame said:

My psychiatrist has suggested going up to 10mg. Is it too soon for that? 

 

If it's only been a week at 5mg it's too soon to tell what effect it will have, so I would not increase dose.

 

2001–2002 paroxetine

2003  citalopram

2004-2008  paroxetine (various failed tapers) 
2008  paroxetine slow taper down to

2016  Aug off paroxetine
2016  citalopram May 20mg  Oct 15mg … slow taper down
2018  citalopram 13 Feb 4.6mg 15 Mar 4.4mg 29 Apr 4.2mg 6 Jul 4.1mg 17 Aug 4.0mg  18 Nov 3.8mg
2019  15 Mar 3.6mg  21 May 3.4mg  26 Dec 3.2mg 

2020  19 Feb 3.0mg 19 Jul 2.9mg 16 Sep 2.8mg 25 Oct 2.7mg 23 Oct 2.6mg 24 Dec 2.5mg

2021   29 Aug 2.4mg   15 Nov 2.3mg

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  • Administrator

Laurame, has the Paxil had any beneficial effect? What time of day do you take it? Has your sleep pattern changed?

 

The Zoloft never did anything good, is that right?

 

On 8/21/2018 at 12:40 PM, Laurame said:

I took Lorazepam morning and evening from February to the beginning of May. Then I phased out the am dose and noticed an increase in morning anxiety that eventually decreased. Later in May I phased out the evening Lorazepam but I've been taking it on and off to sleep since then.

 

 How often do you take lorazepam now?

 

Yes, your taking Zoloft inconsistently while traveling and reducing it could have caused your current wave. If I were you, I'd stick with 5mg Paxil for a good while longer. You've also got the additional Zoloft.

 

Please keep daily notes on paper about your symptoms, when you take your drugs, and their dosages. Use a simple list format with time of day on the left and notation (symptom, drug and dosage) on the right.

This is not medical advice. Discuss any decisions about your medical care with a knowledgeable medical practitioner.

"It has become appallingly obvious that our technology has surpassed our humanity." -- Albert Einstein

All postings © copyrighted.

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Thank you for your responses. I take the Paxil at 9am. I haven't noticed huge beneficial changes other than a reduction in anxiety and a greater ability to control intrusive thoughts. The reduction in anxiety could be connected to my increased depression though, as that has dulled everything. I would say it has gone from a 6/10 to a 3/10. I am still depressed but it's true that the extreme physical lethargy, muscle fatigue and depersonalization seem to be decreasing, though they are always worse after a night of little sleep. 

 

My sleep has perhaps improved marginally. I am able to sleep about 5 hours at a stretch and then maybe an hour more after a wakeup. That is with the help of Lorazepam, which I had stopped using but have gone back to taking almost daily over the last month for sleep. I have been taking .5mg but in the last three days switched to .25mg and .75mg of melatonin. I am able to fall asleep but last night I woke up repeatedly and only slept for 2.5 hours in the longest stretch. Maybe trying to reduce the Lorazepam is not a good idea while I'm adjusting to the Paxil reinstatement?

 

It's possible the culprit of this wave is a missed Zoloft dose but it feels more like a stressful life event (I live abroad and recently returned from a visit home which always provokes homesickness and sadness) unduly affected my very sensitive nervous system. The idea with my doctor was to increase to 10mg Paxil for a week and then go off the Zoloft altogether. Do I need to wean off the Zoloft?

 

2014 Was first prescribed  30mg of Paxil/Paroxetine for an episode of major depression and anxiety. 

October 2017 Decided that I wanted to try to become pregnant and on the advice of my doctor began weaning in October to 22.5 mg, November 15mg, December 7.5mg, January 2018 0mg

February 2018 After recovering from the nausea, dizziness, headaches, back pain, diahhrea and irritability, I began having extreme anxiety. Doctor put me on 50mg of Zoloft/Sertraline and .5mg of Lorazepam in the morning and evening.

March -April 2018 Zoloft seemed to have no effect on the anxiety so I increased first to 100mg and then to 150mg with no benefit and increased gastrointestinal problems. Decreased to 100 and then 50 mg.

May 2018 Slowly cut down on Lorazepam after two months and now only take occasionally for sleep/panic.

July 2018 Sleep problems returned, began taking .5mg Lorazepam almost nightly

August 2018 Reinstated 5mg of Paroxetine after going into a deep depression with extreme fatigue, depersonalization and suicidal feelings

September 2018 Increased to 10mg Paroxetine, also taking .25mg of Lorazepam and .75mg melatonin for sleep

 

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On 9/5/2018 at 1:53 AM, Laurame said:

A week ago I decided to try reinstating 5mg of Paroxetine 

 

Also I was taking 50mg of Zoloft which I have reduced to 25mg. So I'm currently taking 25mg Zoloft and 5mg Paxil.  

 

On 9/7/2018 at 9:07 PM, Laurame said:

That is with the help of Lorazepam, which I had stopped using but have gone back to taking almost daily over the last month for sleep. I have been taking .5mg but in the last three days switched to .25mg and .75mg of melatonin.

 

Please can you update your signature to include these latest changes, i.e. date, drug, dose.

 

 

Edited by Songbird

2001–2002 paroxetine

2003  citalopram

2004-2008  paroxetine (various failed tapers) 
2008  paroxetine slow taper down to

2016  Aug off paroxetine
2016  citalopram May 20mg  Oct 15mg … slow taper down
2018  citalopram 13 Feb 4.6mg 15 Mar 4.4mg 29 Apr 4.2mg 6 Jul 4.1mg 17 Aug 4.0mg  18 Nov 3.8mg
2019  15 Mar 3.6mg  21 May 3.4mg  26 Dec 3.2mg 

2020  19 Feb 3.0mg 19 Jul 2.9mg 16 Sep 2.8mg 25 Oct 2.7mg 23 Oct 2.6mg 24 Dec 2.5mg

2021   29 Aug 2.4mg   15 Nov 2.3mg

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  • Administrator

It sounds like 5mg Paxil is having a good effect.

 

You're taking 25mg Zoloft, correct? What was your doctor's plan for cross-tapering? If I were you, I'd reduce Zoloft to 12.5mg, the 5mg Paxil has reached steady-state. See how that works for a week.

 

I would not increase Paxil, 5mg is enough.

 

What do you mean by "depression"? Is it a lack of feeling? Please forgive yourself every hour and stop the self-recrimination, there's no need to add that to your symptoms.

 

You're getting more sleep now, that could help a lot.

 

Since you're taking lorazepam as well, it's very important to keep daily notes on paper about your symptoms, when you take your drugs, and their dosages. Use a simple list format with time of day on the left and notation (symptom, drug and dosage) on the right. We need this information.

 

Please let us know how you're doing.

Edited by Altostrata
changed dosage

This is not medical advice. Discuss any decisions about your medical care with a knowledgeable medical practitioner.

"It has become appallingly obvious that our technology has surpassed our humanity." -- Albert Einstein

All postings © copyrighted.

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Thank you so much for your responses. I am taking 25mg Zoloft yes. My doctor suggested that I simply stop taking it after 2 weeks on Paxil.  

 

I have to confess that I increased to 10mg of Paxil a few days ago out of desperation. The last two nights I have been able to sleep from 1am to 7am without any wakeups. I take the Lorazepam and melatonin at 12am and the Paxil and Zoloft at 9am. 

 

When I say depression, I mean a lack of feeling, yes. Detachment, depersonalization, hopelessness as well as an overwhelming physical fatigue and body aches. Difficulty organizing my thoughts and speaking more slowly.  These symptoms have lessened in the last few days although my underlying mood has not improved a lot. Most days I awake with low level anxiety and lethargy but by evening the fog lifts and I feel a bit more like myself. 

 

If I continue to sleep more regularly, I'd like to discontinue the Lorazepam. I've been able to go from .5mg to .25mg to 0mg before without a problem but perhaps my situation is not stable enough to do that now?

 

I know that I need to go easy on myself and I try to do that, including practicing loving kindness meditations. Apart from the drug-induced illness, I was already unhappy at work and feeling stuck career-wise so it's easy to get into that negative headspace. I also went off Paroxetine  because I wanted to try and have a child and that now seems like an impossibility. 

 

Thanks again for responding to me. It feels very lonely and confusing to be dealing with all of this sometimes without anyone to talk to who has been through it or a medical professional to rely on who really knows what it's like. My friends and family have been very supportive but they are just as bewildered as I am and have even less information. 

2014 Was first prescribed  30mg of Paxil/Paroxetine for an episode of major depression and anxiety. 

October 2017 Decided that I wanted to try to become pregnant and on the advice of my doctor began weaning in October to 22.5 mg, November 15mg, December 7.5mg, January 2018 0mg

February 2018 After recovering from the nausea, dizziness, headaches, back pain, diahhrea and irritability, I began having extreme anxiety. Doctor put me on 50mg of Zoloft/Sertraline and .5mg of Lorazepam in the morning and evening.

March -April 2018 Zoloft seemed to have no effect on the anxiety so I increased first to 100mg and then to 150mg with no benefit and increased gastrointestinal problems. Decreased to 100 and then 50 mg.

May 2018 Slowly cut down on Lorazepam after two months and now only take occasionally for sleep/panic.

July 2018 Sleep problems returned, began taking .5mg Lorazepam almost nightly

August 2018 Reinstated 5mg of Paroxetine after going into a deep depression with extreme fatigue, depersonalization and suicidal feelings

September 2018 Increased to 10mg Paroxetine, also taking .25mg of Lorazepam and .75mg melatonin for sleep

 

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