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jordidog: Paxil

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jordidog
On 6/5/2012 at 3:18 PM, Rhiannon said:

Just one more note about holds: Over the 27 months that I've been doing this tapering thing, there have been different aspects of the process and the experience that I've focused on. Lately the thing I've been noticing most is how crucial the holds are. Right now I think they're just as important as the cuts. The cuts remove the drug, but the holds then allow your body to turn on and off the genes that need to be adjusted to adapt to the new chemistry, to remove receptors and put new ones in, and then, as you hold further, to refine the adjustments and fine tune the homeostasis.

 

These are concrete physical changes that don't seem to be able to happen quickly. (Especially since, as I've pointed out elsewhere, we don't really have any inbuilt mechanisms for healing what these drugs do to us. Broken bones, our bodies have had billions of years to evolve mechanisms to fix those; but broken brains like this are brand new in evolution. So whatever mechanisms our bodies are using to rebalance things, they're imperfect and improvised and iffy.) At least that's what it feels like to me.

 

Things get less and less wobbly the longer I hold. So that when I cut again, the system I'm re-perturbing is a stable and strong one that's going to be able to handle and adapt to the new perturbations. I think what I see happen to people a lot is, they cut and then they hold for a while, just long enough to allow the worst of it to pass, then they cut again, et cetera, but after a few of those they hit a wall.

 

I'm beginning to think--for me, at least--it's really crucial not to just hold long enough to be able to function, but to hold, at least intermittently, long enough to allow a stable homeostasis to be established, to give the body/mind a chance to attend to some deeper healing.

 

Again, for some people who can safely get off these drugs faster, it's probably ideal to get off them and then do that healing with no drug in the system at all. If you can just jump off the porch and not break your knees, go for it. But I know, for me, I have to take the steps, and even then, to stop from time to time on the way down.

 

Oh and another thing about cutting and holding: I notice that when I get into active withdrawal, I get that restlessness and anxiety and feeling of impending disaster going on, and with that comes a sort of internal pressure to Go Go Cut More Push Push NOW! and usually I cut more than I should during that time. I'm trying, now, to recognize that as a symptom of withdrawal, to hear that voice and know that when I hear it, doing exactly the opposite is what's needed.

 

And as I'm noticing that, yesterday I also noticed that right now I'm in a hold and beginning to notice the early signs of recovery and stabilization (I slept last night! 9 hours!) and I notice that although I feel like, well it would be sort of nice to be able to cut, I don't feel a pressure to, and I know it's not time yet, and that's easy to just accept. As easy as it ever gets, anyway. I grumble, but it doesn't feel like a pressure. So for me there's a sort of built-in self-sabotaging thing that happens that I'm trying to become aware of and work around. Just thought I'd toss that out there in case it helps anyone else.

Thanks for sharing your experience. I’m at 7.5 mg Paxil, reduced from 10 a week ago. I’ve had some really tough days since reducing and now thinking of going back up to 10 mg for awhile to allow my body more adapting time. I also might try making my own liquid for when I do the next cut. I have time to figure it out. Going to do 10% tapers. 

 

Edited by Shep
added new username to title

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ChessieCat

Hi Blandell and welcome to SA,

 

SA's recommended tapering protocol is to reduce no more than 10% of the current dose followed by a hold of at least 4 weeks to allow the brain to adapt to not getting as much of the drug.

 

Going from 10mg to 7.5mg is a 25% reduction which is too much and what you are now experiencing are withdrawal symptoms for such a large decrease.

 

Because you have already been on 7.5mg for 10 weeks, going back up to 10mg may be too much.  You might find that increasing by a small amount, eg 0.5mg or 1mg may be all that is needed to reduce the withdrawal symptoms.  Please read Post #1 of this topic which is relevent to updosing.  About reinstating and stabilizing to reduce withdrawal symptoms

 

Tips for tapering off Paxil (paroxetine)

 

Why taper by 10% of my dosage?


Dr Joseph Glenmullen's WD Symptoms Checklist

 

This is your own Intro topic where you can ask questions about your own situation and journal your progress.

 

 

 

Edited by ChessieCat

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ChessieCat

Please also create your drug signature which allows the mods to see your drug history at a glance.  Please update it whenever you make a change so it remains current.

 

Dates, ALL drugs, doses - no symptoms or diagnoses.  Thank you.  Account Settings – Create or Edit a signature

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jordidog

I just went to 7.5 mg on June 17th so thinking of returning to 10mg until I figure out liquid titration so I can decrease dose to 9mg

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jordidog

 

43 minutes ago, ChessieCat said:

Please also create your drug signature which allows the mods to see your drug history at a glance.  Please update it whenever you make a change so it remains current.

 

Dates, ALL drugs, doses - no symptoms or diagnoses.  Thank you.  Account Settings – Create or Edit a signature

I thought I did create my drug signature🙁

 

Edited by ChessieCat
removed unnecessary quoted posts

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ChessieCat
37 minutes ago, Blandell said:

I thought I did create my drug signature🙁

 

When we join, we fill out information about our drugs.  That is for the site admin.  The drug signature is a different thing.  I got confused about it when I joined.

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ChessieCat
1 hour ago, Blandell said:

I’m at 7.5 mg Paxil, reduced from 10 a week ago.


My apologies, I misread this as reduced 10 weeks ago.

 

42 minutes ago, Blandell said:

I just went to 7.5 mg on June 17th so thinking of returning to 10mg until I figure out liquid titration so I can decrease dose to 9mg

 

You might be able to updose to less then an 10mg.  If you had made a 10% reduction you would have been taking 9mg so you could try that.

 

If you need help with the calculations of how to get your dose when dissolving in water, please let us know and we can help you out.

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Songbird
1 hour ago, Blandell said:

I thought I did create my drug signature🙁

 

Yes, I can see the signature.  It seems you've been able to get from 20mg down to 10mg using 2.5mg dose drops.  Some people are able to taper fairly quickly through the higher doses, but many people find the lower dose ranges more difficult, especially below 10mg of Paxil. 

 

If you are finding withdrawal symptoms difficult and want to go back up to 10mg, I would suggest doing it very soon before your system has had much time to get used to 7.5mg.  After only a week it may not have adjusted much yet, but after a few more weeks it will have done more adjustments to the lower dose and may find a big increase confusing.  Another option is to stick with the 7.5mg dose, if symptoms are bearable, and wait for them to settle down.  How are you getting your 2.5mg dose drops - e.g. cutting a 10mg pill into quarters?  You could try a smaller dose increase as ChessieCat suggested above (e.g. go to 8.5mg), but this does require that you have a method to measure the doses accurately.

 

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jordidog

I’ve decided to return to 10 mgfor now. When I decrease I’ll go to 9mg. In the meantime I have to figure out a liquid form 

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jordidog
13 hours ago, ChessieCat said:


My apologies, I misread this as reduced 10 weeks ago.

 

 

You might be able to updose to less then an 10mg.  If you had made a 10% reduction you would have been taking 9mg so you could try that.

 

If you need help with the calculations of how to get your dose when dissolving in water, please let us know and we can help you out.

I’d like help figuring out how to make my own liquid form..I did read quite a bit last night about it.  I might try a compounding pharmacy 

 

 

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ChessieCat

I'll get back to you on DIY liquid.  I'm off to work today.  It won't be necessary to get compounded.

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ChessieCat

Okay, I'm back.

 

Using a greater amount of water to dissolve your tablet will make it easier for your to get more accurate doses.  I've coloured the font blue for the liquid.

 

So you can understand how the calculations work, if you dissolve your 10mg tablet in 10mL of water each 1mL liquid will contain 1mg of drug.  To get 9mg of drug you would extract and dispose of 1mL and drink the remainder.

 

10mg : 10mL            1mL = 1mg drug     extract and dispose of 1mL for 9mg dose

 

Other quantities of water:

 

10mg : 20mL           1mL = 0.5mg drug     OR     2mL = 1mg drug      extract and dispose of 2mL for 9mg dose

 

10mg : 50mL           1mL = 0.2mg drug     OR     5mL = 1mg drug        extract and dispose of 5mL for 9mg dose

 

10mg : 100mL         1mL = 0.1mg drug    OR     10mL = 1mg drug     extract and dispose of 10mL for 9mg dose

 

If you want to further understand it:

 

to work out what 1mL liquid contains you divide the left figure by the right figure (eg 10/20 = 0.5mg)

 

to work out how much liquid contains 1mg of drug you divide the right figure by the left figure (eg 20/10 = 2mL

 

You need to ensure that you use the same equipment and do everything the same way each time.  It is a good idea to keep notes about what you use and the procedure so that if you ever have a brain freeze, which happens to everyone - even people not tapering.    

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jordidog
On 6/24/2018 at 11:24 PM, ChessieCat said:

Hi Blandell and welcome to SA,

 

SA's recommended tapering protocol is to reduce no more than 10% of the current dose followed by a hold of at least 4 weeks to allow the brain to adapt to not getting as much of the drug.

 

Going from 10mg to 7.5mg is a 25% reduction which is too much and what you are now experiencing are withdrawal symptoms for such a large decrease.

 

Because you have already been on 7.5mg for 10 weeks, going back up to 10mg may be too much.  You might find that increasing by a small amount, eg 0.5mg or 1mg may be all that is needed to reduce the withdrawal symptoms.  Please read Post #1 of this topic which is relevent to updosing.  About reinstating and stabilizing to reduce withdrawal symptoms

 

Tips for tapering off Paxil (paroxetine)

 

Why taper by 10% of my dosage?


Dr Joseph Glenmullen's WD Symptoms Checklist

 

This is your own Intro topic where you can ask questions about your own situation and journal your progress.

 

 

 

I’m not sure at all by this:  THIS IS YOUR OWN INTRO TOPIC WHERE YOU CAN ASK QUESTIONS....

i don’t know what is meant by the statement or what to do about it🙁

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ChessieCat
2 hours ago, Blandell said:

This is your own Intro topic where you can ask questions about your own situation and journal your progress.

 

SA works differently to many other forums.  Each member has their own Introduction topic.  It is the best place for members to ask questions about their own situation.  It keeps your history in one place.  When a member asks a question in their own topic it means that the moderators don't have to try to find the background information on the member (and possibly miss important information) because it is altogether.  When a member asks a question in their Intro topic and it is answered, other members and guests who don't register, can see the information which may help them as well.

 

You can also journal your progress.  For example, if you have had an increase in withdrawal symptoms you can post about it here.  If you have had an improvement it is good to post in your Intro so you can look back and see how things change.  It allows other members to support you during the difficult periods and celebrate with you when you are feeling a bit better.  I recently took the wrong dose for 5 days and posted about it and other members posted encouragement.

 

We encourage members to visit other members' topic so you can support each other.  However, please remember that it is their Intro so don't write too much about yourself, they can visit your Intro to find out more about your situation.  You can also post in the general discussion topics, but remember to ask questions about your own situation here in your Intro topic.  If you post questions specific to your situation in the general discussion topics, the questions might get missed, because the moderators focus on the member Intro topics.

 

I hope that explanation helps.

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jordidog

I am at 10 mg Paxil and started at 20mg on January 30th 2018. It has been a fairly tolerable journey until a week ago when I went from 10mg to 7.5. I now understand that was too much and after just 1 week at the lower dose, I’ve returned to 10 mg. I went through a couple of days with emotional and angry “spiraling “. Awful 🙁

Now will stay at 10 til I return from a week away and give myself time for adaptation and healing. I had no idea of how painful this can be...sadness, anxiety, anger, desperation. I’ll resume my tapering journey 10% at a time by making my own Paxil liquid, thanks to info from folks here. 

I hope I feel myself again and can leave this withdrawal bubble behind.  I am 65 and glad I’m doing this now while I still have energy and strength to handle this intense neurological storm. Glad to have found SA. 

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ChessieCat
22 hours ago, ChessieCat said:

SA works differently to many other forums.  Each member has their own Introduction topic.  It is the best place for members to ask questions about their own situation.  It keeps your history in one place. 

 

I've merged the new Intro topic you created with your original Intro topic.  Each member has only 1 Intro topic.  The reasons for this were explained in the above quoted post.

 

Please do not create any more Intro topics.  Thank you.

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jordidog
30 minutes ago, ChessieCat said:

 

I've merged the new Intro topic you created with your original Intro topic.  Each member has only 1 Intro topic.  The reasons for this were explained in the above quoted post.

 

Please do not create any more Intro topics.  Thank you.

 

30 minutes ago, ChessieCat said:

 

I've merged the new Intro topic you created with your original Intro topic.  Each member has only 1 Intro topic.  The reasons for this were explained in the above quoted post.

 

Please do not create any more Intro topics.  Thank you.

I had no idea! I get confused easily with this stuff. I don’t find the explanations or instructions easy to understand 

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jordidog
23 hours ago, ChessieCat said:

 

SA works differently to many other forums.  Each member has their own Introduction topic.  It is the best place for members to ask questions about their own situation.  It keeps your history in one place.  When a member asks a question in their own topic it means that the moderators don't have to try to find the background information on the member (and possibly miss important information) because it is altogether.  When a member asks a question in their Intro topic and it is answered, other members and guests who don't register, can see the information which may help them as well.

 

You can also journal your progress.  For example, if you have had an increase in withdrawal symptoms you can post about it here.  If you have had an improvement it is good to post in your Intro so you can look back and see how things change.  It allows other members to support you during the difficult periods and celebrate with you when you are feeling a bit better.  I recently took the wrong dose for 5 days and posted about it and other members posted encouragement.

 

We encourage members to visit other members' topic so you can support each other.  However, please remember that it is their Intro so don't write too much about yourself, they can visit your Intro to find out more about your situation.  You can also post in the general discussion topics, but remember to ask questions about your own situation here in your Intro topic.  If you post questions specific to your situation in the general discussion topics, the questions might get missed, because the moderators focus on the member Intro topics.

 

I hope that explanation helps.

I think I understand now. What you refer to as my intro topic is under my name in the introduction...right?

 

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Songbird

 

9 minutes ago, Blandell said:

What you refer to as my intro topic is under my name in the introduction...right?

 

 

That's right.  You can think of it like your journal where you can post all your updates and any questions about your situation.  This keeps your story all together in one place.

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jordidog

I’m unsure about making my own Paxil liquid despite instructions from ChessieCat...I read somewhere else that to be in a liquid then it must be in a suspension..I want to go down to 9 mg by July 10th. I’ve been looking for more info but haven’t found anything yet.

 

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brassmonkey

Paxil has a very good solution rate using water (5.4mg/mL).  Dissolving it in plain water is all that is necessary.  You might let it sit in the refrigerator over night to assure full dissolution.  Any particles that settle out are just fillers and are of no concern.

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jordidog

Great and I like the idea of refrigerating overnight. I think I’d make several doses at once and leave in the fridge 

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brassmonkey

Even with the refrigeration it isn't a good idea to store it much more that a week.  So don't try to get too far ahead. But, yea, try to make things as easy as possible for your self.

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jordidog

A pharmacist who is a friend , suggests transferring over to Prozac and withdrawing from that..

what Should I do?

am on 10mg Paxil and getting ready to reduce again

thanks in advance 

 

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jordidog

Having read some other posts I’ve decided to NOT switch to Prozac in my taper journey 

I might try 5% down from my current dose of 10mg based on what I’ve read here.

Our dog has to have surgery on July 20th so will wait until that’s over to do the reduction based on my past experience with tapering and stressors!

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jordidog

I want to use this method and keep the liquid in the fridge. I was told perhaps ok for 3 days in fridge. 

I guess I’ll need a very accurate oral syringe?

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Altostrata

Hello, Blandell. Please put questions about your particular tapering strategy in this, your Intro topic.

 

We suggest a switch to Prozac only if directly tapering Paxil proves to be too difficult. Switching incurs additional risks.

 

Tapering with a liquid is probably your best best. We have many people here who have successful tapered with a homemade suspension with water, or you can get the prescription liquid.

 

Combining a lower dosage Paxil tablet with the liquid portion to make up your daily dose is probably the easiest way to convert to the liquid.

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jordidog

I thought that I did post under my introduction topic. 

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mammaP
18 hours ago, Blandell said:

I guess I’ll need a very accurate oral syringe?

Yes you will need oral syringes, I have 10ml 5ml 1ml all from Amazon. You can get them from pharmacies. 

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jordidog

I am on 10mg of Paxil and going to start lowering dose in a few days. 

I am having trouble doing the math for future decreases. Can anyone help? I am normally great at math but right now am feeling kind of stunned. 

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brassmonkey

Hi Blandell-- no problem with the math help.  We need to know the specifics of how you want to taper. What percentage decrease are you planning? Will you be using scales and dry cutting? If you're using scales, what is the average weight of your Paxil tablets?That will get us started.

 

Brassmonkey

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jordidog

At the moment I have several options for how to taper: liquid paroxetine; making my own liquid from 10 mg tablets; or a combo of liquid and tablet ie. halve tablet =5mg and then balance with liquid

I think I will start with 2.5% reduction for 1st week. If it is fine then will do again the next week, and then again...each week for 4 weeks and then hold for two weeks or more if I think I need to. 

So will be dropping 2.5% each time I reduce. 

Thanks for your help. This feels like a big step!!

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jordidog
46 minutes ago, ryan1982 said:

@brassmonkey

Thanks so much.  I've probably read your essay 10 times...it's actually screenshot on my phone so I can refer back to it.  Thanks for the reminder!

 

I guess I'm curious...how do I know whether I'm in withdrawals or whether I have new breakthrough symptoms?

 

Do you think I need a higher/lower dose or should I just hold?

 

Lastly, for the dose decrease of 2.5%, do you subtract 2.5% from the previous week or from the original dose of the 6 week cut?  i.e. if I start on 10 MG and then week 1 taper down to 9.75, do I subtract 2.5% for Week 2 from 10 MG or 9.75 MG? 

Now what do I do? I don’t know why you are sending this to me...I’m so sorry but I can’t figure out how to use this site st times. 

Brassmonkey...I asked a question and message sent me to this post...what? 

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brassmonkey

Hi Ryan-- unless you're taking a new drug the symptoms will almost always be from WD.

 

Your signature is showing that your last reduction was about a month a go, so it probably needs some more time to stabilize.  Unless your symptoms are unbearable there would be no need to updose. I would ride it out for a few months and then reassess.

 

Reductions are calculated on the amount of the "previous dose", or more accurately the dose you are tapering from.  So if you are taking 10mgai next week you would take 9.75 the third week would be 9.5 and the fourth through sixth weeks would be 9.25. In each case the new dose is 2.5% less than the one before it.

 

Hope that helps.

 

Brassmonkey

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jordidog

I’m changing my mind about dropping my 10mg Paxil to 9.75 as am struggling right now. I anticipated this as our dog had to have surgery and this has caused me to be tied down and increased my anxiety 

It’s better for me when I can get out more and vary my day. 

I’ve been at 10mg since May 12th. 

The anxiety and sadness I’ve felt in the past 4 days is scary for me. I worry that I won’t be able get off of Paxil. I’m also thinking that I can simply give myself the time I need to settle down. But am afraid that won’t happen 

I used a meditation app yesterday and I’m on the list for a mindfulness group

This is hard...but I have had times recently that felt easier 🙁

will try to consult SA a bit more right now

thanks for being here😊

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