Bee5: reinstated paroxetine, dose too high?

[Bee5]

Thanks @Altostrata. I take my lamotrigine at night with my quetiapine, so I will maybe move the 50 mg earlier an hour each day. 

[Altostrata]

Correct! This may help the brain zaps during the day.

[Carmie]

16 hours ago, Bee5 said:

Thanks @Altostrata. It is amazing that a mere formulation change (not a dosage change) can cause withdrawal symptoms. I take a 100 mg tablet combined with a 50 mg tablet. I think the brain zaps are almost over, but if they don't abate, splitting the lamotrigine dose might be the way to go. 

 

Hi Bee, 

 

How are you doing?  Have your brain zaps lessened a bit? How often are you getting them now? Yes, it is amazing that a formulation change can cause such havoc. I’m experiencing this myself from changing over to compounded capsules as you know, though my measurements n the pharmacies measurements are probably not the same as I noticed different syringes aren’t all the same, they can be off by quite a bit. Also compounded capsules can be off by 3% I’ve read. So with me it’s a combination of two factors. 

 

I hope your brain zaps go away completely soon. Please don’t taper until they do as they may get worse, I’m sure you’re not going too. Ah, stabilisation, now that’s a good word. We always get there. It just takes time n lots of patience n distracting ourselves while we are waiting.

 

Sending hugs🤗

 

 

[Bee5]

Thanks Alto.

 

Thanks Carmie, yes, I am lucky to have a supportive psychiatrist, and he has just extended my quetiapine script for another month, so that I reduce when I am stable following the paroxetine formulation change. Hugs for the weekend!

[Bee5]

Just an update. The brain zaps seem to have abated, but my sleep has not been fully restored. Some nights I struggle to fall asleep, sometimes I have full-body jerks as I'm falling asleep, and sometimes I wake up in the middle of the night, usually because I am cold from sweating through my clothes (side effect of paroxetine). As soon as my sleep is sorted, it will be time for my next quetiapine step-down. Baby steps.

 

Also, I have a few anxious thoughts during the day, so I know I'm not quite at baseline yet...

[Carmie]

On 10/23/2018 at 9:25 PM, Bee5 said:

Just an update. The brain zaps seem to have abated, but my sleep has not been fully restored. Some nights I struggle to fall asleep, sometimes I have full-body jerks as I'm falling asleep, and sometimes I wake up in the middle of the night, usually because I am cold from sweating through my clothes (side effect of paroxetine). As soon as my sleep is sorted, it will be time for my next quetiapine step-down. Baby steps.

 

Also, I have a few anxious thoughts during the day, so I know I'm not quite at baseline yet...

 

Glad to hear the brain zaps have abated Bee. You look like you’re definitely heading towards stability. Don’t put a calendar on it. Yes, definitely baby steps. 

 

I wont be able to tell you how long it takes me to stabilise from changing to compounded capsules now as I accidentally doubled up on the seroquel again last night so that has been thrown in the mix. I did eventually stabilise last time that happened though too. No doubling up for years n then twice in one year. It’s time for a new brain.😀

 

Hope you have a happy day☀️☀️

[Bee5]

Just journalling an update. Brain zaps still happen, but only a few per day, with no pattern (one bout of zaps per day, but at different times each day). Still having a few intrusive thoughts.

 

@Carmie it is so hard not to try put a calendar to everything. It seems ridiculous that it has taken more than 2 months to stabilise following a paroxetine formulation (not dose) change. I feel stuck in this space, and am so worried that I will not stabilise. I am trying to stay hopeful.

[Bee5]

It has been 10 weeks since the formulation change. I think I am approaching stability. However, I still get the occasional brain zap, and pre-bedtime anxiety.

Hoping to reduce quetiapine on the 25th of Nov. Seeing psychiatrist on Wed.

Happy healing SA members!

[ChessieCat]

It's good that things are improving.  You might want to consider making cautious reduction of less than 10%.  That way you could test to see how your respond.  You could try 5% or even 2.5% and if things are okay after a week or two you could reduce some more.

 

Many members find it helpful to take these supplements every day Magnesium (throughout the day) and Omega-3 Fish Oil.

[Carmie]

On 10/31/2018 at 11:57 PM, Bee5 said:

Just journalling an update. Brain zaps still happen, but only a few per day, with no pattern (one bout of zaps per day, but at different times each day). Still having a few intrusive thoughts.

 

@Carmie it is so hard not to try put a calendar to everything. It seems ridiculous that it has taken more than 2 months to stabilise following a paroxetine formulation (not dose) change. I feel stuck in this space, and am so worried that I will not stabilise. I am trying to stay hopeful.

 

On 11/10/2018 at 4:04 PM, Bee5 said:

It has been 10 weeks since the formulation change. I think I am approaching stability. However, I still get the occasional brain zap, and pre-bedtime anxiety.

Hoping to reduce quetiapine on the 25th of Nov. Seeing psychiatrist on Wed.

Happy healing SA members!

 

Hi Bee, 

 

Great to see you are stabilising. Yes, we never think we will stabilise but we always eventually do. In your post on the 31st of October  you said you thought you would never stabilise n then in the next post on the 10th of November  you’re already starting to feel a little better. 

 

It’s soooo easy in waves to think they will never in, especially when they’re severe. I haven’t stabilised as yet but I’m better than I was in the beginning of the taper, though had severe waves yesterday. It’s up n down n up n down, quite a rollercoaster ride.

 

Wishing you the best n please don’t put a calendar on your tapering, only taper when you’re stable, when you’re back to withdrawal normal. What a weird saying withdrawal normal is, there is nothing normal about withdrawals!!

 

Take care💚

Edited November 15, 2018 by Carmie
Wrong date

[Bee5]

On 11/10/2018 at 8:19 AM, ChessieCat said:

You might want to consider making cautious reduction of less than 10%.

Thanks Chessie. I am not planning on reducing the paroxetine until I am completely off the quetiapine. I will try 10% (I am on 250 mg, so I will reduce to 225 mg) to see how I handle it. But this will only happen around the 25th of November anyway.

 

On 11/10/2018 at 8:19 AM, ChessieCat said:

Many members find it helpful to take these supplements every day Magnesium (throughout the day) and Omega-3 Fish Oil.

I take both of these, but not every day. I have found both to be activating in the past. I take Omega 3 every time I have brain zaps, which is about per day on alternating days.

 

@Carmie, I am glad you are feeling a little bit better. It makes me feel better that we do EVENTUALLY stabilise.

 

Sending hugs,

Bee

[Bee5]

Hi SA friends,

So I had a phenomenal week with a fantastic mood, but I should have known that it was too good to be true, because I entered into a wave last night. I am starting to think that windows actually CAUSE waves. And I think that if I tried to keep calm during the window, that I could have avoided the wave. Any thoughts on this? 

Bee

[ChessieCat]

When members get a window they can sometimes overdo things because they feel good.  Overdoing things often leads to a wave.  Instead of going all out next window it would be better if you paced yourself more so that you either don't end up in a wave, or the wave isn't as bad.

[Bee5]

Thanks @ChessieCat. It is so frustrating and scary at the same time. It's sad that we can't celebrate the windows. But lesson learned. My mood was definitely elevated on the weekend, and then last night, the wave. I am so sad that I will be going through this for at least the next few years. 😕

 

[ChessieCat]

Being careful and not overdoing things means that you aren't going to feel as bad afterwards, so things will be levelling out to be more pleasant / less bad most of the time, instead of bad, good, bad, good yo-yoing.

[Bee5]

Thanks @ChessieCat. I think I am going to have to learn this skill; because I was just going with the flow of the excitement, but I realise now that I will need to do things differently.

[Bee5]

Hi All,

 

Just journalling an update. Had my year-end function on Saturday, and had a bit too much to drink (this has not happened since end 2014). Had a very low-mood Sunday, Monday and Tuesday, but am better. Stepped down my quetiapine from 250 mg to 225 mg. I am on Day 4 of this, and so far ok, so I am hoping for the best.

 

Hugs to all,

Bee

[Carmie]

Hi Bee, 

 

Just checking in to see how you’re doing. 

 

Sending hugs🤗

[Bee5]

Hi @Carmie!

Thanks for checking in! I have adjusted nicely to the new quetiapine dose. I am supposed to drop now, to 200 mg, but I am holding until the silly season is over and I resume my usual work routine.

I am going to go to your thread now to see how you are doing  

Keep well,

Bee 

[ChessieCat]

2 minutes ago, Bee5 said:

I am supposed to drop now, to 200 mg, but I am holding until the silly season is over and I resume my usual work routine.

 

That's a good idea.

[Bee5]

Thanks @ChessieCat. I realised that if I consume alcohol and/or get overly excited, that a low follows, so just trying not to overdo anything at the moment.

[powerback]

2 hours ago, Bee5 said:

f I consume alcohol and/or get overly excited, that a low follows,

Stop consuming alcohol ,this is essential to your recovery ,once a month would be too much .Alcohol is a depressive .

I can relate to the over excitement ,im aware of this these days as much as the lows ,all moods need monitoring and controlling .

 

[Carmie]

Hi Bee, 

 

I’m glad you’ve adjusted to the new dose of quetiapine. 

 

Yes, please give up the alcohol. It may hinder you recovering sooner. 

 

Sending hugs🤗

[Bee5]

On 12/27/2018 at 2:20 PM, powerback said:

Stop consuming alcohol ,this is essential to your recovery ,once a month would be too much .Alcohol is a depressive .

I can relate to the over excitement ,im aware of this these days as much as the lows ,all moods need monitoring and controlling .

 

Thanks for this @powerback, I (naively) thought that I could enjoy one or two drinks daily over the festive season, and my moods have been extremely low as a result. I won't be so stupid in future. Anything beyond a single unit of alcohol has an impact on my mood the next day, so as you said, best to stay away.

 

Thanks @Carmie, I am hoping to drop to 200 mg soon. How are you adjusting back on your old dose?

[Carmie]

Hi Bee, 

 

All the best with your next drop. Have you done it yet? Going from 225mg to 200mg is a little more than 10% though. 

 

I only started my crosstaper last night, thanks for asking, and I had no problems. I’ll see how the rest of the crosstaper goes. We can just take a day at a time. I’m going to stick with each step for a week or so. Slow and steady does it. I have to water titrate two different medications. I’ll be glad when I’m back on the original tablet. Then I can start tapering again once I stabilise. Yay! Take care💚. 

 

[Bee5]

Thanks Carmie. This is the last 25 mg drop I am doing, then I will drop in smaller doses.

[Carmie]

25 minutes ago, Bee5 said:

Thanks Carmie. This is the last 25 mg drop I am doing, then I will drop in smaller doses.

 

Sounds like a good plan Bee, 

 

Wishing you all the best with your continued tapering. As you already know please don’t taper again until you stabilise. Sending hugs🤗

[Carmie]

Hi Bee, 

 

How have you been doing?💚

[Bee5]

Hi Carmie,

 

I have just recently dropped to 200 mg quetiapine. I'm on Day 3 and no symptoms. I was a bit sick with a cold a few days back, and it strangely made me feel anxious; but I looked it up on this site and on the internet - when your body is fighting an infection, it can make you feel anxious/depressed.

 

How are you doing with your old pills?

 

Bee

[Carmie]

That’s great news Bee, 

 

I’m glad your taper is going well. I just started phase three of the crossover back to my original tablets tonight, so I should be back on them in a week or two depending on how long I’ll do this phase for. The crosstaper has run very smoothly. I definitely recommend crosstapering. When I changed from the tablets to the capsules I didn’t crosstaper and I went into waves for over three months. 

 

Let’s see how phase three of the crosstaper goes. There’s no certainty in anything as regards these meds, but so far, so good. I’ll be glad when I’m back on the original tablets as I won’t have to water titrate two different formulas every night, and I’ll finally be able to move forward in my tapering. 

 

Wishing you all all the best in your continued tapering, keep us updated.💚

Edited January 28, 2019 by Carmie
Clarification

[Bee5]

Carmie, please explain what you mean by crosstaper - do you mean taking both types of medication at the same time in varying quantities until the one has been tapered out?

[ChessieCat]

Cross over is a better term because there is no tapering, just changing from one form of a drug to another, eg tablet to liquid, brand to generic.

 

It is gentler on the nervous system to do a cross over, 3 to 7 days of each combination:  3/4 + 1/4, 1/2 + 1/2, 1/4 + 3/4.

[Carmie]

Hi Bee, 

 

Yes, I’m doing a cross over as ChessieCat said. I’m going from the compounding capsule of Quetiapine back to the original tablet of Quetiapine. I haven’t actually changed medication. At the moment I’m doing 1/4 of the old formula (compounded capsule) and 3/4 of the new formula (the tablet I want to go back on). After I’ve done this for a week or so I’ll be back to my original tablet.

 

One usually does each part of the cross over from 3 to 7 days but I’ve done the first two phases of the crosstaper longer. It’s been going well so far. Hope you’re doing okay💚

Edited January 29, 2019 by Carmie
Typo

[Bee5]

Thanks @Carmie and @ChessieCat. I will eventually need to do this to move over from part controlled-release paroxetine, part immediate-release paroxetine, to fully immediate-release paroxetine, because those are easier to cut.

 

[ChessieCat]

9 minutes ago, Bee5 said:

I will eventually need to do this

 

At least you know about it so can plan.

[Carmie]

Hi Bee, 

 

Yes, definitely do a cross over when you change formulations. When I went from tablet to compounding capsule I went through about three months of waves. I didn’t know anything about crossovers then and payed for it. Now that I’m going back to my original tablet with a cross over I’ve had no problems.

 

If you’ve got enough of the old formula you can even cross over slower than the 3 to 7 days with each phase, that’s what I’ve done so far, and it’s been all smooth sailing. I’m all for slow and steady. I could have avoided the three months of waves if I knew about it. Knowledge is power.😁

 

Sending hugs🤗