Bee5: reinstated paroxetine, dose too high?

[Bee5]

Thanks Brassmonkey. I use one for travelling, so I will just increase usage in winter. (It's winter here in South Africa).

[Bee5]

Just journalling an update. I have been holding for 6 weeks (no further cuts). I am really stressed about my Master's, and have many deadlines for work and for Master's. I am also about to go on a work trip. My anxiety has been elevated for the past few days, but I am trying to manage it by ensuring I get enough sleep. I used to handle this stuff easily, but ever since my psych meds prescribing cascade, I just can't handle as much stress. This leaves me sad, because I feel like I will never be able to change jobs, to a higher-performance job.

[Bee5]

After holding for 2 months, I felt ready for a small cut. I have only cut by 6.25 mg (about 5%). Let's see how it goes. 

Study stress continues, but all will improve significantly after 20 September, after my draft project submission. 

[Miko789]

 

Hi Bee5,

 

Just poppin in your thread,

 

chocolate has uplifting effect  without any negative effect and can help while taking a/d paxil,

 

Also you can taper paroxetive  liquid if you havent done already.

 

If you  have any numbness in hands in  the morning  could be wd from paroxetine.

Take care

 

[Bee5]

Thanks for popping in @Miko789. trust me, I am eating copious amounts of chocolate. It helps me manage my stress. I am first going to completely taper off quetiapine before attempting a paroxetine taper. If all goes well I will be done with the quetiapine by mid 2020.

I don't have numbness in hands, but I do have tinnitus from the paroxetine.

Just a question, why did your doctor put you on such a rapid taper from olanzapine? I was on olanzapine for a few months in 2015-2016, and I got akathisia when I tried dropping by such large amounts.

[Carmie]

Hi Bee, 

 

How are you going with your latest cut?💚

[Bee5]

Hi @Carmie,

Thanks for checking in. The cut is going well so far, since I only cut about 5%. The weight gain is really troubling me though, because I have an insatiable appetite. No matter how much I eat, I want to eat more. It is really affecting my self-confidence. I can't wait to be off the quetiapine, and it feels like it it taking forever to get off. I hate what these meds do to us. The studies will be stressful until 20 September, so I don't want to try control my eating until then, but after 20 September, I am going to regain control of my eating.

 

How are you doing on your recent cut? You have come so far.

 

Regards,

B

[Carmie]

On 8/22/2019 at 10:17 PM, Bee5 said:

Hi @Carmie,

Thanks for checking in. The cut is going well so far, since I only cut about 5%. The weight gain is really troubling me though, because I have an insatiable appetite. No matter how much I eat, I want to eat more. It is really affecting my self-confidence. I can't wait to be off the quetiapine, and it feels like it it taking forever to get off. I hate what these meds do to us. The studies will be stressful until 20 September, so I don't want to try control my eating until then, but after 20 September, I am going to regain control of my eating.

 

How are you doing on your recent cut? You have come so far.

 

Regards,

B

 

So glad to hear you last cut is going well Bee, 

 

I taper under 5% myself but I still end up in waves along the way as I’ve been so sensitised. I’m hoping to taper again in the next day or two from 6.50mg to 6.25mg. 

 

Yes, I put on a ton of weight with the quetiapine too but I lost it again as I’ve mentioned before. I remember being extremely hungry all the time too, I’m not like that now, maybe because I’m on a lower dose. They had me on 300mg originally. I hope all goes well with your weight loss at the end of September, sending hugs🤗

[Bee5]

Journalling an update:

Have made a small cut and am now on 106.25 mg quetiapine. I cut by about 5% due to studying stress, but after my draft project goes in at the end of the month, then I will cut the other 5% (if I feel ok). I will then stick to 10% cuts where possible.

My only symptoms at the moment is bedtime anxiety, and some twitching of random muscles 2-3 times a day.

[Carmie]

Hi Bee, 

 

Glad to hear that your tapering is going okay.💚

[Bee5]

On 9/20/2019 at 7:08 AM, Carmie said:

Hi Bee, 

 

Glad to hear that your tapering is going okay.💚

 

Thanks Carmie. My draft project submission goes in on Sunday, then I have 2 weeks break before resuming my project. Welcome relief.

[Bee5]

Decided to cut another 6.25 mg. Going to hold on 100 mg quetiapine until I feel ready for another cut.

[Bee5]

Journalling an update:

I have decided to come of the Yaz (oral contraceptive), because it is correlated with depression and recurrent yeast infections. There isn't really an easy way of tapering it, so I am taking one every second day until the pack is finished. I have 10 days to go, and it has been ok (no major symptoms).

I have submitted my Master's dissertation, so that is off my plate. I will be returning to eating healthier and exercising, because my stress levels will decrease.

In terms of my psych meds, I have not made any changes, but I am planning to drop to 87.5 mg of quetiapine near the end of November.

I will also be asking my pdoc to change my script from 12.5 mg CR paroxetine + 20 mg IR paroxetine, to 30 mg IR paroxetine, for the new year (the IR is cheaper and is fully covered by my health insurance).

 

[Bee5]

Update: I have done a quetiapine cut to 87.5 mg.

[Bee5]

Hi All,

I was just wondering if any other SA users need excessive amounts of sleep to function? I get 9 hours of sleep every night, mostly good quality sleep, but I am still sleepy in the mornings until about 10:00, which makes it really difficult to work in the mornings. Will it be like this forever, or will I get back to needing only 8 hours of sleep? Is it possible that the quetiapine is giving me residual drowsiness due to its sedative properties? Would it help to take the quetiapine earlier in the evening? (I take it at 20:00).

Regards,

Bee

[Bee5]

Hi, 

Just journalling an update. I have dropped to 30 mg paroxetine. I will not be changing the paroxetine again until I am off the quetiapine (so probably not until the end of 2020).

Bee

[Bee5]

Journalling an update: I have dropped to 75 mg quetiapine. I know this is more than 10% but the breathing issues are really scaring me, so I wanted to drop the dose a bit more. I will hold until I stabilise.

[Bee5]

  

On 6/13/2020 at 4:58 PM, crashcourse said:

There's a drug shortage. What do I do?

Citalopram and all generic variants have vanished from the market. Most likely due to COVID 19 disrupting supply chains and production. I have not taken any medicine for 5 days now. So far I am feeling okay.

 

The way I see it, I have two options:

 

1) Shift to another drug, which I really don't want to do.

 

2) Cold turkey, and see what happens. I don't like this option either, but it seems I'll be forced into this.

 

What recommendations do you folks have if any?

 

 

 

I have a similar shortage. Paxil is completely unavailable in South Africa at the moment, and it is unlikely that stock will be replenished anytime soon. I have searched the site to find the best generics, but I can't find a thread relating to this. It is unlikely that any of the generics available here will have the same name as the ones in your countries. The generic I have currently been prescribed is and Adcock-Ingram one, but it contains paroxetine mesylate instead of paroxetine hydrochloride. I am very worried. Is there any way to ease the transition (there is no option of cross-taper due to the shortage)? 

 

Edited June 16, 2020 by ChessieCat
added quote for context

[Frogie]

35 minutes ago, Bee5 said:

I have a similar shortage. Paxil is completely unavailable in South Africa at the moment, and it is unlikely that stock will be replenished anytime soon. I have searched the site to find the best generics, but I can't find a thread relating to this. It is unlikely that any of the generics available here will have the same name as the ones in your countries. The generic I have currently been prescribed is and Adcock-Ingram one, but it contains paroxetine mesylate instead of paroxetine hydrochloride. I am very worried. Is there any way to ease the transition (there is no option of cross-taper due to the shortage)? 

You might “google” paroxetine mesylate.  I bet you will come up with online pharmacies that sell it. Hopefully your dr would write a prescription so you could obtain some. 
 

Good luck,

Frogie xx

[ChessieCat]

 

9 hours ago, Bee5 said:

I have a similar shortage. Paxil is completely unavailable in South Africa at the moment, and it is unlikely that stock will be replenished anytime soon. I have searched the site to find the best generics, but I can't find a thread relating to this. It is unlikely that any of the generics available here will have the same name as the ones in your countries. The generic I have currently been prescribed is and Adcock-Ingram one, but it contains paroxetine mesylate instead of paroxetine hydrochloride. I am very worried. Is there any way to ease the transition (there is no option of cross-taper due to the shortage)? 

 

Any sort of cross taper would be better than none at all, so even if you only have a few of the original it would be good to do it as best you can.

 

The other option is to change to Prozac.

 

the-prozac-switch-or-bridging-with-prozac

 

https://www.nps.org.au/assets/Products/Guidelines-switching-antidepressants_A3.pdf

[ChessieCat]

https://www.depressionforums.org/forums/topic/46909-paroxetine-hcl-vs-paroxetine-as-mesylate/

[ChessieCat]

9 hours ago, Bee5 said:

it contains paroxetine mesylate instead of paroxetine hydrochloride.

 

https://www.depressionforums.org/forums/topic/46909-paroxetine-hcl-vs-paroxetine-as-mesylate/

[ChessieCat]

  

8 hours ago, Altostrata said:

If you cannot get an SSRI -- paroxetine, sertraline, citalopram, escitalopram, fluvoxamine -- you might take the opportunity to cross-taper to fluoxetine (Prozac) (or citalopram if fluoxetine is not available).

 

Many doctors routinely substitute fluoxetine to enable their patients to taper off an antidepressant.

 

Cross-taper means you gradually substitute one drug for the other, for example, take half your dose in sertraline, half in fluoxetine for a few days; then a quarter of your dose in sertraline, 3/4 in fluoxetine for a few days; finally, your entire dose in fluoxetine.

 

Substituting another drug may be a little bumpy for some weeks, but it is preferable to running out of your antidepressant and taking nothing.

 

[Bee5]

On 6/15/2020 at 3:11 PM, Frogie said:

You might “google” paroxetine mesylate.  I bet you will come up with online pharmacies that sell it. Hopefully your dr would write a prescription so you could obtain some. 
 

Good luck,

Frogie xx

 

The mesylate is the one I have never tried, and have no idea why the pharmacist (who knows me and my sensitivities well by now) would even recommend it. I took the mesylate generic back and asked for one with the hydrochloride salt, and the pharmacist swopped it out, so now I am on a paxil generic with a hydrochloride salt, and I already feel better.

[Bee5]

On 6/16/2020 at 12:15 AM, ChessieCat said:

 

 

Any sort of cross taper would be better than none at all, so even if you only have a few of the original it would be good to do it as best you can.

 

The other option is to change to Prozac.

 

the-prozac-switch-or-bridging-with-prozac

 

https://www.nps.org.au/assets/Products/Guidelines-switching-antidepressants_A3.pdf

 

@ChessieCat sorry if I was ambiguous. There are plenty of paroxetine generics available, but they gave me one with a mesylate salt (paroxetine mesylate) instead of a hydrochloride salt (paroxetine hydrochloride), and I could feel the brain zaps on the first day. I went back to the pharmacy and asked for a different generic (one with a hydrochloride salt) and they obliged. I already feel better thanks.

[Frogie]

27 minutes ago, Bee5 said:

 

The mesylate is the one I have never tried, and have no idea why the pharmacist (who knows me and my sensitivities well by now) would even recommend it. I took the mesylate generic back and asked for one with the hydrochloride salt, and the pharmacist swopped it out, so now I am on a paxil generic with a hydrochloride salt, and I already feel better.

That’s great news!

 

Glad it worked out.

 

Take care,

 Frogie xx

[Carmie]

Hi Bee, 

 

How have you been doing over the last year?🧡

[Bee5]

Hi Carmie!

Thanks for checking in!

I am slowly slowly cutting, and I am now on 25 mg quetiapine! As you know, every cut brings with it a slew of symptoms, but in general I am in good health, although I do get restless legs from time to time, and I still have some low-grade night-time anxiety.

I find that a Vitamin B complex supplement, and an iron supplement has helped with the restless legs.

Last year was a particularly trying year with working from home and home schooling etc, but luckily I was able to cognitively dissociate, so I got through it pretty well. My aim for this year is to get off my quetiapine!

How are you doing?

Regards,
Bee

[Carmie]

21 hours ago, Bee5 said:

Hi Carmie!

Thanks for checking in!

I am slowly slowly cutting, and I am now on 25 mg quetiapine! As you know, every cut brings with it a slew of symptoms, but in general I am in good health, although I do get restless legs from time to time, and I still have some low-grade night-time anxiety.

I find that a Vitamin B complex supplement, and an iron supplement has helped with the restless legs.

Last year was a particularly trying year with working from home and home schooling etc, but luckily I was able to cognitively dissociate, so I got through it pretty well. My aim for this year is to get off my quetiapine!

How are you doing?

Regards,
Bee

That’s great you’re down to 25mg Bee, 

 

You’ll be tapering quite quickly if you try and get off that amount within a year. Please be careful. You have had akathisia in the past, if I remember correctly, haven’t you? You don’t want to be there again. I think that’s one of the worst symptoms ever! 
 

I’m down to 4.80mg and it’s still going to take me many years to get off that. I can only taper by about 3-4% and then I have to have long holds. I’m going to taper at the end of the month by 0.20mg, which is 4.2%. Let’s see how I go. 

 

I’m glad you’ve found something that has helped you with your restless legs. 
 

It sounds like you’ve had a busy year, good on you for managing so well. 
 

I hope you have a nice day🧡

 

[Bee5]

Thanks Carmie for the advice. As always, if I make a cut and it is too much, I will go back and make a smaller cut next time. I am on 3 meds, so the others help 'buffer' the effects of cutting quetiapine. This is my second taper of quetiapine, and last time I was able to jump off 6.25 mg successfully. The quetiapine was not my big issue, the paroxetine was. But as I said, any cut that feels like too much means going back to previous dose and making a smaller cut next time.

[Carmie]

On 1/20/2021 at 4:51 PM, Bee5 said:

Thanks Carmie for the advice. As always, if I make a cut and it is too much, I will go back and make a smaller cut next time. I am on 3 meds, so the others help 'buffer' the effects of cutting quetiapine. This is my second taper of quetiapine, and last time I was able to jump off 6.25 mg successfully. The quetiapine was not my big issue, the paroxetine was. But as I said, any cut that feels like too much means going back to previous dose and making a smaller cut next time.

Hi Bee, 

 

Glad to hear you’re listening to your body. That’s what I’ve always done. We can’t go according to a schedule. 
 

I see you’re taking vitamin D, like me. Are you taking vitamin K along with it?

 

I hope you have a good day🧡
 

 

[Bee5]

Hi Carmie,

I am only taking Vitamin D, not Vitamin K. Because I am taking a few supplements at the moment, I don't want to introduce new ones just yet. I recently started I3C/DIM for my hormonal acne (because I don't want to be on hormonal birth control), so I am going to hold on the supplements for now, but when I drop one of mine, I will pick up Vitamin K. Why do you recommend Vitamin K?

Regards,

Bee

[Carmie]

18 hours ago, Bee5 said:

Hi Carmie,

I am only taking Vitamin D, not Vitamin K. Because I am taking a few supplements at the moment, I don't want to introduce new ones just yet. I recently started I3C/DIM for my hormonal acne (because I don't want to be on hormonal birth control), so I am going to hold on the supplements for now, but when I drop one of mine, I will pick up Vitamin K. Why do you recommend Vitamin K?

Regards,

Bee

Hi Bee, 

 

Vitamin D and K work synergistically in where the calcium ends up in your body. Just Google it, there’s lots of information. I’m taking high doses of vitamin D for my lungs, so I have to take vitamin K along with it, otherwise I could end up having problems.
 

As usual, with withdrawals, only introduce supplements slowly.  I don’t have a problem with Vitamin D or K. 
 

Take care🧡

 

[Bee5]

Thanks Carmie. I will look it up! Stay safe!

[Bee5]

Hoping that one of the mods would be able to point me to a topic on whether/why mood changes occurs during/after a viral infection. Is there such a topic? @Altostrata

[Altostrata]

Please look in the Symptoms and Self-Care forum.