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frodobaggins85: advice about withdrawal/relapse


frodobaggins85

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Hi everyone 

Hope someone on here will be able give me some sound advice. 

 

was on citalapram for a year and a half for anxiety and as a result of extreme anxiety depression. I was on 40mg. I felt alot better about 6 months in but decided not to rock the boat as had alot of changing life circumstances and moving around the country. I did a short course of CBT but it wasn't deep enough a the time really. When I felt ready to come off. I went from 40mg to 20mg, took me about 8 weeks to stabalise and then from 20mg to 10mg for 3 weeks. As I was then following the Advice of the Linden method I stopped after 3 weeks even though I hadn't stabilised. I had withdrawal for about a week and then had 4 weeks of feeling pretty good and like my old self( without major brain fog which was my main big bear). But then I had horrendous rebound anxiety starting about week 5 of the pills. I tried to stick it out for 2 months as thought it might be withdrawal and my body needing to readjust. But one day it was just so horrendous I ended up going to a n e to get some diazapam and they restarted me on citalapram. Only problem was that after about 2 months it was clear that citalapram for some reason was no longer working for me. My doctor therefore immediately switched me to paroxitine( paxil). And I have been on that for about 7 months. It took a while but it has made me feel normal again.. albeit with bloody brain fog which I think makes normal feelings feel ten times worse. Anyway I decide that I was ready to withdraw from paroxitine but slowly this time. My dose was 40mg. My doctor wanted me to go from 40mg to 30mg over 6 weeks but given my hellish experience coming off citalapram I wanted to do it even slower and so I cut my tablets to go down by 5mg. So in effect I reduced my dose to 35mg. I have now done this for 4 weeks and had definite anxious withdrawal symptoms early on for about the first two weeks. I then had two days of feeling really good and with a really clear head. Horray!! However at about week 4 I've begun to experience some extreme anxiety again and don't know a) whether this is withdrawal or relapse. ( I've had soon much CBT while I've been on paroxitine regarding changing core beliefs tho that I really feel I have a good handle on what my issues were) b) whether I should ride it out c) reinstate my 40mg dose. Also given how violently I came off citalapram 9 months ago I wonder whether even tho I was feeling stable again on paroxitine i should have waited alot longer before begining to reduce my dose even tho I felt better. My doctor doesn't really know what to say on these issues so any advice is greatly appreciated 

 

thankyou very much!

 

Edited by ChessieCat
removed mod note

Aug 2015- may 2017 -citalapram 40mg

May 2017 - July 2017 citalapram 20mg

July/August 2017 - 10mg citalapram  to nothing over 3 weeks. Then massive rebound at 5 weeks off.held for 2 months but no improvement 

September 2017 to October 2017 Citalapram 20mg

October/ November 2017 Paxil 20mg

Nov 2017 - May 2018 Paxil 40mg

May 2018- Jan 2019 Paxil 35mg (switch to part liquid and the rest tablet) 30mg tablet 5mg liquid 

Jan 2019 -Feb 2019 Paxil 34 mg

Feb 2019 - march 2019 - Paxil 33mg

march  2019 -April 2019 -32mg

April 2019 - present 32mg

August 2019 -present 35mg

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  • ChessieCat changed the title to frodobaggins85: Advice about withdrawal/relapse
  • Moderator Emeritus

Hi Frodobaggins, welcome to SA.  It sounds like you have cut too much and suffering withdrawal. When we have been on and off drugs the nervous system becomes sensitive to changes.  You need to stay at the 35mg until you have stabilised, then you will be better with a micro taper. 40 to 35 is over the 10% that we would recommend, at around 12% and you had pretty strong withdrawal so even 10% could be too much.  While you are stabilising you will have windows and waves as your brain adjusts to the new dose.  When you are stable you can start to taper again but will need to go very slowly. It will take a long long time but is so worth it to remain stable. Rushing just causes withdrawal and leads reinstating or updosing, both take time to regain stability. Don't be put off by the length of the taper, it really is worth it to avoid withdrawal. It means staying on longer than you would like but will get off eventually, when the alternative is staying on forever! 

 

It is important that doses are consistent, and that can be difficult with cutting pills. Paxil is available in liquid or you can make a liquid using tablets. 

This topic on tapering paxil explains how to get the different doses. 

https://www.survivingantidepressants.org/index.php?/topic/405-tips-for-tapering-off-paxil-paroxetine/

 

About windows and waves, which is what you will experience as you stabilise from this reduction. Wait until you have been stable for a few weeks before restarting. 

https://www.survivingantidepressants.org/index.php?/topic/82-the-windows-and-waves-pattern-of-stabilization/

 

This has many links to topics that explain withdrawal syndrome.  The one on brain remoddelling explains it beautifully.

https://www.survivingantidepressants.org/index.php?/topic/603-what-is-withdrawal-syndrome/

 

 

 

**I am not a medical professional, if in doubt please consult a doctor with withdrawal knowledge.

 

 

Different drugs occasionally (mostly benzos) 1976 - 1981 (no problem)

1993 - 2002 in and out of hospital. every type of drug + ECT. Staring with seroxat

2002  effexor. 

Tapered  March 2012 to March 2013, ending with 5 beads.

Withdrawal April 2013 . Reinstated 5 beads reduced to 4 beads May 2013

Restarted taper  Nov 2013  

OFF EFFEXOR Feb 2015    :D 

Tapered atenolol and omeprazole Dec 2013 - May 2014

 

Tapering tramadol, Feb 2015 100mg , March 2015 50mg  

 July 2017 30mg.  May 15 2018 25mg

Taking fish oil, magnesium, B12, folic acid, bilberry eyebright for eye pressure. 

 

My story http://survivingantidepressants.org/index.php?/topic/4199-hello-mammap-checking-in/page-33

 

Lesson learned, slow down taper at lower doses. Taper no more than 10% of CURRENT dose if possible

 

 

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Many thanks for this mamma P. That was so useful and just what I needed in my current state of uncertainty. It's a real shame that doctors in the UK can give out support information about this issue especially given how wide spread it is. Mine literally wanted me.t go from 40 to 30 to 20 to 10 to 0 with 6 weeks on each dosage. Not happening in my case!!

Aug 2015- may 2017 -citalapram 40mg

May 2017 - July 2017 citalapram 20mg

July/August 2017 - 10mg citalapram  to nothing over 3 weeks. Then massive rebound at 5 weeks off.held for 2 months but no improvement 

September 2017 to October 2017 Citalapram 20mg

October/ November 2017 Paxil 20mg

Nov 2017 - May 2018 Paxil 40mg

May 2018- Jan 2019 Paxil 35mg (switch to part liquid and the rest tablet) 30mg tablet 5mg liquid 

Jan 2019 -Feb 2019 Paxil 34 mg

Feb 2019 - march 2019 - Paxil 33mg

march  2019 -April 2019 -32mg

April 2019 - present 32mg

August 2019 -present 35mg

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  • Moderator Emeritus

Hey Frodobaggins - Please Put Your Drug History Into your Signature

 

What is your plan?  Are you planning to make a liquid - How to Make a Liquid from Tablets or Capsule or are you planning to get liquid Paxil to help with your taper?

 

If you are getting liquid Paxil, please consider a switch-to-liquid as a change, and take a month to do it.  Some people will cross taper over to a liquid from their current form, as it is a different form and may hit your system differently.

 

I'm not familiar with the Linden Method, perhaps you could tell us a bit about it?

 

I hope you see the Sun today.

"Easy, easy - just go easy and you'll finish." - Hawaiian Kapuna

 

Holding is hard work, holding is a blessing. Give your brain time to heal before you try again.

 

My suggestions are not medical advice, you are in charge of your own medical choices.

 

A lifetime of being prescribed antidepressants that caused problems (30 years in total). At age 35 flipped to "bipolar," but was not diagnosed for 5 years. Started my journey in Midwest United States. Crossed the Pacific for love and hope; currently living in Australia.   CT Seroquel 25 mg some time in 2013.   Tapered Reboxetine 4 mg Oct 2013 to Sept 2014 = GONE (3 years on Reboxetine).     Tapered Lithium 900 to 475 MG (alternating with the SNRI) Jan 2014 - Nov 2014, tapered Lithium 475 mg Jan 2015 -  Feb 2016 = GONE (10 years  on Lithium).  Many mistakes in dry cutting dosages were made.


The tedious thread (my intro):  JanCarol ☼ Reboxetine first, then Lithium

The happy thread (my success story):  JanCarol - Undiagnosed  Off all bipolar drugs

My own blog:  https://shamanexplorations.com/shamans-blog/

 

 

I have been psych drug FREE since 1 Feb 2016!

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  • 3 months later...

 

Hi there 

 
My name is Andrew and I have been suffering from generalised anxiety disorder for 3 years now.
 
It started roughly after my 30th birthday following a health scare with my mom. She was fine but I was very dependent and started having thoughts about how I'd cope in life without my parents being around and being left alone and forgotten as I'm an only child
 
This worry then turned into physical symptoms and it morphed from me worrying about my mom to thinking there was something seriously neurologically wrong with me. However after many private tests I finally accepted I had an anxiety problem and almost upon accepting this went into a deppresion
 
I was put on citalapram at 40 mg for 1 and a half years and while it settled me I had pretty permanent brain fog that varied in intensity and I would often get periods of random extreme anxiety out the blue with no trigger where I would suffer for a week or so.
 
I agreed with my doctor that I thought citalapram was causing this brain fog and we decided to reduce and make me come off the medication. However even following the standard guidlines to come off. I felt really good at 5 weeks off and the fog had completely lifted which proved it was due to the medication however after this 5 week point I had a massive anxiety rebound. I persevered with this for 2 months hoping the effects would wear off but it just got worse and worse and I ended up going to a nd e where they gave me a 4 day supply of diazapam and started me back up on citalapram. I gave that two months only this time the citalapram didn't work.
 
My doctor then switched me to paroxetine at 40mg. And I began weekly physiotherapy as well as NHS CBT. This started to make me feel alot better but again I always had brain fog which felt ten times worse at weekends when I was more aware of it. I did start to feel better overall tho and about 6 months in I decided to make a small cut of 5mg to my dose given why happened when I came off citalapram. Even with this small cut tho I felt horrendous. My GP thought that I was relapsing but I didn't accept this given all the work I had done on my core beliefs so I made an appointment to see a phycologist who explained I was one of a small percentage of people who may have difficulty coming off the medications. 
 
 
Since then I have stabalised but it took 4 months for me to do so and the plan is for me to reduce from my current 35mg with a liquid by 1mg every 4 weeks. However she did say that part of her thought I may be having an extremely slow relapse which scared me.
 
Throughout all this however I have still had persistent fog which is worse at weekends and I have gone through a blip over the last 6 days where my anxiety has returned. So right now I'm trying to fend off questions such as 1) has my medication stopped working and 2) am I having a slow relapse and 3) am I one of those people whose brains don't recover from antidepressant use. It scares me to be honest all this uncertainty.
 
 
I have been told by my phycologist that my anxiety has been triggered and perpetuated by how I think and that it is not organic, but if that is the case how can I get anxiety out the blue? Or am still suffering from withdrawal and sensitive 
 
Long story short I want to know what I can do to reduce effects of withdrawal, correct any damage done to my brain from antidepressants and help my brain heal from the anxiety itself. As I dont know that even if my issue began as a phycological one if it can turn into a brain chemistry issue
 
Edited by ChessieCat
removed surname

Aug 2015- may 2017 -citalapram 40mg

May 2017 - July 2017 citalapram 20mg

July/August 2017 - 10mg citalapram  to nothing over 3 weeks. Then massive rebound at 5 weeks off.held for 2 months but no improvement 

September 2017 to October 2017 Citalapram 20mg

October/ November 2017 Paxil 20mg

Nov 2017 - May 2018 Paxil 40mg

May 2018- Jan 2019 Paxil 35mg (switch to part liquid and the rest tablet) 30mg tablet 5mg liquid 

Jan 2019 -Feb 2019 Paxil 34 mg

Feb 2019 - march 2019 - Paxil 33mg

march  2019 -April 2019 -32mg

April 2019 - present 32mg

August 2019 -present 35mg

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  • Moderator Emeritus

Is it withdrawal or relapse?  Or something else?


How do I know it's withdrawal and not relapse?

 

To help us out please create a drug signature using the following format:

 

Please make it nice simple by following these instructions (NO diagnoses or symptoms please - thank you):

  • details for last 2 years - dates, ALL drugs, doses
  • summary for older than 2 years - just years and drug/s

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* NO LONGER ACTIVE on SA *

MISSION ACCOMPLISHED:  (6 year taper)      0mg Pristiq  on 13th November 2021

ADs since ~1992:  25+ years - 1 unknown, Prozac (muscle weakness), Zoloft; citalopram (pooped out) CTed (very sick for 2.5 wks a few months after); Pristiq:  50mg 2012, 100mg beg 2013 (Serotonin Toxicity)  Tapering from Oct 2015 - 13 Nov 2021   LAST DOSE 0.0025mg

Post 0 updates start here    My tapering program     My Intro (goes to tapering graph)

 VIDEO:   Antidepressant Withdrawal Syndrome and its Management

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  • Moderator Emeritus

Sorry for such a long post, but there is lots of good and helpful information that I want to pass on to you.  I hope that it helps you.

 

1 hour ago, frodobaggins85 said:

I have been told by my phycologist that my anxiety has been triggered and perpetuated by how I think

 

The drug numbs our emotions. It doesn't make the problems go away.  Even though some/all of what you are experiencing may be from the drug or from reducing it too quickly it's important to learn non drug ways to cope with life stresses, both what led to you being prescribed the drug in the first place and also to help you live life without drugs or returning to a drug in the future.  I will provide some links at the bottom of this post.

 

 

1 hour ago, frodobaggins85 said:

My doctor then switched me to paroxetine at 40mg. ... and about 6 months in I decided to make a small cut of 5mg to my dose

 

SA recommends reducing by no more than 10% of the current dose followed by a hold of about 4 weeks to allow the brain to adapt to not getting as much of the drug.  Why taper by 10% of my dosage?

 

Your reduction from 40mg to 5mg was a 12.5% reduction so 2.5% more than SA's recommendation.  You have a history of psychiatric drugs and the effect on our CNS is cumulative.  Dr Joseph Glenmullen's WD Symptoms Checklist

 

This topic explains how to get the dose you need:  Tips for tapering off Paxil (paroxetine)

 

 

1 hour ago, frodobaggins85 said:

phycologist who explained I was one of a small percentage of people who may have difficulty coming off the medications. 

 

Please don't believe this.  Many SA members getting off their drug/s (some have managed to get drug free after years of a drug cocktail) is proof that this is not true.  Even getting to a lower dose will reduce your drug burden.  I started out at 100mg Pristiq with the intention of getting to 50mg and I'm now down to 5.5mg.  Check out the Success Stories.  You may need to go slower than 10%.  Some members do.  Check out the-brassmonkey-slide-method-of-micro-tapering.  BrassMonkey is now drug free.  He's also compiled this excellent topic:  are-we-there-yet-how-long-is-withdrawal-going-to-take

 

You might also find this topic interesting:  Why taper paper: dose-occupancy curves

 

From this topic what-is-withdrawal-syndrome:

 

 

Understanding what these drugs do can help you to understand the reasoning behind tapering.

 

"A lot of people, including healthcare practitioners; in fact, I guess, most people-- are operating from entirely the wrong paradigm, or way of thinking, about these meds. They're thinking of them like aspirin--as something that has an effect when it's in your system, and then when it gets out of your system the effect goes away.

 

That's not what happens with medications that alter neurotransmitter function, we are learning.

What happens when you change the chemistry of the brain is, the brain adjusts its chemistry and structure to try to return to homeostasis, or biochemical and functional balance. It tries to restabilize the chemistry. 

For example: SSRI antidepressants work as "serotonin reuptake inhibitors." That is, they cause serotonin to remain in the space between neurons, rather than being taken back up into the cells to be re-used, like it would be in a normal healthy nondrugged brain.

So the brain, which wants to re-establish normal signaling and function, adapts to the higher level of serotonin between neurons (in the "synapse", the space between neurons where signals get passed along). It does this by removing serotonin receptors, so that the signal is reduced and changed to something closer to normal. It also decreases the amount of serotonin it produces overall. 

To do that, genes have to be turned on and off; new proteins have to be made; whole cascades of chemical reactions have to be changed, which means turning on and off OTHER genes; cells are destroyed, new cells are made; in other words, a complex physiologic remodeling takes place. This takes place over time. The brain does not grow and change rapidly. 

This is a vast oversimplification of the amount of adaptation that takes place in the brain when we change its normal chemistry, but that's the principle.

When we stop taking the drug, we have a brain that has designed itself so that it works in the presence of the drug; now it can't work properly without the drug because it's designed itself so that the drug is part of its chemistry and structure. It's like a plant that has grown on a trellis; you can't just yank out the trellis and expect the plant to be okay.

When the drug is removed, the remodeling process has to take place in reverse.

SO--it's not a matter of just getting the drug out of your system and moving on. If it were that simple, none of us would be here. 

It's a matter of, as I describe it, having to grow a new brain. 

I believe this growing-a-new-brain happens throughout the taper process if the taper is slow enough. (If it's too fast, then there's not a lot of time for actually rebalancing things, and basically the brain is just pedaling fast trying to keep us alive.) It also continues to happen, probably for longer than the symptoms actually last, throughout the time of recovery after we are completely off the drug, which is why recovery takes so long. 

With multiple drugs and a history of drug changes and cold turkeys, all of this becomes even more complicated. And if a person is started on these kinds of drugs at an early age before the brain has ever completely established normal mature functioning--well, it can't be good. (All of which is why I recommend an extremely slow taper particularly to anyone with a multiple drug history, a history of many years on meds, a history of past cold turkeys or frequent med changes, and a history of being put on drugs at a young age.)

This isn't intended to scare people, but hopefully to give you some idea of what's happening, and to help you respect and understand the process so you can work with it; ALSO, because you are likely to encounter many, many people who still believe these drugs work kind of like aspirin, or a glass of wine, and all you need to do is stop and get it out of your system. 

Now you can explain to them that no, getting it out of your system is not the issue; the issue is, you need to regrow or at least remodel your brain. This is a long, slow, very poorly understood process, and it needs to be respected."

 

 

LINKS:

 

Non-drug techniques to cope

 

dealing-with-emotional-spirals

 

Dr Claire Weekes suffered from anxiety and learned and taught ways of coping.  There are videos available on YouTube.

 

Claire Weekes' Method of Recovering from a Sensitized Nervous System

 

Cognitive Behavior Therapy (CBT) for anxiety, depression

 

Audio:  First Aid for Panic (4 minutes)
 
Resources:  Centre for Clinical Interventions (PDF modules that you can work through, eg:  Depression, Distress Intolerance, Health Anxiety, Low Self-Esteem, Panic Attacks, Perfectionism, Procrastination, Social Anxiety, Worrying)

* NO LONGER ACTIVE on SA *

MISSION ACCOMPLISHED:  (6 year taper)      0mg Pristiq  on 13th November 2021

ADs since ~1992:  25+ years - 1 unknown, Prozac (muscle weakness), Zoloft; citalopram (pooped out) CTed (very sick for 2.5 wks a few months after); Pristiq:  50mg 2012, 100mg beg 2013 (Serotonin Toxicity)  Tapering from Oct 2015 - 13 Nov 2021   LAST DOSE 0.0025mg

Post 0 updates start here    My tapering program     My Intro (goes to tapering graph)

 VIDEO:   Antidepressant Withdrawal Syndrome and its Management

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  • 3 months later...

Hi there 

 

As you can see from my signature i was on citalapram for 2 years, came off too fast and had a massive anxiety  rebound which after two months of struggling led to me having to reinstate citalapram - only this time for whatever reason it just didn’t work.

 

i was then put on paroxetine,initially at 20mg which didn’t touch me so after a month my doc bumped me up to 40mg and after about 4 months I stabilised.

 

after 6 months I cut from 40mg to 35mg as i didn’t want a repeat of the citalapram fiasco but the result was horrendous. Intense anxiety and burning nerves all over my body and extreme foggy head.( foggy head always been my main system and reason for coming off).

 

i then found this website and a physiatrist who prescribed me with a liquid form of paroxetine. So the plan was I would take 30mg in tablets and 5 in liquid to make 35mg and then reduce the liquid dose by 1mg a month until I reached 30mg as a starter for ten.

 

i seems to do 35-34 ok with one blip, but after 2-3 weeks in with the 34-33mg drop I feel awful with foggy head and the same  anxiety and burning all over my body. Again my mind is going into overdrive about thinking If it’s withdrawal or relapse but I’ve had like 2 years of therapy now,know what my initial issues are, worked on them so these systems are just like meaningless and out the blue with no rational connection to my thoughts. So due to this I’m trying to convince myself that’s it’s withdrawal again but I can’t believe how sensitive my CNS must be and just want some advice on this.

 

should I hold longer than 4 weeks given how sensitive I am, or should I stay at my current dose and allow my CNS to heal more? If so how long?Is there anything I can do or take that would help my CNS to heal? 

 

Any thoughts greatly appreciated 

Aug 2015- may 2017 -citalapram 40mg

May 2017 - July 2017 citalapram 20mg

July/August 2017 - 10mg citalapram  to nothing over 3 weeks. Then massive rebound at 5 weeks off.held for 2 months but no improvement 

September 2017 to October 2017 Citalapram 20mg

October/ November 2017 Paxil 20mg

Nov 2017 - May 2018 Paxil 40mg

May 2018- Jan 2019 Paxil 35mg (switch to part liquid and the rest tablet) 30mg tablet 5mg liquid 

Jan 2019 -Feb 2019 Paxil 34 mg

Feb 2019 - march 2019 - Paxil 33mg

march  2019 -April 2019 -32mg

April 2019 - present 32mg

August 2019 -present 35mg

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Topic title:  Should I allow a long time for CNS to heal before next taper if I can even take a 1mg drop from 35 to 34?

 

Hi there 

 

As you can see from my signature i was on citalapram for 2 years, came off too fast and had a massive anxiety  rebound which after two months of struggling led to me having to reinstate citalapram - only this time for whatever reason it just didn’t work.

 

i was then put on paroxetine,initially at 20mg which didn’t touch me so after a month my doc bumped me up to 40mg and after about 4 months I stabilised.

 

after 6 months I cut from 40mg to 35mg as i didn’t want a repeat of the citalapram fiasco but the result was horrendous. Intense anxiety and burning nerves all over my body and extreme foggy head.( foggy head always been my main system and reason for coming off).

 

i then found this website and a physiatrist who prescribed me with a liquid form of paroxetine. So the plan was I would take 30mg in tablets and 5 in liquid to make 35mg and then reduce the liquid dose by 1mg a month until I reached 30mg as a starter for ten.

 

i seems to do 35-34 ok with one blip, but after 2-3 weeks in with the 34-33mg drop I feel awful with foggy head and the same  anxiety and burning all over my body. Again my mind is going into overdrive about thinking If it’s withdrawal or relapse but I’ve had like 2 years of therapy now,know what my initial issues are, worked on them so these systems are just like meaningless and out the blue with no rational connection to my thoughts. So due to this I’m trying to convince myself that’s it’s withdrawal again but I can’t believe how sensitive my CNS must be and just want some advice on this.

 

should I hold longer than 4 weeks given how sensitive I am, or should I stay at my current dose and allow my CNS to heal more? If so how long?Is there anything I can do or take that would help my CNS to heal? 

 

Any thoughts greatly appreciated

 

Edited by ChessieCat
added topic title

Aug 2015- may 2017 -citalapram 40mg

May 2017 - July 2017 citalapram 20mg

July/August 2017 - 10mg citalapram  to nothing over 3 weeks. Then massive rebound at 5 weeks off.held for 2 months but no improvement 

September 2017 to October 2017 Citalapram 20mg

October/ November 2017 Paxil 20mg

Nov 2017 - May 2018 Paxil 40mg

May 2018- Jan 2019 Paxil 35mg (switch to part liquid and the rest tablet) 30mg tablet 5mg liquid 

Jan 2019 -Feb 2019 Paxil 34 mg

Feb 2019 - march 2019 - Paxil 33mg

march  2019 -April 2019 -32mg

April 2019 - present 32mg

August 2019 -present 35mg

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  • Administrator

Hello, frodo. You might go up to 33.5mg paroxetine. Please let us know how you're doing.

 

It seems your nervous system is very sensitive to dosage decreases. You may need to wait more than a month between decreases.

 

You had that rough withdrawal from citalopram, plus paroxetine is a very difficult drug to quit. Your nervous system is sensitized. Please be patient with it.

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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  • Moderator Emeritus

Please keep daily notes of your symptoms on paper so you can see how the updose is affecting you.

* NO LONGER ACTIVE on SA *

MISSION ACCOMPLISHED:  (6 year taper)      0mg Pristiq  on 13th November 2021

ADs since ~1992:  25+ years - 1 unknown, Prozac (muscle weakness), Zoloft; citalopram (pooped out) CTed (very sick for 2.5 wks a few months after); Pristiq:  50mg 2012, 100mg beg 2013 (Serotonin Toxicity)  Tapering from Oct 2015 - 13 Nov 2021   LAST DOSE 0.0025mg

Post 0 updates start here    My tapering program     My Intro (goes to tapering graph)

 VIDEO:   Antidepressant Withdrawal Syndrome and its Management

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Thankyou both for your advice. It’s seems however that after one week of hell I have returned back to a normalish state. I have less fog in my head than before though it’s obviously still there and even such a small change has led to me feeling more like the old me and a little lighter in the head. I’m a going to try and do 1mg reduction within a 6 week hold going forward and see if this suits me better. I would like to see how far I can go with this before it gets difficult as at that point my physiatrist has recomended the same approach but to switch to flouxatine and then gradually come off that. I’d rather not switch drugs again though if I can help it 

Aug 2015- may 2017 -citalapram 40mg

May 2017 - July 2017 citalapram 20mg

July/August 2017 - 10mg citalapram  to nothing over 3 weeks. Then massive rebound at 5 weeks off.held for 2 months but no improvement 

September 2017 to October 2017 Citalapram 20mg

October/ November 2017 Paxil 20mg

Nov 2017 - May 2018 Paxil 40mg

May 2018- Jan 2019 Paxil 35mg (switch to part liquid and the rest tablet) 30mg tablet 5mg liquid 

Jan 2019 -Feb 2019 Paxil 34 mg

Feb 2019 - march 2019 - Paxil 33mg

march  2019 -April 2019 -32mg

April 2019 - present 32mg

August 2019 -present 35mg

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  • 2 months later...

Topic title:  Long hold before beginning first taper? And if have a crash before starting subsequent tapers?

 

Hi there 

 

I have been reducing paroxetine for about 6 months now and have dropped from 35mg to 32mg using a liquid with a plan to drop by 1mg every 4 weeks. During each drop I have had a period about 2-3 weeks in of intense anxiety which then passed, leaving me clearer in the head (less brain fog) than before. However on my last drop of 33-32mg I had horrendous anxiety for about a week and after this I have had windows and waves of feeling like the front of my head is “shut down” or filled with something sticky and heavy like treacle. It tends to lift and then comes back so it does seem to have a windows and waves format. My pychiatrist as a result has asked me to drop 1mg over 6 - 8 weeks now and see how I go with that. What has shocked me with the last time was the different symptoms that have occurred. In Your opinion regardless of dropping every 6-8 weeks should I wait till I am stable from my last drop? And secondly do you think that there should be a long hold before  starting a taper? For example from my crash coming off citalapram and then getting stable on paroxetine it took 6 months to stabilise on paroxetine and I started cutting straight away as soon as I felt better. I cut by 5mg from 40mg to 35mg which I found out I could only just tolerate and thus ended up on this site. Should  I have weighted a lot longer? and would waiting a lot longer have made it easier to do smaller cuts now? 

 

Edited by ChessieCat
added topic title

Aug 2015- may 2017 -citalapram 40mg

May 2017 - July 2017 citalapram 20mg

July/August 2017 - 10mg citalapram  to nothing over 3 weeks. Then massive rebound at 5 weeks off.held for 2 months but no improvement 

September 2017 to October 2017 Citalapram 20mg

October/ November 2017 Paxil 20mg

Nov 2017 - May 2018 Paxil 40mg

May 2018- Jan 2019 Paxil 35mg (switch to part liquid and the rest tablet) 30mg tablet 5mg liquid 

Jan 2019 -Feb 2019 Paxil 34 mg

Feb 2019 - march 2019 - Paxil 33mg

march  2019 -April 2019 -32mg

April 2019 - present 32mg

August 2019 -present 35mg

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  • 2 months later...

Topic title:  Timeframe for reaching stabilisation after minor dose drop

 

Hi there. I have been on 32mg of paroxetine for almost 6 months now, I feel that generally I’m better than I was after i initially dropped but sometimes I have a wave when I feel as bad as ever.i had been going down by 1mg every month from 35mg to 30mg but crashed at 32mg and have been waiting to stabilise before i continue my reduction. My doctor is now recommending that when I stabilise I go down by 1mg every two months rather than  1 month.I just wanted to know whether it is considered unusual to take so long to stabilise from such a small dose decrease.Ie 3mg with a 4 week gap in between each drop.

 

Edited by ChessieCat
added topic title

Aug 2015- may 2017 -citalapram 40mg

May 2017 - July 2017 citalapram 20mg

July/August 2017 - 10mg citalapram  to nothing over 3 weeks. Then massive rebound at 5 weeks off.held for 2 months but no improvement 

September 2017 to October 2017 Citalapram 20mg

October/ November 2017 Paxil 20mg

Nov 2017 - May 2018 Paxil 40mg

May 2018- Jan 2019 Paxil 35mg (switch to part liquid and the rest tablet) 30mg tablet 5mg liquid 

Jan 2019 -Feb 2019 Paxil 34 mg

Feb 2019 - march 2019 - Paxil 33mg

march  2019 -April 2019 -32mg

April 2019 - present 32mg

August 2019 -present 35mg

Link to comment

Not a moderator but I would say no it’s not unusual at all. We are all different so you could just be very sensitive to drops. Because your still getting waves of symptoms it’s best to keep holding until they have gone and unfortunately no time frame for this but having windows is a clear sign your getting there. 

 

Take care.

20mg Lexapro 2007

10mg Lexapro 2012

Started tapering approx (October 2017) 12 months ago  from 10mg to 9mg then 8 then 7 then 6 then 5 then 4 then 3.

Held for approx 4 to 6 weeks min on each reduction.

Hit severe symptoms (started 7th Nov) after dropping to 3mg. Dropped to 3mg approx 22nd October.

Back to 4mg (7th November) and stabilising. Current symptoms started 23rd November 2018

Used diazepam (2018) 10mg 10th Nov, 5mg 11th Nov, 2.5mg 12 Nov, 2mg 13th Nov.

Used diazepam 10mg 24th Nov, 7.5 25th Nov and 5mg 26th November 2018

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  • ChessieCat changed the title to frodobaggins85: advice about withdrawal/relapse
  • Moderator Emeritus

2 intro topics merged.  Each member has only 1 intro topic where they can ask questions and journal their progress.  This keeps their history in one place.  Please do not create any more introduction topics.  Thank you.

WDnormal (withdrawal normal)

 

You might consider doing the Brass Monkey Slide

 

BrassMonkey, one of the SA mods, has managed to get off Paxil using this method of tapering which he came up with.  He has now been Paxil free for over 1 year. 

 

His success story:

 

Edited by ChessieCat

* NO LONGER ACTIVE on SA *

MISSION ACCOMPLISHED:  (6 year taper)      0mg Pristiq  on 13th November 2021

ADs since ~1992:  25+ years - 1 unknown, Prozac (muscle weakness), Zoloft; citalopram (pooped out) CTed (very sick for 2.5 wks a few months after); Pristiq:  50mg 2012, 100mg beg 2013 (Serotonin Toxicity)  Tapering from Oct 2015 - 13 Nov 2021   LAST DOSE 0.0025mg

Post 0 updates start here    My tapering program     My Intro (goes to tapering graph)

 VIDEO:   Antidepressant Withdrawal Syndrome and its Management

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  • 2 weeks later...

Thank you All for your comments.

 

i will consider the brass monkey method but I still need to stabilise first. Oddly I have started this week to feel awful. Like I did when I came fully off citalapram. I feel wracked with anxiety and akithesia, with really heavy brain fog. But I don’t feel down! It’s so weird! I find it really odd that I haven’t altered my dose for 6 months and this has suddenly started, bearing in mind I’m still on a high dose really and I’ve only gone down by 3mg over the course of about 4 months.

Aug 2015- may 2017 -citalapram 40mg

May 2017 - July 2017 citalapram 20mg

July/August 2017 - 10mg citalapram  to nothing over 3 weeks. Then massive rebound at 5 weeks off.held for 2 months but no improvement 

September 2017 to October 2017 Citalapram 20mg

October/ November 2017 Paxil 20mg

Nov 2017 - May 2018 Paxil 40mg

May 2018- Jan 2019 Paxil 35mg (switch to part liquid and the rest tablet) 30mg tablet 5mg liquid 

Jan 2019 -Feb 2019 Paxil 34 mg

Feb 2019 - march 2019 - Paxil 33mg

march  2019 -April 2019 -32mg

April 2019 - present 32mg

August 2019 -present 35mg

Link to comment

I wonder sometimes if my CNS is soo sensitised. Does it make sense for me to just stay at a dose for a really long period time. Say 2-3 years. So whatever happens from my coming off citalapram and my recent dose changes can be “sorted out”. Then begin the taper again at a future point, when because my system is more stable I may be in a much better position to cope with the taper? 

Aug 2015- may 2017 -citalapram 40mg

May 2017 - July 2017 citalapram 20mg

July/August 2017 - 10mg citalapram  to nothing over 3 weeks. Then massive rebound at 5 weeks off.held for 2 months but no improvement 

September 2017 to October 2017 Citalapram 20mg

October/ November 2017 Paxil 20mg

Nov 2017 - May 2018 Paxil 40mg

May 2018- Jan 2019 Paxil 35mg (switch to part liquid and the rest tablet) 30mg tablet 5mg liquid 

Jan 2019 -Feb 2019 Paxil 34 mg

Feb 2019 - march 2019 - Paxil 33mg

march  2019 -April 2019 -32mg

April 2019 - present 32mg

August 2019 -present 35mg

Link to comment
  • Moderator Emeritus

Please put dates and doses of your reduction since Feb 2019 in your drug signature so that we can see it at a glance. 

 

Account Settings – Create or Edit a signature

 

* NO LONGER ACTIVE on SA *

MISSION ACCOMPLISHED:  (6 year taper)      0mg Pristiq  on 13th November 2021

ADs since ~1992:  25+ years - 1 unknown, Prozac (muscle weakness), Zoloft; citalopram (pooped out) CTed (very sick for 2.5 wks a few months after); Pristiq:  50mg 2012, 100mg beg 2013 (Serotonin Toxicity)  Tapering from Oct 2015 - 13 Nov 2021   LAST DOSE 0.0025mg

Post 0 updates start here    My tapering program     My Intro (goes to tapering graph)

 VIDEO:   Antidepressant Withdrawal Syndrome and its Management

Link to comment

Hi Cheshire Cat

 

i have updated my signature 

Aug 2015- may 2017 -citalapram 40mg

May 2017 - July 2017 citalapram 20mg

July/August 2017 - 10mg citalapram  to nothing over 3 weeks. Then massive rebound at 5 weeks off.held for 2 months but no improvement 

September 2017 to October 2017 Citalapram 20mg

October/ November 2017 Paxil 20mg

Nov 2017 - May 2018 Paxil 40mg

May 2018- Jan 2019 Paxil 35mg (switch to part liquid and the rest tablet) 30mg tablet 5mg liquid 

Jan 2019 -Feb 2019 Paxil 34 mg

Feb 2019 - march 2019 - Paxil 33mg

march  2019 -April 2019 -32mg

April 2019 - present 32mg

August 2019 -present 35mg

Link to comment
  • Moderator Emeritus

Thank you, but please add dates.

* NO LONGER ACTIVE on SA *

MISSION ACCOMPLISHED:  (6 year taper)      0mg Pristiq  on 13th November 2021

ADs since ~1992:  25+ years - 1 unknown, Prozac (muscle weakness), Zoloft; citalopram (pooped out) CTed (very sick for 2.5 wks a few months after); Pristiq:  50mg 2012, 100mg beg 2013 (Serotonin Toxicity)  Tapering from Oct 2015 - 13 Nov 2021   LAST DOSE 0.0025mg

Post 0 updates start here    My tapering program     My Intro (goes to tapering graph)

 VIDEO:   Antidepressant Withdrawal Syndrome and its Management

Link to comment
  • Moderator Emeritus

You are assuming that what you are experiencing are withdrawal symptoms.  You may actually be experiencing side effects.

 

See this link for a more comprehensive list (scroll right to the bottom of the page):  https://www.drugs.com/sfx/paxil-side-effects.html

 

From https://www.drugs.com/dosage/paxil.html

 

Common side effects of Paxil include:

  • headache,
  • nervousness,
  • restlessness,
  • drowsiness,
  • dizziness,
  • nasal irritation,
  • sleep problems (insomnia),
  • nausea,
  • constipation,
  • weight changes,
  • decreased sex drive,
  • impotence,
  • difficulty having an orgasm,
  • dry mouth,
  • yawning, or
  • ringing in the ears.

* NO LONGER ACTIVE on SA *

MISSION ACCOMPLISHED:  (6 year taper)      0mg Pristiq  on 13th November 2021

ADs since ~1992:  25+ years - 1 unknown, Prozac (muscle weakness), Zoloft; citalopram (pooped out) CTed (very sick for 2.5 wks a few months after); Pristiq:  50mg 2012, 100mg beg 2013 (Serotonin Toxicity)  Tapering from Oct 2015 - 13 Nov 2021   LAST DOSE 0.0025mg

Post 0 updates start here    My tapering program     My Intro (goes to tapering graph)

 VIDEO:   Antidepressant Withdrawal Syndrome and its Management

Link to comment

Hi again

 

would in normal though to experience side affects out the blue 5 to 6 months post a really small drop? I think this is what confuses me about the whole thing. Ordinarily I’d associated how I’m feeling currently with a relapse of my original condition given how far out these sometimes have occurred since my last drop. But my phyciatrist is almost certain what I am experience is withdrawal as she wouldn’t except relapse to occur on such a high dose and with no life pressures going on. She said she would only consider relapse as a hypothesis if I was below 20mg 

Aug 2015- may 2017 -citalapram 40mg

May 2017 - July 2017 citalapram 20mg

July/August 2017 - 10mg citalapram  to nothing over 3 weeks. Then massive rebound at 5 weeks off.held for 2 months but no improvement 

September 2017 to October 2017 Citalapram 20mg

October/ November 2017 Paxil 20mg

Nov 2017 - May 2018 Paxil 40mg

May 2018- Jan 2019 Paxil 35mg (switch to part liquid and the rest tablet) 30mg tablet 5mg liquid 

Jan 2019 -Feb 2019 Paxil 34 mg

Feb 2019 - march 2019 - Paxil 33mg

march  2019 -April 2019 -32mg

April 2019 - present 32mg

August 2019 -present 35mg

Link to comment
  • Moderator Emeritus

Q:  When specifically was the 5 or 6 months (month/year)?

 

Q:  Are you taking any other prescription or OTC drugs, supplements, etc?

 

Q:  What about things containing caffeine and alcohol?

 

If it was me, I'd be trying a small reduction as a test.  If you have been feeling about the same for the last few months then it may be the drug causing the issues, and not withdrawal from the drug.  The only way you will know for sure is to test the waters.  You would need to be patient and try not to stress out about the reduction because you will then add fear to the reduction and not be able to figure out if it is the reduction or the fear causing any symptoms.

 

Some members do find it more difficult to get past different doses of their drug, so it may be that you are having difficulty getting past the dose/s you are on now but once you get a bit lower it may be easier.  You might just have to tough it out for a short while.

* NO LONGER ACTIVE on SA *

MISSION ACCOMPLISHED:  (6 year taper)      0mg Pristiq  on 13th November 2021

ADs since ~1992:  25+ years - 1 unknown, Prozac (muscle weakness), Zoloft; citalopram (pooped out) CTed (very sick for 2.5 wks a few months after); Pristiq:  50mg 2012, 100mg beg 2013 (Serotonin Toxicity)  Tapering from Oct 2015 - 13 Nov 2021   LAST DOSE 0.0025mg

Post 0 updates start here    My tapering program     My Intro (goes to tapering graph)

 VIDEO:   Antidepressant Withdrawal Syndrome and its Management

Link to comment

So my last drop was 5 to 6

months ago. It was just 1mg so to 32mg. I have held at this since. I have had the typical windows and waves, but then out the blue about a week ago just began to feel awful even in comparison to previous waves. Ie can’t sit still, gagging, stomach issues, nerves on fire etc.

 

i am as well as a CBT therapist, an EMDR therapist and a private phyciatrist I have also started seeing a nutritional therapist in London at the optimal nutrition for the mind centre. She has recommended I start omega 3 and magnesium supplements, as well as glycine, vitamin D spray, a multi vitamin, and 5kP with the idea that it provides all the building blocks to repair neurotransmitters. I’m also doing a genetic and urine test to assess my neurostrasmitter levels and the expressiveness of the genes associated with each of the neurotransmitters.

 

i don’t take any other prescription drugs and I have completely cut out caffiene and alcohol.

 

i suppose it could just be a random blip. I also imagine the windows and waves petering out towards stability in quite a smooth way but I suppose on this journey I could have a random bad blip at anytime 

Aug 2015- may 2017 -citalapram 40mg

May 2017 - July 2017 citalapram 20mg

July/August 2017 - 10mg citalapram  to nothing over 3 weeks. Then massive rebound at 5 weeks off.held for 2 months but no improvement 

September 2017 to October 2017 Citalapram 20mg

October/ November 2017 Paxil 20mg

Nov 2017 - May 2018 Paxil 40mg

May 2018- Jan 2019 Paxil 35mg (switch to part liquid and the rest tablet) 30mg tablet 5mg liquid 

Jan 2019 -Feb 2019 Paxil 34 mg

Feb 2019 - march 2019 - Paxil 33mg

march  2019 -April 2019 -32mg

April 2019 - present 32mg

August 2019 -present 35mg

Link to comment
  • Moderator Emeritus
12 minutes ago, frodobaggins85 said:

i suppose it could just be a random blip. I also imagine the windows and waves petering out towards stability in quite a smooth way but I suppose on this journey I could have a random bad blip at anytime 

 

It could have been anything.  Some added stress, work/relationship, over eating, your body fighting a virus which you didn't know you had, some nights of poor sleep (sometimes we sleep but are restless without realising it).

 

Before adding in the supplements I think it would be better to do a small test reduction.  I'm not saying not to use the supplements, but to try reducing your Paxil first before you start adding in other things.  If you start any supplements and then make a Paxil reduction you aren't going to know for certain what is improving/worsening things.

 

8 minutes ago, frodobaggins85 said:

She has recommended I start omega 3 and magnesium supplements, as well as glycine, vitamin D spray, a multi vitamin, and 5kP

 

SA recommends only adding one thing at a time and and a smaller dose than recommended to test to see how you react to it:  Keep it Simple, Slow and Stable

 

Q:  What is 5kP?  Do you mean 5htp?  5-htp-5-hydroxytryptophan-and-l-tryptophan

 

I suggest you do a search and research other members' experiences with all suggested supplements.  I like to use google and add survivingantidepressants.org to my search term.

* NO LONGER ACTIVE on SA *

MISSION ACCOMPLISHED:  (6 year taper)      0mg Pristiq  on 13th November 2021

ADs since ~1992:  25+ years - 1 unknown, Prozac (muscle weakness), Zoloft; citalopram (pooped out) CTed (very sick for 2.5 wks a few months after); Pristiq:  50mg 2012, 100mg beg 2013 (Serotonin Toxicity)  Tapering from Oct 2015 - 13 Nov 2021   LAST DOSE 0.0025mg

Post 0 updates start here    My tapering program     My Intro (goes to tapering graph)

 VIDEO:   Antidepressant Withdrawal Syndrome and its Management

Link to comment
  • 2 weeks later...

Thanks For the info... bit of an update to

 

so....I saw my phyciatrist today.

 

she has said that it is extremely unusual to still have withdrawal symptoms at 6 months post a drop of 1mg.so given my symptoms of the last week (ie gagging, nervous tummy,head feeling shut down/pressured and anxiety peaking at 10am and lasting for quite a while in the day )she thinks I have an undertreated anxiety disorder and feels I am one of those people who needs to be on medication for life. Not sure where to turn now. I’m doing everything.CBT, EMDR, eating right, excercising. I don’t know what else I can do. I know all my reasons for being on the meds in the first place are gone which is what makes this so frustrating.she wants me to go back up to 35mg for now. 

 

Update since as I forgot to post this last night!!I did as she instructed and went back to 35mg. I felt great today.bit quick!

makes me think maybe withdrawal after all.

Aug 2015- may 2017 -citalapram 40mg

May 2017 - July 2017 citalapram 20mg

July/August 2017 - 10mg citalapram  to nothing over 3 weeks. Then massive rebound at 5 weeks off.held for 2 months but no improvement 

September 2017 to October 2017 Citalapram 20mg

October/ November 2017 Paxil 20mg

Nov 2017 - May 2018 Paxil 40mg

May 2018- Jan 2019 Paxil 35mg (switch to part liquid and the rest tablet) 30mg tablet 5mg liquid 

Jan 2019 -Feb 2019 Paxil 34 mg

Feb 2019 - march 2019 - Paxil 33mg

march  2019 -April 2019 -32mg

April 2019 - present 32mg

August 2019 -present 35mg

Link to comment
  • 2 months later...

Hi there 

 

following on from the above. I have now been on 35mg for just over 3months. It took about 7 weeks to begin to feel better but now I have the feelings of anxiety in my stomach, unjustified fear, and heavy brain fog again. Yet previously I was stable and relatively ok on 35mg before I began my slow taper.

 

since my last appointment with my phyciatrist I have been seeing a nutritional therapist at the brain bio centre in London and I have had a neurotransmitter panel test. The interesting thing about this test is that I took it when I was in my worst “withdrawal” at 32mg. It showed that all my neurotransmitters were all in balance apart from one called PEA, for which my levels were through the roof. Paroxetine isn’t even designed to work on that so, either the meds were holding my transmitters in balance, apart from that one, or I’m better and the PEA is the major issue.

 

howevever given my recent wave, I’m again questioning my next steps. Ie. Should I wait this out and see if I stabilise on this dose or do I go up to my original 40mg?

 

. I have a fear that it may be a poopout issue (which my phyciatrist doesn’t believe in ) but if she thinks again that it’s an untreated anxiety disorder she will up my dose again, and then the same thing will happen again, only for her to finally realise that I need to taper down. I don’t want to do that. I have also called the Bristol tranquilisor project in England who help with these issues and the advisor was of the view that if I was feeling anxious at 6 months out from last drop of 1mg to 32mg then he thought it would be a tolerance issue and I should keep cutting despite how I feel.

 

so essentially I’m faced with an expert telling me I have an undertreated anxiety disorder and should go up in dose, an advisor saying I should cut because it looks like tolerance , and testing showing I have a particular neurotransmitter imbalance for which I have been given supplements to address. It’s also worrying me as I start a new job in 2 weeks time and the last thing I want it’s to take time off sick just as I start. Any advice would be greatly appreciated! 

Aug 2015- may 2017 -citalapram 40mg

May 2017 - July 2017 citalapram 20mg

July/August 2017 - 10mg citalapram  to nothing over 3 weeks. Then massive rebound at 5 weeks off.held for 2 months but no improvement 

September 2017 to October 2017 Citalapram 20mg

October/ November 2017 Paxil 20mg

Nov 2017 - May 2018 Paxil 40mg

May 2018- Jan 2019 Paxil 35mg (switch to part liquid and the rest tablet) 30mg tablet 5mg liquid 

Jan 2019 -Feb 2019 Paxil 34 mg

Feb 2019 - march 2019 - Paxil 33mg

march  2019 -April 2019 -32mg

April 2019 - present 32mg

August 2019 -present 35mg

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