Nervous1: trying to taper Xanax, Need advice tapering Paxil

[Nervous1]

Looking for Shep to make a spreadsheet for me.

 

I’m trying to taper Xanax and someone on this site recommended you to make a spreadsheet for me. I need to spread out my doses. I am very scared

 

not sure how to do signature

 

ive tapered to 5mgs of paxil

 

need to spread out Xanax dosing and taper 4mgs

 

Edited January 22, 2023 by manymoretodays
Added orig topic title to post and renamed topic, added Paxil tapering to title

[SkyBlue]

Hi N, 

Here is a link for creating a signature: https://www.survivingantidepressants.org/topic/18343-please-put-your-withdrawal-history-in-your-signature/

 

Edited August 11, 2018 by manymoretodays
updated signature link

[Nervous1]

The link didn’t work

 

im currently holding at 5mgs of paxil

on Xanax 4mgs (taken 2mgs at 6am, 1mg-10am, 1mg-2pm)

Am having interdose withdrawal

Was wondering if someone named Shep, who helped a friend by making a spreadsheet of get her doses even, could do the same for me

 

am feeling very nauseous, shaky, racing heart before my doses 

[manymoretodays]

I updated the link and here it is again.  Please put your withdrawal history in your signature.

Sorry about that......we had a recent URL change.

 

It will be helpful to know a bit more about your Paxil tapering to date.  We generally advocate for A/D withdrawal prior to benzo tapering.   If you are already on a benzo, often that can offset some of the withdrawal symptoms of Paxil.

 

I can see your point though....... about asking for some help with the Xanax dosing and spacing, as that does appear to be a problem, that may well be causing some of your present discomfort.  We don't ordinarily act as a spreadsheet drive-by site........and hopefully you would also like to learn more about some harm reduction ways of continuing your Paxil taper.  Depending on how quickly you might have tapered your Paxil.........some of your symptoms may be due to that as well.

I'll leave you a few links as well around tapering in general, withdrawal syndrome,  and Paxil.

Why taper by 10%

Tips for tapering off Paxil

What is withdrawal syndrome

 

How long have you been on the Xanax?

How long and at what doses have you been on the Paxil?

 

And welcome aboard.  This page will act as your main introduction.........both a place for you to introduce yourself to the community, ask questions regarding your situation, and keep us updated.

 

So.......give us a bit more information via your signature, now that the link is corrected.   And any additional information can go here on your introduction.

 

And I'll go ahead and ask Shep to take a look regarding your Xanax.

 

Love, peace, healing, and growth,

mmt

 

 

 

 

[Nervous1]

 

I made a signature and saved. I need to know how to insert it on my post. Sorry I’m having a hard time navigating the site. My intentions were not to sign up as a “drive by” for a spreadsheet, but, I can see how you thought that by my post. I’ve come off Paxil before, so I’m aware of symptoms. I’ve spoken with Alta strata on Facebook before and was previously on this site, but, for some reason it’s not showing that previous activity.

 

 

The link didn’t work

 

im currently holding at 5mgs of paxil

on Xanax 4mgs (taken 2mgs at 6am, 1mg-10am, 1mg-2pm)

Am having interdose withdrawal

Was wondering if someone named Shep, who helped a friend by making a spreadsheet of get her doses even, could do the same for me

 

am feeling very nauseous, shaky, racing heart before my doses 

 

[Shep]

3 hours ago, Nervous1 said:

I’ve spoken with Alta strata on Facebook before and was previously on this site, but, for some reason it’s not showing that previous activity.

 

Hi, Nervous. Do you remember your previous username here on the site? If so, please post it so we can link your two accounts together and perhaps have more of your taper history.

 

Thank you for adding your signature, but we need a bit more information. You don't mention when you started taking Xanax and you list Paxil starting in 2015, but is that the year you started taking Paxil or the year you started your taper? 

 

Please update your signature.  Include drugs, doses, dates, and discontinuations & reinstatements in the last 12-24 months. Also include supplements. This will help us give you the most accurate advice we can. 

• Any drugs and supplements prior to 24 months ago can just be listed with start and stop years. 
• Please use actual dates or approximate dates (mid-June, Late October) rather than relative time frames (last week, 3 months ago) 
• Spell out months, e.g. "October" or "Oct."; 9/1/2016 can be interpreted as Jan. 9, 2016 or Sept. 1, 2016. 
• Please leave out symptoms and diagnoses. 
• A list is easier to understand than one or multiple paragraphs. 
• This is a direct link to your signature:  Account Settings – Create or Edit a signature.

Before offering a schedule for your benzo, I wanted to draw your attention to a drug interaction between Paxil and Xanax. Please see this report off the Drug Interaction Checker:

 

Drug Interactions - Paxil, Xanax, Colestid

 

Using alprazolam [Xanax] together with paroxetine [Paxil] may increase side effects such as dizziness, drowsiness, confusion, and difficulty concentrating. Some people, especially the elderly, may also experience impairment in thinking, judgment, and motor coordination. 

 

3 hours ago, Nervous1 said:

am feeling very nauseous, shaky, racing heart before my doses 

 

I think you're right that you are getting some interdose withdrawal between Xanax doses, but I also am concerned that you may be taking Paxil at the same time as one of your Xanax doses and this may also be causing an uptick in symptoms. 

 

For the next few days, please list a drug and symptoms journal. This will help us figure out a schedule that will include moving the Paxil at least 2 hours away from the Xanax to prevent the drug interaction. The best format for this is:

 

Drug and Symptoms Journal Format

 

Please also include any supplements you take, along with the number of hours you are sleeping. 

 

Also, please let us know more about your Paxil taper, including when your last reduction was and how much you reduced. In your signature, you have "Slow, 1mg every 4-6 weeks". Removing 1 mg every 4-6 weeks is fine on higher doses, but if you removed 1 mg to get down to your current 5 mg (i.e. went from 6mg to 5mg), that's about a 17% reduction. So you may be getting more symptoms due to tapering the Paxil too quickly. 

 

Over the coming days as  you list your Drug and Symptoms Journal, we can help you set up a schedule that will make you more comfortable. 

[Nervous1]

I started Xanax 6mgs in 2009. I have been taking Xanax with Paxil ever since I started taking the Xanax, so it’s not an interaction. Please can you help

me with a schedule?

[Shep]

Although you didn't have problems with the Xanax/Paxil combo in the past, your nervous system has changed since then. In the thread One theory of antidepressant withdrawal syndrome, Alto writes:

 

 

On 5/24/2011 at 10:59 PM, Altostrata said:

The first phase of withdrawal, the acute phase, is the initial shock of withdrawal, with the most defined symptoms, such as brain zaps and nausea and possibly waves of unusually intense "depression" and "anxiety" -- actually, emotions generated by the neurological upset. Later, glutamatergic hyper-reactivity and autonomic instability take over. Often the autonomic instability causes wide hypersensitivity to drugs, supplements, and even foods.

 

 

It's possible that your nervous system has destabilized and you are picking up symptoms now that you never did before. 

 

 

18 minutes ago, Shep said:

Also, please let us know more about your Paxil taper, including when your last reduction was and how much you reduced. In your signature, you have "Slow, 1mg every 4-6 weeks". Removing 1 mg every 4-6 weeks is fine on higher doses, but if you removed 1 mg to get down to your current 5 mg (i.e. went from 6mg to 5mg), that's about a 17% reduction. So you may be getting more symptoms due to tapering the Paxil too quickly. 

 

We also need more information about your Paxil taper. If you are tapering your Paxil too quickly, then adjusting your benzo is unlikely to cover the problems being created by a too-fast antidepressant taper. 

 

Please post a Drug and Symptoms Journal.  Without a Drug and Symptoms Journal, I would be blindly throwing a schedule at you without knowing any details. We also need to know any supplements you are taking. As Manymoretodays posted, we are not a "drive-by" site.

 

Please note:

 

On 6/15/2011 at 2:45 PM, Altostrata said:

Being uncooperative, specifically, not keeping notes and reporting your symptom pattern when requested to do so.

Keeping daily notes of your symptoms, when you take your drugs, and their dosages is quite simple. In many situations, particularly when you're taking multiple drugs, we need this information to tell if a drug is causing an adverse reaction or if an adjustment is working.

 

If, after requested, you avoid doing this, we can't help you. If you persist in withholding this essential information, you may receive more than one warning point, up to being banned from the site (4 warning points).

 

[Nervous1]

I could only fit 12 lines in my signature. I have been sitting at 6mgs Paxil since April of this year. I assure you I have only reduced when I was symptom free.

 

i listed all of my supplements in my signature. Multivitamin, fish oil, probiotic

 

i started Paxil withdrawal around 2015. This is my fourth time coming off of it. Originally, I started it in 1999 as off label use for ibs d. I came off of it in a week a year later and was labeled “depressed” This was before they acknowledged difficulty getting off it.

 

The last time I came off of it was in. 2009 because they wanted me to take an antidepressant patch called emsam. I told them I couldn’t do a rapid taper, so that is the reason for the high Xanax amount given. The patch did not work and I was reinstated on Paxil 20mgs, but, kept on 6mgs of Xanax. I took myself down 2 mgs around that time (can’t remember exactly...probably 2010) I didn’t have any problems. I learned about the addictive ness of Xanax and am very angry that I wasn’t monitored better. Now, I’m having problems with the Xanax and my dr doesn’t want me to proceed with w/d from Paxil until my anxiety is improved. They want me to take more. I tried to take 2mg for my second dose once and had a paradoxical reaction. My dr has said I’m a slow metabolizer since I don’t get full relief till my 2pm dose

 

i fo not remember the year I started on the site or user name. That is a big issue I’m having with these drugs. My memory, especially short term is very poor. I have spoken with alto strata at beginning of this taper

[Nervous1]

I’m not being uncooperative? I’m reaching out to help. I’m telling you everything I know. My symptoms have not changed. 

I don’t know what more I can tell you for help. If you want, I can leave this site, but you helped my friend so much, I thought it would help me. Please, let me know if you don’t want to and I will willingly leave. 

Thank you. I am really struggling and appreciate any help

[Nervous1]

I don’t understand the “drive by” reference? 

[Nervous1]

My symptoms have remained constant since holding Paxil withdrawal in April of this year. A journal would show that I have relief after taking Paxil, Xanax at 6am (I went back to sleep this morning after taking it and woke at 9ish) around 9, I start having interdose withdrawal until my 10am dose, then I’m fine until about an hour before my 2pm dose. Then, symptom free and sleeping well. 

 

I am dealing with a broken elbow and sprained ankle right now and in the middle of packing for a quick move, as well as being a single mom trying to get my daughter ready to start school. I hope you understand this leaves little to no time to journal or anything at this time. If you are uncomfortable, I most certainlly understand. I will move on. I’m just trying to get help. I don’t want to get banned. I’m not here for a “drive by” only to get continued support. Please let me know if you can help. 

[Nervous1]

Sorry, I read back and I typed I’ve been sitting at 6mgs Paxil, I meant to type 5mgs

[Shep]

7 minutes ago, Nervous1 said:

My symptoms have remained constant since holding Paxil withdrawal in April of this year. A journal would show that I have relief after taking Paxil, Xanax at 6am (I went back to sleep this morning after taking it and woke at 9ish) 

 

When you say "I have relief after taking Paxil, Xanax" and then you say you go back to sleep, I think you may be getting the drug interaction (i.e. drowsiness). But if you're fine with going back to sleep, that may work for you and there may not be any reason to adjust this. 

 

9 minutes ago, Nervous1 said:

around 9, I start having interdose withdrawal until my 10am dose, then I’m fine until about an hour before my 2pm dose. Then, symptom free and sleeping well. 

 

You are symptom free from 2 pm until the next day? You aren't having any interdose withdrawal from the 2 pm dose until the next day's 6 am dose? 

 

If so, this doesn't sound like interdose withdrawal from the Xanax. If it were, you would be getting symptoms after the 2 pm dose. 

 

Do you eat when you take your drugs? The reason I'm asking is withdrawal causes drops in blood sugar for a lot of people. The symptoms mimic withdrawal - anxiety, shakiness, crying spells, anger, etc. So if you're eating when you take your Xanax, it may be the food that's causing the improvements, not just the drug. 

 

The Drug and Symptoms Journal allows you to track your diet, which is very important during withdrawal. I would encourage you to keep a journal, if not here on SA, than on paper for your own use. 

 

21 minutes ago, Nervous1 said:

I am dealing with a broken elbow and sprained ankle right now and in the middle of packing for a quick move, as well as being a single mom trying to get my daughter ready to start school.

 

I'm sorry you're dealing with so much and trying to taper, as well.

 

Are you taking any drugs for your injuries, even over the counter meds? 

 

21 minutes ago, Nervous1 said:

I hope you understand this leaves little to no time to journal or anything at this time. If you are uncomfortable, I most certainlly understand. I will move on. I’m just trying to get help. I don’t want to get banned. I’m not here for a “drive by” only to get continued support. Please let me know if you can help. 

 

 

I'm a bit hesitant to even offer a change in what you are doing because you are symptom free for most of the day and you are sleeping well. 

 

How severe are your symptoms? Are there any non-drug coping techniques that you can use to get you through those periods?

 

Non-drug techniques to cope with emotional symptoms

 

Some of the morning and early afternoon symptoms may be the result of cortisol, which naturally decreases later in the day. 

 

Again, since you aren't having any symptoms after 2 pm and you are sleeping well, I would be very hesitant to make any changes and try to use some of the non-drug coping skills to get you through the few hours a day that you are having symptoms.

 

Eating every 3 - 4 hours with a high protein, low sugar meal or snack will also help with the low blood sugar drops that withdrawal can cause. 

 

Since you have more symptoms in the morning than in the afternoon, I'm not sure that removing the earlier doses  - the time when you're having the most symptoms - and moving them to later in the day - the time when you're having the least symptoms - is going to help.

 

If I'm missing something, please let me know. 

 

 

[Nervous1]

You are pretty spot on with what you said. Xanax does make one drowsy and I will sleep if I lay down, for sure. It’s summertime, so I have been doing that when I can. As soon as school starts, I wouldn’t be doing that as I have commitments.

 

yes, after the 2pm dose, I don’t have symptoms until 6am next day. My dr thinks I’m a slow metabolizer now. She wants to add doses after 2. I thought about slowly moving one mg off of the first dose to a 6 o’clock dose to keep it in my system longer?

 

i have been given meds for my injuries, but have not taken them. I took Advil the first day of my fall. (July 1st) My only stipulation is to not lift anything heavier than a ink pen with my right hand. 

 

I eat eat with my morning dose, but, I’m very nauseous, so I eat a protein bar. I have low blood sugar already, so I know the importance of stabilizing blood sugar

 

i guess I was just thinking, as per fb groups, getting my doses even in my system would alleviate the morning problems. The nervousness is pretty severe. I sweat profusely, as well. 

 

I have researched the cortisol and I do think that is probably part of the issue and maybe it wasn’t when I was at higher levels of Paxil

 

Do you think it would hurt to slowly move the 2mg morning dose to a 1mg dose at 6pm and have four even doses?

 

Thank you for your responses. You have no idea how much they are appreciated!

[Nervous1]

I found this on my messenger when I was friends with alto strata on fb. It shows when I actually started taper 

[Nervous1]

I would like to dose 6,9,12,3,6,9 and when stabilized start a taper. That’s what I thought might help. Can you help me with that. I think it would stop the interdose withdrawal and keep the Xanax steady in my system

[Shep]

5 minutes ago, Nervous1 said:

yes, after the 2pm dose, I don’t have symptoms until 6am next day. My dr thinks I’m a slow metabolizer now. She wants to add doses after 2. I thought about slowly moving one mg off of the first dose to a 6 o’clock dose to keep it in my system longer?

 

 

I'm confused - why would your doctor want to add doses after 2 when you have no symptoms and you're sleeping all night? 

 

 

20 minutes ago, Nervous1 said:

Do you think it would hurt to slowly move the 2mg morning dose to a 1mg dose at 6pm and have four even doses?

 

You could, but dosing 4 times evenly would be taking it 5 hours apart, for example, 6 am, 11 am, 4 pm, and  9 pm, so you still would have the same morning problems in between the morning and afternoon doses. From what you've posted, since you're getting slammed with symptoms an hour before you take the 10 am and 2 pm Xanax (which are currently only 4 hours apart), I fear that moving them 5 hours apart will only make that worse. I hope that makes sense. 

 

Instead, I would stick to working with only the morning and early afternoon doses, since that's when you're having the problems. 

 

You may want to space it as follows:

 

6am-  Paxil 5mg and  Xanax 1mg

7am- colestid 

9 am - Xanax 1 mg

12 pm - Xanax 1 mg

3 pm-    Xanax 1 mg

9pm- colestid

 

I'm hesitant to recommend taking doses after 3 pm because you don't have any symptoms that late in the day, and it's possible you may be getting more symptoms earlier in the day due to a paradoxical effect. If that's the case, then you don't want to dose too close to bedtime. 

 

If there is an adverse reaction going on with the Paxil and Xanax that may be causing problems even hours later, having a lower dose of Xanax when you take Paxil is a good idea. So with this schedule, you'll only take 1 mg Xanax with the Paxil instead of 2 mg. 

 

We generally recommend moving doses only one hour a day, as this is gentlest on your nervous system. However, your doses are already so close to this schedule, you may do fine simply adapting to the schedule right away.

 

Please let me know your thoughts on this. 

 

5 minutes ago, Nervous1 said:

I would like to dose 6,9,12,3,6,9 and when stabilized start a taper. That’s what I thought might help. Can you help me with that. I think it would stop the interdose withdrawal and keep the Xanax steady in my system

 

I was about ready to click "submit" when you posted this. 

 

This may or may not be a good idea. Please let me know what you think about the first part of this post. If you don't like it and wish to dose 6 times a day, we can discuss that, as well.

[Nervous1]

I’ll try it your way. Do you think dropping a whole milligram will cause more interdose with drawls? I like it and thank you! If it doesn’t work, we can try it the other way. Plus, now I have something to show my dr. I want off this med, badly. The idea of the other dosing came from group saying it’s easier to come off with keeping a certain amount in bloodstream. I’m pretty sure between 2pm and 6pm, it’s worked it’s way out and it might be working now, but,as far as tapering, I don’t know. PS. I’m trying to get my dr to authorize alprazolam intensol, a liquid Xanax rx. My ins doesn’t cover it, so if she can’t make a good case for it, what is recommended method of withdrawal here. 

[Shep]

15 minutes ago, Nervous1 said:

Do you think dropping a whole milligram will cause more interdose with drawls?

 

I'm sorry, it seems my post  was confusing, but no, we're not discussing dropping - just changing the timing. You'll still be taking 4 mg of Xanax a day. Please don't make any reductions. 

 

17 minutes ago, Nervous1 said:

The idea of the other dosing came from group saying it’s easier to come off with keeping a certain amount in bloodstream. I’m pretty sure between 2pm and 6pm, it’s worked it’s way out and it might be working now, but,as far as tapering, I don’t know.

 

Your other group is correct when it comes to interdose withdrawal. And as you reduce the dose, you may notice that you need to make changes to address interdose withdrawal as your dose is lowered because there's less in your bloodstream. But right now, you are functional for all but about 2 hours a day and you're sleeping all night. So what you are doing now is working well. 

 

Please don't get ahead of yourself regarding the benzo taper, as you still have a ways to go with Paxil first. 

 

18 minutes ago, Nervous1 said:

I’m trying to get my dr to authorize alprazolam intensol, a liquid Xanax rx. My ins doesn’t cover it, so if she can’t make a good case for it, what is recommended method of withdrawal here. 

 

Once you get your Xanax dosing sorted out, I would continue with the Paxil taper. This is a great thread for understanding which drug to taper first (you may have already been referred to it by your other group):

 

Taking multiple psych drugs? Which drug to taper first?

 

Tips for tapering off Paxil

 

Using liquid Xanax will work when you are get to the point where you wish to reduce the Xanax. Or you can make a homemade liquid. Xanax is not very soluble in water, however, some people like to use a small amount of alcohol or propylene glycol to dissolve the pill first and then add water in order to taper. And others are able to use water, as Rhiannon writes:

 

 

On 2/27/2013 at 12:30 PM, Rhiannon said:

Mostly I would just say, I don't think it really matters if the medication is soluble in whatever vehicle you're using, as long as it can be evenly distributed. What really matters is that it be evenly distributed and that your method be repeatable and consistent. 

 

Other people are able to use a scale and do just fine. So there are a few options. 

 

Once you get the benzo adjusted and you feel ready, please continue to post and the antidepressant moderators can assist with the Paxil taper. As I mentioned previously, you may be tapering too fast and switching over to a micro-taper may be a better option for you. These are good links to read about the different types of micro-tapers out there:

 

Micro-taper instead of 10% or 5% decreases

 

The Brassmonkey Slide Method of Micro-tapering

 

Please pay special attention to the Brassmonkey Slide link, as we are seeing some very good results from this method of micro-tapering. You may also want to read Brassmonkey's Success Story, as he's a Paxil survivor: 

 

Tao of the Brassmonkey - Success Story

 

[Nervous1]

Ok, so you don’t think going from 2 mg at 6am to 1mg will make me feel bad because I’ll be dosing at 9? Thank you EVER SO MUCH!!!!

[Shep]

You should be okay. You'll be at 1 mg at 6 am but you'll have the second 1 mg dose at 9 am. And all of the doses are spaced out evenly every 3 hours until the middle of the afternoon when you have a history of having no symptoms. 

 

Please note that it takes 4 days for your nervous system to notice a change and it could take a few weeks to completely adapt to the change. 

 

Let us know how you do over the coming days. 

[Nervous1]

Thinking I may start taking my Paxil at night if you think that is interfering. I usually wake up in a sweat and when I take my first dose (2mg) it stops . Changing it this morning, it didn’t stop, so I took my full 2mg. I have thought that I may be menopausal, but, perhaps it is the long span of time without Xanax (2pm-6am) I’m just really scared

[Shep]

Nervous, please see my earlier post:

 

49 minutes ago, Shep said:

Please note that it takes 4 days for your nervous system to notice a change and it could take a few weeks to completely adapt to the change. 

 

 

The change isn't an automatic fix. Please give it some time. 

 

13 minutes ago, Nervous1 said:

I usually wake up in a sweat and when I take my first dose (2mg) it stops . Changing it this morning, it didn’t stop, so I took my full 2mg.

 

This may be a symptom that is not going to completely resolve with a timing change. Are you able to take cold showers for the sweats? (Cold showers and hot flushes). Cold showers are also good for stimulating the vagus nerve (How to Stimulate Your Vagus Nerve for Better Mental Health). Also, your diet may be in play if you're menopausal, you may want to google some dietary / lifestyle changes that may be helpful.

 

You likely are getting some interdose withdrawal from the Xanax and spacing it out farther in the day may help so it's not as intense first thing in the morning. But in order to do this, you'll reduce part of that 2 mg morning dose in order to space your doses out farther into the day. 

 

 

11 minutes ago, Nervous1 said:

Thinking I may start taking my Paxil at night if you think that is interfering.

 

Since you are sleeping all night, I would be hesitant to move the antidepressant to nighttime. Do you know if Paxil on its own (without taking a Xanax tablet) makes you sleepy? 

 

Nervous, I would be very careful about playing around with your drugs. You state you only have symptoms for a couple of hours a day and you are sleeping all night. This is excellent for someone who's reduced Paxil by 75%. 

 

 

[Shep]

Also, you may want to check out these threads:

 

PMS and menstrual cycle issues during withdrawal

 

Female hormone issues: perimenopause, menopause, WD or something else?

[Nervous1]

Paxil does not make me sleepy on its own. I take showers at night, as I get upst 530-6 to take my daughter to school.

[Nervous1]

I’ve had a hysterectomy, so, no menstrusl changes 

[Nervous1]

I have appt with dr on 22nd. I will see if I she thinks spreading out doses will help. She keeps wanting to add more Xanax, but I don’t want to do that for several reasons. Our intent is getting off the Paxil, but, she wants to get my anxiety under control first. I feel good about my Paxil taper. I have held at times when life stressors were too much to taper more and, in the beginning it was harder, ...crying spells and zaps. The crying has stopped and high potency fish oil has stopped the zaps. I had gained 100lbs on Paxil and I am finally losing the weight. It was putting too much pressure on my knees and I need knee replacements, but, dr wants to put it off,as I’m only 😁 48. Apparently, I’m still young? 

[manymoretodays]

10 hours ago, Shep said:

Please note that it takes 4 days for your nervous system to notice a change and it could take a few weeks to completely adapt to the change. 

 

Hi Nervous,

I'm just reiterating ^.  If I were you, I'd sure give this new change in your morning dosage, and dosing schedule a bit more time.  Did you find any non-drug coping that might help?  I think that your doctor is more than likely to convince you to go from a 4 mg dose of Xanax total/day all the way up to 6mg/day. 

And I would certainly not change the timing of your Paxil or dosage,  right now.  We strongly advocate for just one change at a time.

See:  The rule of 3KIS: Keep it simple

 

Now that you have the signature part down(accessing it) could you just add a bit more of your history, briefly.  I see that you note in your intro/journal here that you started Xanax and probably Paxil back in 2009.  Just the year, month(if you remember), date(especially with the more recent changes), and dosages(if remembered).   You can keep the colestid there too.   Then add current dosage of Xanax to it, your signature.

 

And then you could do the Keeping daily notes of your symptoms log on paper first, then share here(on your journal/introduction page)........include symptoms in it..  Like what you presently have in your signature.  Only add a date at the top and times and symptoms as well.  I made a copy from your signature of what you've got there presently. 

6am- Paxil oral suspension 5mgs

           Xanax 2mgs

           Probiotic, fish oil, multi vitamins

7am- colestid (bile acid sequestrant given 

           after gallbladder removal)

10am- 1mg xanax

2pm-    1mg xanax

9pm or before bed- colestid

That's ^ actually a good start to daily notes.

 

If I were you, I'd sure give it a bit longer with your new dosing regimen........and don't rely on your prescriber's guidance too, too much.  Shep gives some great advice, based on years now of studying this, and helping others here.

 

Great on the weight loss.  So sorry for your other difficulties of late.   And hope your move goes well........I think you had mentioned moving with your now teenaged daughter.  Perhaps work on organizing here a bit more in the evenings, when your mind feels a bit clearer?

 

All my best with your journey into healing from many years of medications.......

 

Love, peace, healing, and growth,

mmt

 

 

Edited August 12, 2018 by manymoretodays

[Nervous1]

I originally put more in my signature, but, it will on take 12 lines

[manymoretodays]

I'm just trying to clarify that the times can go in your daily symptom logs. 

And then just years, month, date, drug, dosage in your signature, with any pertinent changes as well, in dosage.

A lot of members get confused between symptom logs and signatures.

 

I hope that's not more confusing and helps.  It will help a lot  going forward.  It saves moderator time when trying to address your questions and concerns.

 

Best,

mmt

Edited August 12, 2018 by manymoretodays

[Nervous1]

I need to take a break from this activity, for now and concentrate on packing for my move. It’s overwhelming, as I have only the use of one arm with broken elbow and sprained ankle. I will continue when I am settled, if that is ok? I don’t know what more I can fit in my signature 

[manymoretodays]

I understand.  Your having a lot of anxiety and it feels like you have to do everything right now.

That's why I said to perhaps take a look at another time.

Look at both the daily symptom log link again and the signature link........and I'm sure you will figure it out.

Happy packing. 

And perhaps I should clarify.......it's more about what you could minimize or take out of your signature, keep in mind you can use your 12 lines horizontally too.  And then I'm just encouraging the daily symptom log format, which would go right here on your main introduction page.  After you have begun doing it on paper.

Edited August 12, 2018 by manymoretodays
further clarity

[Altostrata]

Hi, Nervous1. It looks like we corresponded on Facebook, you did not previously register here.

 

I am glad your Paxil tapering has been going well.

 

On 8/10/2018 at 12:30 PM, Nervous1 said:

am feeling very nauseous, shaky, racing heart before my doses 

 

On 8/11/2018 at 7:55 AM, Nervous1 said:

A journal would show that I have relief after taking Paxil, Xanax at 6am (I went back to sleep this morning after taking it and woke at 9ish) around 9, I start having interdose withdrawal until my 10am dose, then I’m fine until about an hour before my 2pm dose. Then, symptom free and sleeping well. 

 

6am Paxil 5mg, Xanax 2mg

7am colestid

9am very nauseous, shaky, racing heart

10am Xanax 1mg

1pm very nauseous, shaky, racing heart

2pm Xanax 1mg

9pm colestid

 

Sleep is okay. As you're not getting interdose withdrawal from Xanax overnight, like Shep I question whether this is the cause of your symptoms.

 

Let us not overlook the potential side effects of Colestid https://reference.medscape.com/drug/colestid-colestipol-342452#4 How long have you been taking it, have you had a dosage change that coincided with the emergence of the "very nauseous, shaky, racing heart" pattern?

 

Do you get any symptoms after your nightly Colestid?

 

On 8/11/2018 at 10:20 AM, Shep said:

....

Instead, I would stick to working with only the morning and early afternoon doses, since that's when you're having the problems. 

 

You may want to space it as follows:

 

6am-  Paxil 5mg and  Xanax 1mg

7am- colestid 

9 am - Xanax 1 mg

12 pm - Xanax 1 mg

3 pm-    Xanax 1 mg

9pm- colestid

 

This seems like a good schedule and may reduce your drowsiness after the 6am Paxil + Xanax dosing

 

10 hours ago, Nervous1 said:

Thinking I may start taking my Paxil at night if you think that is interfering. I usually wake up in a sweat and when I take my first dose (2mg) it stops . Changing it this morning, it didn’t stop, so I took my full 2mg. I have thought that I may be menopausal, but, perhaps it is the long span of time without Xanax (2pm-6am) I’m just really scared

 

Wake up in a sweat, hmmmmm. Any other symptoms when you wake up?

 

10 hours ago, Shep said:

Nervous, I would be very careful about playing around with your drugs. You state you only have symptoms for a couple of hours a day and you are sleeping all night. This is excellent for someone who's reduced Paxil by 75%.

 

Shep is right on here. We're in a "if it's not broke, don't fix it" situation.

 

6 hours ago, Nervous1 said:

I have appt with dr on 22nd. I will see if I she thinks spreading out doses will help. She keeps wanting to add more Xanax, but I don’t want to do that for several reasons. Our intent is getting off the Paxil, but, she wants to get my anxiety under control first. I feel good about my Paxil taper. I have held at times when life stressors were too much to taper more and, in the beginning it was harder, ...crying spells and zaps. The crying has stopped and high potency fish oil has stopped the zaps. I had gained 100lbs on Paxil and I am finally losing the weight. It was putting too much pressure on my knees and I need knee replacements, but, dr wants to put it off,as I’m only 😁 48. Apparently, I’m still young? 

 

You've done a great job with your Paxil taper. I would not increase Xanax. Everybody thinks Xanax can fix anything, but it often causes more problems than it fixes.

 

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

 

Good luck with your move, that's a lot for someone with a broken elbow, sprained ankle, and weird symptoms from drugs. Please let us know how you're doing.

 

[Nervous1]

Hi. ive not been active in quite a long time. i finished a long taper off of 4mg of xanax in September of 2022. i tapered for a little over 2 years staying within the 10% guidelines. Now i need to finish my taper off of Paxil. I am currently on 8.4mgs using the liquid suspension. 

My tapering plan for monthly reductions is  (will hold if needed):

 

8mg

7.5mg

7mg

6.5mg

6mg

5.5mg

5mg

4.5mg

4mg

3.5mg

3mg

2.5mg

2mg

1.5mg

1mg

 

The only other med i take is colestid, once a day prescribed after gallbladder removal surgery. its a bile acid sequestrant. 

Do you think this is a good taper plan?

Thanks in advance

 

 

[manymoretodays]

Hi there Nervous1.  Welcome back.  @Nervous1

And congratulations on getting off the Xanax.

 

I've merged your most recent post back to your Introduction topic, and so you will now see it above, as well as your previous history with us.

So for now, just post here.  This will serve as your main topic.

 

What I can see in your post above is that you are planning on doing a linear taper.  Reducing by 0.5 mg every time.

 

What you may recall, is that we go with a harm reduction model of tapering by 10% or less, off each previous dosage.

See:

Why taper by 10% of my dosage?

 

With your plan, you'd be going down by less than 10% of each previous dose, up until you got to 5 mg, and then you'd be reducing by more than 10% of each previous dose.  So, I would, if it was me, re-calculate your tapers, and do it by calculating 10% or less of each previous dose.  When you get to those doses below 5 mg, you'd be tapering by too much, increasingly so, and likely would get into trouble is what I think.

How long were you planning to hold between tapers?

I would recommend at least 4 weeks.

Are you familiar with WD and WD symptoms now, should they occur?  Often each persons taper is based on their own responses too, and may need to be re-adjusted accordingly.

 

To calculate a 10% taper:

multiply present dose X 0.90 = and you get the next dose with a 10% taper

To calculate a 5% taper:

present dose X 0.95 = the next dose with a 5 % taper

 

Or you can micro taper or do a brassmonkey slide taper.  There are various ways to do tapers and stay within the not greater than 10% from each previous dose.

-the-brassmonkey-slide-method-of-micro-tapering/

 

Tips for tapering off Paxil(paroxetine)

this will be helpful too ^

 

How are you doing right now overall?  You might have seen or read how we often have members save the benzo(xanax in your case) taper for last, as sometimes it can help buffer some of the WD(withdrawal) from AD's(antidepressants). 

 

Would you update your signature to reflect your drug changes please?  I will give you the link to that topic, which will then have a link in it, so you can edit/update your signature:

How to Summarize Your Drug History in Your Signature

and thank you for updating your signature in advance.

 

All for now,

L, P, H, and G,

mmt

Edited January 22, 2023 by manymoretodays