Sottana: Paxil withdrawal - questions and concerns

[Sottana]

Thanks for checking in. I have this new thing where during waves I feel like the ugliest creature to ever walk on the planet. Very strange, hyper-critical of my appearance. I’ve never been like this. 

[ChessieCat]

3 hours ago, Adili13 said:

 

Hey Bee, I think my taper speed has been pretty standard, actually. Only reducing to 18.7 in about 16 months. I crashed bc I couldn’t handle the ten percent drops, which it seems some ppl have a problem with. I’ll be stabilizing for a bit before I start a brasmonkey slide, possivbly with only 5 percent drops monthly. 

 

Hope you start feeing better soon!! 

 

 

It may not just be the Paxil decreases/increases but also the Lamicatal, going from 175mg to 0mg over approximately a 5 month period:

 

september 2017: 37.5 mg Paxil ER 

october 2017: lamictal upped to 100 mg

november 2017: lamictal upped to 175.

January 2018: Paxil drooped to 25 er

february 2018: lamictal dropped to 100 

march 2018: lamictal dropped to 50

april 2018: lamictal dropped to 0

may 2018: Paxil dropped to 20 mg 

december 2018: dropped Paxil to 18 mg 

[Sottana]

Good point, Chess. I guess I figured lamictal wasn’t a big issue since I was only on it for like 9 months, but that’s enough to destabilize, for sure. 

[Sottana]

Like i said, don’t see myself making any substantial changes till at least July. Will start a much slower taper then  

[ChessieCat]

Once you stabilise you might still be able to make 10% reductions.  However, for the first reduction, if it was me, I'd be trying a maximum 5% reduction.

[Sottana]

Ok. That’s a good plan, I’ll for sure only do 5 percent once I stabilize for the first month. Then, after maybe a month or two of that, go to ten if I feel ready. 

[Sottana]

After my updose and subsequent taper down to 18.7, i've been experiencing intense somnolence as well as a lobotomized feeling for most of the day. I sleep more than 12 hours everyday. Was wondering if this is common. Here's my symptom pattern. 

 

6:30 AM: wake up to take meds then go back to sleep due to intense exhaustion 

12:00ish PM: wake up and struggle to get out of bed as body and mind exhaustion is super intense

1:30PM: manage to do a 30 minute incline walking workout at the gym 

3:30PM usually hit a wave that renders me back in bed for another 2 hour nap

5:00PM wake up and again struggle to get out of bed due to intense exhaustion

5:00PM-10:00PM usually experience some increase in energy

10:00PM-2/3:00AM: sometimes a pressure headache returns at this time and the exhaustion comes back. Falling asleep during this period is variable. 

 

[Altostrata]

Which drugs do you take at 6:30 a.m., at what dosages? Which drug is causing you to be sleepy?

[Sottana]

i take paxil 18.7 mg at 6:30 AM. I'm not sure if this is the cause of my sleepiness, as i'm sleepy for most of the day. This is all i take, other than magnesium and fish oil. 

[Sottana]

Just re-responding to bring attention to my post. 

[Sottana]

Anyone cycle through windows and waves within the course of one day like me? 

[Longroadhome]

No can’t say I do . I have days and days  of symptoms and low mood and the odd day where symptoms don’t disappear but seem more manageable. 

I think finally  after four months  staying put on 8.5mg Paxil I’m starting to stabilise after a too fast taper . However while holding with Paxil dose I started to taper pregabalin and should be off it by Mid July . Then I will start to taper again with Paxil. I’ve experimented by dropping .1mg for the last week and nothing major has happened. 

 

[Sottana]

I don’t know much about pregabalin, long. What kind of drug is it? 

[ChessieCat]

8 hours ago, Adili13 said:

Anyone cycle through windows and waves within the course of one day like me? 

 

Yes, this can happen.

[Sottana]

I hit a wave that lasts a couple of hours every day at like 3 o’clock. It’s been going on for almost 3 weeks now with little improvement. I guess I’ll just keep holding for a bit longer. If things don’t improve soon, I think I’ll just judiciously tapering. 

[Sottana]

Or should I just hold a lot longer? 

[Sottana]

 

hello to anyone listening...

 

I've been holding at 18.7 mg of paxil since may 4th. i have seen a lot of improvement in my state in between waves. I'm laughing, feeling more emotion, and generally feeling more like myself. The issue is waves haven't really lessened in intensity or duration. I usually experience 2 a day, anywhere from 1-2 hours long. I am going to hold for another few weeks, but am wondering. Do people ever taper while still experiencing waves? Or do ppl just hold indefinitely. I know it's a personal choice, and something i'll have to decide on my own. I'm thinking that if i dont see any really improvement with the waves, i'll start a 5 percent taper on a monthly basis. 

 

any advice would be greatly appreciated 

 

[brassmonkey]

At 18.7mg pf paxil you are going to be seeing fluctuations in your mood through out the day.  The thing to watch out for is the really big swings in either direction.  If your symptom pattern is pretty consistent day after day with no huge swings then you probably have stabilized at your current WDnormal.  That would indicate that starting a taper would be fine.

 

There is a difference between the fluctuations in symptoms that happen through out the day and the "Windows and Waves pattern".  Windows and waves are significant changes in symptoms such as feeling blah one day and then not being able to function the next.  Waves seldom last a short time when a person is in the middle of a taper.  They typically last a week to several months before resolving.  As a person tapers waves tend to get shorter and less sever.  Windows on the other hand usually start out being so short they often go unnoticed.  My first one lasted fifteen minutes and I didn't realize it had happened until several hours later.  As a person tapers they grow in length.

 

Daily fluctuations in mood/symptoms are quite common for even normal people.  Most people experience changes in how they feel many times throughout the day.  People going through ADWD are just more likely to notice because they are more focused on how they feel.

[Sottana]

That’s super interesting, brass. I never really thought of it that way. Perhaps my fluctuations are normal and just really pronounced bc I’m laser-focused on them during WD. My symptom pattern seems pretty predictable at this point. Seems like going ahead with my taper in a couple weeks is a good idea.

 

thanks so much for the help and advice. I feel like I understand the concept of WDNormal a bit better now. 

[Sottana]

The thing is, it really doesn’t feel like fluctuations in mood. Like, every day, at 4 o’clock and 10:00 I have a sudden immense drop in energy and mood. I go for feeling “ok”, to feeling like I can’t do anything. No energy, deep depression and anxiety. It very much feels chemical and not like random fluctuations. 

[Sottana]

The weird thing is, even though I’m experiencing these mini waves every day, I’m also still experiencing akathisia from a failed updose. Ughh, my nervous system is so outta wack 

[ChessieCat]

56 minutes ago, Adili13 said:

Like, every day, at 4 o’clock and 10:00 I have a sudden immense drop in energy and mood.

 

What time do you eat lunch and dinner?  It may be a drop in your blood sugar levels.  You might find having a small snack at about 2.30pm or 3pm and again at 8.30pm or 9pm.

 

If you don't want to increase your food intake, are you able to keep a small portion of your lunch and dinner to eat a bit later.

[Sottana]

Interesting. I’ll keep that in mind. Maybe I’ll start snaking right before those times 

[ChessieCat]

low-blood-sugar-and-symptoms-withdrawal-hypoglycemia

 

I find that apples actually make me hungry.  I've googled this and other people find the same thing.

 

From https://www.medicalnewstoday.com/articles/320518.php:

 

Quote

 

When blood sugar drops within 4 hours of eating a meal, a person may be experiencing reactive hypoglycemia. This condition is caused by excessive insulin production after eating.

Hypoglycemia symptoms including:

• trembling
• feeling weak or faint
• headache
• feeling mentally sluggish
• confusion
• anxiety and irritability
• feeling tearful
• heart palpitations
• turning pale
• blurred sight
• tingling lips

 

 

 

Quote

 

Snacks

People with hypoglycemia should try to include small, nutritious snacks in between meals to keep blood sugar levels constant and ensure they are having enough vitamins, minerals, healthy fats, proteins, and fibrous carbohydrates in their diet.

Eating one snack mid-morning, another mid-afternoon, and something small close to bedtime can help keep blood sugar levels stable throughout both the day and night.

Some healthy snack options are:

• a small apple with a few slices of cheddar cheese
• a banana with a handful of nuts or seeds
• a slice of wholegrain toast with mashed avocado or hummus
• whole-grain crackers topped with a small can of sardines or tuna
• carrots, peppers, and cucumber dipped in hummus
• a vegetable smoothie

 

 

 

 

[Sottana]

oh, cool. Thanks! Can WD actually cause hypoglycemia? 

[ChessieCat]

If you look at the wide variety of symptoms on the Dr Joseph Glenmullen's Withdrawal Symptoms list it makes sense that this can happen.

 

However, even "regular" people can experience drops in blood sugar level at different times during the day.

[Sottana]

That’s interesting. I don’t think it’s hypoglycemia though. I tried eating right before it happens and it didn’t seem to do much. Think they’re just mini waves. Doesn’t seem like most ppl get them. I’ve had pure anxiety before and know this is something different. Essentially, I feel like I have to lie down at certain points in the day due to a massive dip in mood and energy. Seems to happen very suddenly at around the same time every day. 

[ChessieCat]

6 hours ago, Adili13 said:

I tried eating right before it happens

 

You would need to eat earlier than than to give the food a chance to be digested.

On 6/16/2019 at 10:17 AM, ChessieCat said:

However, even "regular" people can experience drops in blood sugar level at different times during the day.

 

There is a thing nicknamed 3.30 itis.  I did a search for it in google.  It's a slump that people experience which generally hits mid afternoon.

[ChessieCat]

5 hours ago, Adili13 said:

Is there a thread anywhere on SA where ppl talk about how they got their drugs without insurance? 

Like cheap psychiatrists or something that will just fill your script 

 

I've moved your post to this topic:  low-cost-drugs-getting-your-prescription-filled-on-a-budget

 

Q:  Are you asking about getting a script written OR getting a script filled?

 

Any doctor can write a prescription.  You don't have to see a psychiatrist.

[Sottana]

more the script written, as my psychiatrist is very expensive without insurance. I know with GoodRx I can get the prescription for a low cost 

[Sottana]

Hello SA,

 

So, if you look at my signature, you'll see i've reduced 5 percent since my last post. Since my reduction, i've experienced one crash that only lasted like an hour, and then the typical dips. I have found that my OCD can be a real issue with thinking about my taper speed. I think I can handle 5 percent (though I feel like a zombie/tired and kinda crappy most days). I think this is tolerance though, as I was definitely in tolerance when I started tapering meds. I was very depressed, anxious, low-energy when I started. I was wondering if anyone else struggles with obsessing about their taper-speed, and whether they constantly overthink if their symptoms are tolerance or regular WD. I know tapering out of tolerance is an incredibly slow and frustrating process. I was wondering if anyone had any tips for retaining an appropriate but cautious speed without overthinking everything and letting their taper rule their life. 

 

[Sottana]

i also know that a 5 percent monthly drop means its going to take me like another 8-9 years to get off. I'm really not willing to go any slower than this. Side note, since quitting my job ive been able to do like 10-15 hours of doordash a week. Hoping to work part time in the next few months if i feel up to it. 

[brassmonkey]

Hi Adili--  Tapering paxil out of tolerance is no fun at all, been there, done that, but it can be done and once things stabilize and you've broken through the tolerance things get a lot better.  I think you would really benefit from trying a Brassmonkey Slide. It is designed to minimize the symptom spike from each reduction, making it possible to do a fairly rapid taper with a lower symptom load. Also it involves making changes to your dose on an almost weekly basis which can help placate the OCD.  Basically it is four small weekly reductions and a two week hold. The original method gave a 10% reduction every 6 weeks, but many of our members are using 5%.  Both with great success.  If this sounds interesting we can help set you up.

 

I've battled hypoglycemia most of my life and know it's a total PITA.  It also has cleared up to a large extent since I got off of paxil two years ago, not totally, but not like it was.  At the worst of it I had to eat five or six small meals a day.  More like grazing than really eating.  I learned that "rainbow trail mix" was my friend. A small hand full every few hours really helped keep things on an even keel.  Also peanuts and chocolate (AKA snickers bars) were excellent for stopping an "attack" if things got out of control.

[Sottana]

Hey Brass! 

 

Thanks for responding.

 

Ok, let’s set up a slide at 5 percent. My next cut is on the fifth of August, and I’m at 17.8. 

 

Whats the game plan 🙃

[Sottana]

Oh, by the way. I did two 2.5 percent reductions this last time. So not quite a slide, but closes. Two cuts, and a two week hold to make it 5 percent every month 

[Sottana]

@brassmonkey