Sebas: seeking advice about paroxetine

[Rozon1]

Hey @PerAsperaAdAstra how many times did you try to ct? What was the longest CT you did before you reinstated? 

[PerAsperaAdAstra]

17 hours ago, Rozon1 said:

Hey @PerAsperaAdAstra how many times did you try to ct? What was the longest CT you did before you reinstated? 

 

Hi @Rozon1! I have tapered way too quickly three times (big crash!). Although no CT I consider the effects near-CT. In the summer of 2018 I really CT'd. Inadvertently. I was off 2 months before I crashed, HARD! Had to reinstate. Took a while before I stabilised but I've survived!

[PerAsperaAdAstra]

How are you doing @Sebas? Hoe gaat het? 🙂

[Sebas]

Found out today that grapefruit messes up your antidepressant. First did some research cause i had no iday what caused the worsening of wd.symptoms (nausea, dizzy, familie etc). First thought it could be lemon Juice (??), then looked into magnesium biglycenate (but started using this more than just a couple of days ago and used citrate before, so could not imagine).

Then thought it might be some candy.

 

BUT turns out that grapefruit f***s up the system. So be Careful with this (summer drinks) also regering other meds.

 

Source: https://metro.co.uk/2017/07/04/can-you-eat-grapefruit-when-youre-on-antidepressants-and-other-medication-6754558/

[PerAsperaAdAstra]

That's a shame you had to find that out the hard way. I was told that when I used benzodiazepines for several months.

 

How are you now? 🙂

[Sebas]

Hope to regain a normal state of mind within days. But thats always the question...

[Sebas]

Hey guys,

 

Have recently become stressed out from to much stress at work. Called in sick 2 weeks ago. Still no paxil stabilisation since small taper from 11/2019.

 

Currently extremely nauseous, and heart is racing. Sleeping problems. I feel very sick. Tried mag bisglyxinate for heart racing but it messes up the paxil. Tried tiny dosis (sipping) but also problematic.

 

Should i try a small updose?? Any advice about possible medication for this extreme nauseousness. Is paracetamol safe to use?

 

I feel like stress from work is currently enhancing withdrawl. I could use something for relaxation.

 

Let me know what you think.

@Altostrata

[Fallensoul]

Hello Sebas,

 

I'm also from Holland, and struggling with the evil poisons.
My Paroxetine pooped out suddenly arround aug 2018, after many months of bad sleep, which could be a sign for decreased working.
The theory that receptors downregulate in sensivity and quantity is one of the main hypothesis, but does that take 20 years before problems appear I wonder??

Since 2019 I've tried many additions and crossovers to other medications, but it didn't work, only Buspar worked miraculous for a month.

When paroxetine was down at 10mg, I tried Clomipramine, which seems to do something, but only for a very little amout and I am allready down from 50mg to 26mg, beacause I simpley don't feel right on it and on 50mg I was a restless panicly wreck  (Akathisia).

Now I'm at 5,7 mg paroxetine and 26mg clomipramine and sympthomes have changed and I feel (severe) fatique mentally and physically, which strange enough subseed in the evening and come back in full force the next day, left me lifeless lying on the couch till ~16.00u.
I want to taper the clomipramine further down to 25 or 20mg and then only the paroxetine with 5-10/month and see how it goes.
Eventuelly I want to get rid of it all.

Still no stabilisation since 2019 is a long time, I cann't give you any answers, hopefully Altostrata does. Btw do you sleep well?

[Erell]

@Sebas : I'm sorry to read that you're struggling after a long hold.

 

You are holding at the same dose since March 2019 ?

 

How did your symptoms evolve since 2019 ? (Symptoms, intensity, windows and waves,...)

 

Sending hugs 🤗

[Altostrata]

Paroxetine is probably the most difficult antidepressant to go off.

 

It may be worth it to you to consider a cross-taper to fluoxetine or citalopram, see The Prozac switch or "bridging" with fluoxetine

 

You'd stabilize for a while and taper off the substituted drug.

[Sebas]

@Erell no since november 2019, but had some bad interactions along the way. First diclofenac for knee injury, which messed up withdrawl, then grapefruit and then an amino acid in a protein shake. So the length is also due to these circumstances. 

[Sebas]

11 hours ago, Altostrata said:

Paroxetine is probably the most difficult antidepressant to go off.

 

It may be worth it to you to consider a cross-taper to fluoxetine or citalopram, see The Prozac switch or "bridging" with fluoxetine

 

You'd stabilize for a while and taper off the substituted drug.

 

Thanks but given the current experience of Erell a switch to prozac is not on my shortlist of wishes. My main question is would a small updose possibly have any effect or best to leave it this way.  Might be too long the way for an effective updose i guess.

 

Yes its definitely very difficult (especially considering a 4 day employment), sofar stabilisation has come whatsoever. I'm taking some time off to recuperate.

[PerAsperaAdAstra]

Sorry to hear that work-related stress put you in this bad spot Sebas. I hope you will feel better soon, and that not working will give you some time without that added stress to recoup. 

How are you doing today?

 

I can understand that you're weary to do a cross-taper, especially to Prozac since Erell's switch didn't go too well. 

I'm still not as far in my taper as you are, but if it will get that difficult too I might consider switching to citalopram because of its longer half-life. Maar laten we hopen dat het niet nodig gaat zijn. 

[Sebas]

@PerAsperaAdAstra had a nice window today after a very restfull couple of days. Didn't even need my afternoon nap 😴. 

 

Indeed working and coping with stress from (long term) withdrawal can be too much in some hectic periods. Must learn to take a step back then @work. Btw my collaegues are not familiar with my taper.

 

My first period of tapering went relatively smooth but since 12mg it's become heavy. As soon as im stabil again i'm taking 3-6 months off (no taper) to give CNS some time to recover.

 

About switching...have also read some things about (es)citalopram regarding to cardiac problems. However i'd rather have gotten this back in the days than paxil 😐. If there's a 'safe' way then i might definitely consider it in the future.

 

Fijn weekend! 

 

[Altostrata]

No one could be more sorry than me that it's so difficult to go off paroxetine! Unfortunately, choices are few. 

 

Good to hear you got a window.

[Sebas]

On 3/25/2021 at 10:20 PM, Altostrata said:

Paroxetine is probably the most difficult antidepressant to go off.

 

It may be worth it to you to consider a cross-taper to fluoxetine or citalopram, see The Prozac switch or "bridging" with fluoxetine

 

You'd stabilize for a while and taper off the substituted drug.

@Altostrata is it possible that stabilisation might not occur because of drug tolerance? If this is the case then it might be a possibility to add a minor dosis of citalipram for example. And from there on carefully proceed. I'll read the thread you linked above.

[Sebas]

1 hour ago, Sebas said:

@Altostrata is it possible that stabilisation might not occur because of drug tolerance? If this is the case then it might be a possibility to add a minor dosis of citalipram for example. And from there on carefully proceed. I'll read the thread you linked above.

I'm thinking it must still be withdrawal one way or the other. I've got wider pupils, foggy brain, heartrate is up. And when eating spices my anxiety goes up. Does seem like wd symptoms to me.

[Altostrata]

Yes, you might prefer to cross over to citalopram.

 

I do not think you have reached tolerance to Paxil. You are having a difficult time going off Paxil.

[Erell]

Hello Sebas

 

Thank you very much for your support on my thread.

 

I'll try to answer clearly to your questions :

 

- "Do you think you were stable (no withdrawal symptoms) when you started bridging in april 2020?"

 

Well, I did the crossover because of Paxil out of stock, so I didn't wait to see if I was stable.

I don't know if I was stable on Paxil when I started the bridge : I was holding my Paxil dose since around 7 months, and was definitely better than my Paxil crash. I was still having intense spikes, but I was functionnal.

 

- "In bridging topic (p.3) i read a post about 5mg being almost as effective as 10 or 20mg but less side effects."

 

Yes, at first my plan was to bridge from 10mg Paxil to 5mg Prozac.

Then intense symptom led me to make the choice to increase my Prozac dose.

 

In fact, as everything in WD, I don't think there are universal rules.

I know a lady who did a cold switch from 20mg Paroxetine to 30mg Prozac and did perfectly fine except for one day of symptom.

It seems that some people can switch relatively easily between ADs while others have more issues.

And in fact, there are people who are really helped by a bridge.

Unfortunately we don't have the ability to predict how it will work.

 

Feel free to ask more if you want  ☀️

 

Sending healing vibes 

[Sebas]

Haven't been feeling much better last weeks. Home from work several weeks now. Wake up feeling tired mostly, often feel nauseous throughout the day with diarrhea, slightly worried and unhappy. Heartrate still up during activities, no clear vision. Again wondering if i should updose. Have adjusted diet for better food absorption. No stabilisation whatsoever. Current dose 5.56 ml (=11.2 mg).

[brassmonkey]

What is the definition of stabile that you are aiming for?

Edited May 17, 2021 by brassmonkey

[Sebas]

1 hour ago, brassmonkey said:

What is the definition of stabile that you are aiming for?

 

Hello Brassmonkey; the feeling that a certain connection has been made in the brain and things settle in like

they normally do after a period of WD. Thoughts turn calmer again and energylevel is up. No more dizzyness and a clear mind and vision (vision in my right eye is always unsharp during WD). CNS becoming less overstimulated. Heartrate normal for practicing sports without it going up real fast. Being able to tolerate certain foods or stimulants again. Those kind of things.

 

I did a tiny updose a week ago from 5.55 to 5.6. Currently feel like i've got more energy, so hope the rest (see above) will also improve in the next weeks.

 

Was also doubting cause of the long term WD symptoms if it could be related to tolerance. But might also be stress related (work). The thing is, sometimes it's hard to analyse weather it's relapse, WD (post-acute) and/or tolerance. 

[brassmonkey]

That helps. Some people have the idea that stability is "symptom free", which it is  not. I describe it as feeling the same level of blah day in and day out with no big swings in either direction.

 

The area of 12 to 9 mgai for paroxetine is frequently a tricky one to get through. At this point symptoms can be very unpredictable and at times quite harsh. Once a person gets below 9 it seems that things calm down for a while. I had a fairly strong uptick in symptoms at this level and then it was much better once I "broke through". 

 

Trying to pinpoint the cause of symptoms is practically impossible. There are so many variables involved, none of which can be fully controlled. If you haven't seen it please do a site search on AAF (Acknowledge, Accept, Float). There is a lot of good information on acceptance of symptoms that you might find useful.

 

It sounds like the small updose has helped. It might be a good idea to hold at this level for several months to let things settle in.  Then continue to slowly taper. If things are manageable here, then I would not recommend trying to crossover to fluoxetine. Yes, fluoxetine has a longer half life and is meant to be easier to taper, but in my experience making a successful crossover has a less than 50% chance of working. If it doesn't work it can leave you in a much worse place than you are now. But the choice is yours.

 

One quick side note, would you please report your dose in mg instead of mL. It makes it so we don't have to figure out what the dilution ration of your liquid is and calculate the dose strength every time we come on your thread. It will save everyone a lot of time and possible mistakes.

[Sebas]

Thanks @brassmonkeyappreciate your insights very much.

[Erell]

Hello @Sebas,

 

How are you doing these days?

 

Take care ☀️

[PerAsperaAdAstra]

Hi Sebas! Hope you're doing well! I read that you will be starting to work again soon, right? 

Let's hope that will work out well. How are you doing with your hold? Is it helping?

 

Sterkte man, toi toi toi!

[Sebas]

I think my Paxil has pooped out. It really feels like it. What are my options? Is there an antidepressant i could add while continuing to go down with paxil. Will it help to go down with paxil? @Altostrata

[ChessieCat]

What makes you think that Paxil has reached tolerance?

[Sebas]

Thx for replying @ChessieCatBeen feeling so dizzy lately and stabilisation is just not happening after a long period of time. It's a strange feeling. Bit flat too. Woke up last night middle of the night feeling anxious. Almost fainted this morning. I'm currently in my bed and have to call in sick today. 

I've read that poop out during tapering is unlikely.

What are your thoughts?

 

[ChessieCat]

It's been about 8 months since you last posted.  Please fill in some details of what has been happening during this time.

 

Have you had Covid?

Have you missed any doses, is your suspension old, has the brand/generic changed, have you continue tapering when you still had withdrawal symptoms?

What about your non AD health issues? 

How is your sleep? 

Have you been experiencing any major life stressors, eg work, financial, relationship,moving, loss of a relative, close friend or pet?

[Sebas]

Hi @ChessieCatI have sorted out the cause of my complaints . It's a sandwich that I bought this weekend. It has lots of pumpkin seeds on the bottem (didnt notice) containing tryptophan. Amazing what emotional and physical rollercoaster certain foods can cause during WD. I was really upside down.

 

I also tested negativ for covid this morning, just to check.

 

The last approx 2 years i've been holding, had my 2nd Pfizer shot in december '21 which caused a bump in WD. 

 

Thanks for your quick assistance, really did appreciate it 👌.

[ChessieCat]

I'm glad you found the cause.  Whenever my symptoms worsened I would usually try to think of what other things might be the cause (including poor sleep because this can have a big impact) and not automatically "blame" withdrawal.  And then, if I couldn't find something else, then I would assume that it might be withdrawal.

[Sebas]

Hey guys,

 

I'm currently making a switch from liquid suspension to pharmacy capsules (liquid out of stock). These capsules contain 0.5 mg each.

 

What would be the best way if i need to extract 0.1 or 0.2 mg from 0.5 mg capsules?

 

I just bought a scale for micro measurement. I guess i should buy empty capsules?

 

A sitelink would be appreciated.

[souim]

Hi Sebas, as a fellow paxil taperer dealing with the liquid version shortage I just wanted to express my support. Hope you're doing okay. This situation is quite stressful. I guess I'll just buy a super precise scale myself..

[ChessieCat]

1 hour ago, Sebas said:

A sitelink would be appreciated.

 

using-a-scale-to-weigh-and-measure-doses

 

From the above topic:

 

Quote

 

large gelatin capsule (size 00 works well)

 

 

[ChessieCat]

1 hour ago, Sebas said:

What would be the best way if i need to extract 0.1 or 0.2 mg from 0.5 mg capsules?

 

You could add the entire contents of the 0.5mg capsule to water and then extract the dose you need.  I think this would be more accurate than weighing the powder.  You can store the remainder in a covered container in the fridge for 3-4 days.