success DanaG: Reinstatement after Paxil taper

[DanaG]

Hi all, this is my first post on this forum

 

I am confused and am looking for some advice regarding possibly tapering off of St. John's Wort. 

 

I was put on SJW by a naturopath back in June (2018) to help ease the withdrawal symptoms of tapering off of Paxil (10mg) which I had been on for 10 years. I basically began tapering off of Paxil starting in Feb 2018 and I believe I went a bit too fast; I definitely started to feel all of the typical WD symptoms once I got down past half of my original dose and by June (at the end) I was feeling pretty crappy. I went to see my naturopath who put me on a supplement to support mood (Thorne product "Mood Plus") which contains 100 mg of 5-HTP and 100 mg of GABA, 400 mg of L-Tyrosene, 100 mg of Rhodiola,  and 100 mg of ginseng among other, more minor vitamins (including b12).  She also gave me St. Johns Wort and told me to take one 400 mg capsule 3 times per day (total of 1200 mg) .

 

I can't really say that I felt a huge difference in my mood after starting these supplements (nor that I do now), but I think there was some 'lift' to my spirits, bearing in mind that other factors that boosted my mood may have been the fact that it was summer, the sun was shining, and I was going on a big adventure in July (trip to Morocco).  The one thing I have noticed since June / July is that I have had a lot of trouble with sleep. It is hard to really tell if it is the SJW though because there have been some good nights of sleep...and there are so many factors that influence mood and sleep.

 

Generally speaking, my 'withdrawal symptoms' tend to be more on the anxiety and agitation end of the spectrum as opposed to depression... recently, I have begun to wonder about the SJW and if that wasn't causing or at least exacerbating my symptoms. 

 

I spoke with my naturopath just the other day and she said that this should't be the case and I should keep taking it (it has been basically 5 months now). She said that SJW is calming and most people really derive a soothing effect from it. But, after having read things on this site re how the sensitized nervous system can have different reactions to things versus the 'typically functioning' nervous system, I still have my doubts.  I am also more than a bit peeved to read that SJW can cause withdrawal symptoms if it is stopped too abruptly. Given the hell the past few months have been after coming off the Paxil, I am not keen to go through another 'withdrawal saga'...

 

I don't know what to do...should I keep taking the SJW? If not, how would it be best to taper, given that it has been 5 months on it? Right now I have decided to only take 2 capsules (so 800 mg) per day and only up to 1 pm...maybe that's too much of a drop, but I don't know how else to do it since the capsules cannot be cut. I figure I can do this for a few weeks then go down to 1 capsule..?

 

Again, I am not sure it IS the SJW that is causing me symptoms, but I feel like I need to minimize what I have in my body at this point so that it can regulate / heal itself.

 

Any advice / thoughts would be much appreciated. 

 

Oh, and BTW, when I asked the naturopath about tapering off of SJW she said she had never heard of people having adverse reactions to quitting SJW cold turkey...sheesh!

 

Thanks!

 

Edited November 1, 2018 by ChessieCat
spc

[Altostrata]

Welcome, Dana.

 

I've moved your post to the Introductions forum, to start your Intro topic, where you can ask questions about your taper and track your progress.

 

St. John's Wort is a type of antidepressant called a MAOI (monoamine oxidase inhibitor). It can cause many types of symptoms, including interactions with some foods, which alone could cause sleeplessness.

 

How much are you taking now? Are you taking any other drugs?

 

Yes, to be safe, you should taper it, see Tapering St. John's wort

 

To help us out, follow these instructions Please put your drug and withdrawal history in your signature

[DanaG]

Hi all, 

I tapered off of Paxil 10mg in 4 months (too fast) after being on it for 10 years. Besides withdrawal symptoms during taper, I began having delayed significant withdrawal reaction about 2 months later. I am 6 months out from my last micro-dose of Paxil (stopped in mid June 2018) and I am quite depressed and anxious. I would like to soldier on without any drugs but I am not sure I can make it. After having read through a lot of the stuff on reinstatement on here, my question is if I were to go back on an SSRI, should I go back to Paxil, or could I try something else (since I HATE Paxil now)??

I did read about starting at a low dose to see if it works...

Any help would be appreciated.

Thanks.

 

[ChessieCat]

Hi Dana and welcome to SA,

 

To help us out we need to know your drug history so please create a drug signature.  Use the following format.  Keep it 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

Account Settings – Create or Edit a signature

 

 

Q:  What are your current symptoms?

 

This is a list which you can check:  Dr Joseph Glenmullen's Withdrawal Symptoms

 

Once we have more information we will be better able to offer suggestions and provide you with information.

 

This is your own Introduction topic which is the place to ask questions about your own situation and where you can journal your progress.

[DanaG]

Hi Chessie. I updated my signature. Hopefully I did it correctly. 

Symptoms are as follows:

Low mood

Anhedonia

Trouble concentrating

Insomnia

Poor appetite

Anxious /nervous/tense

Ringing in the ears

Feeling detached

 

 

[ChessieCat]

Thank you for creating your drug signature.

 

Please add the dates and doses for the period Feb 2018 to June 2018 and the last date and dose for Paxil.  Just in one line separated by a comma.

 

If you don't know the exact date, use early, mid or late and the month.

 

Eg

 

Paxil:  date 2018 dose, date (no year needed here) dose, date dose, date dose, date dose.  StoppedPaxil date 2018 dose.

 

Thank you.

[Altostrata]

Welcome, Dana.

 

If I were you, I might try Prozac rather than Paxil, Paxil being such a bear to go off.

 

Since your nervous system has been bumped around, I might try perhaps 1mg to start. Even that small amount might help, you'd taper off it by miniscule amounts later. Please let us know how you're doing.

[ChessieCat]

If you decide to make a change, please keep daily symptom notes on paper so you can see how the change is affecting you:

 

Example:

 

6 a.m. Woke with anxiety
8 a.m. Took 2.5mg Lexapro
10 a.m. Stomach is upset
10:30 a.m. Ate breakfast
11:35 a.m. Got a headache, lasted one hour
12:35 p.m. Ate lunch
4 p.m. Feel a bit better
5 p.m. Took 2.5mg Lexapro
6 p.m. Ate dinner
9:20 p.m. Headache
10:00 p.m. Took 50mg Seroquel
10:20 p.m. Feeling dizzy
10:30 p.m. Fell asleep
2:30 a.m. Woke, took 3mg Ambien (NOT "took 1/2 tablet Ambien")
2:45 a.m. Fell asleep
4:30 a.m. Woke but got back to sleep

[DanaG]

Dear Alto and Chessie, thank you for your input. Just a question...Alto, why do you suggest Prozac as opposed to something else? Just curious.

Thanks so much.

Dana

[Altostrata]

Since you're out of the Paxil frying pan anyway, you might as well reinstate Prozac instead, a drug that's somewhat easier to taper. Paxil is perhaps the most difficult antidepressant to go off (followed by Effexor, Pristiq, and Cymbalta).

 

After reinstating a tiny dose, you'd stabilize for some months, then taper by miniscule amounts. You're less likely to feel dosage decreases with Prozac.

[ChessieCat]

Some people do a cross over or bridge to Prozac from another drug in order to taper more easily.  Here is the topic.  the-prozac-switch-or-bridging-with-prozac

 

You don't need to do the cross over because as Alto said:

 

3 hours ago, Altostrata said:

you're out of the Paxil frying pan anyway

[DanaG]

Thank you so much for this info you guys. I so appreciate it. Never again in the paxil frying pan! I loathe that drug. 

Will talk to my doctor about  doing prozac small dose...

Will update later. Thanks again.

D

[ChessieCat]

10 minutes ago, DanaG said:

Will talk to my doctor about  doing prozac small dose

 

Yes, small dose.  Alto said:

 

On 12/27/2018 at 10:35 AM, Altostrata said:

 

If I were you, I might try Prozac rather than Paxil, Paxil being such a bear to go off.

 

Since your nervous system has been bumped around, I might try perhaps 1mg to start.

 

 

It would probably be best to get liquid prozac because it will be easier to get the doses you need as you taper.  I've quoted 2 lots of relevant information below so that it is in your topic and you can refer back to it more easily.

 

  From tips-for-tapering-off-prozac-fluoxetine

 

On 7/3/2011 at 4:11 AM, Altostrata said:

 

Using fluoxetine liquid to taper

This is by far the easiest way to taper by very small amounts. It comes in a concentation of 20mg fluoxetine in 5mL of liquid, meaning there is 4mg of fluoxetine in 1mL. If you are taking 10mg Prozac now, the liquid equivalent would 2.5mL. If you want to take 9mg of Prozac, you would take 2.25mL of the liquid.

Always check the concentration of the liquid you get as it can vary among manufacturers, and adjust your calculations accordingly.
 
If your fluoxetine liquid contains 20mg fluoxetine in 5mL of liquid:

•    1 mL= 4mg
•    0.5mL = 2mg
•    0.25mL = 1mg
•    0.2ml = 0.8mg

You will need an oral syringe to measure out your dose of the liquid.

To use the oral syringe, you need a special cap to put on the bottle of liquid Prozac. The cap should have a hole in it, the tip of the oral syringe fits into this. Read this about oral syringes.

If your pharmacist doesn't have a cap, ask for a smaller medicine bottle with this type of cap. Pour some of your liquid Prozac into it and draw your dosage from the smaller bottle.

Here's an illustration of how to draw the medication from the bottle http://survivingantidepressants.org/index.php?/topic/235-tapering-techniques/page__view__findpost__p__2284

Also see http://survivingantidepressants.org/index.php?/topic/235-tapering-techniques/page__view__findpost__p__21391

See more detail about how to measure and taper Prozac-brand liquid here http://survivingantidepressants.org/index.php?/topic/759-tips-for-tapering-off-prozac-fluoxetine/page__view__findpost__p__41090

 

 

 

On 1/18/2013 at 8:09 AM, Altostrata said:

 

Measuring Prozac-brand liquid

The concentration of the Prozac liquid from the pharmacy can make measurements confusing.

 

Usually, it contains 20mg Prozac in 5mL of liquid. (Check the label on your bottle.) If 20mg = 5mL, then there are 4mg in 1mL.

 

If you are taking 1mL, you are taking 4mg Prozac. To make a 10% reduction, you would decrease by .1mL (.4mg Prozac). A 5% reduction would be .05mL (.2mg Prozac).

 

Measuring Prozac-brand liquid dosage tables

At 20 mg/5ml (4mg Prozac in 1mL solution), if you wish to take

 

• 20mg Prozac, take 5mL liquid
• 10mg Prozac, take 2.5mL liquid
• 5mg Prozac, take 1.25mL liquid
• 2.5mg Prozac, take .625mL liquid
• 1mg Prozac, take .25mL liquid
• .08mg Prozac, take .02mL liquid
• .04mg Prozac, take .01mL liquid

Using a syringe to measure Prozac-brand liquid dosage

If you are using a 10mL oral syringe (photo here), and there are 5 ticks between 1mL and 2mL, each division is .2mL (2/10 mL).

 

At 20 mg/5ml (4mg Prozac in 1mL solution):

 

• .2mL (1 tiny division on 10mL syringe) = .8mg Prozac
• .4mL (2 tiny divisions on 10mL syringe) = 1.6mg Prozac
• .6mL (3 tiny divisions on 10mL syringe) = 2.4mg Prozac
• .8mL (4 tiny divisions on 10mL syringe) = 3.2mg Prozac
• 1.0mL (5 tiny divisions on 10mL syringe) = 4.0mg Prozac

If you are using a 1mL oral syringe (photo here), and there are 5 ticks between .10mL and .20mL, each division is .02mL (2/100 mL).

 

At 20 mg/5ml (4mg Prozac in 1mL solution):

 

• .01 ml (1 tiny divisions on 1mL syringe) = .04 mg Prozac
• .02 ml (2 tiny divisions on 1mL syringe) = .08 mg Prozac
• .03 ml (3 tiny divisions on 1mL syringe) = .12 mg Prozac
• .04 ml (4 tiny divisions on 1mL syringe) = .16 mg Prozac
• .05 ml (5 tiny divisions on 1mL syringe) = .20 mg Prozac

Increase dilution to make measuring easier

Increasing the dilution might make measuring easier. For example, you may wish to make it 1mg = 1mL. To do this, add 10mL (40mg) of the 20:5 solution to 30mL of water. Now you have 40mL of liquid containing 40mg Prozac, or 1mg in 1mL.

 

If you wish to take 4mg Prozac, take 4mL of the diluted liquid. A 5% reduction would be .2mL, for a dose of 3.8mL (3.8mg Prozac).

 

 

[Altostrata]

DanaG has written a Success Story here

 

 

As is our tradition, I will close this topic. Please congratulate DanaG in her Success Story topic.