DeterminedAnna: long time Seroxat / Paxil / paroxetine user

[Oliver1974]

Hi 🙂

 

What about  dropping coffee and tea completely? I have, and it’s helped my morning anxiety.  Are you drinking enough water throughout the day?  I’m not saying this because of your bathroom habits.  Proper hydration helps sleep. Do you take any medications to relax the nervous system? Are you trying to eat things that you enjoy?

 

regards

Stefan

[DeterminedAnna]

Hi Stefan,

 

Thank you for your concern. I don't drink tea or coffee at all, just the occasional chamomile tea which does help me relax. I drink about two litres of water a day (I think that's about half a gallon in your neck of the woods).

 

I don't take any medication other than 7mg Seroxat (Paxil) a day, plus the supplements in my signature.

I do eat things I enjoy, in fact that is one thing that does give me a few moments' distraction from withdrawal symptoms. My partner is a great cook and he makes me a lot of vegetable-based dishes. Chinese-stir fried veg with chicken, ginger and garlic is one of the things he makes me a lot. He doesn't put anything chemical-based in it, just some soy sauce (that doesn't contain MSG) and sesame oil for seasoning.

 

How are you going with the Zoloft? I see you're holding there on that and reducing other meds. How is that going?

[Altostrata]

Well, that account of the meeting with the doctors was enlightening.

 

Telling that the one said withdrawal = relapse. That's the general state of psychiatric knowledge about withdrawal symptoms -- zero.

 

It seems there is room for negotiation, as the doctor brought up the proper way to do a drug switch, cross-tapering, towards the end of your visit. See The Prozac switch or "bridging" with Prozac

 

Given how much paroxetine you're taking now, I personally would not start a cross-taper with any more than 5mg Prozac. The doctors might stand by with a benzo prescription if you find dropping the Paxil to be difficult.

 

You are extraordinarily patient and good-humored, Anna.

[Sassenach]

Hi Anna

 

I hope you are feeling better today.

[Sassenach]

Hi Anna

 

Are you still able to go back to the psych team if you want to?

[DeterminedAnna]

4 hours ago, Sassenach said:

Hi Anna

 

Are you still able to go back to the psych team if you want to?

Hi Sassenach, thank you for your concern.

The psych team I saw was for a crisis. And I think (though they never explained) they only have a limited number of sessions. In any case, I think they'd be reluctant to help because I rejected (or showed uncertainty about) their Prozac suggestion.

[DeterminedAnna]

Hello @Altostrata

Thank you for all your posts. I'm really desperate now. I don't know what to do. I have just had a big row with my mum who, after months of saying 'we'll support you no matter what' has said just quit the Seroxat and get it over with and shot down everything I've read that says not do this. She has once again reminded me that my partner is only going to tolerate me and the situation for so long. I have this fear anyway and her pointing it out does nothing to help. I have told her I want nothing more to do with her and my dad. This is not how I want it to be.

My life is falling apart. I went to see a client who I freelance for with the view of getting more work (I need the money) and had a panic attack with floods of tears in front of them. It's unlikely that I'll get the work.

I have spent five months trying to stabilise yet the extreme anxiety, panic, suicidal depression, obsessive, intrusive thoughts and all the associated symptoms with that do not seem to be abating. I need to do something. The options I have are:

1. Keep holding in hope of my own healing. I can't see this will happen. And I have external stresses in my life (as we all do) that are compounding the situation. I cannot remove these external stresses. And the effect withdrawal is having on my income is a vicious circle.
2. Updose Seroxat, the devil I know.
3. Do a cross-taper to Prozac.
4. Do a cross-taper to citalopram, the one you mentioned, which might be better for the liver.

I know you and the moderators are not here to help with psychological or circumstantial issues. But I need to do something that will put an end to, or at least reduce, these withdrawal symptoms and let me start rebuilding my life.

Thank you once more.
 

[Longroadhome]

Anna did you get my email address ?

Anna  I really feel for you I’m sure your mum is just really worried about you and with that brings tension between you. Don’t fall out you need support from loved ones. 

Believe me I truly understand how you feel every minute of every day wd won’t let you forget it’s around. People on this forum have used the right word “torturous”. I also understand why yr mum says  just come off it. Nobody but us not even GPs understand how SSRIs affect the body. It interrupts every working organ and cell .

You have friends on this site. 

Stay strong. 

[Sassenach]

Hi Anna.

 

What a day!

 

First, Longroad home has offered help, please contact her you could really do with a flesh and blood friend now.

 

I cannot comment on the meds as I know nothing about it but am sure the mods will.

I am not going to dwell on today's events I suspect you are doing enough of that.

You did well  with the psych doctors last week and I was hoping to get you to take control at your GP appointment tomorrow.

If you feel you can find the strength get back to me.

Despite all this you need to find the cause of your physical issues to allow you to start and mend.

Stay strong, there is a way back.

 

love from Scotland

 

Sassenach

[DeterminedAnna]

Hello @Longroadhome and @Sassenach

 

Thank you both for your messages and support and friendship. Thank you. I will reply properly, individually, tomorrow. I wish I could reciprocate the help and positivity you've given me. I hope I can one day. As unbelievable as it might seem, I am actually a fun and optimistic and go-getting person. 

LHR, I did get your email address and will be in touch via that soon. It would be great to meet a kindred spirit.

 

Thank you both so much again for taking the time to read and write. Thank you.

[Sassenach]

Good Morning Anna

 

Replying to LRH and myself is not your priority today.

You have a GP appointment.

Alto is trying to help but she needs facts.

You need to get better physically and that the NHS can help with.

I know you think GPs are a waste of space but remember they may be useless with withdrawal but that does not make them bad doctors with normal medical problems.

You need to see your liver results.

Which if any are abnormal.

What they mean and what symptoms they could be causing.

Alto wants to know about enzyme cyp 2d6, if this is not shown or mentioned, ask.

I am sorry if this sounds curt but after yesterday you need to move forward.

If at all possible keep your questions concise and targeted.

Come away with the info and move forward again.

I know it's hard but you can do it.

Please do not spend time discussing withdrawal the only help they can give is to provide the meds you need.

Let us know how you get on this evening if you can.

 

Strength from the north.

 

Sassenach

[Longroadhome]

Sassenach I’m going to shorten your name to “Sassy” 

i agree with you ! 

Anna let us know how you go ? 

[Longroadhome]

Anna how are you and how did you get on? 

[DeterminedAnna]

Hello @Altostrata

 

Thank you for all your help. As you know I've now connected with you social media as I want to help you and others in your campaigning. I can't do much right now, as I find it all very upsetting, but I will one day.

 

You asked about my liver enzyme numbers and I got them from my GP yesterday. These results are based on my blood test of 5 April 2019:

 

                                              My level        Units            Normal range
Albumin                                 46                 g/L               35 - 50
Total bilirubin                        7                  umol/L         0 - 21
Akaline phosphatase          89                IU/L              30 - 130
Alanine transaminase         39                IU/L              5 - 33

 

It is the alanine transaminase that she is concerned about, hence my ultrasound next week. I was also tested for this on 5 March 2019, and the result for alanine transaminase was 45, so it has come down. (For ease of reference, my worst withdrawal symptoms in my latest taper has been in January and February this year, while I held at 5.96mg from end of December 2018. It was only mid-February that started my round of GP and other medical professional appointments. And I updosed at the end of February to 7mg).

My alanine transaminase was also tested around the time I crashed after my 10-month taper in 2013 (40mg at January 2013, down to 0mg by 1 October 2013). At that time, a different testing methodology was used so the normal range was 9 - 52:

• 17 November 2013 (when I'd been at 0mg for about a month, with dreadful symptoms) was 37
• 18 December 2013 (when I'd reinstated Seroxat for about a week) was 53.

All similar blood tests during the time I have been routinely taking Seroxat and not tapering have been within normal ranges. So in my limited knowledge, this is some proof that withdrawal is a massive disruption to the body (well we know that anyway). I don't know if it is relevant that in both cases the levels have risen after reinstatement / updosing. My GP did say that this can happen with other drugs, like antibiotics.

 

I did ask about CYP2D6 testing but the doctor gave that 'hmmmm, let's not go there now' look so I didn't push it any more. I get the impression she isn't massively concerned about my numbers as (and I now see this myself) they aren't hugely outside the range.

 

I don't know where this leaves me, but I thought I'd update you. Thank you as always.

Edited May 9, 2019 by DeterminedAnna
Added point about CYP2D6

[DeterminedAnna]

6 minutes ago, Longroadhome said:

Anna how are you and how did you get on? 

Hi LRH,

 

Thank you so much for asking – I've just posted my update. How are you doing? I'm going to visit your Intro thread in a moment.

 

I don't know enough to comment much on my numbers. But as you can see from my post, there may be some kind of pattern with tapering and withdrawal. Perhaps all I'm seeing – and all that's being documented by the blood tests I've had – is that withdrawal is a massive disruption on the body. And we know that already.

The past few nights I have had some positive feelings and thoughts, and a real sense of determination to do things and be productive, with mental clarity. Annoyingly (but only a minor annoyance), it's been happening between 9pm and bedtime at 11.30pm when I should be winding down for sleep. It would be great to have those feelings on waking up. But I'm making a point of dwelling on those good moments.

 

I'm still having the racing, jumbled, nightmarish thoughts and terror in the morning. And I'm very fragile, with crying outbursts, about anything stressful or potentially stressful.

My GP agreed that I should not adjust my dose and she said it would be risky to try switching to Prozac at the moment. So I'm getting conflicting messages from my own health professionals. (Remember, the psychiatrist's own number 1 'preference' was me to just stop Seroxat, leave it a week, then start Prozac).

'Sassy' was totally right with the point about not making decisions when desperate. I WAS desperate a week ago, which is why I was saying I need to do something drastic.

Right, I'm coming over to your thread to read your latest updates and say another hello.... x

[Oliver1974]

I’m really glad you didn’t do anything in desperation. Now you know that even if you’re desperate you’ve got the strength to pull through. Trust me, I realize how horrifying and minute to minute the terror is when you’re stuck in there. BRAVÓ!

 

Stefan

[Longroadhome]

5 hours ago, DeterminedAnna said:

Hi LRH,

 

Thank you so much for asking – I've just posted my update. How are you doing? I'm going to visit your Intro thread in a moment.

 

I don't know enough to comment much on my numbers. But as you can see from my post, there may be some kind of pattern with tapering and withdrawal. Perhaps all I'm seeing – and all that's being documented by the blood tests I've had – is that withdrawal is a massive disruption on the body. And we know that already.

The past few nights I have had some positive feelings and thoughts, and a real sense of determination to do things and be productive, with mental clarity. Annoyingly (but only a minor annoyance), it's been happening between 9pm and bedtime at 11.30pm when I should be winding down for sleep. It would be great to have those feelings on waking up. But I'm making a point of dwelling on those good moments.

 

I'm still having the racing, jumbled, nightmarish thoughts and terror in the morning. And I'm very fragile, with crying outbursts, about anything stressful or potentially stressful.

My GP agreed that I should not adjust my dose and she said it would be risky to try switching to Prozac at the moment. So I'm getting conflicting messages from my own health professionals. (Remember, the psychiatrist's own number 1 'preference' was me to just stop Seroxat, leave it a week, then start Prozac).

'Sassy' was totally right with the point about not making decisions when desperate. I WAS desperate a week ago, which is why I was saying I need to do something drastic.

Right, I'm coming over to your thread to read your latest updates and say another hello.... x

Anna your ups and downs mirror me exactly. I’m frightened to put a positive on this forum , though I have,  because the next day could be the total opposite (and has been) let’s face it ! 

We all go to sleep wondering what tomorrow will bring. 

I think we are all so very brave.

On a positive note the longer I spend in wd the better I’m getting to know how wd works on me and my body. For instance at the beginning of wd I was so scared because I hadn’t  a clue what was happening to me. Now I am so much wiser and although I can’t control the symptoms coming,  going, more intense,  less intense, I can control to some extent the anxiety I feel towards them which can make them bearable and in the background .

The depression is another thing but even this abates of an evening and I do get the odd few days where it’s in the background before it comes bounding back to start again !

this sounds like what your experiencing too.

ive thought about your OCD around ruminating thoughts and I totally get it as I have such guilt about my mum and dad and arguments we had that can’t be sorted because they both passed away last year . I know what I’m feeling is way way over the top but I can’t stop the thoughts and the feelings I’m getting and sometimes it’s just unbearable. I didn’t consider this as part of wd until I read your posts  and thought about it. It really helped to put it into perspective . 

Its so good to share how we feel and information . 

what would we do without this site . 

So glad you’re  getting some respite Anna and now the GP has said it yes I think it’s the right think to do hang tight on the dose your on and give it that little while longer.

 

Onward and upward it’s the only way .  look how far we’ve come already   Xx 

 

[Sassenach]

 

Hi Anna

 

First Stefan is spot on Bravo indeed.

I see you have updated Alto.

I would suggest that her advice is the best here, but you already knew that!

From my own experience with a permanently damaged liver it can be outside factors which affect it.

Medication certainly can.

My results have been much worse in the distant past but have settled down and been ok for many years now.

Was the Dia............. can't spell today😁 discussed?

I did not experience terrors which must be horrible, just trepidation which I still get from time to time.

I did go through the morning Cortisol lethargy perhaps that makes them worse.

The plus side is it only lasted for a few weeks once I started to improve.

You are definitely improving Anna. It is evident in your writing and now in your health.

But remember there will still be tough days ahead and you will feel anxious, just remember what you have achieved in the last two days.

I am really proud of you because you pulled yourself from a horrible day, got to the doctors, obtained the info you needed and posted clearly and concisely.

You will eventually reconcile with your mum and dad ( I did not speak to mine for 7 years ) but for now you do not need the hassle.

So stop beating yourself up, it is not your fault unless you choose to make it so and use the friends you have on here immediately when necessary.

Now LRH and you are in trouble but as she started it that is where I go next.

Stay strong

 

SASSENACH

 

[DeterminedAnna]

On 5/9/2019 at 1:35 PM, Oliver1974 said:

I’m really glad you didn’t do anything in desperation. Now you know that even if you’re desperate you’ve got the strength to pull through. Trust me, I realize how horrifying and minute to minute the terror is when you’re stuck in there. BRAVÓ!

 

Stefan

Thank you Stefan, your words mean so much. Just getting a big BRAVÓ made me smile. Perhaps I have more strength than I realise. My self-belief has taken a hit thanks to withdrawal, but it *feels* like it's creeping back.

How are you doing with the Zoloft taper?

[Sassenach]

Hi Anna

 

The Dia....... was diarrhoea, can spell today.

How are you feeling?

My last week has been good but there is no single reason, I hope and feel that I am stabilising and not every day is as good as the best.

It does feel as though the improvement is gently accelerating and I no longer doubt that I will eventually get better. It is a great feeling and make the now smaller waves seem less important.

I have no doubt that you will get to same state as long you as are good as your screen name, and on the days you doubt ( which you will for a while ) come to this sanctuary and talk. It is important not to spend too much time looking at other's problems particularly on down days.

The hobby makes me a total anorack so keeping stum.

The goal is to see my family in York for the first time in 3 years as I have not been up to the 3 hr drive since then.

I am not sure I should have answered this at the moment but if we are not honest with each other it is difficult to trust when we need to.

In any event I believe the past is just that, we cannot change it but we can decide how we proceed in future.

 

Sassenach

 

[Oliver1974]

DeterminedAnna   

 

In the last 10 months I’ve managed to taper off of trazodone and Xanax. This September I’m going to start tapering from Zoloft, and after that I will taper off the 2 mg of diazepam I have as a buffer.

 

My first two attempts at Zoloft titration were ignorant and foolhardy, thus absolute horrific failures. This time I have done a lot of research on the topic and feel quite confident that I will be in good shape. I’ve been through so much physical & psychological pain this last year that I feel cauterized. And I’m so grateful for the support available on this website.

 

You totally earned your BRAVO!  As a matter fact here are few more  BRAVO BRAVO BRAVÓ!

 

Stefan

[DeterminedAnna]

1 hour ago, Sassenach said:

Hi Anna

 

The Dia....... was diarrhoea, can spell today.

How are you feeling?

My last week has been good but there is no single reason, I hope and feel that I am stabilising and not every day is as good as the best.

It does feel as though the improvement is gently accelerating and I no longer doubt that I will eventually get better. It is a great feeling and make the now smaller waves seem less important.

I have no doubt that you will get to same state as long you as are good as your screen name, and on the days you doubt ( which you will for a while ) come to this sanctuary and talk. It is important not to spend too much time looking at other's problems particularly on down days.

The hobby makes me a total anorack so keeping stum.

The goal is to see my family in York for the first time in 3 years as I have not been up to the 3 hr drive since then.

I am not sure I should have answered this at the moment but if we are not honest with each other it is difficult to trust when we need to.

In any event I believe the past is just that, we cannot change it but we can decide how we proceed in future.

 

Sassenach

 

Oh go on, spill the beans on the hobby. 😉

If it makes you feel less anoracky then here's mine: when I'm well (haven't for a long time) I can spend 10 hours cleaning my car. And for my first Christmas with my partner I got a Karcher pressure washer from him. Romantic.

[DeterminedAnna]

39 minutes ago, Oliver1974 said:

DeterminedAnna   

 

In the last 10 months I’ve managed to taper off of trazodone and Xanax. This September I’m going to start tapering from Zoloft, and after that I will taper off the 2 mg of diazepam I have as a buffer.

 

My first two attempts at Zoloft titration were ignorant and foolhardy, thus absolute horrific failures. This time I have done a lot of research on the topic and feel quite confident that I will be in good shape. I’ve been through so much physical & psychological pain this last year that I feel cauterized. And I’m so grateful for the support available on this website.

 

You totally earned your BRAVO!  As a matter fact here are few more  BRAVO BRAVO BRAVÓ!

 

Stefan

Wow wow wow, you've done a double taper. A double whammy. That means you need double fist punches (and much much more, but distance has its limitations): 👊👊

Definitely wait until you are in a super strong place before you start your GENTLE Zoloft taper. If September comes and you aren't ready, then don't do it.

'Cauterized' is a great word to describe the horrendous situation. But we WILL be stronger and better people for all of this.

BRAVO TO YOU TOO!

[Altostrata]

Anna, elevated ALT is exactly the red flag I had when I got liver damage from a drug. If you remove the offending drug, ALT goes back to normal in about 6 months. (This suggest a crossover to citalopram to replace paroxetine.)

 

Do not let your doctors panic -- point out the possibility of your being a poor cyp 2D6 metabolizer and paroxetine being the culprit. See https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4335312/

 

(Of course, they need to rule out other potential causes as well.)

 

Lorazepam does not appear to be conflicting with paroxetine via the liver enzymes.

[DeterminedAnna]

21 hours ago, Altostrata said:

Anna, elevated ALT is exactly the red flag I had when I got liver damage from a drug. If you remove the offending drug, ALT goes back to normal in about 6 months. (This suggests a crossover to citalopram to replace paroxetine.)

 

Do not let your doctors panic -- point out the possibility of your being a poor cyp 2D6 metabolizer and paroxetine being the culprit. See https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4335312/

 

(Of course, they need to rule out other potential causes as well.)

 

Lorazepam does not appear to be conflicting with paroxetine via the liver enzymes.

Hi Alto,

 

Probably didn't make this clear in my last post on the liver topic, but my ALT has only been elevated during tapering down to lower doses of Seroxat, or when withdrawal symptoms have gone into overdrive and I've subsequently updosed or reinstated. So my ALT levels have been elevated towards the end of 2013 when I got to 0 then reinstated, and again this year when I got down to 5.96mg and held despite terrible symptoms, then updosed to 7mg.

 

When I've been on a so-called therapeutic, or stable, dose of Seroxat, my ALT levels have been normal. This might give my GP cause to say 'see, you need to take Seroxat and stop this tapering lark'. (Although that's me projecting my thoughts – my GP has actually been very good and hasn't at any point rubbished my desire to stop taking Seroxat).

 

I have no doubt something is going on with my liver and Seroxat isn't good for it, but it appears from the numbers and timing that tapering and withdrawal has caused/coincided with the elevated ALT in me... and I can only theorise that the elevated ALT is a sign of the systemic stress withdrawal causes to the body. If it was Seroxat per se that is damaging my liver, surely my ALT levels would be raised throughout the whole time I've been taking Seroxat, and especially so on higher doses?

I have the ultrasound on Tuesday (14 May) and will then return to my GP. I'll ask her again about cyp 2D6 tests and give her the paper you kindly shared. Thank you.

The past six weeks, with my encounter with an urgent care psychiatrist, has exposed me to the option of cross-tapering to Prozac, and discussion here has introduced the idea of citalopram. However, I'm coming round to the idea that I need to just continue holding at my 7mg dose of Seroxat (I'm not taking anything other than the supplements in my signature) until I'm more consistently stable and in a place to restart my tapering. It may be that the elevated ALT is a response to changing my dose and that it will settle down if I continue holding. Does this sound sensible?

 

However, I might have got the wrong end of the stick from your post and you may be suggesting that a switch to citalopram in order to restart and continue my taper and prevent further liver issues. If so, do you have any idea of what kind of dose of citalopram would be equivalent to 7mg paroxetine? I have looked online and found this: https://www.jwatch.org/na39621/2015/11/23/optimal-doses-ssris-treating-depression-meta-analytic but not sure if it is reliable. From what I can tell from it, 20mg paroxetine is equivalent to 33.3mg citalopram (but I realise they don't have the same pharmacological profile). So, based on this ratio, if I was to switch from 7mg paroxetine to citalopram, I should go for 11.66mg of citalopram. And perhaps to give me some extra coverage for withdrawal symptoms from paroxetine, I should round it up to 15mg, but then again that might cause kindling / be too destabilising.... I don't know... I'm totally guessing now...

You mentioned lorazepam – and thank you for the liver considerations on this – but I'm not taking it at all now and only took it for a week while I updosed from 5.96mg to 7mg at the end of February. Perhaps you've mentioned it as a very short-term way to buffer a switch from paroxetine to citalopram?

Every option causes me anxiety and confusion, especially the possibility that I might not be able to get below a certain threshold of Seroxat without a lot of pain. Yes, I'm heaping anxiety on top of the likelihood that further Seroxat tapering will have anxiety as part of the symptoms (fear of fear). But tapering and withdrawal symptoms are traumatic. Voluntarily, knowingly, putting myself through that trauma takes a lot of guts. I don't think I have that strength right now. So maybe holding for some more months at this dose will help me build up this strength.

Thank you for reading all this. How on earth do you manage to find the time for this work? I ask because I have no idea if it's your full-time job and how that works (sorry, don't mean to pry). I can only thank you once again for all of this, and the incredible difference you are making to so many people. I suspect there are very few people in the world that have real knowledge and experience of antidepressant withdrawal and you must be right at the top of that list. (Sorry, that sounds sycophantic but it's true).

I have started the day with huge anxiety and panic following nightmares. But for some reason, among all that, I had the urge to play the Bee Gees and listening to Nights on Broadway has given me the tiny glimmer of a plan to visit New York again one day. This feels like the real me is still there, somewhere.

[thecowisback]

sorry to hear you're having rows with your family anna. my family have been really unsupportive at times, better at.others. the sentence i used to hear most was 'why don't you just start taking your pills again?'. now i am back on meds i get them asking why they're not working and maybe i should try a different kind. stick to yoir guns. only you know what is right for your body and mind. i'm sure your parents will come round eventually xxxx

[miT]

Don’t worry too much about these ALT levels. Mine have been more than double of your level and actually were the trigger for me to stop taking these drugs about three years ago. Obviously my habbit back then of drinking red wine didn’t help. A year later i was on approximitely your level now. I was elated and the specialist didn’t ring any alarm bells then. I think this could give you some perspective.

[Altostrata]

Anna, we have to see if the additional tests indicate anything else affecting your liver.

 

I understand your reasoning, but liver damage is cumulative, it's due to something physically in the liver, it's not a stress reaction.

 

I don't know how I do it, either.

[Sassenach]

Hi Anna

 

That won't work, a girl who loves cars is any petrolheads dream.

Do you like cars or just cleaning them😂 mines a bit mucky at the moment.

It is great to hear you sounding so much more positive.

My opinion for what is worth ( not a lot ) is stay with what is working for the moment and only change when there is proof of what may causing the liver issue.

I think I am agreeing with Alto, not sure , today has not been great.

Head fog and symptoms racing in and out like a runaway train.

I think your partner is brilliant, he knew what you needed. Flowers are so unimaginative.

Look after yourself, stay strong.

 Sassenach

[Sassenach]

Hi Anna

 

I hope you are well.

 

Chat soon

 

Sassenach

[Longroadhome]

Anna how are you ? 

The weathers beautiful so I hope your out and about xx

[DeterminedAnna]

On 5/13/2019 at 6:12 PM, Sassenach said:

Hi Anna

 

I hope you are well.

 

Chat soon

 

Sassenach

Hi Sassy,

 

Thank you for the message. I'm ok-ish. Had bad anxiety over the weekend, but it seems to be calming down now. I'm throwing myself into work this week...

 

And yes, I love cars... My one is a Seat Leon Cupra, which packs nearly 300BHP but has a lovely balance of refinement and roar (it's got a little button under the gas pedal that if I press it kicks in the Cupra mode, so I can be quietly, respectively driving along and then WHAM it moves)...

 

But I'm giving it back in June 😣as I need to downgrade for financial reasons. I'm considering a VW Up!. I like German cars.

 

What about you? I take it you're a petrolhead? (And yes, my partner buying me a Karcher was one of the best gifts ever).

 

How have you been?

 

I saw on your thread you lost a dear fellow not long ago. I'm so sorry, they are truly the best companions. (My loving mog is nearly 20 and I've had him since I was 20, so he has grown up with me. I dread the day...) Big well done for braving through it, you are doing fantastically. I love your spirit and chipper words.

 

So thank you again for your message and encouragement. XXX

PS. I'm probably going to take a break from this site for a bit. The help, knowledge and experience here is fantastic and second-to-none, but at the moment, reading anything about withdrawal, antidepressants and symptoms just feeds my anxiety and obsessive thoughts about it all. I need a break from thinking about it, so don't worry if I go quiet.

 

 

[DeterminedAnna]

1 hour ago, Longroadhome said:

Anna how are you ? 

The weathers beautiful so I hope your out and about xx

Hello LRH,

 

Thank you so much for dropping by. We're getting the hang of this site aren't we?

 

I'm ok. Actually feeling quite calm. And I've just had a Pepsi Max with caffeine in it, so that's an achievement! I'll be putting a proper update below.

 

I've just had a work meeting moved to tomorrow so I might use the free time to mow the lawn! It's so long I might disappear in the grass.

 

How are you? I just read your post about Georgie. It's lovely,  I was moved, what a lovely story.

I love dogs and cats, and have a 20-year-old moggy named Cedrick. He's my constant companion, following me everywhere I go (and often sitting on my laptop computer, which sometimes means it looks like I type strange jumbled things).

 

Do let me know how you're going. And thank you again for all your kind words XX

 

[Oliver1974]

Friends,

 

Why test these  treacherous  waters and risk aggravating your already stressed out nervous system!  Caffeine is anything but  benign. It’s  a drug like any other that can easily accumulate in your system and  shock the hell out of you. Plus all that sugar. Honestly, stay away from any stimulants and that includes sugar. You do not want the highs and lows of insulin spikes. Give your brain and body a brake  and it will respond kindly.

[DeterminedAnna]

On 5/11/2019 at 5:55 PM, Altostrata said:

Anna, we have to see if the additional tests indicate anything else affecting your liver.

 

I understand your reasoning, but liver damage is cumulative, it's due to something physically in the liver, it's not a stress reaction.

 

I don't know how I do it, either.

Hi Alto,

This is as much a general update to my thread as anything else, so really really don't expect you to comment on everything, or even anything. Am grateful of course for anything you could add.

I had my liver ultrasound yesterday and it found nothing other than a mild case of fatty liver. No gallstones. Kidney, spleen, pancreas, abdominal aorta, gall bladder all normal.

I don't drink alcohol and have hardly touched it throughout my life, so it's not caused by alcohol. I'm overweight, and I suspect that has something to do with the fatty liver. But being overweight is one of the many reasons I want off Seroxat! I've always gained weight when on it, but then lose it without trying when I'm tapering (lost more than two stone / 30lbs when I tapered to 0mg in 2013, then promptly put it all back on plus more when I reinstated). All the females in my family are naturally slim so I really believe Seroxat has messed with my metabolism over the years.

 

Still unsure why the ALT level has risen alongside the emergence of withdrawal symptoms. 

 

After giving much thought to switching to fluoxetine, or switching to citalopram over the past month, I decided the only 'reliable' – or least risky – way to improve my symptoms was to either continue toughing it out and let time do its thing, or make an updose.

 

My life and my partner's life has taken such a hit over the past five months that I decided that I can't continue toughing it out. I know there are people on this site who suffer for much longer than this, but my tolerance is at an all-time low. And my updose at the end of February is the only thing that's made any substantial difference to my withdrawal symptoms.

 

So on Sunday (12 May) and every day since, I have taken an increased amount of my daily Seroxat, having upped it by about 10% to 7.72mg. My 1ml oral syringe has 0.02ml increments, so I can only accurately measure even values of hundredths of mls. So every day I'm taking 3.86ml liquid Seroxat.

 

It might be stupid, and I might regret it, but I did this to improve withdrawal symptoms. And, inspired by @Sarahbarah's suggestion, I've split the doses, because I have a strong suspicion that my daily symptom fluctuations are linked to Seroxat's short half life, especially as it is now being more quickly processed now I'm at a lower dose and its metabolism isn't being inhibited as much. I know that after, maybe a week, that Seroxat gets to steady state, but I also theorise that there are daily peaks and troughs despite this – for example, peak plasma concentration. (The numbers in here suggest huge variability in pharmokinetics: https://medsafe.govt.nz/profs/Datasheet/p/Paroxetinemesylatetab.pdf)

 

I realise I might be vastly overestimating my layman's understanding, but as my symptoms are worse in the morning and often unbearable, I decided to try taking the extra 10% in the evening to see if it would ease morning symptoms. So I'm now taking 7mg (which I've done since end of February) at about 11am, and 0.72mg at about 8pm. I started this new schedule on Sunday just gone (12 May).

 

I've not changed any supplements or routines as I very much agree with the advice on this site about only doing one thing at a time.

 

It's too early to confidently say if this change has improved symptoms, although I have been calmer on waking for the past few days. I would like to work towards making the doses more evenly split and perhaps make the evening dose larger than the morning dose. But I'm not going to meddle with that right now.

I also know that splitting doses will make future tapering more complex.

This might all be complete conjecture, but I want my life back. Or I want to regain at least some stability.

 

I'm listing here my current symptoms and status of the past few weeks so I have something to look back to:

 

• Sleep at least five solid hours a night between midnight and 7am. In total, it's usually seven hours, but last two are very broken, with nightmares and half-awake panic, so I don't count this as good sleep.
• On waking, have body trembles, hot and cold sensations, shallow breathing.
• On waking, have intensely jumbled nightmarish thoughts, often suicidal, interspersed with earworms and random phrases. My day always starts with negative thoughts about Seroxat withdrawal. Sometimes I have about 30 seconds before the thoughts kick in and the cycle starts again.
• On waking and in the run-up to waking, I'm hypervigilant - can't stand sound or light, or being touched. I jolt and shout in response to being touched which is straining my relationship with my partner.
• Soon after waking, I have diarrhoea, which often continues into the early afternoon.
• Throughout the day, anxious, ruminating thoughts about Seroxat withdrawal, symptoms, depression, and anxiety dominate my mind and push out thoughts of all other topics, making it hard to concentrate and complete tasks. It feels like an obsession that dominates every waking moment.
• I often feel agitated, like I need to escape.
• Between anxious thoughts, I feel depressed and completely demotivated. Nothing inspires me into action and nothing gives me pleasure. I have to force myself to do things and often just want to sleep and never wake up.
• If the thoughts build up to a crescendo or if I encounter anything remotely challenging, I burst out crying.
• I have zero tolerance for anything remotely stressful outside of routines. For example, new unfamiliar freelance work (new client, new project, new product to write about). If I encounter this I have a panic attack and/or start crying. But I can also react like this to something mundane, like making a sandwich.
• The obsessive thoughts make it really difficult to concentrate on anything else or maintain clear thoughts. It's making my writing job really difficult.
• I have itchiness all over my body (and have done for months). Put this down to reduction in antihistamine effect of Seroxat as I'm at a lower dose.
• My breasts are so itchy that I've scratched them raw and they're now covered in dry scales. This has been the case for months, but have been too shy to say it here. (There's no history of eczema, psorasis or allergies in my family and I never had any skin complaints, apart from teenage spots, before going on Seroxat).
• The back of my neck is covered in tiny itchy blisters.
• My appetite is ok and was improved by my February updose. I'm not concerned by losing my appetite as I need to lose weight.
• I'm calmest and at my most positive while at my tutoring job (Tuesday/Wednesday/Thursday afternoons) and in the evening. Suspect the tutoring job helps me through distraction. Wish I could find something as equally distracting for the rest of the time.
• Weekends when my partner is home are the worst. I think there is a subconscious negative association between the time when my withdrawal symptoms emerged (Christmas break) and my partner being at home on holiday. I love my partner, and it isn't him per se that makes the weekends bad, but the association. I also feel guilty that I am not doing fun things with him at the weekends because so much brings on anxiety.
• Similarly, visiting and returning from my parents has negative connotations. I've seen and spoken to them much more over the past few months while being unwell, but this has now formed a negative association in my mind. When driving home from my parents, I usually feel terrible with depressed, on-edge feelings. Even certain roads can compound this.
• I have to be careful about what I watch on TV or the music I listen to (can stimulate anxiety or negative past memories and rumination). However, I'm trying not to get into an avoidance situation. Watching TV shows with my partner has always been a good routine – in the past we have had running commentary and debate and banter, and I don't want to lose that.
• Conversation with my partner and people has dried up as I can't think about anything much apart from Seroxat withdrawal.
• My periods are about 35 days apart. My latest one (started 9 May) was unusually light.

 

I think that's everything. I can handle physical symptoms, but the psychological ones just knock me sideways.

 

Thank you for all you are doing for me and so many many people.

 

PS. I know this site is about going off drugs, so please don't boot me out for the updose. I still ultimately want to get off Seroxat.

 

[DeterminedAnna]

1 hour ago, Oliver1974 said:

Friends,

 

Why test these  treacherous  waters and risk aggravating your already stressed out nervous system!  Caffeine is anything but  benign. It’s  a drug like any other that can easily accumulate in your system and  shock the hell out of you. Plus all that sugar. Honestly, stay away from any stimulants and that includes sugar. You do not want the highs and lows of insulin spikes. Give your brain and body a brake  and it will respond kindly.

Hi Stefan,

 

I agree wholeheartedly, but... part of me wants a 'normal' life. I don't want to think about and analyse everything I consume. I'm close to a full-on obsession over all of this as it is.

 

I had one Pepsi and I survived. And I think that's partly because I'm having a fairly good day. I wouldn't dabble in caffeine if I was in an anxious state.

 

I'm certainly not about to start guzzling double espressos all day. I also drink a lot of water and chamomile tea. I know that doesn't counteract caffeine, but I need some normality. I need to be able to relax about SOME everyday things. I need to do the occasional naughty thing to prove to myself my body isn't totally messed up!

 

Thank you for concern. I promise I won't be touching caffeine for a while now.

 

You made me smile with that post, so thank you. X