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MikeysMum: Paxil

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Hi Everyone. I wish I'd found this site before I began going off Paxil . It's a bit of a blur but I began going off this drug about 18 months ago. My dr at time said just gut down by going to 1/2 dose 1 day a week, then next week halve a dose etc. All was fine, I was doing great until I rushed the last taper because I was feeling great. Had last  10 mg on December 29th last year. 5 or 6 days later severe flu like symptoms, nausea, diarrhoea, anxiety etc. went back to dr who said definitely no connection to coming off Paxil. These symptoms continued with lots of hot sweats, nausea, fear, anxiety. Went back to dr on Feb 12 who suggested I re start Paxil. Took 20 mg on this day. Next morning I collapsed at home. Ended up in hospital with Tachycardia and broken ankle. Cardiologist thought there might be a link between Tachycardia and withdrawal. Home again 2 days later with no recommendations. Anyway symptoms have continued (not as extreme ) but nausea, loose stools, anxiety, fear, tinnitus etc. I don't know what to do. Terrified of re starting Paxil. Don't have a dr who believes that symptoms are withdrawal. Any advice greatly appreciated.  I had been on Paxil for close to 20 years and another AD prior to that.

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Hi MikeysMum and welcome to SA,


What you are experiencing is withdrawal symptoms from having stopped your Paxil too quickly.  SA recommends tapering by no more than 10% of the current dose followed by a hold of about 4 weeks to allow the brain to adapt to not getting as much of the drug.  Why taper by 10% of my dosage?


When the drug is taken away too quickly we can get withdrawal symptoms:  Dr Joseph Glenmullen's Withdrawal Symptoms


The only known way to reduce withdrawal symptoms is to take the same drug that the brain has adapted to.  If you would like to try reinstatement please let us know and we can suggest a dose for you to try.  Please note that will probably suggest a dose that is no more than 5mg.  Please read Post #1 of this topic:   About reinstating and stabilizing to reduce withdrawal symptoms


Because your brain will have already made some adaptations during the time you have been off the drug, it is better to start with a lower dose than you last took.  It is better to start with a small dose and increase if needed than to risk taking too much.  The idea of reinstating isn't to get rid of withdrawal symptoms completely but to bring them to a bearable level.  You will need to stay as calm and patient as possible and try not to panic.  When we panic we can make bad decisions.  Some members have panicked and increased too much and/or increased too soon and made things much worse.


It generally takes about 4 days for a dose to get to full level in the blood and a bit longer for it to register in the brain.  We suggest that you keep daily symptom notes on paper so you can see the effect that reinstatement is having on your symptoms.  It is also helpful to provide us with those notes so we can assess whether you might need to take a tiny bit more.


It is also important to take the same dose, every day, at about the same time.  The brain likes consistency.  Do not skip doses to taper.


Once you have stabilised after reinstating, which might take several months, then you can taper following SA's protocol.


This topic explains how to get the dose you need:  Tips for tapering off Paxil (paroxetine)


Tapering Calculator - Online


It would be helpful if you could amend your drug signature and try and give more precise information about dates and doses.  If you don't know exact dates, use early, mid, late.


Please use the following format.   Keep it simple.  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



I will provide some more information in the post.  This is your own introductions topic where your can ask questions about your own situation and journal your progress.

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Here's some additional information which might help you to understand what is happening:


Recovery isn't linear it happens in a Windows and Waves Pattern


Withdrawal Normal Description

When we take a psychiatric drug, we are adding chemical/s to the brain.  The brain then has to change to adapt to getting the chemical/s.  It might have to change something to do with A and then once that change has been made it affects B so another change has to be made and so on down the line.  It is a chain reaction, a domino effect.


The same thing happens when we take the drug away.  That's why it's possible to experience such a vast array of withdrawal symptoms, and they can change, and be of different intensity.




These explain it really well:


Video:  Healing From Antidepressants - Patterns of Recovery


On 8/31/2011 at 5:28 AM, Rhiannon said:

When we stop taking the drug, we have a brain that has designed itself so that it works in the presence of the drug; now it can't work properly without the drug because it's designed itself so that the drug is part of its chemistry and structure. It's like a plant that has grown on a trellis; you can't just yank out the trellis and expect the plant to be okay. When the drug is removed, the remodeling process has to take place in reverse. SO--it's not a matter of just getting the drug out of your system and moving on. If it were that simple, none of us would be here. It's a matter of, as I describe it, having to grow a new brain. I believe this growing-a-new-brain happens throughout the taper process if the taper is slow enough. (If it's too fast, then there's not a lot of time for actually rebalancing things, and basically the brain is just pedaling fast trying to keep us alive.) It also continues to happen, probably for longer than the symptoms actually last, throughout the time of recovery after we are completely off the drug, which is why recovery takes so long.




On 12/4/2015 at 2:41 AM, apace41 said:

Basically- you have a building where the MAJOR steel structures are trying to be rebuilt at different times - ALL while people are coming and going in the building and attempting to work.

It would be like if the World Trade Center Towers hadn't completely fallen - but had crumbled inside in different places.. Imagine if you were trying to rebuild the tower - WHILE people were coming and going and trying to work in the building!  You'd have to set up a temporary elevator - but when you needed to fix part of that area, you'd have to tear down that elevator and set up a temporary elevator somewhere else. And so on. You'd have to build, work around, then tear down, then build again, then work around, then build... ALL while people are coming and going, ALL while the furniture is being replaced, ALL while the walls are getting repainted... ALL while life is going on INSIDE the building. No doubt it would be chaotic. That is EXACTLY what is happening with windows and waves.  The windows are where the body has "got it right" for a day or so - but then the building shifts and the brain works on something else - and it's chaos again while another temporary pathway is set up to reroute function until repairs are made.  


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Thank you so much for your quick response.  Those links are very helpful and I am surrently reading through much of the content on this site. I'm sitting on the fence regarding reinstatement  of Paxil. Just trying to listen to my body and acknowledge that all the awful things I'm experiencing is my nervous system trying to heal. I found the article by apace41 very helpful. I will try and adjust my signature soon.

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Hi MikeysMum,


I wanted to welcome you to SA as well. Listening to your body is really the best way to go. Once you’re off the meds the only thing that might help is reinstating a little bit, but it doesn’t always work, and a few times it’s made things worse. It has helped a lot of people though, especially if it’s done not long after you’ve come off the meds. Before I knew anything about medications and tapering I updosed once and it worked for me, but it was a week after I tapered too quickly. 


You will eventually heal whether you reinstate or not. We all heal no matter what we’ve gone through. I’ve been on and off a myriad of things myself, I’m tapering off Seroquel now. My downward medication and withdrawal journey started with chronic pain. It would be great if we knew when we would heal. Some people heal quickly and others take many years to heal. 


The “ Are We There Yet, How Long Is Withdrawal Going To Take” article is really good to have a read of. You may have read it by now. 


If you do decide to reinstate please let us know. 


Wishing you all all the best in your recovery.💚

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Welcome, mikeys.


You had classic withdrawal symptoms and your doctor should have known it. How have your symptoms changed in the last month?


If you decide to reinstate, you might try a very small amount, perhaps 1mg Paxil or 1mg Prozac. Prozac may be easier to taper later. Both drugs come in prescription liquid form.

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Thanks Altostrata and Carmie. In the first 6 weeks after my last 10 mg dose late Dec 2018  (apart from the 20 mg tablet I took on drs advice day before I collapsed on feb 13th) my symptoms were quite acute. Trembling, aches and pains, nausea, diarrhoea, very emotional, despair, sore liver, tinnitus, hot flushes, sweats and what I now know to be Tachycardia . I must say that over the last week my symptoms seem to have stabilised. They are not as extreme. I don't have much appetite most of the time, soft stools, intermittent sleep, feeling depressed and flat but not extreme. Still getting hot flushes but not extreme. I'm just letting my body have its way really. Watching lots of gentle TV which I haven't really done much of before (Golden Girls giving me smiles). After reading on this forum I'm aware that the 3 month mark could be traumatic so I will try and find a dr willing to listen and will re instate minute doses if necessary. My broken ankle is restricting my movements which has given me reason not to have to socialise etc which is great but will appreciate a gentle walk when I'm out of plaster. Seeing cardiologist on Tuesday and hoping he can offer reassurance as he was the only medical person who thought my symptoms could be linked to the AD withdrawal. I'm aware I may still be in honeymoon phase but I can only take each day as it comes. Thanks for your replies. So glad I found this forum albeit a little too late to do this whole WD properly. 

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Hi MickeysMum, 


Glad to hear that your symptoms aren’t as extreme now.


Sending hugs💚

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