Kendras: trying to decide what to do regarding SSRIs

[Kendras]

Hi, 

 

My name is Kendra. I'm 38 and have been on antidepressants since I was 17. I took Zoloft from 17-22, and then Paxil and strattera from 22-29. I then took lexapro for 6 months (very bad for me), and went back to Paxil. I was on Paxil 20 mg from 29 until 37 (about a month ago). The past 6 months, it started to be inconsistent in how it worked. I finally decided I would have to try something else. My psychiatric nurse agreed to taper me to zoloft 50 mg.  She said I could take 25 mg of zoloft and 10 mg of paxil the first couple of weeks and then 50 mg of zoloft. Coming off paxil was not pleasant, but doable. Then when I was fully on the zoloft, within a week I started to feel really weird. I guess what you would call depersonalization. I was also getting severe diarrhea. I finally asked if I could go back to 25 mg zoloft/10 mg paxil. I also realized I want to at least decrease what I'm taking, and have really started to hate what these drugs do. I"m at a loss of where to go from here. Any suggestions on my situation would be greatly appreciated. I've been reading a lot on this site, and I really admire what people are doing here. 

 

[ChessieCat]

Hi Kendras and welcome to SA,

 

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

 

Please put all the drug you are currently taking into the drug-interactionchecker.  Please copy and paste the results here in your Introduction topic.

 

Important topics in the Tapering forum and FAQ

 

 

Please create your drug signature using 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

 

 

This is your own introductions topic where your can ask questions about your own situation and journal your progress.

 

Edited March 16, 2019 by ChessieCat
changed to medscape interaction checker

[Altostrata]

Welcome, Kendra.

 

It sounds like you got Paxil withdrawal symptoms even though you're taking Zoloft. This does happen.

 

Putting some Paxil back into the mix is a good idea. How do you feel now on this combination? When did you reinstate 10mg Paxil?

[Kendras]

Thank you Altostrata,

 

I agree that I think I started to get withdrawal symptoms from the Paxil. I reinstated on 3/14/2019 (this past Thursday night). The first night it felt ok, last night I felt like I was getting too much medicine, felt kind of panicky and couldn't sleep. Today, I felt better than when only on the zoloft, but I also felt like I was overmedicated or something. Everything seemed really bright. So tonight, I've already taken the Paxil 10 mg and feel ok. I'm guessing I should take the zoloft 25 mg as well, but I"m hesitant with how I felt last night. I know I shouldn't be jumping all over the place as it will do more damage. 

 

In the long run, I don't know if I should try to stabilize on this combination and wean down. I'm not sure if it's safe being on the two, but I'd to try to reduce in the near future and don't want to risk destabilizing myself. I know no one is a doctor here of course, but I feel like my psychiatric nurse will do anything I ask within reason. It seems people on this web site have a lot of experience with meds, tapering and withdrawal. Any words of wisdom are much appreciated. 

[Altostrata]

It may take some weeks or months for you to stabilize, Kendra. Your nervous system has gotten a shock.

 

Paxil is very difficult to go off. You might ask the nurse if she is familiar with The Prozac switch or "bridging" with Prozac

 

This also requires a cross-taper, to Prozac. You may need to do it more gradually.

[Kendras]

Do you think I should continue with the Zoloft 25 mg as well? 

 

I know Paxil is very difficult to go off. Unfortunately, I did briefly try Prozac twice and I couldn't tolerate it. 

[Kendras]

I just wanted to update that I feel way better physically today. I will continue on with the Zoloft 25/Paxil 10 for the time being until I stabilize and go from there. I appreciate your help greatly:) 

[Kendras]

Actually, one more question. Does anyone know of a psychiatrist in Massachusetts educated in tapering and withdrawal? Thanks and have a good night:)

[ChessieCat]

Medical professionals who understand tapering and withdrawal are rare.  That is the reason this site exists.

 

You do not need a psychiatrist to write a prescription.  Any doctor can do that.

 

In Post#1 of this topic there are links to locations that members post in.  You could post in the relevant area asking other local members if they know of anyone.

 

recommended-doctors-therapists-and-clinics/

 

How do you talk to a doctor about tapering and withdrawal?

What should I expect from my doctor about withdrawal symptoms?

[Kendras]

Thank you ChessieCat:)

[Kendras]

Hi everyone, 

 

I’m 6 days in to reinstating 10 mg of Paxil (half my original dose) with 25 mg of Zoloft. I have felt somewhat better, although still having periods of feeling like things aren’t right ( disoriented). And I’ve had really bad diarrhea and nausea. I do have ibs, but nothing like this. I went to acupuncture yesterday ( i go weekly), and it greatly helped with how I felt yesterday. But then by the evening, I was feeling strange again. I woke up today with diarrhea again and very nauseous. It may be impossible to tell, but do you think this is withdrawal still or my body trying to work things out/stabilize? 

[Kendras]

Hi everyone,

 

I've had a bunch of issues trying to cross-taper from Paxil to Zoloft over the past five weeks. I had first cut out the Paxil after two weeks, but then added a smaller dose in and halved the zoloft dosage. Now I"m at a loss of what to do. I'm on Paxil 10 mg/zoloft 25 mg and I'm really scared of doing anything to be honest. I"ve been on this combination for a week today. I still have been having symptoms, lots of nausea and diarrhea.  Off and on, I've felt fatigued, spacey and disoriented. Originally, I wast trying to cross-taper to Zoloft and be done with it. But this whole experience has been terrifying. Its now been almost five weeks I've been on zoloft as well so I know fast taper is probably not an option either. Eventually I would like to taper the drugs, but now is obviously not the time. 

 

My question is how safe is it to be on the Paxil 10 mg/Zoloft 25 mg and for how long? Should I just go back to Paxil totally and then taper? I know nothing is a guarantee, but I really am in a  tough spot as many of us are. Any responses or help would be greatly appreciated. The psychiatric community is pretty much clueless when it comes to this stuff, even well respected ones! I spoke to a recommended psychiatrist on the phone and she said maybe the symptoms are because I'm not getting enough zoloft!!! She did mention discontinuation syndrome, but said don't read the horror stories on the internet. It's totally insane. 

[Altostrata]

On 3/20/2019 at 8:57 AM, Kendras said:

Hi everyone, 

 

I’m 6 days in to reinstating 10 mg of Paxil (half my original dose) with 25 mg of Zoloft. I have felt somewhat better, although still having periods of feeling like things aren’t right ( disoriented). And I’ve had really bad diarrhea and nausea. I do have ibs, but nothing like this. I went to acupuncture yesterday ( i go weekly), and it greatly helped with how I felt yesterday. But then by the evening, I was feeling strange again. I woke up today with diarrhea again and very nauseous. It may be impossible to tell, but do you think this is withdrawal still or my body trying to work things out/stabilize? 

 

Hi, Kendras. Very sorry this is not going well.

 

It is possible your system still needs to settle down from the switch from Paxil to Zoloft.

 

Do your symptoms follow any daily pattern? What times of day do you take your drugs, and their dosages?

[Kendras]

Hi everyone, 

 

I’m 6 days in to reinstating 10 mg of Paxil (half my original dose) with 25 mg of Zoloft. I have felt somewhat better, although still having periods of feeling like things aren’t right ( disoriented). And I’ve had really bad diarrhea and nausea. I do have ibs, but nothing like this. I went to acupuncture yesterday ( i go weekly), and it greatly helped with how I felt yesterday. But then by the evening, I was feeling strange again. I woke up today with diarrhea again and very nauseous. It may be impossible to tell, but do you think this is withdrawal still or my body trying to work things out/stabilize? 

[Altostrata]

Your body is still stabilizing.

 

Do you take Paxil and Zoloft at the same time each day? What time?

 

When you were on Paxil only, did it make you sleepy?

[Kendras]

Sorry I resent that by accident, sorry

[Kendras]

I am still feeling weird though. Some nights I have a lot of trouble sleeping and feel very anxious, like jumping out of my skin. I just got my period too and that’s making me feel strange. 

 

The paxil did not make me sleepy

[Kendras]

I take the zoloft and paxil at night time. 

 

I'm not sure how much longer I can go on feeling as I do. I'm not sure if I should continue on with the combination or go back to the paxil and start weaning. I've been having trouble functioning at work. 

[Kendras]

Hi everyone,

 

So I"ve now been on the combo of paxil 10 mg/zoloft 25 mg for 17 days  in an efforts to stabilize and start tapering. I"m honestly not sure how long I should be on those combo until I consider tapering down. Things have gotten more stable, although my stomach is not that much better. This could be due to all the changes though, as I already have ibs. I'd like to start slowly tapering the paxil when I'm ready, and I may start with the brass slide monkey method as I"m very sensitive. I am starting to feel like I'm getting too much medicine. I wake up at night and feel physically overwhelmed, that's the only way to describe it. My stomach gets really crampy and I can tell my body is trying to process the  medicine. It's pretty uncomfortable. 

 

Two questions: 

 

Alto, how long do you feel I should stabilize on this until I can start to taper down? 

 

And as far as the brass monkey slide method, would it go like this:

 

paxil 10 mg-

 

first week-2.5% reduction is 9.75mg

second week-2.5% reduction is 9.5 mg

third week-2.5% reduction is 9.25 mg

fourth week-2.5% reduction is 9 mg

fifth and sixth week you hold

 

And then next cut would be 2.5% of 9 mg and keep going? 

 

Thanks of for your help. 

[Kendras]

Hi everyone,

 

I"m hoping someone can answer me. I've been on paxil 10 mg/zoloft25 mg for 21 days now. It did help to stabilize the withdrawal symptoms I was having. I do still have diarrhea, although it has decreased. I"m concerned though because I"m walking up in the night time and feel like I"m going to jump out of my skin. It's very uncomfortable. My heart feels a bit strange as well. Last night I couldn't sleep until 2:30am. I'm concerned about any kind of serotonin toxicity. Does anyone have experience with this? 

 

I was going to try to wait until 5 or 6 weeks of being on this combo to wean, but I'm thinking I may have to start tapering the paxil sooner because of this. Please, if any experienced members could answer me, I'm feeling very concerned. Thanks and hope everyone has a good day:)

[Kendras]

Hi, 

 

I am now almost five weeks into taking Paxil 10 mg/Zoloft 25 mg. I was feeling overwhelmed taking both meds at night and not sleeping well. So almost two weeks ago my psychiatric nurse suggested taking the Zoloft in the morning, which I did in one day. I did that before reading here to move back an hour at a time. That being said, I’ve definitely felt weird since doing that. I am sleeping better, but I feel physically sh*tty and spacy during the day now. I really just want to start tapering, but not sure when I should do this with switching the Zoloft to the morning. I was originally trying to get off Paxil because it was being inconsistent. Now I want off all of it.

 

I meet with the nurse Thursday. Any suggestions, Alto? 

 

Im in Massachusetts and I saw in the suggested doctor list Mark Green. Does anyone have experience with him? I actually left a message for Dr Glenmullen a few weeks ago, but he never returned my phone cell. 

 

Thanks and thinking of everyone whose struggling:)

 

 

 

[Gracee]

5 minutes ago, Kendras said:

Hi, 

 

I am now almost five weeks into taking Paxil 10 mg/Zoloft 25 mg. I was feeling overwhelmed taking both meds at night and not sleeping well. So almost two weeks ago my psychiatric nurse suggested taking the Zoloft in the morning, which I did in one day. I did that before reading here to move back an hour at a time. That being said, I’ve definitely felt weird since doing that. I am sleeping better, but I feel physically sh*tty and spacy during the day now. I really just want to start tapering, but not sure when I should do this with switching the Zoloft to the morning. I was originally trying to get off Paxil because it was being inconsistent. Now I want off all of it.

 

I meet with the nurse Thursday. Any suggestions, Alto? 

 

Im in Massachusetts and I saw in the suggested doctor list Mark Green. Does anyone have experience with him? I actually left a message for Dr Glenmullen a few weeks ago, but he never returned my phone cell. 

 

Thanks and thinking of everyone whose struggling:)

 

 

 

 

Sometimes with doctors, the squeaky wheel gets the grease.   You have to be persistent. 

[Kendras]

Thanks for your reply Graces:)

[Kendras]

I was going to try to use a compounding pharmacy, but I just talked to two that said if something is commercially available, they can’t make it! I was going to try to have them compound generic Paxil into liquid. Does anyone have experience with this?

[Kendras]

Hi, 

 

I'm hoping I can get an answer to this, as the last couple of times I've written there's been no response. I finally found a compounding pharmacy that was willing to break down 10 mg of generic paxil and dilute it in a pharmacy suspension/syrup. I took it last night and did not feel well at all.  I'm not sure what to do. Could there be a reaction to doing this? I'm not sure if I should just go the scale method of tapering, although that seems painstaking to be honest. The pharmacist said she had never made paxil liquid from a tablet before, which didn't make me feel great! I"m extremely sensitive, and I don't know if the generic is from the same manufacturer I usually get at CVS. Ugh, please any help/direction would be great. 

[Kendras]

Hi,

 

I’ve been tapering Paxil over the last few months, and I’m currently at 5.5 mg. I get it compounded from a pharmacy and they mail it out when it’s ready. This past time, it came early and was in my mailbox overnight for about twelve hours. It was about 20 degrees out. I started the new script on Sunday, and have felt a bit off. Some of it is withdrawal I know, but I’m wondering whether the cold compromised the medication. The pharmacy said that shouldn’t happen with Paxil and the cold. Has anyone else had experience with this? 

 

Thanks,Kendra 

[Altostrata]

Hello, @Kendras

 

I'm glad you found a more reliable compounding pharmacy. Is it a liquid? Did it freeze solid? Did it separate?

 

Generally, it's heat and light exposure that cause these drugs to degrade, not cold.

 

 

[Kendras]

Thanks! It’s a powder in a capsule. Everyone has said the same thing about the cold and medications . I’m guessing it’s just withdrawal symptoms then. I  just never know what I’m going to get with tapering, just when I feel like I can get used to how I’m feeling, it changes. Thanks for the response. Hang in there everyone:)