Bellamy: paroxetine / Paxil withdrawal

[Bellamy]

Hello all,

 

I was prescribed 40 mgs of paroxetine in 1997 for depression. It worked fine for six months, I was then advised by my doctor to come off it and I tapered as per instructions (reducing by 5 mgs a week) and I was fine until I was off the drug completely for six weeks, then I crashed. I felt so bad I went back on. The next time I came off I tapered more slowly, but with the same result, so I went back on again.

 

Fast forward to Christmas 2017 when, stupidly, I reduced from 40 mgs to 20 mgs in one go and went through terrible withdrawal symptoms, but was able to go to work even though I was obviously ill. After reading the advice on this site I up-dosed slightly to 22.5 mgs using a pill crusher, and after a couple of months the withdrawal symptoms remitted. I stayed on the 22.5 mgs for 6 weeks and then reduced by 1mg, I waited 6 more weeks before reducing again by 1 mg. I continued with this schedule until I got to 18 mgs, then everything went haywire with the very worst withdrawal symptoms I have ever experienced. I immediately up-dosed to 20 mgs, hoping this would give me some relief. After 6 weeks I was getting continually worse with increasingly suicidal/self-harming impulses. In desperation I went up to 25 mgs for two weeks and then up to 30 mgs which I have now been on for seven weeks. I've currently been off work sick for nearly three months and I can only describe my symptoms as horrific, as well as ever changing, the worst being extreme agitation and twitching of the body, along with depression, and hyper-sensitivity to any noise, as well as fear of the future.

 

Recently the Royal College of Psychiatrists in Britain has acknowledged SSRI withdrawal as a serious problem and I am contemplating asking for a referral to see a psychiatrist in order to at least to get my experience validated as none of my regular doctors seem to believe that what I am going through is protracted withdrawal.

 

I would be interested to know if anyone has any advice as to what I should do?

[Bellamy]

I was hoping to join this site to discuss my situation. I am currently waiting for a psychiatric assessment.

[Songbird]

Hi Bellamy, welcome to SA.  I'm sorry to hear you're having such a rough time.  It's great that psychiatry is beginning to acknowledge SSRI withdrawal at last, although I don't believe most psychiatrists have much knowledge yet about how to successfully taper off ADs.  If they did, this site wouldn't be needed.  Hopefully that will change eventually.

 

It would be helpful if you could please create a signature containing a summary of your med history, including all drugs, doses and dates (starting and stopping).  Your signature appears below every post you make, and allows us see your situation easily without having to read your topic from the top every time.   You could look at my signature for an example.  Instructions for creating your signature are here: Please put your withdrawal history in your signature.  You can edit your signature here: edit your signature in Account Settings.

 

What symptoms are you currently experiencing?  Have you felt any improvement in the seven weeks you have been at 30mg?

 

 

 

 

 

[Bellamy]

Hi Songbird,

 

My symptoms are all over the place and I can't say I feel better at all. I'm currently trying to apply for sick pay as my condition makes it impossible for me to work now. I need the psychiatrist to help with my claim. Also undergoing a needs assessment for social care as I'm having trouble looking after myself.

[Bellamy]

What has thrown me this time is that I really did a slow taper - approx 5% every six weeks and I got hit harder than I've ever been hit before. I can only surmise that this has something to do with the cumulative effects of multiple reductions over the years making me much more sensitive to alterations in dose. Last night I had a semi window for a couple of hours.

[Bellamy]

In the past two weeks I've been experiencing a lot of akathisia, which I've never suffered from before. The akathisia starts upon waking and waxes and wanes throughout the day. Is this because I up-dosed to 30 mg I wonder, or would I have got it anyway? I don't know whether to stay at 30 mg now as I've changed my dosage so often with such disastrous results, or to possibly reduce so as to hopefully reduce the akathisia. I'm feeling pretty clueless right now.

[Bellamy]

There has been no noticeable change since my last posting - I still spend nearly all day in bed suffering from a myriad of symptoms, the worst being akathisia and SI. I am barely hanging on.

 

I was thinking of maybe trying a switch to Prozac out of sheer desperation. I've been on paroxetine now for over 22 years and am currently taking 30 mg having up-dosed from 20 mg after severe withdrawal set in, the up-dose hasn't worked.

 

What do people think about a switch to Prozac? Maybe doing a cross-taper, say initially taking 20 mg Prozac and 15 mg paroxetine, then 40 mg Prozac and 0 paroxetine?

 

Thanks

[ChessieCat]

That sounds like a high dose of Prozac.

 

The Prozac switch or "bridging" with Prozac

[Bellamy]

Hi Chessie,

 

I am just thinking in terms of dose equivalence.

[ChessieCat]

You already have a major interaction for Paxil and mirtazapine.  If you add Prozac into the mix at the high dosages for the cross over you could make things much worse.

 

Q:  Are you getting any serotonin toxicity symptoms currently?

 

I've had mild serotonin toxicity when I was taking 100mg Pristiq (no other serotonin drug involved) and my diastolic blood pressure went up very high and the doctor didn't make the connection and just increased my blood pressure medication.  I was also experiencing bad sweating even in the middle of winter, confusion, agitation, flipping/skipping heart beats, leg muscle cramps.  It wasn't until I started researching online that I realised that what I was experiencing was caused by the SNRI I was taking. 

Interactions between your drugs

Major

PARoxetine mirtazapine

Applies to: Paxil (paroxetine), mirtazapine

Using PARoxetine together with mirtazapine can increase the risk of a rare but serious condition called the serotonin syndrome, which may include symptoms such as confusion, hallucination, seizure, extreme changes in blood pressure, increased heart rate, fever, excessive sweating, shivering or shaking, blurred vision, muscle spasm or stiffness, tremor, incoordination, stomach cramp, nausea, vomiting, and diarrhea. Severe cases may result in coma and even death. You should seek immediate medical attention if you experience these symptoms while taking the medications. Talk to your doctor if you have any questions or concerns. Your doctor may already be aware of the risks, but has determined that this is the best course of treatment for you and has taken appropriate precautions and is monitoring you closely for any potential complications. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.

 

 

 

 

[Bellamy]

I haven't had anything noticeable since going on Mirt for sleep - I now take 7.5 mg btw (I'll change my sig for that) and was thinking of tapering off it completely as I'm oversleeping if anything. Do you think a direct change from paroxetine to Prozac might be better (I wouldn't even be contemplating this if I wasn't totally desperate - I've now been off work for 4 months with the withdrawal and am afraid of losing my job, as well as everything else).

[Altostrata]

Hello, Bellamy. It is possible that your symptoms are due to too much SSRI from your updose. When you go on and off psychiatric drugs, your nervous system can become sensitized and react badly to dosages you tolerated before. What times of day do you take your drugs? Do you feel better or worse after you take them? At what times of day are your symptoms better or worse?

 

Paroxetine is indeed a very difficult drug to go off, as you've found, and sometimes a switch to Prozac is all you can do.

 

6 hours ago, Bellamy said:

What do people think about a switch to Prozac? Maybe doing a cross-taper, say initially taking 20 mg Prozac and 15 mg paroxetine, then 40 mg Prozac and 0 paroxetine?

In my opinion, a cross-taper is a better way to make the change. On the theory that you might be suffering from too much SSRI, f I were you, I would take 10mg Prozac with 15mg paroxetine for a few days, then 20mg Prozac for a few days and drop the paroxetine. Be prepared for bumps over the process and at least a few weeks afterward. Or, it may go smoothly and you'll feel relieved.

 

Might be best to bring one of those consulting psychiatrists into this. He or she probably won't know anything, but you'll be able to get more prescriptions.

[Bellamy]

Hi Alto,

 

My current difficulties started in Feb when I became incapacitated after tapering down to 18 mg. I take paroxetine at 7 am each day. I am usually at my worst when I first wake up which is normally around 5 am and things are consistently bad - akathisia, waves of toxic depression, nausea -  until early evening when the symptoms begin to subside. Recently early mornings have been slightly less horrendous.

 

I'll ask my GP if he'll prescribe Prozac as a referral to see a psychiatrist, while in the works, can take months.

[Altostrata]

Please answer

2 hours ago, Altostrata said:

What times of day do you take your drugs? Do you feel better or worse after you take them? At what times of day are your symptoms better or worse?

 

[Bellamy]

I take my drugs at 7 am. I feel equally bad before and after I take them. My symptoms are slightly better in the early evening.

[Bellamy]

Got to see a psychiatrist today after going to A&E yesterday because I was so desperate. She half believed me when I told her this was withdrawal and she offered me a Prozac switch without me mentioning it - she said take 10 mg Prozac along with my 30 mg of paroxetine for a week and then she'll review things, but I'll take Alto's suggestion to do 10 mg Prozac and 15 mg paroxetine and see how that goes. My brain seems to have given up hope that anything will work.

 

I asked her for a few benzos as an insurance policy but she refused and gave me  promethazine instead. I took one at 14:00 and it did nothing but give me a dry mouth. 

 

My symptoms can change by the hour or last all day and they are all severe enough that any kind of meaningful life is impossible. Even looking after myself has become impossible. The emotional pain of the last 6 months has been relentless.

 

I feel no connection to the person I used to be.

 

 

[Amanda167]

Hi Bellamy 

 

So sorry 😓

 

I'm struggling too, really badly.

 

I hope so much that the Prozac help you, I was thinking of going down this route.

 

I was just going to message you and saw you made a post.

 

I haven't gotten out all week, only at night to walk my dog but can only do this after my zopiclone. 

 

I'm beginning to think the Paxil is hindering us rather than helping.

 

Just a note, I regret starting the valium so please try to avoid a benzo, things got worse for me after starting them and it only takes a few doses to mess you up.

 

I feel for you but know you're not alone and it's only because my boy is here that I am holding on with dear life.

 

It HAS to get better, it HAS to.

 

Know your thoughts and feelings are NOT the real you, you are so much more but these meds trick us.

 

Hopefully the Prozac will be a success for you.

 

I'm praying for your recovery and thinking of you. 

 

You're not alone in this, trust me.

 

Keep reaching out.

 

Big hugs to you warrior 🙏❤❤❤

[Bellamy]

Thanks Amanda.