medfreeoneday: withdrawal symptoms after Prozac bridge from paroxetine?

[medfreeoneday]

Hi everyone

 

I was on Paxil 20mg for 19 years- most of which time it worked well (except for some weight gain and bloating). While studying at grad school I started taking Adderall for four years until it developed until a problem and managed to come off it inn July 2017. Went through the PAWs from that which lasted for a long time (and is maybe still ongoing). However, since I came off the Adderall, the Paxil appeared to have stopped working (either than or the PAWs from the Adderall was overriding its effects). So 5 months ago I decided to do the Prozac bridge to see if Prozac would work for me. I did a straight switch to Prozac 20 mg without any tapering and felt some withdrawals and also felt weird most likely from starting on the Prozac as well. While taking Prozac I have been up and down, with good weeks and bad. However, in the last two weeks I have had what seem suspiciously like the 'waves' I hear about on this site. I have felt the worst I have ever felt in my life and it seems very much like SSRI withdrawal to me (I've experienced withdrawals from Paxil several times before when I either ran out or tried to quit). This time symptoms include a sense of impending doom, nausea, tinnitus, hypersensitivity to stress, depression. It seems unusual to be suddenly hit with withdrawal symptoms 5 months after giving up Paxil and while still taking Prozac right? So my question is- is this some delayed withdrawal to the Paxil I stopped taking 5 months ago or is it some adverse reaction to the Prozac (even though I have had periods of feeling fine on it).

 

I am leaning towards to the possibility of coming off the Prozac and reinstating the Paxil. Even though I was feeling pretty depressed when I was on Paxil last I didn't feel like this now where I basically feel like I'm losing my mind. Any recommendations on what I should do?

[medfreeoneday]

Hi everyone

 

I started taking Paxil (20mg) around year 2000 and have pretty much been taking It until end of January this year (2019). For most of the time it worked pretty well- reducing depressive symptoms and my social anxiety. However, 6 years ago, while at grad school I was diagnosed with ADHD and started taking Adderall every day. This worked initially but then I started to overuse it and abuse it. So in July 2017 decided to go cold turkey on the Adderall but carried on with the Paxil. Since then either the Paxil has stopped working or the withdrawal symptoms from the Adderall cancelled out the benefits of the Paxil or both as I suffered from depressive symptoms and anhedonia for a year and a half. Then in January 2019 I decided to switch to Prozac (20mg) as I thought since the Paxil wasn't working any more I might as well try another medication and since Prozac was supposed to be the easiest to withdraw from I chose that. I did a straight switch- stopping my 20mg tablet of Paxil one day and starting on the Prozac 20 mg capsules the following day. For the first month I felt weird as one would expect when switching between SSRIs and then started to feel a bit better though not great (although my libido went down and I felt pretty flat- has anyone had low libido with one SSRI and not with another?). However, in the last month I have started to feel very very bad. In fact the worst I've felt in my life- a feeling of overall dread/impending doom, major depression, nausea, diarrhoea, loss of appetite, anxiety, cognitive problems. This definitely doesn't feel like the withdrawal from Adderall. In fact this all sounds suspiciously like a 'wave' coming from SSRI withdrawal (I have had some experience of this before due to temporarily running out of Paxil at various points in the past).

 

 I have a number of questions for you guys- any ideas what is happening?

 

1.Is it possible to have withdrawal symptoms from the Paxil kick in suddenly 5 months after stopping taking it and even though I am still taking another SSRI (Prozac)?

2. Alternatively am I feeling so bad because of serotonin syndrome? As in I had some adverse reaction to the Prozac?

3. Could it be something else? (I completely cut out caffeine a month ago after being a relatively heavy user- might that have triggered this reaction?)

 

What should I do? Should I reinstate the Paxil? If so at what dose?

Alternatively should I try to ride it out or up the dose of the Prozac?

Should I just taper off the Prozac as well?

Any other suggestions?

 

 

[Altostrata]

Welcome, medfree.

 

Yes, you can still get withdrawal symptoms from the first drug even if you have substituted another.

 

Are these symptoms occurring in any daily pattern? What time do you take Prozac? Do you feel better or worse after you take Prozac every day? Are you taking any other drugs?

 

Please keep daily notes of times of day you take your drugs, their dosages, and your symptoms. You can post them in this topic with a simple list format with time of day on the left and notation (symptom, drug and dosage) on the right. This will help us figure out if these symptoms are an adverse reaction.

[ChessieCat]

Hi medfree and welcome from me too,

 

This is an example of what Alto is needing:

 

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

[Erell]

How are you doing medfreeoneday ?

[Altostrata]

@medfreeoneday, how are you doing?

[medfreeoneday]

Hi there

 

So an update from me. After my dreadful experience in June 2019 as described above I was prescribed Effexor (150mg) and have been on it ever since. After around two weeks of taking it, the Effexor started to work and I managed to feel better with both the anxiety and depression declining substantially.  Fast forward two years and, although I am doing well, I am starting to get fed up with the negative side effects of Effexor. These include weight gain, fatigue, low libido, ED and RBD (i.e. thrashing around sometimes violently in my sleep). So I have decided to do a very slow taper. Since December last year I have been slowly tapering very slowly using a digital scale. I am now at 93mg (having started on 150mg) and plan to keep going down by 10% each month for the next couple of years.

What do you all think of this strategy? Do you think it would be possible to taper faster? I really don't want to be on Effexor (or any other antidepressant) for another two years but I also really really don't want to return to the hell I experienced before.

[brassmonkey]

Welcome back, It's nice to see you again.

 

That sounds like a good plan for getting off of the effexor. I wouldn't go any faster than that, maybe even slow down or throw in some longer holds from time to time. Your body will let you know when. It can seem like it takes for ever to get off of these drugs, but we have proved time and again that it is faster to go slowly.

[medfreeoneday]

Thanks Brass monkey- I noticed that you do 2.5% drops each week rather than the 10% in one go. Have you found that to be more successful at reducing withdrawals? I dropped 10% last month and started to feel weird after a week or so.

[brassmonkey]

Reducing 2.5% a week is the basis for the Brassmonkey Slide method. It is 2.5% a week for four week and then an additional two week hold. This will give a 10% reduction every 6 weeks. We are having wonderful success with it. Many of our members have adopted it because of the reduced symptom load.

[medfreeoneday]

Month 17 of Effexor XR taper

 

Hi all,

 

Quick update. I am now down to 45mg from a starting dose of 150mg. The pattern has been dropping on average between 7-10% every 4 weeks. It hasn't been an easy ride so far with lots of ups and downs. I am feeling quite dispirited that I will probably have another two years of tapering after this and I really would like to get off this crap as soon as possible. But I know going any faster would be too much for me given that I've been on ADs for such a long time (22 years). Since going down a dose I have noticed that I have less fatigue than I did when I was at 150mg. Other than that I still seem to be unable to lose weight and suffer bloating- normally after about a week or so of dropping down a dose. At the moment I'm having a lot of brain fog with quite bad concentration and a far lower tolerance of stress plus some tinnitus. But thankfully it hasn't been as bad as the episode I had in 2019 (most likely due to switching off Paxil to Prozac far too quickly). I am planning not to drop my dose in May to see with the WD symptoms calm down a bit as being hit by them every month is exhausting.

 

Would appreciate some encouragement from people on here as I feel very much like I'm still in the trenches at the moment...

 

 

Edited April 7, 2022 by ChessieCat
added Intro topic title before merging with intro topic

[medfreeoneday]

1 hour ago, medfreeoneday said:

Hi all,

 

Quick update. I am now down to 45mg from a starting dose of 150mg. The pattern has been dropping on average between 7-10% every 4 weeks. It hasn't been an easy ride so far with lots of ups and downs. I am feeling quite dispirited that I will probably have another two years of tapering after this and I really would like to get off this crap as soon as possible. But I know going any faster would be too much for me given that I've been on ADs for such a long time (22 years). Since going down a dose I have noticed that I have less fatigue than I did when I was at 150mg. Other than that I still seem to be unable to lose weight and suffer bloating- normally after about a week or so of dropping down a dose. At the moment I'm having a lot of brain fog with quite bad concentration and a far lower tolerance of stress plus some tinnitus. But thankfully it hasn't been as bad as the episode I had in 2019 (most likely due to switching off Paxil to Prozac far too quickly). I am planning not to drop my dose in May to see with the WD symptoms calm down a bit as being hit by them every month is exhausting.

 

Would appreciate some encouragement from people on here as I feel very much like I'm still in the trenches at the moment...

 

 

2000:went on Paxil 20mg

2019-Feb: came off Paxil switched to Prozac 20mg

2019-June: had mother of all WD waves

2019-July: went on Effexor XR 150mg

2020-Dec: started 10% per month taper

2022-April: currently at Effexor XR 45mg

 

[ChessieCat]

I have moved your new topic to your original Introduction topic.  Only one Intro topic per member.  This keeps your history in one place.

 

Please create your drug signature:

 

Instructions:  Withdrawal History Signature

 

This link goes straight to your signature - remember to Save:

Account Settings – Create or Edit a signature

[medfreeoneday]

Partial reinstatement of Effexor- any advice?

Hi all,

 

Quick update. Unfortunately my taper from 50mg to 45mg completely floored me and I started spiralling with withdrawal symptoms. So I decided to reinstate a dose of 51mg and pretty much within a day the symptoms disappeared. I am now on day 5 since upping my dose and I got hit with another round of intense symptoms. I am confused and scared about what is happening. Is this the same withdrawals coming back for another round or my body reacting to the higher dose? How long should it normally take to stabilise after raising the dose?  Also did I raise the dose by enough? 

 

Any advice most welcome.

 

Edited April 24, 2022 by ChessieCat
added Intro topic title before merging with intro topic

[ChessieCat]

On 4/7/2022 at 10:08 AM, ChessieCat said:

I have moved your new topic to your original Introduction topic.  Only one Intro topic per member.  This keeps your history in one place.

 

I have moved another new Introduction topic to your original Introduction topic.  Previous move noted above.  Please do not create any more Introduction topics.  This topic is the best place to ask questions, journal your progress, keep your history in one place, connect with the SA community and not have to repeat your story.

[ChessieCat]

4 hours ago, medfreeoneday said:

So I decided to reinstate a dose of 51mg and pretty much within a day the symptoms disappeared. I am now on day 5 since upping my dose and I got hit with another round of intense symptoms.

 

You have gone from 50mg to 45mg and then to 51mg so you ended up taking more than you had reduced from.  The fact that the symptoms disappeared within the day means that you had reduced too much.  However the second lot of symptoms are NOT withdrawal symptoms.  They are from taking too high a dose.  From a previous post you reduced to 45mg from 50mg at the start of April which means that you had been on the new dose of 45mg for about 3 weeks.  During that time your brain made some adaptation to getting the lower dose.  After several weeks at the lower dose SA would have suggested only making a small increase, possibly only 1 mg to 45mg.

 

It 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.

[medfreeoneday]

Apologies. Will try to avoid starting a new topic in future.

[medfreeoneday]

Thanks @ChessieCat

so would you recommend moving the dose back down to say 46mg or should I just continue with 51mg since I have started down that path now?

[ChessieCat]

It's up to you.  You said you feel intense symptoms after going to 51mg which indicates it is too high a dose.  If you do decide to reduce then you will need to do it straight away and because you have already been on 51mg for 5 or 6 days, if it was me I would not go back down to 46mg; I wouldn't go any lower than 48mg.

 

Whatever you decide on you are going to have to stay on that dose for a while until things stabilise.

[medfreeoneday]

Update: so I switched to 50mg on 25 Apr. Felt better for a bit then got a wave of depression which made it hard to get out of bed. Today I had to call in sick for work which hasn’t happened before and is very scary as I am petrified of losing my job. Absolutely no question this is withdrawal and not my original depression. I’ve run out of ideas and getting worried as feeling like this doesn’t seem sustainable.

[ChessieCat]

Q:  Did you make a reduction from 51mg to 50mg or did you go lower before going to 51mg?

 

Please add the doses and the dates you started the doses to your drug signature so that we can see the information at a glance and not have to read back through your posts.  Thank you.

[ChessieCat]

After you stabilise, you might consider doing a Brassmonkey Slide taper.  The basic taper is 10% over a 6 week period instead of 10% over a 4 week period, but you can make a reduction of less than 10% if you want to.

 

the-brassmonkey-slide-method-of-micro-tapering

[medfreeoneday]

I went from 51 to 50mg like you recommended.

Any idea how long it will take to stabilise?

[ChessieCat]

14 minutes ago, medfreeoneday said:

I went from 51 to 50mg like you recommended.

 

I did not make a recommendation of what dose to take.

 

On 4/25/2022 at 5:57 PM, ChessieCat said:

 

if it was me I would not go back down to 46mg; I wouldn't go any lower than 48mg.

 

[medfreeoneday]

Sorry I didn’t mean to sound accusatory. You only said what you would do in my situation not what you would recommend for me. I see the difference.

 

If I am on day 8 since going to 50mg- I’m hoping to stabilise in the next week or so- does that seem right?

[ChessieCat]

10 hours ago, medfreeoneday said:

If I am on day 8 since going to 50mg- I’m hoping to stabilise in the next week or so- does that seem right?

 

Because you upset your nervous system when you updosed too much (you noticed fast improvement and then worsening which seems to indicate this), nobody can say how long it will be before you are stable again.

 

It is better to hold for longer than to risk reducing too soon.  If it was me, I would not even consider reducing again for at least 8 weeks (counted from the last dose change), even if I started to feel a bit better, this is because the brain may still be working on things that can't be felt.

[ChessieCat]

And when you do make your next reduction my suggestion would be to only make a small one, no more than 2.5%.

[medfreeoneday]

thanks @ChessieCat
 

Going down only 2.5% sounds like a good plan. Definitely not going to taper again for at least 2 months either.

 

On a positive note I am feeling better today so praying the worst has passed. After that awful experience I will be very very careful going forward.

[ChessieCat]

2 hours ago, medfreeoneday said:

Going down only 2.5% sounds like a good plan.

 

This suggestion is only to start with, a bit of a test.  For two reasons, to reduce your anxiety about reducing and give you confidence to taper which reduces anxiety and also to see how it affects you.  If the 2.5% goes okay you could try 5% the next time.

[Nicolas45140]

On 6/12/2019 at 10:37 PM, medfreeoneday said:

Hi everyone

 

I was on Paxil 20mg for 19 years- most of which time it worked well (except for some weight gain and bloating). While studying at grad school I started taking Adderall for four years until it developed until a problem and managed to come off it inn July 2017. Went through the PAWs from that which lasted for a long time (and is maybe still ongoing). However, since I came off the Adderall, the Paxil appeared to have stopped working (either than or the PAWs from the Adderall was overriding its effects). So 5 months ago I decided to do the Prozac bridge to see if Prozac would work for me. I did a straight switch to Prozac 20 mg without any tapering and felt some withdrawals and also felt weird most likely from starting on the Prozac as well. While taking Prozac I have been up and down, with good weeks and bad. However, in the last two weeks I have had what seem suspiciously like the 'waves' I hear about on this site. I have felt the worst I have ever felt in my life and it seems very much like SSRI withdrawal to me (I've experienced withdrawals from Paxil several times before when I either ran out or tried to quit). This time symptoms include a sense of impending doom, nausea, tinnitus, hypersensitivity to stress, depression. It seems unusual to be suddenly hit with withdrawal symptoms 5 months after giving up Paxil and while still taking Prozac right? So my question is- is this some delayed withdrawal to the Paxil I stopped taking 5 months ago or is it some adverse reaction to the Prozac (even though I have had periods of feeling fine on it).

 

I am leaning towards to the possibility of coming off the Prozac and reinstating the Paxil. Even though I was feeling pretty depressed when I was on Paxil last I didn't feel like this now where I basically feel like I'm losing my mind. Any recommendations on what I should do?

Hello, 

I have exactly the same problem at the moment. I was on 20mg Paxil, and i think has its stopped working, my psychiatrist changed my treatment for lexapro 5mg. To be on the same level of action, i should have 10mg of lexapro for an equivalent dosage of previous paxil. Its been 9 months i switched and have waves and windows, with tinitus, insomnia, anxiety, neck pain and tension headach.... I could not understand why after 9 months and still with another SSRI, i do have withdrawal and feeling like hell. 

Underdosing ? withdrawal ? 

Should I wait to feel better ? should I change lexapro for another SSRI ? If someone has the same problem, i would be glad and happy to discuss with to help me 

[medfreeoneday]

Update: so I’ve held my dose at 50mg since 25 April and I’m a lot better. The only thing left is that every 8 or 9 days I get hit with a wave of mild depression which is hard to shake off. Each wave does seem milder than the previous one so hopefully this means my nervous system is stabilising. I will continue to hold at this dose until the end of the month and then see about next steps.

[ChessieCat]

Remember that you don't have to make a full 10% reduction.  When you do make your next reduction you might consider making a smaller reduction.  This can help to reduce any stress you might have because you are worried. Anxiety symptoms can be similar to withdrawal symptoms.

[medfreeoneday]

Thanks @ChessieCat Yes I will definitely be going down at a much lower rate than 10%. Do you think it is worth holding for a bit longer to see if these waves of depression completely subside before lowering my dose again? Also is there anyway I can be sure that this is not just the return of my underlying depression?- I'm thinking it is not the underlying condition as the cycle of depression and then feeling better seems much faster but you know how you start to wonder when going through all this.

[medfreeoneday]

@Nicolas45140 it’s a very difficult situation to be in. I think it’s likely you are suffering from delayed onset of withdrawal from Paxil. As to what to do I’m not sure. I got out of the situation by switching to Effexor and then the withdrawals stopped- but I think I just got lucky (if you can call it that). Rather than give you specific advice I will defer to what the most experienced/knowledgable people on this forum say. The problem is that if you switch back to the Paxil the withdrawals may stop for Paxil but you could then be hit by withdrawals from the Lexapro.

Anyone else have any suggestions?

[Nicolas45140]

1 hour ago, medfreeoneday said:

@Nicolas45140 it’s a very difficult situation to be in. I think it’s likely you are suffering from delayed onset of withdrawal from Paxil. As to what to do I’m not sure. I got out of the situation by switching to Effexor and then the withdrawals stopped- but I think I just got lucky (if you can call it that). Rather than give you specific advice I will defer to what the most experienced/knowledgable people on this forum say. The problem is that if you switch back to the Paxil the withdrawals may stop for Paxil but you could then be hit by withdrawals from the Lexapro.

Anyone else have any suggestions?

@medfreeonedayhello. you completely right. 
Brain dont like too many changes and the switch i done wasn’t right as 20mg paxil is like 10mg lexapro and i switched for 5mg. 
going back to paxil isn’t a good idea i supposed. I would think about two possibilities, going to 10mg lexapro or patience and Hope that withdrawal will stop before starting to reduce the lexapro.

i could Also starting my 5% réduction of lexapro every 1 or 2 months. 

i assure everyone that i can still work and be active on everyday basis.

i Hope to have your suggestions !

take care all !! 

[Altostrata]

Hello, @medfreeoneday What does this wave feel like?