paxiladdict: want to get off Paxil after 20+ years

[paxiladdict]

Been on paxil (paroxetine) since the late 1990s.

 

My life is pretty stable and I don't have strong psychological symptoms or medication problems.  I'm interested in getting off paroxetine because there's some evidence that drugs with anticholinergic effects might cause dementia.

 

I'm pretty sure that I can't get off SSRIs entirely.  In the late 1990s I went off paxil (inadvisedly), and had a very hard time of it.  The psychiatrist I started seeing put me back on Serzone (nefazodone), which didn't do anything for the symptoms I was experiencing.

 

(My best guess is that in my case, the symptoms I get if I discontinue paxil are those of "withdrawal", not "relapse".)

 

My hunch is that if I go off paxil, even extremely slowly, with no replacement, I won't do well.

 

My plan is to cross-taper the paxil with prozac (generic fluoxetine), in 10% decrements (and corresponding increments of the fluoxetine), with each step taking 8 weeks.

 

Edited July 7, 2019 by ChessieCat
added drug general name

[ChessieCat]

Hi paxiladdict and welcome to SA,

 

Without knowing the way you tried to come off Paxil previously it is difficult to comment specifically, but I would imagine that the way you tried to come off was too quick.  I'll explain SA's recommended harm reduction method.

 

SA recommends tapering by no more than 10% of the current dose with a hold of about 4 weeks to allow the brain to adapt to not getting as much of the drug.  We also suggest listening to your body/symptoms and if you aren't stable to hold for longer before making another reduction.

 

Generally we suggest staying on the drug your are currently taking because you can end up experiencing withdrawal symptoms from the original drug and/or start up/side effects/adverse reaction from the new drug.  Because of the two drugs being involved you will not know what is causing any issues if they arise.

 

My original goal was to reduce my drug but not necessarily get off it completely.  However I learned more about psychiatric drugs and as I was tapering successfully I decided to keep going.  I've gone from 100mg Pristiq and am now down to 2.75mg.

 

I'll give you links to some information to check out.  I'll also give some extra information in a second post so that you don't get too overwhelmed.  Just work your way through it as you can.

 

Why taper by 10% of my dosage?

Dr Joseph Glenmullen's WD Symptoms Checklist

 

Tips for tapering off Paxil (paroxetine)

 

The Prozac switch or "bridging" with Prozac

 

 

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

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

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.

 

are-we-there-yet-how-long-is-withdrawal-going-to-take

 

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.

 

AND

 

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.  

 

[brassmonkey]

Hi Paxiladdict-- looks like CC has hit all the bases on information.  It seems like a lot to cover but getting off of ADs successfully takes a lot of information, but there will be plenty of time for that.  I just wanted to reassure you that it can be done.  I was on 40mg Paxil for 18 years when I started to taper.  It took me five and a half years to get off.  I'm now over two years out and life is wonderful. 

 

Looks like you are starting from a place of relative stability, which is a good thing.  Because of that I would strongly suggest not switching to prozac but rather taper the paxil.  Doing a Prozac bridge, as it is called, is an iffy proposition at best and can frequently lead to some pretty bad WD symptoms and bad reactions that can take for ever to stabilize before a taper can be attempted.  Tapering Paxil has a reputation for being a rough trip, which is why I developed the Brassmonkey Slide method.  It is designed to minimize WD symptoms so a person can maintain their quality of life, while tapering the drug at a fairly fast rate.  We are having great success with a lot of our members using it for Paxil and other drugs.

 

I'll stop before you get totally overloaded with information.

 

Welcome to the group.

 

Brassmonkey

[ChessieCat]

Brass Monkey Slide