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Bigbird

Bigbird: Paxil / paroxetine withdrawal

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Bigbird

Hello, first off I want to show tremendous appreciation for the advice given on this board. It’s so needed and so helpful. I’m 52 years old and female. I used Paxil for about one year at 29 years of age 20 mg for postpartum depression. In my early thirties I also used Zoloft for about a year, the dose would only be the starting dose. Any psychiatric medication I’ve taken has only been at the lowest starting dose.

In the fall of 2011, I started 20 mg of Paxil for anxiety. I tried discontinuing in the fall of 2017 into 2018 following the recommendations The Antidepressant Solution by Joseph Glenmullen. I watched for any withdrawal symptoms and held the doses if needed any only reduced every 4 weeks. My taper was (cut tablets as tapered,  used 10 mg tablets to cut when I reached 10 mg) 17.5 mg, 15 mg, 12 mg, 10 mg, 7.5 mg, 5 mg, 2.5. mg.  7 month taper. At 2.5 mg I started to have withdrawal issues, mostly early morning anxiety. I panicked and upped my Paxil to 10 mg and went to a walk in clinic to try lexapro, cross taper with lexapro 5 mg and Paxil, I tried that for about a week, stopped, horrible reactions, burning skin , anxiety. So went back to family doctor and slowly over the next few weeks increased back up to 20mg. During this process I also acquired tinnitus which I still have presently. Never a good idea to try another medication or add one in this state! I learned my lesson.

 

Fast forward to December 2018, I wanted to finally get off Paxil. Again I used a similar taper according to Dr Glenmullen, I also made a l make a 1:1 solution diluting a 20 mg tablet in 20 ml of water to use, use 10 ml syringe. I guess this is considered a fast taper, since I didn’t use 10% reduced dosages because I never had more than minor withdrawal issues . My problem is this taper when July 10, 2019 I reached 2 mg I felt just minor withdrawals until the past few days when I started having insomnia and night anxiety, night urinating a few times. The insomnia makes me feel worse and just not sleeping makes me more anxious,  A vicious cycle. I’m not sure what to do. I was considering stopping the 2mg in another two weeks, but since I’ve been reading this site I’m not sure what to do? Do I reinstate another mg of Paxil to 3 mg and see how I do, or do I try and stabilize at this dose for however long until I feel stable before reducing again. Thank you and I hope this makes sense, lack of sleep doesn’t feel so good! Also very low withdrawal issues throughout the taper, mild irritability, moodiness that went away as I adjusted to the new dose. Until now. Below attached is my most recent taper. I was almost 50 years old when I tried my first taper and almost 52 wi5h this taper, pretty much two years apart. Thank you!

AD38A1F0-4F58-4B7B-94AC-03859D757245.jpeg

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Gridley

Hello, Bigbird, and welcome to SA.

 

As you know, you've been tapering much faster than the 10% of current dose every four weeks that we recommend. 


Why taper by 10% of my dosage?

  

Slow tapering is especially important at the lower doses  The graphs in this topic might help to explain the reason for this:
 
 
These links will help you understand what you're experiencing.
 
 
 
 
These explain it really well:

 

 

   On 8/30/2011 at 2:28 PM,  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.
 
 
 
 
Reinstatement of a very small dose of the original drug is the only known way to help alleviate withdrawal syndrome.  The only other alternative is to try and wait out the symptoms and manage as best you can until your central nervous system returns to homeostasis.  Unfortunately no one can give you an exact timeline as to when you will start feeling better and while some do recover relatively easily, for others it can take many months or longer.  
 
Reinstatement isn't a guarantee of diminished symptoms for everyone but it's the best tactic available.  You're still in the time period where reinstatement predictably works, up to 3 months after last dose.  It is best to reinstate as soon as possible after withdrawal symptoms occur. We usually suggest a much smaller reinstatement dose than your last dose.  These drugs are strong, and when reinstating it is better to start with a small amount and increase if symptoms remain unbearable. Your system has become sensitized and If you take too much it may be too much for your brain and can cause you become more unstable.  
Please read:
 
About reinstating and stabilizing to reduce withdrawal symptoms. -- at least the first page of the topic
 
I'd suggest an updose of 0.5mg Paxil, making your dose 2.5mg.  It will take about a week for the increase to reach steady-state in your bloodstream.  The effect should get stronger during that time. Please be patient and allow the updose time to work.  Reinstatement is definitely an area where more is not better.
 
If you do decide to updose, please post daily notes here in your Introduction topic on your symptom pattern.  We need to see how 0.5 affects you.  If 0.5 is enough, it still may take weeks or months for your nervous system to settle down, but symptoms won't be as intense.  
 
Once you've stabilized on 2.5mg, which can take several months, you can begin a 10% per month taper down to zero.  By the way, jumping to zero from 2mg is far too high.
 
This is your Introduction topic, where you can post your daily symptom pattern (if you update), ask questions and connect with other members.  We're glad you found your way here.
 

 

 
 

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Bigbird

Gridley thank you for your reply. I sent a message back earlier but I’m not seeing it posted . Maybe it didn’t post, I’ve read this board years ago, using the search function. I’m not sure what to do, if I should just stay in the 2 mg until I stabilize or go up  to 2.5 mg. It scares me, I was reading some of the information that you linked in your response to me, but since the past few days I haven’t had good sleep it’s hard to comprehend, mostly the link on how such low doses affect the brain still in a great way. Thank you so much for your help. My system has been sensitized, I was fine at 4 mg, but the 2 mg was too much obviously. The only way to ever get completely off this drug is in 10% reductions in the future. Thank you, I’m not sure what to do.

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brassmonkey

Hi Bigbird-- welcome to SA, I'm sorry that you had to find us this way. A new members first several posts have to be approved by the moderation staff, which is why you can't see them.  We do this to make sure that your posts get seen and answered by a member of staff so we can get things off on the right foot.

 

Getting off of long term paxil use can be a tricky one, but it can be done.  Looking at the schedule you posted it shows that you've tapered much too fast and the results of those reductions are catching up with you.  As Gridley pointed out a small updose is the only known way of reducing the symptoms that you are now experiencing.  But it has to be kept small because you have become sensitive to changes in the drug level and a large updose would set off an adverse reaction, and we don't want that.  His suggestion of increasing to 2.5mg is a good place to start.  It will take some time for you to stabilize, but many people get some relief fairly quickly. (a couple of hours to a couple of days).  It would be best to start out small and see what happens. Luckily it's only been a couple of weeks since your last reduction so there is a good chance that the updose will help, but it will take some time.

 

Once we get things stabilized we can help work out a taper schedule that will be more manageable.  There is a lot of information to try and understand and most of it can be pretty confusing at first.  So please don't let it all scare you, it will all get explained as we go along.  For right now I think a small updose will help and then we can go from there.

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Bigbird

Brass monkey thank you so much for your reply, I never thought that I would ever get off this Paxil. I will reinstate to 2.5 mg tonight and see how I feel. I hope that things settle down for me. I’ve read some of the others struggles and it makes me feel anxious. I see that your now Paxil free. Thank you so much for your support!

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Bigbird

Just an update, I’ve increased the Paxil for the past two days to 2.5 mg from 2 mg. Maybe it’s placebo but I am actually feeling better. It’s pretty shocking to me . It’s very surprising how low dosages affect the brain. It’s really like the withdrawals for me starts after the 10 mg doses.  I’m very apprehensive about tapering in the future. How long is it recommended that I stay at 2.5 mg before I initiate future tapering. I guess the recommended amount is 10% per month. Thank you for the help.

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Gridley
28 minutes ago, Bigbird said:

Maybe it’s placebo but I am actually feeling better. It’s pretty shocking to me

 

Bigbird,

 

That is great news that you're feeling better.  Yes, the low doses are really strong.  An updose can be felt, as yours has, within a couple of days, and I'm really pleased that you seem to have hit the "sweet spot" amount to updose.

 

I would hold there at 2.5 for three months, and let's reappraise at that point whether to hold further or resume the taper.  The 10% figure is the maximum we recommend.  It's often advised here to go even slower at the low doses, so when the time comes you might consider a lower percentage or a longer hold.

 

I'm in a similar position at 2.0 Lexapro and may be slowing down or holding longer as I continue.

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Bigbird

Thanks for replying Gridley. I’m not 100% normal but I’m sleeping better and I can manage. If it gets worse I know who to turn to. Thankfully the world still has such wonderful helpful people who give their time to help others. I greatly appreciate the support. I regret so much trying to taper faster, thinking that I would be ok when clearly the lowest doses appear to be the most challenging. Currently I am halving a 20 mg Paxil and dissolving it in  10 ml of water. Hopefully doing that is accurate, I don’t think that liquid Paxil is available here in Canada. Plus my doctor, who is new is only 31 years old and has little experience. Months ago when I started my taper I spoke to him about discontinuing and he gave the generic reductions rate, mentioning every other day, when I already know that it’s an extreme no no.  Discontinuing the drug with in weeks.  I regret being so impatient. Thank you again Gridley and I wish you well with your own taper.😊

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brassmonkey

Hi BigBird-- I'm so glad to hear that the updose is working.  It's surprising just how fast it can help. 

 

As Gridley pointed out a good long hold is now in order to let things settle out. These drugs work by making physical changes to our bodies.  To continue working our bodies need the drug to be present to tell it what to do. When we decrease the amount of drug the body no longer understands how to work, gets confused and that causes the symptoms we feel.  Once the drug is removed the body starts to undo all those physical changes and that can take a very long time.  Even if we start to feel a lot better there is a good deal of healing going on that we don't feel.  So It is very important not to rush things even if we start to feel better. Learning patience is one of the "benefits" of ADWD. 

 

Making your own liquid is a good way to do it and it sounds like your plan is fine.  Keeping the liquid for four days shouldn't be a problem, keep it i the refrigerator.

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Bigbird

Hey brass monkey thanks for your help. I still feel tired and my sleep isn’t perfect, I think that I’m well enough to manage. Do you think that it’s best to just stay at the 2.5 mg or increase it more. I was just wondering when you now when to stop with the increased doses, is somewhat feeling better enough? I guess I’m hoping to feel great! Maybe just wishful thinking on my part.

 

I usually use a new tablet  and throw out the rest.  I’m paranoid I guess, and the generic paroxetine is inexpensive. I dissolve it in the refrigerator.

Thank you again for your help and support, it’s so appreciated.😊

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Gridley
17 minutes ago, Bigbird said:

Do you think that it’s best to just stay at the 2.5 mg or increase it more.

You are just 2 days in and it takes a week for you to feel the full effect of the updose, so it's likely you'll feel better as the week progresses.  The goal of reinstatement is not to eliminate withdrawal symptoms but to make them more tolerable.  From everything you've said, you are a reinstatement success story. I would stay at 2.5.

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Bigbird

Thanks Gridley for the explanation. My brain isn’t as sharp as it normally is. Appreciate your response.😊

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Bigbird

Gridley or brassmonkey, I’ve taken 4 days now with the 2.5 mg Paxil increase. My sleep still isn’t great, awakening during the 4 am time, cortisol hormone spike, hard to fall back to sleep. So I’m getting maybe 5-6 hours of sleep per night. I’m feeling tired and discouraged. I’ve learned a lot reading this site and to be honest it all makes me feel more anxious. I’m afraid that my withdrawal will  get worse. I’ve read so many others and their painful experiences and it just makes me worry and feel more anxious. I’m so regretful for taking this terrible medication and at times wish I had never taken it or never tapered.  Any words of encouragement to help keep me positive? I don’t want to increase the dose unnecessarily just hoping to reduce withdrawal symptoms. Thank you for your help.

 

 

 

 

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Gridley
4 hours ago, Bigbird said:

ny words of encouragement to help keep me positive?

 

Bigbird, you need to be much more selective in your reading.  Google "SurvivingAntidepressants.org success stories" and make that part of your daily regimen.  Take a look at Brassmonkey's thread.  He tapered from a high dose of Paxil and is now more than a year off the drug and doing great.  5-6 hours of sleep is doing pretty well.  Withdrawal is not easy but you will be a much stronger person having gone through it.  We all wish we hadn't taken these drugs, but we did -- acceptance of your situation is an essential attitude.  

 

We strongly encourage the practice of non-drug coping skills to deal with withdrawal.  Take a look at this link and see which techniques might be of help to you.

 

 Non-drug techniques to cope

 

 

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Bigbird

Gridley thank you so much for your reply. I think my sleep is broken, so I feel like garbage. I appreciate the support, this is the only place that I’ve found good support. I never could get off my  last taper because I didn’t understand what was happening at the lower dosage levels. I’m concerned that I’ve totally messed myself  with this faster taper. I felt fine for most of the taper. I guess your correct and that I need to focus on the positive stories. I just feel a little directionless at the moment. Thanks again.😊

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Frogie
4 hours ago, Bigbird said:

Gridley or brassmonkey, I’ve taken 4 days now with the 2.5 mg Paxil increase. My sleep still isn’t great, awakening during the 4 am time, cortisol hormone spike, hard to fall back to sleep. So I’m getting maybe 5-6 hours of sleep per night. I’m feeling tired and discouraged. I’ve learned a lot reading this site and to be honest it all makes me feel more anxious. I’m afraid that my withdrawal will  get worse. I’ve read so many others and their painful experiences and it just makes me worry and feel more anxious. I’m so regretful for taking this terrible medication and at times wish I had never taken it or never tapered.  Any words of encouragement to help keep me positive? I don’t want to increase the dose unnecessarily just hoping to reduce withdrawal symptoms. Thank you for your help.

 

 

 

 

Hi BIgbird:

 

Please, please, please, listen to Gridley. He is very experienced and knows what he is talking about. That what the mods are for. Information.

 

When I was tapering my Lexapro, I read horror stories on here and thought I would never get through it. With a lot of help from the mods, (Apace41, Gridley, ChessieCat, Brassmonkey and others),  and stopped reading the horror stories, I was able to taper off Lexapro on March 31, 2019. I feel really good now. I am now tapering my Xanax. I wish that was over with, but it will be in no time.

 

I just wanted to stop by an give you my input.

 

Hang in there. You will do it and be fine.

 

Just time and patience.

 

Take care,

Frogie xx

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Bigbird

Frogie, thanks so much for your kind encouragement, I really appreciate it. I’m going to only read positive stories from now on. I need to just accept how I feel and do my best to move forward. I need to get myself feeling better. I have many things to be grateful for. My husband and young adult children are very supportive and I don’t have a daily job outside the house that I have to go to and of course the great support and information on this site. Thank you again for you support. One day at a time is all I can do. 😊

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Bigbird

My sleep is the same, restless, light sleeping, awakening and sweating. I also had something new, as I was trying to fall asleep my legs would intermittently tremble. Obviously my nervous system. Dry mouth. So I know this is all withdrawal symptoms. So am I to expect these withdrawal symptoms to level out and calm down? I can’t believe that just a month ago my withdrawal symptoms were relatively mild. This is so difficult. This Thursday coming would be a week of increase Paxil by .5 to 2.5 mg. Not sure what my next step would be, increase to 3 mg or wait out and hopefully have the withdrawal symptoms calm down.

I was having one cup of regular tea in the very early morning, but as I sit here now I have a decaf tea instead. I’ve read the sleep  recommendations on the site, but I see negative comments and they get stuck in my brain. I think secondary anxiety is happening from me reading negative stories on this site. This morning and from now on I’m going to read only the success stories. Any more suggestions and positive words I’d love to hear.  I use the moderators words as my strength to go forward. 

Since I did what’s considered a fast taper on this site, is it possible for me to stabilize and lesson the withdrawal symptoms that I’m currently experiencing ? I don’t know if I can tolerate these symptoms long term.  This is really difficult for me, thanks for the support.

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Gridley
3 hours ago, Bigbird said:

This Thursday coming would be a week of increase Paxil by .5 to 2.5 mg. Not sure what my next step would be, increase to 3 mg or wait out and hopefully have the withdrawal symptoms calm down.

 

It still may take some weeks or months for your nervous system to settle down. You probably will continue to have waves and windows, but symptoms won't be as intense. 
 
If it seems you need a higher dose, it will be easy to very carefully increase it.  I'd suggest you hold where you are for a bit  longer and see if things calm down. 

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Bigbird

Thanks Gridley,  seven days of the new 2.5 mg will be Thursday. So how much longer do you suggest that I hold here for?

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Gridley
7 minutes ago, Bigbird said:

So how much longer do you suggest that I hold here for?

 

Two more days.

 

Important question: are you worse or better than before you started the updose?

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Bigbird

I felt better initially, then Sunday and Monday night were not good at all. I’m not sure if my anxiety over not sleeping well is making the situation worse. I don’t know how to get myself into a positive mind set and deal with how I feel, I'm just starting to feel desperate and wish I never started to taper in the first place. I’ve never been able to off Paxil since 2011 and I was going to accept that I would be stuck on it for life. I decided to taper because of the side affects and my low energy and fear of long term side affects namely Alzheimer’s seeing I’m now 52. That really made me want to taper.  I’m also peri menopausal which isn’t helping. The minute the insomnia kicked in I felt panicked from the history of past failed tapers. I’m feeling alone and afraid and confused how to help myself cope.

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Gridley
2 minutes ago, Bigbird said:

I’m not sure if my anxiety over not sleeping well is making the situation worse.

It doesn't do any good to wish you hadn't started to taper. Accept that you did.  Assume that the updose is going to work.  The fact that your first days were better is very encouraging.  

 

Again, in general, on average, all things considered, are you better or worse that before you started the updose?  

 

Here are some techniques to cope with anxiety.

 

 

 

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Bigbird

Thanks Gridley, at first I felt better,  my husband and I went away to our cottage for a few days then when I came home I started to feel worse. It’s like since the withdrawals hit, I’m all needy and want someone around to support me and reassure me. I know that’s anxiety. I went on Paxil anxiety in the first place. I’m sorry if I seem all over the place, my terrible sleeping has been the main problem. Thank you again for the links. I’ll keep at the 2.5 mg for another two days and see how I do.Thank you for for your help.😊

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Gridley
4 hours ago, Bigbird said:

I’ll keep at the 2.5 mg for another two days and see how I do.Thank you for for your help.😊

 

It would be helpful if takes nots on paper of your symptoms and post them once a day for the next couple of days so you can see how reinstatement is going.  This is an example:

 

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

 

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Bigbird

Thanks Gridley, good idea,  I tend to feel worst in the early morning hours and feel better as the day goes on. I really don’t like looking at the clock during the nighttime, I find that keeps me more anxious and worried about not sleeping. I usually awaken tired and anxious somewhat because I’m upset that I haven’t slept much. Mild nausea in the mornings, more anxious in the evening before bed because I’m worried about not sleeping. I have been feeling pretty consistent throughout the day, just tired and brain fog from lack of sleep. Gridley what can I say to myself to help me cope and tell myself that I can cope with these  withdrawals and to not let the symptoms freak me out, it’s like a secondary fear. That’s where I’m having struggles.Any suggestions. Thank you again,  your support is greatly appreciated.😊

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Gridley
58 minutes ago, Bigbird said:

don’t like looking at the clock during the nighttime

You don't have to look at the clock in the nighttime.  Just recollect as best you can in the morning how the night went and write it down.  Use the list format I sent in the last post.

 

Listen to those Claire Weekes audios.  She talks about the fear of the fear.  Acknowledge the anxiety, accept that you have it and float with it.  These symptoms you have are perfectly nomal.  

 

Insomnia is perfectly normal and nothing to be anxious about.    We all have it.   The symptoms are not going to harm you or continue forever.  Say to yourself, "This is perfectly normal.  I can cope with this.  It's not a big deal.  And it's not permanent."

 

 

 

 

 

 

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Bigbird

Thank you Gridley, your words were so helpful. That’s exactly what I needed to hear. Thank you so much.😀hugs

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Frogie
On 7/29/2019 at 9:40 AM, Bigbird said:

Frogie, thanks so much for your kind encouragement, I really appreciate it. I’m going to only read positive stories from now on. I need to just accept how I feel and do my best to move forward. I need to get myself feeling better. I have many things to be grateful for. My husband and young adult children are very supportive and I don’t have a daily job outside the house that I have to go to and of course the great support and information on this site. Thank you again for you support. One day at a time is all I can do. 😊

I’m glad I could help just a little😊

 

I wish you well and all the luck in the world.

 

Take care,

 Frogie xx

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Bigbird
9 minutes ago, Frogie said:

I’m glad I could help just a little😊

 

I wish you well and all the luck in the world.

 

Take care,

 Frogie xx

Thank you so much Frogie, your a sweat heart. I’m a complete stranger and you’ve been so kind to reach out and give me such great moral support . I wish you all the best in your own recovery.

hugs, Lita

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Frogie
1 hour ago, Bigbird said:

Thank you so much Frogie, your a sweat heart. I’m a complete stranger and you’ve been so kind to reach out and give me such great moral support . I wish you all the best in your own recovery.

hugs, Lita

I was once a stranger on here and very scared. People reached out to me and helped me.

 

 I hope you do well in your recovery.

 

Please keep me posted. 

 

Take care,

 Frogie xx

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Bigbird
3 minutes ago, Frogie said:

I was once a stranger on here and very scared. People reached out to me and helped me.

 

 I hope you do well in your recovery.

 

Please keep me posted. 

 

Take care,

 Frogie xx

I will thank you. Wishing  you the best.

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Frogie
13 hours ago, Bigbird said:

I will thank you. Wishing  you the best.

You as well 😊

 

Take care,

 Frogie xx

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Altostrata

Please include your sleep pattern in your daily notes, which should be at least 24 hours of notes at a time.

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Bigbird

Thanks Altostrata, I’ve been keeping notes today. I follow a pretty much set routine. I go to bed around 9:30 -10 pm and I’ve been awakening earlier since tapering the Paxil . I usually awaken once during the night to go to the bathroom and awaken I’m guessing between 3:30 and 4:45 am when my husband gets up for work. ( I don’t want to look at the time because it makes me more anxious about not sleeping enough) I usually get up at 5:45 am before he is about to leave. I just sleep lightly and I know around that 4 am I awaken and can’t go back to sleep. I will post my schedule for today and then tomorrow’s. P.S. I haven’t had naps since the insomnia started.  The past month prior I could have a short nap in the afternoon and sleep usually until 5 am  without early awakening . I was getting about 7 hours nightly until the past 10 days when the withdrawals hit. Thank you for your help.

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Altostrata

Waking around 4 a.m. is due to the change in early-morning light. You might sleep better if you use a sleep mask and blackout shades and curtains. See

 

Tips to help sleep -- so many of us have that awful withdrawal insomnia

 

Path to Better Sleep FREE online for everyone from the US Veterans Administration

 

Music for self-care: Calms hyperalertness, anxiety, aids relaxation and sleep

 

What is the sleep cycle?

 

TV or computer use in evening can disrupt sleep: Bright light signals the brain that it's daytime


Waking with panic or anxiety -- managing cortisol spikes

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