Albert: preparing to get off Paxil / paroxetine for good

[Altostrata]

Welcome, Albert.

 

Exactly what drugs are you taking now, at what times of day and dosages?

 

Paxil is a bear for withdrawal syndrome. Your doctor is an idiot regarding psychiatric drugs. Please be patient, breathe through the bad patches.

[Albert]

Thanks for reply.  
Back to Paxil 30 mg 3 days ago and I take it in the morning. 
discontinued Cymbalta after being on it for over 30 days.  Started at 30 and worked up to 60

7.5 hydro at 12:00 and at 6:00 pm

pages of symptoms and no relief yet.  

[Altostrata]

I would have suggested substituting 5mg Prozac instead of Paxil. Paxil will always be difficult to go off.

[Albert]

You mean Instead of Cymbalta 

[Albert]

Do u mean instead of Cymbalta? 

Or would u have stayed off Paxil and tried Prozac 

[Albert]

Is it possible that I have kindled??

 

As I try to educate, I have a few questions. All vitals checked out in ER on Thursday.  My doc dropped me completely down from 30mg of Paxil in 2 1/2 weeks while starting me on Cymbalta at same time.  Once off Paxil completely for about two weeks, is when It all broke loose.  Does this seem odd that there was a two week delay.?  As I started to freak out, they put me onto 60 mg Cymbalta and when that did not work, then cut Cymbalta completely and back onto 30 mg of Paxil and I have been there for about 4 days but very little relief.  My symptoms seem very similar to serotonin syndrome.  Is it possible for me have a mild case of it ?  Has anyone ever experienced that?  I was also in middle of a Hydro taper from a major back surgery.  Any thoughts?? My emotional state is super up and down.   I have xanex for emergencies and have avoided it.  I read about kindling and wonder if that is happening to me?   The symptoms are out of control.  
Do I just need to give it more time?  Have I shocked my nervous system that badly?  Any other ideas at all?  I don’t even feel like I am alive, it is like an out of body experience.  Was jumping back on the initial dose to much of a shock?  

 

Edited June 7, 2020 by ChessieCat
added topic title

[ChessieCat]

11 hours ago, Altostrata said:

I would have suggested substituting 5mg Prozac instead of Paxil. Paxil will always be difficult to go off.

 

10 hours ago, Albert said:

Or would u have stayed off Paxil and tried Prozac 

 

Alto means staying off Paxil and taking Prozac instead.

[ChessieCat]

I merged your new topic with your original Introduction topic.  One Introduction topic per member.  Please ask questions and journal your progress here in this topic.  That way all your information is in one place.  Thank you.

[Albert]

13 hours ago, Gridley said:

 

It is very bad idea.  There is a major drug interaction between Paxil and Cymbalta (Duloxetine)..

Interactions between your drugs

Major

Using PARoxetine together with DULoxetine 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

-----------------------

I'm confused about something in your signature: "1st drop = August 14 from 30 to 25"  Does this mean you plan to start tapering Paxil on August 14, with a drop from 30mg to 25mg?  If so, that is faster than we recommend.  Please see the link in my first post to you about tapering no more than 10% of your current dose every four weeks.  A 10% reduction from 30 would put you at 27mg.  The link I gave you, "Tips for tapering off Paxil" tell you how to get the nonstandard doses you'll need.

 

Also in your signature you say: "Plan on doing 10 every 3-4 weeks moving forward"  Does this mean you plan on tapering 10% every 3 to 4 weeks?"  If so, every 3 weeks is too fast.  We recommend every four weeks.   Before I found SA, I tapered Imipramine 10% every three weeks and it caught up with me and caused withdrawal symptoms.

Well, that was from a long time ago

[Albert]

15 minutes ago, ChessieCat said:

I merged your new topic with your original Introduction topic.  One Introduction topic per member.  Please ask questions and journal your progress here in this topic.  That way all your information is in one place.  Thank you.

Thank you, just getting used to everything.  Do you know if anything that can help.  Does reinstatement usually bring one back to somewhat normal 

[ChessieCat]

I've asked the other mods for their assistance.

 

Here is SA's reinstatement topic.  Please read Post #1.  You might find some of the information helpful:

 

About reinstating and stabilizing to reduce withdrawal symptoms

[mstimc]

1 hour ago, Albert said:

Thank you, just getting used to everything.  Do you know if anything that can help.  Does reinstatement usually bring one back to somewhat normal 

Hi Albert

 

Speaking from personal experience, I reinstated twice due to tapering too quickly.  "Normal" is pretty subjective and situational, depending on where you are before reinstating. It got me back to a point where I could think clearly enough to plan a proper taper.  After I reinstated the second time, I took the time while I was stable to work on my coping skills so when I did my final taper I was prepared the deal with the feelings and symptoms. 

 

As Chessie said, the other moderators may be able to offer additional perspective.

 

[Albert]

41 minutes ago, mstimc said:

Hi Albert

 

Speaking from personal experience, I reinstated twice due to tapering too quickly.  "Normal" is pretty subjective and situational, depending on where you are before reinstating. It got me back to a point where I could think clearly enough to plan a proper taper.  After I reinstated the second time, I took the time while I was stable to work on my coping skills so when I did my final taper I was prepared the deal with the feelings and symptoms. 

 

As Chessie said, the other moderators may be able to offer additional perspective.

 

 

[Albert]

How do I go about seeing if some of the other moderators can help?   Will they just hopefully see my post?  Thanks 

[Albert]

43 minutes ago, mstimc said:

Hi Albert

 

Speaking from personal experience, I reinstated twice due to tapering too quickly.  "Normal" is pretty subjective and situational, depending on where you are before reinstating. It got me back to a point where I could think clearly enough to plan a proper taper.  After I reinstated the second time, I took the time while I was stable to work on my coping skills so when I did my final taper I was prepared the deal with the feelings and symptoms. 

 

As Chessie said, the other moderators may be able to offer additional perspective.

 

How do I go about seeing if the other moderators have some advise?  I am just wanting to make sure all my symptoms are related to this and can heal. 

[Albert]

49 minutes ago, mstimc said:

Hi Albert

 

Speaking from personal experience, I reinstated twice due to tapering too quickly.  "Normal" is pretty subjective and situational, depending on where you are before reinstating. It got me back to a point where I could think clearly enough to plan a proper taper.  After I reinstated the second time, I took the time while I was stable to work on my coping skills so when I did my final taper I was prepared the deal with the feelings and symptoms. 

 

As Chessie said, the other moderators may be able to offer additional perspective.

 

Were u able to think clearly enough to hold down a job and function?  Were your symptoms similar to mine by chance? 

[mstimc]

1 minute ago, Albert said:

How do I go about seeing if the other moderators have some advise?  I am just wanting to make sure all my symptoms are related to this and can heal. 

They check all the posts periodically.  Most are in the US so its still pretty early in the morning for them.  You can also PM a specific mod or admin or tag one on your thread by entering the "@" symbol and typing in their name.  Just be judicious using either feature--remember there are a lot of members here and a limited number of mods. 

[Albert]

Ok, banks a bunch.   I have been up nearly all night long. 

[mstimc]

3 minutes ago, Albert said:

Were u able to think clearly enough to hold down a job and function?  Were your symptoms similar to mine by chance? 

Yes, I worked the whole time.  I actually found it helped by forcing me to focus on something other than myself and the negative thoughts for several hours a day. 

 

Since WD affects us all uniquely, no two people have the same symptom profile.  Also, symptoms can come and go and vary in intensity.  I did have similar symptoms, especially teeth grinding,  trouble focusing, pins and needles, muscle aches from being uptight all the time, crawling out of my skin, and insomnia. 

[ChessieCat]

13 minutes ago, Albert said:

How do I go about seeing if the other moderators have some advise?

 

1 hour ago, ChessieCat said:

 

I've asked the other mods for their assistance.

 

 

[mstimc]

2 minutes ago, Albert said:

Ok, banks a bunch.   I have been up nearly all night long. 

Insomnia sucks.  Just a word of advice--lack of sleep spikes your cortisol and adrenaline, so people tend to catastrophize a lot more than they would otherwise. 

[Albert]

That is me, Did you have pins and needles in your arms and legs?  Were your symptoms the most severe when trying to re-instate?  Did you see how I got off balance?  The Dr also put me on Cymbalta and tried to cross taper me over to another drug.  Awful!!  I hope that this does not cause the reinstatement not to work.   What do you think?  

At what point does someone have to go get help?  

[mstimc]

Hi

Cross-tapering isn't my area of expertise so I'll let a mod with more knowledge step in on that one.  Feelings of being off-balance are common in WD. 

 

What do you mean by getting help?  As in therapy?  

 

Beware of fortune-telling and projecting your fears on your recovery--reinstatement may or may not help but the best thing you can do for yourself is find ways to manage your anxiety and negative thought patterns. 

[Albert]

The Dr suggested that I go back on 30 mg of Cymbalta to stabilize since I was on it for over 30 days.  What do u think.  He said that some people have been on both.  Then wonder if I could do a slow taper? 

[mstimc]

2 minutes ago, Albert said:

The Dr suggested that I go back on 30 mg of Cymbalta to stabilize since I was on it for over 30 days.  What do u think.  He said that some people have been on both.  Then wonder if I could do a slow taper? 

I'll let the mods comment on that...

 

Have you  looked into CBT or any other kind of coping/behavior management techniques?

[Albert]

How do you suggest I sleep though.  I have very severe pins and needles. Among all other sorts of symptoms 

[mstimc]

If you have a smartphone or Ipad, try going on Youtube to find some calming video or audio tracks--one with vocal narrative so you can focus on the sound of the voice.  Your body will make you sleep when it needs it.

Quote

 

 

Edited June 7, 2020 by mstimc

[Albert]

Thank you, I will try that. 

[mstimc]

I know how miserable insomnia is.  Try not to "force" yourself to relax or sleep--that'll just make it worse.  The key is toning down the speed and intensity of your racing thoughts.

[Altostrata]

20 hours ago, Altostrata said:

I would have suggested substituting 5mg Prozac instead of Paxil. Paxil will always be difficult to go off.

 

20 hours ago, Albert said:

Do u mean instead of Cymbalta? 

Or would u have stayed off Paxil and tried Prozac 

 

6 hours ago, Albert said:

The Dr suggested that I go back on 30 mg of Cymbalta to stabilize since I was on it for over 30 days.  What do u think.  He said that some people have been on both.  Then wonder if I could do a slow taper? 

 

I guess I wasn't clear. It appears to me you have Paxil withdrawal syndrome. Cymbalta is a red herring.

 

Paxil is very, very difficult to go off. You went off too fast with your doctor's ill-advised switch to Cymbalta WHILE YOU WERE TAPERING OPIOIDS.

 

Your doctor knows very little about tapering and nothing about withdrawal. It's bad medical practice to change more than one drug at a time. It's possible you have opioid withdrawal, too.

 

Rather than reinstate Paxil, as you've already done, I would have suggested taking 5mg Prozac instead. If after 3 days the Paxil isn't helping, you can make this change without cross-taper. I would get a prescription for Prozac liquid and start with 0.5mg (one-half milligram), to avoid a kindling reaction if you are sensitized.

[Albert]

Can u elaborate please so that I can make sure I have it right.  Instead of going back onto Paxil, you would have recommended taking a dose of Prozac?  Or you would have went onto Prozac vs Cymbalta?  Can u tell me why.  I am willing to suggest anything at this point.  Thank you

[Altostrata]

That is correct, instead of going back on Paxil, I would have gone on a little Prozac, which is an SSRI like Paxil. This is the third time I've said this.

 

Not sure why you're fixated on Cymbalta, that's your doctor clutching at straws because he or she is clueless.

[Albert]

Sorry, can I try that to calm down the withdrawals?  

[Altostrata]

We suggest reinstatement to reduce withdrawal symptoms. However, you may ALSO have opioid withdrawal syndrome, which will not be addressed by taking any antidepressant.

 

How do you feel after taking 30mg Paxil again?

[Albert]

5 hours ago, Altostrata said:

 

Now I read your entire post. Sorry, but I am getting used to the format.   You make some good points and I am very concerned.  Today is day 5 back on regular full dose of Paxil.  I am starting to get some small waves of improvement, but definitely not a lot of improvement.  I start to settle down just a little in the evening time. Is that normal?  Since I have shown some minor windows of improvement, would you advise to Stay with Paxil for a little longer?  Are there specific signs of kindling ?  Is that common?  I am definitely not going back to Cymbalta.  When you mention Prozac, are you thinking You would add it on top of the Paxil to help stabilize, or would you replace Paxil with Prozac?  Do u see Kindling very often?  Thanks again

 

I guess I wasn't clear. It appears to me you have Paxil withdrawal syndrome. Cymbalta is a red herring.

 

Paxil is very, very difficult to go off. You went off too fast with your doctor's ill-advised switch to Cymbalta WHILE YOU WERE TAPERING OPIOIDS.

 

Your doctor knows very little about tapering and nothing about withdrawal. It's bad medical practice to change more than one drug at a time. It's possible you have opioid withdrawal, too.

 

Rather than reinstate Paxil, as you've already done, I would have suggested taking 5mg Prozac instead. If after 3 days the Paxil isn't helping, you can make this change without cross-taper. I would get a prescription for Prozac liquid and start with 0.5mg (one-half milligram), to avoid a kindling reaction if you are sensitized.

 

[Albert]

12 hours ago, mstimc said:

Did you ever go into a withdrawal shock like this?  Did u have to reinstate 

 

 

Yes, I worked the whole time.  I actually found it helped by forcing me to focus on something other than myself and the negative thoughts for several hours a day. 

 

Since WD affects us all uniquely, no two people have the same symptom profile.  Also, symptoms can come and go and vary in intensity.  I did have similar symptoms, especially teeth grinding,  trouble focusing, pins and needles, muscle aches from being uptight all the time, crawling out of my skin, and insomnia.