Albert: preparing to get off Paxil / paroxetine for good

[ChessieCat]

There are many existing topics on SA.  You can either use the site search or use a search engine and add survivingantidepressants.org to the search term.

 

tolerance-or-poop-out-or-tachyphylaxis

 

Do a search for urination.  There is a topic about it.

 

[Kostas]

5 hours ago, Albert said:

When one finally experiences Paxil "poop out" can it cause WD symptoms, or would that only take place when discontinuing the drug.   Also wondering if anyone has experienced urgent and frequent urination as a symptom?  ( embarrassing ), but I have had several tests for this that all check out fine.  However, I still have this condition and was wondering if this could be the cause and if so, can it correct itself as you decrease the drug ( taper ) or get completely off ?  Thanks

 

Hi  

I experienced frequent urination, in most cases  with high volume of urine, during my withdrawal from 20 mg citalopram. 

It lasted many months, with ups and downs in frequency. 

All usual lab tests, negative! 

Gradually it was vastly improved, and now after 8 years off the drug, hardly bothering. 

[Albert]

7 hours ago, Cocopuffz17 said:

Yes, I feel like I will be able to. I am not 100% yet. But light years where I was on the AD and during the brunt of withdrawals. 

Has your sleeping went back to normal ?

 

[Albert]

14 hours ago, Altostrata said:

 

Cutting back to 20mg should be okay. As for how it does for your withdrawal syndrome, we'll have to see how it goes.

 

You won't have Cymbalta withdrawal also, it's all one withdrawal syndrome. It so happens your withdrawal started  when you went off Paxil during the switch to Cymbalta. As I told you before, Cymbalta is a red herring.

 

Please put the information about Cymbalta in your signature.

OK, dropped from 30 mg of Paroxetine to 20 today.  Completely off Cymbalta now for 6 days and was only on the 30mg of Paroxetine for those 6 days.  Sure hope this works.  I also did some reading on " poop out " and unless I am wrong, it would appear that poop out can cause same symptoms as w/drawl.  I was on this medication for 20+ years and now after reading, I am starting to think that over the last 6 months I may have started to get symptoms of poop out.  Severe fatigue, urgent urination, brain fog, waking early, pins and needles, twitching muscles, pressure headache, vision changes, buzzing in ears.  Then this complete w/drawl when they tried to change medications.  Do you sometimes see some improvement in these cases when dropping the dose a little Alto?   Do you think I can stabilize at the 20 mg area for awhile?  I know that there are some severe cases out there and I could be one of those.  However, how long does it usually take to stabilize after these types of changes?  Thanks a bunch Alto, I appreciate the feedback.

[Albert]

1 hour ago, Albert said:

OK, dropped from 30 mg of Paroxetine to 20 today.  Completely off Cymbalta now for 6 days and was only on the 30mg of Paroxetine for those 6 days.  Sure hope this works.  I also did some reading on " poop out " and unless I am wrong, it would appear that poop out can cause same symptoms as w/drawl.  I was on this medication for 20+ years and now after reading, I am starting to think that over the last 6 months I may have started to get symptoms of poop out.  Severe fatigue, urgent urination, brain fog, waking early, pins and needles, twitching muscles, pressure headache, vision changes, buzzing in ears.  Then this complete w/drawl when they tried to change medications.  Do you sometimes see some improvement in these cases when dropping the dose a little Alto?   Do you think I can stabilize at the 20 mg area for awhile?  I know that there are some severe cases out there and I could be one of those.  However, how long does it usually take to stabilize after these types of changes?  Thanks a bunch Alto, I appreciate the feedback.

I updated my signature as well.  I think it is better and more accurate.  

[Cocopuffz17]

4 hours ago, Albert said:

Has your sleeping went back to normal ?

 

My sleep is better than it was. I had crap nutrition before and struggled sleeping all the time. 

[Altostrata]

You might have had poop-out before but now you have withdrawal syndrome. Withdrawal syndrome trumps poop-out.

 

4 hours ago, Albert said:

Sure hope this works. 

 

Your expectation should be that your withdrawal symptoms gradually diminish. This is not going to return you to your honeymoon days on Paxil. It probably will take weeks for you to feel better from withdrawal from Paxil and maybe the opioid as well. It's unlikely you'll feel great any time soon.

[Albert]

That makes

1 hour ago, Altostrata said:

You might have had poop-out before but now you have withdrawal syndrome. Withdrawal syndrome trumps poop-out.

 

 

Your expectation should be that your withdrawal symptoms gradually diminish. This is not going to return you to your honeymoon days on Paxil. It probably will take weeks for you to feel better from withdrawal from Paxil and maybe the opioid as well. It's unlikely you'll feel great any time soon.

That makes sense Alto, even though I am having trouble processing the fact that it could take weeks like this.  I will tell you that I had a window of about 5 hours yesterday where I could tell that I felt about 30 or 40 percent better.  Is that a good sign?  You have way more experience with this and have seen a lot.  You don't think that the fact that I initially re-instated at 30 mg as per Dr orders and now dropped to 20mg will throw me into another worse whirl wind do you?  I actually had a general follow up w/my PCP today and he was in agreement w/following your direction and said it was worth a try to stabilize on the 20 mg.  I also ordered the supplements that are recommended on the site.  One thing he is concerned about is me still being stuck on Hydro.  After a few weeks, do you think I can level out enough to go ahead and start working on dropping the hydro?   That is my game plan.  Do you think that is a good plan, or do you think I should go ahead and continue my hydro taper now?   One last thing.  My PCP has prescribed me .25 mg of xanex I the past for emergencies and he confirmed w/me that I still have some.  He suggested that if I continue not to be able to sleep at night that I take one before bedtime so that I can sleep as that might make the situation worse if I am not sleeping.  Your thoughts around that ?  Thanks AJ

[Albert]

I had about a 5 hour period yesterday that I felt better.  I saw about %40 improvement.  However, maybe a total of 4 hrs sleep and back to complete discomfort today and can't even see straight or function.  All the symptoms are flaring back up.  I had reinstated at 30 mg of Paxil for 6 days and dropped to 20 today and hoping to hold there.  I know that there is no easy fix to this.   Is the WD delay something that is common.  Obviously the cross taper did not work and 6 weeks after the start of the taper and 3-4 weeks post paxil it all hit.  Psyc says he has never seen this before.  Not sure I believe him after looking at all the people struggling on this site.  How can they do this.  This is the most awful thing that I can imagine.  Super scary as it has even effected my bladder to the point I am running to the bathroom.  Makes one feel like they are going crazy for sure.  Below are all of my symptoms again today.  I know I have listed some symptoms before, but do these symptoms sound familiar to everyone?  Thanks again

 

                                                                        Symptoms

 

• Bowl dysfunction

• Tiny muscle twitches and electrical shocks that can be body wide.

• Small burning nerve impulses behind my eyes

• Frequent episodes of head pressure anywhere along forehead or side of head.

• Tight jaw and grinding teeth

• Urgent Urination and some minor leakage when stopping stream.

• Frequent small and intense bouts of nausea that comes and goes

• Pins and needles up and down arms, legs and into scrotum

• Severe cognitive impairment

• Inability to focus

• Vision Changes

• Feeling off balance

• Muscle Spasticity and burning ( Backs of Legs )

• Hot and Cold Flashes

• Lock Jaw and Grinding Teeth

• Taste and Smell Changes

• Racing Thoughts

• Extreme feelings of Anxiety

• Noise in ears

• Completely unable to stay still for any length of time

• Insomnia – Only sleeping about 4 hours per night

[Altostrata]

Albert, you are asking the same question over and over. Before you ask again, read this topic from the beginning.

 

Your symptoms are those of garden-variety withdrawal syndrome. No need to repeat them every day. They should fade over weeks.

 

Yes, recovery from withdrawal syndrome can take weeks, even if you reinstate.

 

I have given you my opinion about your Paxil dosage.

 

If you don't care for this perspective, please take your questions to your doctor. He or she gets paid to answer them, we don't.

[Albert]

15 minutes ago, Altostrata said:

Albert, you are asking the same question over and over. Before you ask again, read this topic from the beginning.

 

Your symptoms are those of garden-variety withdrawal syndrome. No need to repeat them every day. They should fade over weeks.

 

Yes, recovery from withdrawal syndrome can take weeks, even if you reinstate.

 

I have given you my opinion about your Paxil dosage.

 

If you don't care for this perspective, please take your questions to your doctor. He or she gets paid to answer them, we don't.

Sorry Alto, I just have a feeling that you know more about this than a Dr.  I am going to try to exercise some patients.  I do care for your perspective and I really need the support of this site and appreciate what you do.  I have never been through something as disturbing as this currently is.  If I could only get it to settle down even just a little.  Again, sorry. 

[Altostrata]

This site exists because doctors are so poorly informed about tapering and withdrawal. That's why people are here. I would happily close the site if people could rely on their doctors.

[Albert]

I

14 minutes ago, Altostrata said:

This site exists because doctors are so poorly informed about tapering and withdrawal. That's why people are here. I would happily close the site if people could rely on their doctors.

I just can't believe this happened to me.  I think that they just continue to medicate people vs trying to actually get them off of the medications.  Thanks again Alto and again, I am sorry.  I really do appreciate your help and I am going with your advise.  I am hoping that I settle down by just doing the 20mg.  However, if I do not settle down, can I keep in touch with you for advise?  If no change after a couple of weeks, should I consider going back up to the original dose of 30?  Thanks again.

[Hanna72]

Hi Albert, glad to see that you found this site. I am also a Paxil user for 20 years. I am off it now almost 3 months💪 
This is a very hard journey, and can be scary at times. And yes I have had most of the symptoms you posted on here. Still have some still. What I have found that helps me is focus on the smallest improvements, even though they are tiny, it is still a good sign.

1 hour ago, Albert said:

 

I had about a 5 hour period yesterday that I felt better.  I saw about %40 improvement. 

 

This is really good. Now you need to stabilise, and you will. 
We want to heal faster then we actually are, but we have to give our bodies and minds time. 
This journey will make us stronger in the end, and though we might not feel it at the moment, it will be a great accomplishment and an amazing feeling when we cross over the finish line.

Have faith in yourself, and a positive thinking goes along way.

I will be rooting for you💪
My best wishes to you🙏

[Albert]

16 minutes ago, Hanna72 said:

Hi Albert, glad to see that you found this site. I am also a Paxil user for 20 years. I am off it now almost 3 months💪 
This is a very hard journey, and can be scary at times. And yes I have had most of the symptoms you posted on here. Still have some still. What I have found that helps me is focus on the smallest improvements, even though they are tiny, it is still a good sign.

This is really good. Now you need to stabilise, and you will. 
We want to heal faster then we actually are, but we have to give our bodies and minds time. 
This journey will make us stronger in the end, and though we might not feel it at the moment, it will be a great accomplishment and an amazing feeling when we cross over the finish line.

Have faith in yourself, and a positive thinking goes along way.

I will be rooting for you💪
My best wishes to you🙏

You don't know how much that means to me?  I really appreciate the reply.  If you don't mind me asking, how long did it take you to taper and recover?  Were you able to work and hold down a job at the same time as you were tapering.  I sure I hope I can somewhat stabilize so that I can at least focus and start trying to slow taper.  Thanks again

[Albert]

19 hours ago, Cocopuffz17 said:

I went through a very similar situation as yours. I used melatonin to get sleep. I used 20-30 mg a night, sublingual tablets. Much higher than recommended. But I would much rather get sleep than stay up all night. I did this probably 20-30 nights that I was absolutely crushed by insomnia. Now my sleep is the BEST I’ve ever had in my life.

 

One thing you must do is not make a ton of changes, the body needs to stabilize and from there you can make one change at a time to see what helps or is bad. These drugs do not just disappear or have the damage they have done repaired in a week or two. It takes a lot of time. I was on the exact same drug as you for 11 years. You will get through it. Follow the advice from mods here. I received better care here than I did with 11 years of doctors, psychiatrists, surgeons, naturopaths and many more. 
 

Everyday that passes is one day closer to being healed 😊

Did you find yourself with a lot of the same symptoms as me?  Even the physical symptoms.  I nearly threw up today but was able to hold back.  When you had your major w/drawls, did you have to reinstate as I did?  Do you mind telling me how long it took you to settle back down?  Thanks a bunch !!! 

 

[Hanna72]

I started the tapering process in January 2019. I have tried many times before to quit with horrible results. I did a bridge with Prozac when I reached 10 mg Paxil, I was on 20 mg. I ended my taper on 16 of March, so 15 months taper all together. I never made a cut unless I felt I had stabilised. And yes I had many withdrawals symptoms, but I could function and work through out it all. I made many changes in my lifestyle, stopped alcohol, coffee and have almost been sugar free for few weeks now. I also made my life a simple as possible, avoided stressful situations. I am still recovering and working through many aspects of being med free. This site has been the biggest factor in me being Paxil free, and faith and determination play a huge role.

 

[Cocopuffz17]

3 hours ago, Albert said:

Did you find yourself with a lot of the same symptoms as me?  Even the physical symptoms.  I nearly threw up today but was able to hold back.  When you had your major w/drawls, did you have to reinstate as I did?  Do you mind telling me how long it took you to settle back down?  Thanks a bunch !!! 

 

 

I would say everything you had and more. I have been an active person my whole life and played sports my whole life. I was crippled to not being able to do one push up a day for months. I have had nights where I wake up in the middle of sleep and run to the bathroom and puke. It happens. It will get better. No, I was 6 months out when I considered reinstatement and was advised of the risks so I chose to power through and go toe to toe with the withdrawals. I had really bad symptoms for about 6-8 months. I was sleeping 14-16 hr days and maybe getting 1 hr or sports activity a week and this was all I had. I physically could not do more. I normally get 5-10 hrs per week. The common theme I see is the longer you let your body heal the better you will feel. It sounds like a no brainer but people want the quick fix. There is no quick fix with this. I did find nutritional changes helped immensely in my situation. All the best. Remember everyday that passes is one day closer to being healed 

[Albert]

3 hours ago, Cocopuffz17 said:

 

I would say everything you had and more. I have been an active person my whole life and played sports my whole life. I was crippled to not being able to do one push up a day for months. I have had nights where I wake up in the middle of sleep and run to the bathroom and puke. It happens. It will get better. No, I was 6 months out when I considered reinstatement and was advised of the risks so I chose to power through and go toe to toe with the withdrawals. I had really bad symptoms for about 6-8 months. I was sleeping 14-16 hr days and maybe getting 1 hr or sports activity a week and this was all I had. I physically could not do more. I normally get 5-10 hrs per week. The common theme I see is the longer you let your body heal the better you will feel. It sounds like a no brainer but people want the quick fix. There is no quick fix with this. I did find nutritional changes helped immensely in my situation. All the best. Remember everyday that passes is one day closer to being healed 

We’re u able to work?  

[Albert]

Thanks for all the replies, I really appreciate it

[Albert]

Good news !!!  Slept about 6 hours last night.  Not really sound sleep, but off and on.  Hopefully that is a sign that I have a chance at settling in at 20 mg.  Spoke w/Neurosurgeon today following up on my back.  He advised that this entire cocktail of symptoms seems to be more in line w/the antidepressant w/drawls than cervical spinal cord issues.  I also reviewed my current dose of Hydrocodone with him and felt 15mg daily should not be super difficult to get off of.  As soon as I settle in at 20mg of Paxil and can get some stabilization, I am going to drop 5 mg every 5 days till I am off the Hydro and then probably allow myself a week or so to stabilize a little further and then start my Paxil Taper.  Can say that this is definately the most difficult thing that I have ever dealt with.  I really hope that I am starting to feel a wee bit better here in a couple of weeks.  Thanks for everyone's advice and especially the help of the mods.  I really appreciate it. 

[mstimc]

Hi Albert

 

That is great news.  I'll let others more familiar with hydro and its related WD symptoms advise/comment as they see fit.  What's best about your post is that it seems you're regaining a positive attitude.  That's huge.  Really, the key to recovery is to decide you're going to get there no matter what, and you just need to find the right path.  I kept trying various CBT and other coping methods until I developed a "toolbox" of about a half-dozen methods that seem to work for me.  I still use them.  Keep going! 👍

[ChessieCat]

1 hour ago, Albert said:

I also reviewed my current dose of Hydrocodone with him and felt 15mg daily should not be super difficult to get off of.  As soon as I settle in at 20mg of Paxil and can get some stabilization, I am going to drop 5 mg every 5 days till I am off the Hydro and then probably allow myself a week or so to stabilize a little further and then start my Paxil Taper. 

 

You have made lots of drug and dose changes in the last few months AND had 3 surgeries in the last 6 months or so.

 

It would probably be better to wait at least 3 months AFTER you have stopped the hydrocodone before you even consider reducing the Paxil.  And when you do start to reduce the Paxil I think it would be worthwhile making a test reduction by only reducing a very small amount, no more than 0.5mg which is a 2.5% reduction of your current dose, to see how it affects you.  If after a few weeks you find that you are feeling okay then you could try reducing by a larger amount, eg a 5% reduction of the new dose (not the original 20mg dose).

 

It's better to hold for longer and try to get as stable as possible before starting a taper.  I had to make large reductions at the beginning because I was suffering from mild serotonin syndrome, but once my serotonin syndrome eased I made a couple of really long holds (one was 3 months and another was 7 weeks) to allow my brain to "catch up".

 

It might feel that the long hold is a waste of time, but if you start reducing too soon and you aren't stable then you might need to hold for longer and/or updose.  In the long run it can actually save time and discomfort too.

 

Edited June 11, 2020 by ChessieCat

[Albert]

13 hours ago, ChessieCat said:

 

You have made lots of drug and dose changes in the last few months AND had 3 surgeries in the last 6 months or so.

 

It would probably be better to wait at least 3 months AFTER you have stopped the hydrocodone before you even consider reducing the Paxil.  And when you do start to reduce the Paxil I think it would be worthwhile making a test reduction by only reducing a very small amount, no more than 0.5mg which is a 2.5% reduction of your current dose, to see how it affects you.  If after a few weeks you find that you are feeling okay then you could try reducing by a larger amount, eg a 5% reduction of the new dose (not the original 20mg dose).

 

It's better to hold for longer and try to get as stable as possible before starting a taper.  I had to make large reductions at the beginning because I was suffering from mild serotonin syndrome, but once my serotonin syndrome eased I made a couple of really long holds (one was 3 months and another was 7 weeks) to allow my brain to "catch up".

 

It might feel that the long hold is a waste of time, but if you start reducing too soon and you aren't stable then you might need to hold for longer and/or updose.  In the long run it can actually save time and discomfort too.

 

I will take that advice.  I do have one question.  Since I had reinstated at my original dose for 5 days before taking Altos advice and dropping it to 20, now that I have started to experience a couple of windows and waves that include a few positive areas, do u think I would be in jeopardy of experience another major withdrawal episode or do u think That should have passed for the most part?  Thank you!!!  If you don’t mind me asking, could one start to experience that seratonin syndrome on 20 mg?  Could the lower dose of the hydro be causing that as well

[ChessieCat]

As you lower and get off the hydrocodone the serotonin toxicity should lessen.  You are heading the right direction.

 

From https://reference.medscape.com/drug-interactionchecker

 

"Coadministration of drugs that affect the serotonergic neurotransmitter system may result in serotonin syndrome."

 

Generally serotonin syndrome is caused by taking 2 serotonergic drugs (which you currently are).  In my case it was because of the high dose of 1 serotonergic drug.

 

19 minutes ago, Albert said:

I have started to experience a couple of windows and waves that include a few positive areas

 

This is a good sign.

 

19 minutes ago, Albert said:

do u think I would be in jeopardy of experience another major withdrawal episode or do u think That should have passed for the most part?

 

Unfortunately we can't see into the future, but we sure do wish we could because it would make helping members here so much easier.  Generally as you stabilise the windows become more frequent and longer and the waves are not as bad and don't last as long.

[Albert]

2 hours ago, ChessieCat said:

As you lower and get off the hydrocodone the serotonin toxicity should lessen.  You are heading the right direction.

 

From https://reference.medscape.com/drug-interactionchecker

 

"Coadministration of drugs that affect the serotonergic neurotransmitter system may result in serotonin syndrome."

 

Generally serotonin syndrome is caused by taking 2 serotonergic drugs (which you currently are).  In my case it was because of the high dose of 1 serotonergic drug.

 

 

This is a good sign.

 

 

Unfortunately we can't see into the future, but we sure do wish we could because it would make helping members here so much easier.  Generally as you stabilise the windows become more frequent and longer and the waves are not as bad and don't last as long.

Thanks again, I appreciate the reply more than you know.

[Albert]

A couple of new symptoms today.  Made it into work ( barely ), I have had some of my other symptoms tame down a touch, but I an noticing an increase in vision impairment to include some difficulty focusing, I have also became itchy all over and have developed severe tingling and stinging sensations in my saddle area.  Reason I ask about these symptoms is that I am also recovering from some spine surgery and I am kind of trying to sort these out.  These seem like they might be more consistent with the antidepressants though.  Anyone have these symptoms and can these be consistent w/the antidepressant w/drawl syndrome or serotonin syndrome?  Thanks again Albert  

[Altostrata]

Is the itching worse at any particular times of day? Do you have a rash anywhere?

 

Have you started using a new soap, laundry detergent, shampoo, or lotion? Are you taking any drugs other than Paxil?

[Albert]

23 minutes ago, Altostrata said:

Is the itching worse at any particular times of day? Do you have a rash anywhere?

 

Have you started using a new soap, laundry detergent, shampoo, or lotion? Are you taking any drugs other than Paxil?

I think I have entered into complete state of chronic w/drawl Alto.  No  rash and no  new lotions or shampoos.  I feel like my skin is crawling and there are creepy crawlies everywhere.  Also in sides of my face and even down both legs.  My focus and attention span is about 30 seconds.  I also can't sit still.  I had an improved afternoon yesterday and now completely back to full throttle.  I am now 4 days dropping from the 30mg of Paxil down to the 20 Mg dose.  Your thoughts?  I am also experiencing some burning in the backs of my legs as well as blurry vision as if I am walking around in a picture.  Can this cause all of this.  Please advidse, thanks a bunch !!!

[Altostrata]

3 minutes ago, Albert said:

I had an improved afternoon yesterday and now completely back to full throttle.

 

What does this mean? Did the symptoms you report go away yesterday?

[Albert]

16 minutes ago, Altostrata said:

 

What does this mean? Did the symptoms you report go away yesterday?

Yes,  Yesterday afternoon, they were nearly gone.  Today, all symptoms have reached a new height.  

[Albert]

4 minutes ago, Albert said:

Yes,  Yesterday afternoon, they were nearly gone.  Today, all symptoms have reached a new height.  

I am also experiencing severe pins and needles again today and some in the form of burning.  Can this happen in w/drawl.  I just don't know what to do.

 

[Altostrata]

Is the itching worse at any particular times of day? What time of day do you take Paxil?

[Albert]

5 minutes ago, Altostrata said:

Is the itching worse at any particular times of day? What time of day do you take Paxil?

This itching / pins and needles has really gotten super heightened today.  I had always taken my 30mg of Paxil 1st thing in the morning so I had dropped it to 20 mg and still taking it 1st thing in the morning.  I have been waking at like 4:00 and staying awake.  That has not changed.

 

[Altostrata]

Does the itching get worse after you take Paxil in the morning?

[Albert]

Reminder of my timeline and medications.  Wednesday the 3rd, everything broke loose after about 6 weeks on Cymbalta and a quick taper from Paxil over the course of the 1st 2 and a half weeks.  On Thursday the 4th, I discontinued Cymbalta all together and started back on 30 mg dose of Paxil.  Stayed there until the 8th or 9th and then as we kind of reviewed, I dropped down to 20mg ( Mon or Tues )  Over the entire last week I only had a couple of small pockets that weren't COMPLETE misery.  Yesterday afternoon they tamed down but back even more intense today.   

 

Current Medications - Paxil 20 mg, Statin 10 mg, Hydro  - Only 12.5 mg through entire day.    I recently did a drop from 15 mg daily down to 12.5.  I think this is pretty low dose.