Albert: preparing to get off Paxil / paroxetine for good

[Colonial]

Sorry...

Autumn can give some nasty waves..

Maybe put it for some days off at work if possible. 

Some long weekends or a week or 2 off of work can go along way to calming the system

Regardless your occupation, the bodily and mental stress of working full time complicates things.

 

 

[Albert]

Thanks for reply.   
Sleep - 9:30 to 2:30

Woke with twitching, burning, and nausea.  

[Albert]

11/06/2020

Woke 2:30 AM - Panic / symptoms

2:30 AM to 5:30 AM - Broken sleep with very vivid dreams

Moderate burning, twitching, shallow breathing, cramping.

7:30 AM - Paroxetine 20mg

7:30 to 9:30 AM - Mild to Moderate symptoms - Leg weakness and balance issues.

9:30 AM - Window of improvement

>> Moment where my vision cleared up and I could see my cell phone clear as a bell.

10:26 AM - Right hand tingling, mild burning sensations, internal burning feeling, mild panic

11:36 AM - Small window

12:00 - Minor twitching and nausea

1:00PM to 6:00 PM - WINDOW of improvement. 

Noticed improvement in leg strength, balance, concentration, took a broken nap for about 20 minutes,

7:30 PM - Mild return of some symptoms - Nausea, backs of legs burn, prickling ( All minor )

Food - 2 eggs, apple, 4 strawberries, grapes, almonds, lean pork, mixed veggies, fresh mushrooms. 10 bottles of water

Overall, day of improvement.  Try to keep positive and build on improvement.   

[Albert]

11/06/2020

Woke 2:30 AM - Panic / symptoms

2:30 AM to 5:30 AM - Broken sleep with very vivid dreams

Moderate burning, twitching, shallow breathing, cramping.

7:30 AM - Paroxetine 20mg

7:30 to 9:30 AM - Mild to Moderate symptoms - Leg weakness and balance issues.

9:30 AM - Window of improvement

>> Moment where my vision cleared up and I could see my cell phone clear as a bell.

10:26 AM - Right hand tingling, mild burning sensations, internal burning feeling, mild panic

11:36 AM - Small window

12:00 - Minor twitching and nausea

1:00PM to 6:00 PM - WINDOW of improvement. 

Noticed improvement in leg strength, balance, concentration, took a broken nap for about 20 minutes,

7:30 PM - Mild return of some symptoms - Nausea, backs of legs burn, prickling ( All minor )

Food - 2 eggs, apple, 4 strawberries, grapes, almonds, lean pork, mixed veggies, fresh mushrooms. 10 bottles of water

Overall, day of improvement.  Try to keep positive and build on improvement.   

[Albert]

Saturday 11/07/2020

 

Slept for a full 8 hours for the 1st time in months !!!   Still experiencing symptoms, but they were less severe than have been in the past few weeks.  Cold feet, mild burning in legs and right arm, minor twitching, some agitation, and rumbling stomach.  Spent day outside and had a good time helping my dad.  Late evening some symptoms returned.  Still a much improved and needed window. 

 

[Albert]

Sunday 11/08/2020

Woke 6:00 - Total of 7 hrs sleep

Paxil 20mg 8:00 AM

Mild twitching, Mild burning, mild agitation, rumbling stomach, cold feet, stinging in upper legs, minor brain burn.   Symptoms manageable .  

9:00 AM 2-Eggs and some organic cheese.  Also some grapes and 3 bottles of water.

 

[Colonial]

1 hour ago, Albert said:

Slept for a full 8 hours for the 1st time in months !!!   Still experiencing symptoms, but they were less severe than have been in the past few weeks.

 

That's great! 😃

 

Once sleep returns, windows become stronger and longer it seems, as sleep is what is needed to really help heal the CNS. 

Just remember it's 5 steps forward, 3 back, so don't be bummed out when the waves happen as they will.

 

[Albert]

Going to try not to panic when I have a return of symptoms. 

[Altostrata]

Your problems stem from hydrocodone withdrawal symptoms. We do not address those here.

[street129]

9 hours ago, Albert said:

Saturday 11/07/2020

 

Slept for a full 8 hours for the 1st time in months !!!   Still experiencing symptoms, but they were less severe than have been in the past few weeks.  Cold feet, mild burning in legs and right arm, minor twitching, some agitation, and rumbling stomach.  Spent day outside and had a good time helping my dad.  Late evening some symptoms returned.  Still a much improved and needed window. 

 

@Albert

hi albert, we're not on the same pill but I'm experiencing burning also, after my first two tapers in June 2020,  I began feeling it coming on real slowly in september,  now in November it's just in my back without settling down.  it's not going away like when it first appeared, I know it's wd but mines is very pronounce, I'm also having heat in my left leg also, I wish it wasn't so noticeable, I can deal with the other wd's, not the heat, what do you do for your burning, I put cold wrap on my leg and back, then put in frig to get cold

[Albert]

28 minutes ago, street129 said:

@Albert

hi albert, we're not on the same pill but I'm experiencing burning also, after my first two tapers in June 2020,  I began feeling it coming on real slowly in september,  now in November it's just in my back without settling down.  it's not going away like when it first appeared, I know it's wd but mines is very pronounce, I'm also having heat in my left leg also, I wish it wasn't so noticeable, I can deal with the other wd's, not the heat, what do you do for your burning, I put cold wrap on my leg and back, then put in frig to get cold

Well, my burning and stinging is in the backs of my legs.  I find that moving a lot seems to help things for me.  I did not really find any difference with magnesium or anything like that.  I also drink about 12  bottles of water per day.  My burning is in short spells.  The intensity is high and it will be in the back of my legs for 5-10 minutes, then it can move to my arms / chest 10 to 15 minutes later.  What other symptoms do you have? 

[Albert]

Been on a rollercoaster for 11 months attempting to stabilize on 20mg Paroxetine vs my original dose of 30mg.  This after cross taper attempt with Cymbalta gone bad.  Symptoms are continuing to worsen.  Reviewed and considered splitting Paroxetine dose from 20mg to 10mg twice daily.  Any experience around this good or bad?  At this point is staying at the 20mg of Paroxetine vs trying to go back to the original dose of 30 the best ?  I was on it for well over 20 years.   Thanks 

[Altostrata]

Albert, how have the hydrocodone withdrawal symptoms changed, the ones that emerged after you went off hydrocodone too fast?

 

What time of day do you take paroxetine? Is your symptom pattern better or worse at any particular times of day?

[Albert]

Yes, my symptoms have seemed to be changing.   I sometimes feel like I am on a rollercoaster as my brain tries to stabilize for small moments and then back to full w/drawl and severe symptoms. 

 

Wake: 4:30-5:00 AM ( average ) Moderate to Severe panic, fear, doom

Fear / Panic / Doom seems to reduce some as day goes on. 

 

POR Relax supplement - 5:00 AM to try to help morning cortisol spike ( not sure if it helps ) 

 

Paxil 20mg:  7:00 AM 

 

Between 7:00 and 9:00 AM I usually have lots of yawning and eyes watering. 

 

Symptoms are heightened in the AM and then clime up till about 2:00 and then slowly decline 

 

My symptoms are not constant:  They come and go and rotate all day long.  

 

Temp regulation:  Moderate to Severe - can last 2 to 4 hours - body will be freezing and unable to    regulate temp. 

Agitation:  Moderate to Severe  

Frequent Urination and Urgent ( Minor Leakage ) Moderate to Severe 

Bowel Diarrhea- Moderate  

Ice Cold Feet:  Moderate to Severe 

Cognitive Impairment :   SEVERE 

Balance and Weakness: Moderate to Severe

Eye Prickling and Skin Prickling: Minor to Moderate = has reduced from severe

Nausea stomach cramping: Moderate 

Blurry Vision: Moderate to Severe

Muscle Twitching: Moderate - Has reduced from severe 

Burning skin:  Moderate 

Head Pressure:  Minor to Moderate 

Eye Twitching: Minor 

Sinus Congestion: Moder

Tinnitus : Minor 

Tingling: Minor 

 

[Colonial]

"POR Relax supplement - 5:00 AM to try to help morning cortisol spike ( not sure if it helps ) 

 

Between 7:00 and 9:00 AM I usually have lots of yawning and eyes watering. 

 

If your taking a herbal relaxation supplement at 5am, the yawning 2 hours later would seem more likely related to that than inter dose wd from the paxil, but I still think it's a good idea to go to 2 dosages of 10 mgs 2 times a day.

 

I had alot of interdose wd taking all of my paxil once a day and in your condition of instability it may make a significant difference.

 

Please list whatever ingredients are in the supplement.

The timing is suspicious as you were doing better and now your worse again.

 

It could just be a wave but if you went back to drinking coffee again and added this unknown supplement it could be related to the 2 of them. 

 

Thanks

 

 

[Altostrata]

Sorry, Albert. We can't help you with post-acute hydrocodone withdrawal symptoms from going off that drug too fast.

 

Like any other withdrawal symptoms, you have to allow them to fade away with time.

 

It's unlikely making changes in Paxil will affect those symptoms.

[Albert]

3 minutes ago, Altostrata said:

Sorry, Albert. We can't help you with post-acute hydrocodone withdrawal symptoms from going off that drug too fast.

 

Like any other withdrawal symptoms, you have to allow them to fade away with time.

 

It's unlikely making changes in Paxil will affect those symptoms.

Thank you for input Alto, I am trying to educate myself around where my symptoms are being generated from that way, I can form some tools to try to help me with the symptoms.  Do you have any suggestions around a good place to get information around Post Acute Hydrocodone Withdrawal?  

[ChessieCat]

https://hydrocodonewithdrawals.org/

 

https://www.drugs.com/answers/support-group/hydrocodone/

 

https://www.drugs.com/answers/support-group/opiate-withdrawal/

 

There is also patientslikeme.com

 

Hydrocodone is an opioid/opiate so you could do a general internet search for support group forum and add all/any of those words.

[Albert]

If one continues to do the same thing and it has been over a year, and still experiencing symptoms, does that mean that the reinstatement did not work and just going ahead and tapering the med is needed to avoid doing CNS damage?  What is usually suggested in this case?  Just continue trying to stabilize and waiting it out?  I am just having so many symptoms.  Thanks 

 

[ChessieCat]

If it was just that you had been taking consist drug or combination of drugs then it might be easier to work out what might be worth trying.

 

However you have been on and off other drugs over the previous 18 months to 2 years (going from your drug signature).

 

Please note that these are my thoughts and not my advice/recommendation.  Just some things for you to consider.

 

You have been tapering the hydrocodone recently so it might be worth holding on everything for 2-3 months and see if things improve.  It would be a good idea to keep notes of symptoms during this time.  It can sometimes make it easier to improvement that you don't notice, simply because when we we feel awful we can't always notice that something isn't as bad as it was or it has gone altogether.

 

If you are required to get off the hydrocodone now then you might reduce that slowly but keep everything else the same.  After you are off then it might be best to hold for a few months before making any changes. 

 

And then I suggest that when you do start to reduce your psychiatric drug (paroxetine?) only make a tiny test reduction first to see how it affects you.

[Albert]

Thank you for the advice Chessie Cat.  I will stay put where I am at.  I am at 20mg daily currently.  Only other thing I was gonna consider is splitting that to 10mg twice daily to rule out the spikes of possible inter dose withdrawals.  I will start recording my symptoms daily so that I can look back on them.  

[Albert]

43 minutes ago, ChessieCat said:

If it was just that you had been taking consist drug or combination of drugs then it might be easier to work out what might be worth trying.

 

However you have been on and off other drugs over the previous 18 months to 2 years (going from your drug signature).

 

Please note that these are my thoughts and not my advice/recommendation.  Just some things for you to consider.

 

You have been tapering the hydrocodone recently so it might be worth holding on everything for 2-3 months and see if things improve.  It would be a good idea to keep notes of symptoms during this time.  It can sometimes make it easier to improvement that you don't notice, simply because when we we feel awful we can't always notice that something isn't as bad as it was or it has gone altogether.

 

If you are required to get off the hydrocodone now then you might reduce that slowly but keep everything else the same.  After you are off then it might be best to hold for a few months before making any changes. 

 

And then I suggest that when you do start to reduce your psychiatric drug (paroxetine?) only make a tiny test reduction first to see how it affects you.

Thank you!!!  I will try to post my symptoms as frequent as possible 

[ChessieCat]

At this time I don't think it is necessary for you to post your symptoms here for assessment, but for your own assessment, unless you wish to journal them here.

 

Q:  Are you off the hydrocodone completely now?  If yes, please update your drug signature.  Thank you.

 

2 hours ago, Albert said:

I am at 20mg daily currently.  Only other thing I was gonna consider is splitting that to 10mg twice daily to rule out the spikes of possible inter dose withdrawals.

 

That is definitely something to consider because the half life is less than 24 hours.  If your symptoms are worsening every day or most days at a particular time of the day that might be an indication that you are experiencing interdose withdrawal.  So you might want to keep notes over the next few days to a week to see if that is happening, unless you are already noticing it.

 

To split your doses you would move a portion of your dose by 1/2 or 1 hour each day (earlier or later depending on when you are taking it now).  Be alert for changes in your sleep.  You might find that taking part in the morning and part at lunch time might cover the 24 hour period.

[Albert]

No, I am not completely off, but VERY close.  I will just journal my symptoms on my cell phone so I can keep track of them and that way if here are questions, I will have some answers.  My symptoms can often be somewhat random.   I sleep till almost exactly 5:00 every morning, then make a few trips to the bathroom between 5:00 and 6:30 with waves of fear and panic.   I take my Paroxetine at 7:00 AM and then usually by mid 10:00 I start to deal with temperature irregularity as well as ice cold feet and cognitive problems.  Then I usually notice a minor improvement in the evening.  I have had an improved afternoon today and I am thankful for that.  All of the other symptoms ( to many to list ) seem to be very random in nature.  I need to journal them to see if there is a pattern.  They can come and go out of the blue and I can even experience small moments of no symptoms ( Awesome ).    Thanks for the information on splitting the dose.  Since they make 10mg tablets, I thought it might be easy to split them .  So I can just take 10 at my normal time and then take my next 10mg 30 minutes later until I get to 12:00 or so.   Will splitting it out by 12 hours be necessary / better?  Or do you recommend to just split it by maybe 6-7 hours to cover the gap.   Thanks again. 

[ChessieCat]

Only make one change at a time.  If you are going to move your paroxetine dose, hold off on reducing the hydrocodone, otherwise you won't know what is causing any issues/improvements.

 

It's hard to know if the early morning symptoms are from cortisol or it might be interdose withdrawal.  If you notice that there is an improvement at about the same time every day during the hours after you take your dose (could be any time but needs to happen with regularity) then it could be interdose withdrawal causing it.

 

When I say improvement, I do not mean that you are free of symptoms, just that you feel a bit better in some way than how you feel at your worst.  The symptoms that you get might be different and appear at different times on different days, but you are looking out for a time when you do not feel as bad.  This is where keeping notes can help because when you feel awful it can be hard to notice a small improvement.

 

No you do not need to take them 12 hours apart.  That's one reason you need to keep notes.  Number 1 is to make sure that your sleep is not affected.  If you notice that happening, then you move the dose backwards gradually (you might try to stay at one time for a few days instead of moving every day).

 

Number 2 is to only move the dose to where the interdose withdrawal is reduced.  You are not trying to get symptom free just an easing of the symptoms.  At any time during the moving process you could stay at the same time for more than one day.

 

Once you get to a point where things are a bit better then my suggestion would be to keep things like that for a while and see how it goes.  If you are still noticing that there is a time when your symptoms worsen at a consistent time during the day then you might decide to move a little bit more.  However I suggest that you don't try and tweak things too much to find a "sweet spot".  Be satisfied with feeling somewhat better than you did.

 

One consideration about the time that you take the second dose is will you be able to consistently take your dose at that same time every day for the near future.  Down the track when you start tapering you may need to move the time of your dose/s for convenience.  You would again need to do this gradually and be alert for changes in sleep.

[Albert]

20 hours ago, ChessieCat said:

Only make one change at a time.  If you are going to move your paroxetine dose, hold off on reducing the hydrocodone, otherwise you won't know what is causing any issues/improvements.

 

It's hard to know if the early morning symptoms are from cortisol or it might be interdose withdrawal.  If you notice that there is an improvement at about the same time every day during the hours after you take your dose (could be any time but needs to happen with regularity) then it could be interdose withdrawal causing it.

 

When I say improvement, I do not mean that you are free of symptoms, just that you feel a bit better in some way than how you feel at your worst.  The symptoms that you get might be different and appear at different times on different days, but you are looking out for a time when you do not feel as bad.  This is where keeping notes can help because when you feel awful it can be hard to notice a small improvement.

 

No you do not need to take them 12 hours apart.  That's one reason you need to keep notes.  Number 1 is to make sure that your sleep is not affected.  If you notice that happening, then you move the dose backwards gradually (you might try to stay at one time for a few days instead of moving every day).

 

Number 2 is to only move the dose to where the interdose withdrawal is reduced.  You are not trying to get symptom free just an easing of the symptoms.  At any time during the moving process you could stay at the same time for more than one day.

 

Once you get to a point where things are a bit better then my suggestion would be to keep things like that for a while and see how it goes.  If you are still noticing that there is a time when your symptoms worsen at a consistent time during the day then you might decide to move a little bit more.  However I suggest that you don't try and tweak things too much to find a "sweet spot".  Be satisfied with feeling somewhat better than you did.

 

One consideration about the time that you take the second dose is will you be able to consistently take your dose at that same time every day for the near future.  Down the track when you start tapering you may need to move the time of your dose/s for convenience.  You would again need to do this gradually and be alert for changes in sleep.

Thank you very much !!  

 

[Albert]

I had a virtual Dr appointment this evening and my Psyc noticed that the Hydro and Paroxetine are both broken down by the exact same enzymes in the liver.  Therefore we could be changing the levels of Paroxetine in the system every time that I drop or change dose.  Have you every came across something like this?  Can this be a huge factor in stabilizing?  Could it be that every time that I take a dose of the Hydro it changes the Paroxetine, or would this just be on an overall / daily scale?   

[ChessieCat]

I think from the following that is should not be too much of an issue.  If it was the other way around then it would be a different situation.

 

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

 

Monitor Closely

• paroxetine + hydrocodone

  paroxetine will increase the level or effect of hydrocodone by affecting hepatic enzyme CYP2D6 metabolism. Use Caution/Monitor. Hydromorphone (<3% of the circulating parent hydrocodone) is mainly formed by CYP2D6 mediated O-demethylation of hydrocodone. Hydromorphone may contribute to the total analgesic effect of hydrocodone.

• hydrocodone + paroxetine

  hydrocodone, paroxetine. Either increases effects of the other by serotonin levels. Use Caution/Monitor. Coadministration of drugs that affect the serotonergic neurotransmitter system may result in serotonin syndrome. If concomitant use is warranted, carefully observe the patient, particularly during treatment initiation and dose adjustment.

[Albert]

I noticed that I have nearly all of the side effects of serotonin syndrome. I would assume that I am just in withdrawals.  However, I have become pretty sick feeling this weekend and is there any distinct symptoms that differentiates serotonin syndrome from symptoms of Withdrawals? Nearly all of my current symptoms mimic the symptoms that I see are caused by serotonin syndrome but I have not had seizures or anything like that.  

[Colonial]

22 minutes ago, Albert said:

I noticed that I have nearly all of the side effects of serotonin syndrome. 

Did you ever research the ingredients of the herbal supplement you were taking every morning? Certain Herbs can boost serotonin levels. Some can be dangerous when mixed with a powerful anti depressant like Paxil.

[ChessieCat]

How long did you take 30mg paroxetine for?

 

How did you feel when you were taking 30mg?

[Albert]

I took 30 mg for 22+ years and I did fine on it.  No real problems but maybe some weight gain.   I have now lost 60 lbs.   

[Albert]

5 hours ago, Colonial said:

Did you ever research the ingredients of the herbal supplement you were taking every morning? Certain Herbs can boost serotonin levels. Some can be dangerous when mixed with a powerful anti depressant like Paxil.

After we talked I quit taking it.  I can get the ingredients and do some research.  If I give u the ingredients ,can Yiu check them for me?  

[ChessieCat]

44 minutes ago, Albert said:

If I give u the ingredients ,can Yiu check them for me?  

 

Please respect the time of the staff.  ALL the SA staff are volunteers and do not get paid.   Try researching them yourself.  We do not mind helping members if they are unable to find the information themselves, but it is unfair to expect staff to do the research for you without you making any effort to do so yourself.  Thank you.

 

Here are some things that you could try:

 

To search SA, use a search engine and add site:survivingantidepressants.org to the search term.  For example:  site:survivingantidepressants.org melatonin

 

If you do an internet search for the ingredient name and include wiki you might find some information that way.

 

You could also try searching for the supplement name and include the word serotonin in the search term.

 

You could try searching these, however not all supplements are covered:

 

https://reference.medscape.com/

 

https://www.drugs.com/

 

[Albert]

[Albert]

Is there a site that will let me search the actual ingredients?  The supplement Relax would not pull up.   If not, no worries.  I have quit taking it for the time being just in case.