Albert: preparing to get off Paxil / paroxetine for good

[Albert]

I seem to have gotten worse since my dose was moved to 4x per day.  Should I go back to 3 times, or just wait it out?  

[Albert]

I need to adjust my signature and for some reason I a struggling to figure out how to do that.  I do not see in my profile where I would change it. 

[Albert]

Please disregard the needed help w/the signature change.  I was able to figure that out by getting on the full site.  I have it updated now.  Thanks AJ 

[Colonial]

You were worse long before you went up to 4 times a day, thats why you went up.  You became worse after starting the supplement relax and you took it about the same time as the paxil and all your symptoms were worse about the same time of day. You need to contact the manufacturer and find out what was in it. That being said, you never indicated when you started it and how long after you started to become worse to see any causality. Now that you're off it you need time to see if it helps. 

 

I really think you put too much blame and hope on thr hydro issue. Clearly you psych med issues are your primary problem which is why ive been suggesting for months you split your paxil. Your hydro issue isnt going to stabilize until you get your paxil sorted out and stop adding supplements and going back to coffee.

 

Im not saying you don't have hydro wd, but until you fix whats preventing you from healing system wide thats not going to resolve either, they are just going to exacerbate each other.   

 

Your also too quick to want to change dosages at every wave.  You tend to panic and look for quick fixes like supplements.

,

You need to sit down, figure out when you started it, when you became worse, what new symptoms came after you started it, and contact the manufacturer or who ever you bought it from and find out what is in it.  

 

Your on such trace amounts of hydro. Its a red herring to the underlining problem.  The only reason you ended up on hydro is because your ad wd was so bad they misdiagnosed you and did surgery on you.

 

Your system is still reeling from all the other psych drug changes you had recently in the past 2 years.  

 

I realize the reason you misinterpreted the hydro wd was because every time you dropped it the instability made your ad wd worse, but we have been having this same conversation privately for six months now. Stop tampering with the hydro, address the possible ad interdose wd by splitting your paxil dose, and stop accidentally shooting yourself in the foot by dabbling in herbs and over the counter products.

 

And stop the coffee you restarted. The coffee interpheres with your system, regardless if there is caffeine in it or not.  

 

You need to give your system time to stabilize off the herb, see which symptoms change and work on your paxil interdose.

[Albert]

I started breaking my Paroxetine pill in 1/2 today and spreading it out.  I noticed that the tablet is scored so I was able to break it in 1/2.  I will be getting 10mg pills hopefully in a week and that will be even more accurate. I only started with one hour today.  Will move to 2 hours tomorrow and then 3 the next day and then will hold there for awhile.  I will keep in touch and THANK you for the input.  I have discontinued all coffee and supplements.  Only thing I will take is the Omega 3 .  

[ChessieCat]

4 hours ago, Albert said:

I started breaking my Paroxetine pill in 1/2 today and spreading it out.  I noticed that the tablet is scored so I was able to break it in 1/2.  I will be getting 10mg pills hopefully in a week and that will be even more accurate.

 

Breaking a tablet in half and taking parts of the same tablet at different times of the day is unlikely to cause too much of an issue (if at all) because you are still taking the entire dose.  Some members seem to be very sensitive and the very small difference in the dose might cause an issue.

 

So you might be able to use the current tablets until they are finished, of course keeping an eye on your symptoms.

[Albert]

11 minutes ago, ChessieCat said:

 

Breaking a tablet in half and taking parts of the same tablet at different times of the day is unlikely to cause too much of an issue (if at all) because you are still taking the entire dose.  Some members seem to be very sensitive and the very small difference in the dose might cause an issue.

 

So you might be able to use the current tablets until they are finished, of course keeping an eye on your symptoms.

Thank you ChessieCat, if all is going ok, I will try that.  I am having a slightly improved day.  Even despite waking at 3:00 AM 

 

[Albert]

Yesterday, moved the Paroxetine apart by 2 hours.  Took 1/2 tablet at 7:00am and 1/2 at 9:00.   Noticed change in sleep pattern last night.  Woke several times to go to the bathroom and sleep very broken with a racing mind.  Overall yesterday was improved in regards to symptoms.  Will also note that I went to my boys varsity basketball game last night and that may have been a little stimulating.  Not sure if they would have had anything to do with it or not.   

[Albert]

After a long night and morning full of symptoms, I have had an improved afternoon.  I have actually even been able to focus a little.  I took the 2nd dose of Paroxetine at about 9:30 and by about 12:00 I started to feel some slight symptom relief and they have been a little less intense this afternoon. 

 

[Albert]

Night before last slept till 5:00 AM but last night I woke again at about 4:00 and no more sleep.  Went to bed at 11:00 so I am starting to worry that I am getting sleep deprived.  Still splitting paxil and taking once at 7:00 AM and once at 10:00 AM 

[Colonial]

If your getting 5-6 hours sleep that not that bad.

It's not great but it's not serious for a few days or week.

 

I only slept 3 hours myself last night.

My AD insomnia usually cycles for about 4 nights of only 2-4 hours and then it breaks and I'm back to 6.

 

How long has it been since you stopped the Herbal supplement?

Do you have the ingredient list yet

 

We don't want to blame the insomnia on splitting the Paxil if it can be linked to the herb.

Either way, I did warn you to expect temporary uptick in symptoms when you started to split the Paxil as your brain adjusts to the new regime, that's perfectly normal.

 

 "Will also note that I went to my boys varsity basketball game last night and that may have been a little stimulating.  Not sure if they would have had anything to do with it or not. "

 

Absolutely can be.  Your still attempting to live a full life schedule, working full time, etc.  Any stimulating interaction, even good stress can make your symptoms worse.  

 

[Albert]

The Ingredients in the supplement are Milk Protein decapeptide 150mg, gelatin, microcystaline, cellulose.  I tried to check for interactions but did  not see any, but I am also not sure I am checking correctly.  Sorry to hear that you did not sleep well last night either.  Hope yours clears up soon.  My son has final basketball game of his senior year this evening.  As bad as I do not want to make my condition worse, I just do not think that I can miss it.   I will stay calm.  He has worked for this since he has been 6 years old.   I have spread the dose out 3 hrs for 3 days.  Is it ok to go ahead and move it further apart starting tomorrow?  How far apart should I keep it from my other medicine?  Thanks 

[Colonial]

 

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

 

"The Ingredients in the supplement are Milk Protein decapeptide 150mg, gelatin, microcystaline, cellulose."

 

Are we talking about the same supplement?

What does POR stand for?

I'm not sure how that was a sleep aid.

10 minutes ago, Albert said:

As bad as I do not want to make my condition worse, I just do not think that I can miss it.  I have spread the dose out 3 hrs for 3 days.  Is it ok to go ahead and move it further apart starting tomorrow?  How far apart should I keep it from my other medicine? 

 

I think it would be ok. 

I think your overall lifestyle choices over an extended period of time and the fact that your still recovering from so many psych med changes in the past 2 years have more to do with your continued issues that moving half the Paxil 3 hours but if you want to wait a few days it's up to you.  You can always stretch it out by half hour increments too.

 

[Albert]

Yes, we are talking about the same PIintnof Return supplements.  I have discontinued taking them but if u think they might be ok, I will start them back up.  I think at times they help but hard to tell.  That is the fish oil that I take as well.  I will start stretching out the dose by 1 ht till I get to 6 hrs apart and see how I do then.   Thank u so much.  

[Colonial]

I found it now, the Point of Return programme.

I found the supplement page, although it does not clearly state what time to take, it does seem that general understanding of the page is that it helps by taking it BEFORE bed to help fall asleep, and then, the "CLAIM" Is that it may help the morning cortisol spike hours later.

 

Who told you to take it 5 am when you woke up and why?

Or did you think that was the proper time?

How could it help the spike if you dont take it until after the spike when you woke up?

I'm confused on the logic

 

Any supplement taken at the "wrong" time for it's function would go awry.

That's most likely why you were yawning 2 hours later, not interdose wd or seretoinin syndrome.

 

No, I can't recommend it, nor could you really have an idea if it caused you to get worse unless you sat down without dates of start and ending, and when your symptoms got worse.

 

As you know, we recommend magnesium and omega 3.

Edited March 6, 2021 by Colonial

[Colonial]

Here is the article on Coffee, regardless of caffeine content affecting the nervous system.

While it is mainly done to discuss blood pressure since it does affect the Symathetic Nervous system is why we urge caution.

 

"Because decaffeinated coffee also increases BP and MSA in nonhabitual drinkers, ingredients other than caffeine must be responsible for cardiovascular activation. (Circulation. 2002;106:2935-2940.)"

 

Coffee Acutely Increases Sympathetic Nerve Activity and Blood Pressure Independently of Caffeine Content (ahajournals.org)

 

 

[Albert]

Yes, we are talking about the same PIintnof Return supplements.  I have discontinued taking them but if u think they might be ok, I will start them back up.  I think at times they help but hard to tell.  That is the fish oil that I take as well.  I will start stretching out the dose by 1 ht till I get to 6 hrs apart and see how I do then.   Thank u so much

[Albert]

I just had been taking it in the morning as I thought it would help cortisol spike.   What time do you recommend taking the magnesium and fish oil?  I will go ahead and start spreading apart my Paroxetine a little further starting today.   What is best for calming a racing mind?  Woke at 4:00 and mind is racing.  Thanks

[Albert]

As I spread out the Paxil dose, do you recommend that I go ahead and shoot to spread it out by a full 12 hrs, or just start with 6 hours 

[Colonial]

I think the point of the supplement was you would have to take it at bedtime in order for it to have time to work on keeping the cortisol spike down.  Waiting until your already having the spike at 5 am is too late.  Regardless, since you don't know what made you worse, the going back to coffee, the supplement taken at the wrong time, the daily schedule, everything together, etc that made you worse, I would think the safe course to only take the 2 things we know work.

 

I think the racing mind could be a little bit of obsessing about your symptoms.  This is completely understandable as the worse they are the more we all want to find an answer, and you have had a lot of variables that were not your fault and out side your control to have to manage through which has made your plight worse and caused alot of misunderstanding about the nature of your issues.

 

I think at this point, you have all you need to know for now and a pretty good game plan for the coming 6 months. The racing mind will probably calm down once you decide to stick to the plan and then mentally refuse to worry about the symptoms when they come, and use the coping skill methods suggested or ones that you find work best for you, which all pretty well boils down to learing how to "ignore it", for lack of a better term.

 

Based on our private messaging, I think I can pretty well say that where you go wrong in your logic is that you tend to hold too close of a causal relation to having a wave with to something that must have recently been done or, 2.: Assume that a wave means your game plan is wrong and the wave means you need a med dose change.

 

Waves will ALWAYS come, even if you game plan is perfect.  You tend to panic when they do and look for something to be a quick fix for them.

 

As for the paxil, it's a 19 hour med, so you are going to have two 2.5 hour "lulls" when you only have 50% of your daily dose in your system regardless of when you choose to take them.  When those lulls happen is based on the 2 times a day you take the med.  To me, common sense say you do eventually want to get to every 12 hours, since that separates the two drops as far apart as possible to give the brain time to remain as stable as possible. 

 

Other wise if you forever continue to take the second dose close to the first your going to continue to have 2 drops in concentration very close together during the night and it's still a yo yo effect that can only be problematic for your sleeping pattern.  You don't have to rush to get there, however, but I do think in the long run its best that you don't take forever either.  If you want to continue to move it a half an hour forward every 2 or 3 days, I don't think that's rushing it, but will eventually get you there soon enough.

 

 

 

 

Edited March 6, 2021 by Colonial

[Albert]

Thank you Colonial, I am actually on pill form.  Dr just prescribed me the 10mg doses.  And I will take that twice per day.   I think I am gonna try to jump forward a couple of hours here today so I can avoid my other medication and keep that spread out.  Do you think that is OK? 

[Albert]

I have a question about my other med, would u allow me to Pm you once? 

[Colonial]

3 minutes ago, Albert said:

  I think I am gonna try to jump forward a couple of hours here today so I can avoid my other medication and keep that spread out.  Do you think that is OK? 

 

No, I just wrote about what I think. You can take 2 meds close together for a few days.

I take 3 meds together at times, unless there is a warning against a particular med having to be hours apart from another substance, which does not apply to your meds, you will be fine for a week.

 

11 minutes ago, Colonial said:

If you want to continue to move it a half an hour forward every 2 or 3 days, I don't think that's rushing it, but will eventually get you there soon enough.

 

 

[Albert]

Ok, thank you very much.  I am considering making a switch from compounding over to liquid with one of my medications.  Just waiting for the right time.  I am a little worried about it. 

[Colonial]

We really only recommend one change at a time.

I think the Paxil separation is the one that is most likely to procure the most benefit.

 

When you do change the other meds formulary, remember to first only change the administration method and not the dosage as well.  Considering your very lengthy history of destabilization I would recommend atleast a month on the liquid before any dose adjustment. 

 

If the dose you are on does need to eventually be adjusted to arrive at stabilization, it may be wise to do that first, stabilize, and then the formulary change may not be as potenially problematic.

Edited March 6, 2021 by Colonial

[Colonial]

Unless it's an issue of insurance or your particular bodies abilty to absorb, I would think the compound, if its in pill or capsule form, the more precise and less problematic route, especially for travel and temperature requirements. Going to liquid is going to rely on your ability to manually get the right dosages with syringes, etc. 

 

I'm having this very problem in my own thread right now, fighting with the insurance to cover the compound so I can get an exact dose because my ability to do it with the overly concentrated liquid is not going so well and is making me symptomatic.

 

But worrying about the future is keeping your cortisol raised. You consistantly try to go too far too fast in your mind's eye and all the future planning is compromising your ability to relax.

 

[Albert]

I would agree with that.   I have been compounding myself and weighing on a scale and then putting it in a capsule on my own.  I use the Gemini scale and I think I get pretty close.  Anything that can improve my cognitive function?? 

[Colonial]

 

My mistake, I thought you were getting it compounded by a pharmacist.

That really would be the way to go if possible.

 

Your cognitive function will improve when you get your meds sorted out and aren't changing dosages as much, as well as spring coming and getting some sunshine and fresh air with mild exercise.

 

 

Edited March 6, 2021 by Colonial

[Albert]

Yea, unfortunately they will not compound Hydrocodone and this is how a pharmacist told me to go about it.  Not sure I can really get it as exact as having done professionally that is for sure.  Only other option would be liquid and my Psych is on board, but I will hold off and give this more time.  Thank you Colonial and I hope you are having an improved day. 

[Albert]

Woke again this morning at 4:00 AM with AIR HUNGER.  I have had an increase in this symptom in the last week or so.  It can be scary, is it just another symptom and try not to worry about it?  Is this common? Kind of like shallow breathing and gasping for air. 

[Colonial]

I had a 2 week long episode of this past year. I would wake up and it felt like I had stopped breathing except I wasn't really gasping.   I would have to be awake for 5 to 10 minutes before it would pass so I know it  wasn't that I had stopped breathing.  It's a very curious thing.

 

3/1/2021: Chessie Cat said:

 

"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."

 

A very quick google search produes the following results, showing it is a symptom with many causes such as anxiety or infections.  Since you continued to go to the basketball games even though you were in a bad wave I might assume it to have a causality.  As we've said, behavior choices can aggrivate WD, so its a learning curve between not living in a closet all day to over doing it.

 

"One potential cause is a condition called paroxysmal nocturnal dyspnea (PND), according to the NLM. This condition will cause you to wake up suddenly during the night and feel short of breath. You might even awaken and find yourself coughing or wheezing. PND could be caused by congestive heart failure or COPD, obesity, or anxiety."

Edited March 7, 2021 by Colonial

[Albert]

Yes it is very weird.   It is kind of on and off throughout the day.  Hope I adjust to the medication time of day chance soon . Hope u have a good day!!!  

[Albert]

It may just be part of the Change in symptoms when I start to spread out the Paxil doses.  

[Albert]

UPDATE:  

Yesterday = Paroxetine 10mg at 7:00 AM and 10mg at 11:30 AM .   Still having focus problems.  I started to notice changing in symptoms.  I noticed several small periods during the day of about 10 to 15 minutes where things started to improve.  

 

1 magnesium 200mg before bed and 4 fish oil yesterday.  

 

 

Focus:  Still the same 

Jaw pain - Woke this morning with some significant jaw pain and this is new 

Brain burn:  Have noticed a few small episodes of brain burning sensations and I have not had this for a long time. 

Frozen feet:  This has actually gotten a little better 

Weakness and balance:  This may have improved slightly 

Air Hunger:  Improved during the day yesterday

Vision:  Is all over the place.  One moment I need glasses to see and the a few moments later, it clears up. 

Sleep:  My sleep improved by 1 hour last night.  

Burning legs = Has been off and on  but improved some.  

NOTE:  Experienced the closest to normal bowel movement that I have had for 3 months.  

[ChessieCat]

You might consider staying at those dose times for a few days and possibly as long as a week.  This would give you a clearer indication if the dose splitting is in fact helping.  It will also give the doses a chance to level out and the brain to recognise the change.

 

It is good that you have noticed some improvement, even if tiny.  However, if it was me I would be very cautious about trying to get more improvement too soon.  Now is the time to be very patient.  If after 1 week you can see for sure that things are improving but still not reasonable then you might move by 1/2 hour and wait another week.

[Albert]

Thanks for the advise.  I will stay put for a few more days and see how it goes.  I had a scary event this afternoon that started about 1:00 and has lasted till about 3:30.  I experienced pretty significant cognitive impairment.   It has started to clear up a little.  I have had some focus problems but this was pretty severe.  Like in a complete daze.  It seems to be slowly getting better.