DiscJockey: intro

[ChessieCat]

6 hours ago, DiscJockey said:

WINDOW HEAVY DAY

 

Q:  What do you mean by this?

[Altostrata]

20 hours ago, DiscJockey said:

 

Hi @Altostrata I did do a small change today. I took the 20mg Lexapro @1130AM, then the 8.82mg Paxil at 1230PM. Notice no change, today was a WINDOW Heavy Day. Pretty good day thus far. 

I was thinking maybe tomorrow taking the Lexapro earlier like @ 1030AM, then keep the Paxil at 1230PM. So a 2 hour gap in between. I would then document any symptoms here. 

I know @ChessieCat recommended to take them separate, so it does not activate all at once, and to try not to take the paxil too late so it does not effect my sleep because it is very activating.  

How far long apart in hours should I keep the 2 separate? 4 Hours? 6 Hours? 8 Hours? Or to where I can tolerate the gaps? I would just listen to my body, how I feel, and understand how far I can take it.

 

@Altostratathe 10mg Paxil tablets I have now have the letters "APO" on one side.... then the other side has numbers "097"

Is there a link or post that states what kind I have based on the letters and numbers on them. The prescription bottle does not have that info, only my medical info on it.

 

Phone your pharmacist and ask them whether your Paxil is extended-release.

 

Why do you think Paxil is very activating?

[DiscJockey]

19 hours ago, ChessieCat said:

Q:  What do you mean by this?

 Hi @ChessieCat it means that day is a GOOD day. Windows of relief. Feel stable, hopeful, and optimistic. In a heavy window day there would only be small wd symptoms throughout the day, but manageable to carry on and live.

 

On HEAVY WAVE days, I feel like crap majority of the day. Anxious, tingling, dread, fight or flight feeling constantly, and a whole bunch of other bad symptoms. 

 

[DiscJockey]

16 hours ago, Altostrata said:

Phone your pharmacist and ask them whether your Paxil is extended-release.

 

Why do you think Paxil is very activating?

 

Hi @Altostrata, I finally got on the phone with a pharmacist from Kaiser, but they told me the same thing surprisingly. The person just told me that it was just Paxil. It was neither immediate release or the other one. Just plain Paxil they said. I don't know if that is even a thing. It took forever to get someone on the phone as well. 

 

But I did take my Lexapro @1030AM and Paxil @1230PM yesterday. So far ok, nothing drastic happened.

 

Ever since Monday 12/14/20, I have been feeling a lot better, stable, windows of relief. I will just hold here till after my next video appt with my doc next month. 

 

I feel a bit more hopeful and optimistic that I should taper off the Paxil first, but real slow and small drops.

 

I think that last 2% drop indicates that is all my body can take going forward. 

 

Only thing every now and then is this slight tingling on my feet and back/shoulders. When I am resting, my mind focuses on those sensations, its hard to ignore and move on. Its my CNS. 

[Altostrata]

it will take at least 4 days for a dosage change or schedule change to take full effect.

[ChessieCat]

  

On 12/16/2020 at 3:56 AM, DiscJockey said:

WINDOW HEAVY DAY

 

2 hours ago, DiscJockey said:

 it means that day is a GOOD day. Windows of relief. Feel stable, hopeful, and optimistic. In a heavy window day there would only be small wd symptoms throughout the day, but manageable to carry on and live.

 

2 hours ago, DiscJockey said:

On HEAVY WAVE days, I feel like crap majority of the day. Anxious, tingling, dread, fight or flight feeling constantly, and a whole bunch of other bad symptoms. 

 

It might be better to use different wording because when I saw window heavy day I thought you meant that you were in a window but it wasn't a very good one, so the opposite of what you meant.

 

I think most members use the terms good window, bad wave.

[ChessieCat]

2 hours ago, DiscJockey said:

Ever since Monday 12/14/20, I have been feeling a lot better, stable, windows of relief.

 

Q:  Did this start before OR after you started moving your doses apart?

 

Q:  Has it improved / improved more since moving the doses apart?

[DiscJockey]

51 minutes ago, ChessieCat said:

Q:  Did this start before OR after you started moving your doses apart?

 

Q:  Has it improved / improved more since moving the doses apart?

 

@ChessieCat I am not sure. I just started moving the doses apart on Monday 12/14/20. As the week continues I will post on my thread of any changes. 

 

It could also be that my body was finally adjusting to the 2% drop of Paxil. I made that 2% decrease on Sunday 12/6/20. 

 

So I wrote down notes that it takes me about 8 days to adjust, and when I make a decrease, to expect the wds to hit the day of or the next morning. 

[DiscJockey]

Today I went back to taking the Lexapro @1030 and Paxil @1230

 

Yesterday after changing dose change, no difference noted. 

 

But around 4pm started having some slight wds. (doom, depressed, nausea)

This feeling stayed until 11pm.

 

So I got scared a bit, and decided the next day to go back to the regular split time. 

[DiscJockey]

Hi @Altostrata & @ChessieCat just updating on symptoms. 

 

Yesterday 12/23/20 was hit with a very hard wave around 245PM. I was out shopping for Christmas stuff then out of nowhere I got real anxious, burning/tingling sensation all over, and very spaced out. Got nauseous and lost all appetite. 

 

This lasted the rest of the day. I was trying to lay down and take a nap but the wds were just keeping me awake.

 

Out of fear I was thinking maybe there was something wrong with the dose of my paxil tablet. I rechecked all the tablets I pre made and a made sure they all were the right dose/weight on my digital scale. They were.

 

Finally at around 10PM I caved in and took half a tablet of benadryl to help me get to sleep.

 

I was also thinking that maybe could it be exercise intolerance catching up to me? On Monday 12/21/20 I did an evening workout and pushed a bit harder than usual. The next day(Tuesday) I was sore and ok. But the next (Wednesday) I started feeling bad wds late in the afternoon.

 

@Altostrata @ChessieCat let me know your thoughts when you can. Just need some reassurance. I know that the patterns of waves and windows are not linear so I am hoping this is just a one day thing. And any topics on what others say about exercise. I will look myself.

[Altostrata]

You seem to get very anxious about any bump. You will experience bumps. It's important that you learn to surf these bumps rather than make frequent drug changes.

 

Please post 24 hours of notes at a time in this topic, in a simple list format with time of day on the left and notation (symptom or drug and dosage) on the right. This can help us determine if the bumps are significant.

[DiscJockey]

3 hours ago, Altostrata said:

You seem to get very anxious about any bump.

 @Altostrata yes I do. I cant help it. I do have coping mechanisms and strategies yes. But like I wrote in my thread I went through an awful tailspin this past summer, the worst of all previous tailspins I had in the past. I had to take a medical disability leave from work. I feel when I do feel any bump big or small it is like PTSD, the memory of the last horrible tailspin is always there. Plus it is difficult now that I am taking 2 types of SSRIs. So when problems do arise Im thinking "is it the paxil or lexapro?"

I am thinking though that since I am tapering the low mg dose of paxil it is very difficult, but that I am going to have to do it twice, one for the paxil, then next will be the lexapro. Trying to remain optimistic even knowing of the hell that is ahead of me, twice.

[Altostrata]

If you look around, you'll see many people here have experienced the same kind of disaster. Getting stable on the drugs means not making changes because you get anxious.

 

Tapering Paxil and then Lexapro may not be as bad as you expect.

[DiscJockey]

2 hours ago, Altostrata said:

If you look around, you'll see many people here have experienced the same kind of disaster. Getting stable on the drugs means not making changes because you get anxious.

  

I have looked around and see other people had similar kind of disaster as mine, are you telling me in a way that I should stop venting about my fears of the past because I am not the only one? I am kind of being thrown off from your comment, does not seem nice as what other responses other people get here from other moderators. 

 

And I am not trying to make any changes right now, just here to document my journey, symptoms, symptoms which include being anxious because of the drugs. I am just trying to get reassurance that I am not alone, and motivation like many of us here, but right now I am not feeling that, quite the opposite actually. 

[ChessieCat]

What you are experiencing is similar to what many others going through AD WD experience so it is not unusual and is actually quite "normal" for AD WD as it the up and down nature (ie windows and waves pattern).

 

SA strongly encourages members to learn and use non drug coping techniques to get through the discomfort of their symptoms and try not to add more anxiety to yourself from being concerned about the symptoms.

[Altostrata]

@DiskJockey, your getting perspective on your own situation will better enable you to cope with it. You can gain perspective from acquiring more context for your own symptoms. If you look around at the community, you will see you're not alone.

 

Chronicling your progress is what your Introduction is for. But we urge people to stop cycling their anxieties. You need to move forward with your own understanding.

[DiscJockey]

Hi admin need some advice here. I have been having bad wd symptoms now for about 5 days. I made a 2% decrease of my Paxil on 1/19/21. The dose is now 8.6mg. Should I up dose back to 8.82 if the wd symptoms persist and do not let up? Since the decrease, I felt nothing at first surprisingly, but in my mind was always expecting to feel some sort of withdrawal in the next coming weeks. Then bam! On Wed 1/3/21 they came very hard. These wds are much more intense than the last drop. Severe anxiety, akathaisa, intrusive thoughts, waking up real early, and staying awake. These feel way intense than withdrawal normal. Should I just wait a bit more longer? I dont know how much of it I can take at this point

 

I feel discouraged at the moment. It seems getting off the paxil is going to be impossible, especially having Lexapro in the mix. I really do not know if I am tapering the Paxil wrong, or the Lexapro is not holding up anymore. Sometimes I wish I would just be straight on Paxil, that way it would be one ssri and not two. But at the time of the change I entrusted my psychiatrist that we could get off the Paxil adding the Lexapro.  

 

I did email my psychiatrist about it, and she stated that if the symptoms persist that we could add a small amount of Prozac. But I do not want to be on 3 ssris at the same time. When she said that I feel as if she has no clue what to do. We have a video appt coming up soon. I might even go along with the Prozac bridge. But so afraid of doing a change. I even requested to put me off work (medical disability) if we do any changes so I can adjust. And she kind of just brushed me off and said that will not be necessary, and that these wds and change would not require for me to be off work. 

 

Any advice would be appreciated, thank you.

[DiscJockey]

The wds are bad.... but I do get these small mini windows in the day. They last for like 1 minute it seems. Its weird. I will be driving feeling like crap and a little window comes up for a bit. So when this happens, I am like ok, maybe we are getting somewhere good, my body is healing, hold on, keep going. But when I get back to the wave part, they are very extreme. The wds start in the morning, and I am afraid to even get up and get going on with the day. 

[DiscJockey]

Hello Admins! Any tips on the Prozac bridge. My doctor recommended it since I am having a hard time on my current Lexapro and Paxil dose. I was prescribed liquid Prozac but I have not fully decided to take it yet. I am currently on 20mg Lexapro and 8.82mg Paxil. Both are in tablet forms. 

My doctor said that I would start with 5mg Prozac (liquid) then take 15mg Lexapro and 8.82mg Paxil for 1 week. 2nd week would be 10mg Lexapro  8.82mg Paxil and then 10mg Prozac (liquid). 3rd Week 15mg Prozac, 5mg Lexapro, 8.82mg Paxil. Then 4th week would be 20mg Prozac, no Lexapro, and 8.82mg Paxil. 

 

After all that assess, to see if we can drop the Paxil all together. Possibly increase the Prozac.

 

The goal is to get rid of both Lexapro and Paxil, and just be one SSRI (Prozac).

 

I wanted to ask is this way that my doctor is proposing the right way? Or will it cause me problems. Should we be trying to eliminate the Paxil first? Then the Lexapro. 

 

Any tips or ideas on how to go about this would be appreciated. 

 

I am currently having a hard time tapering my current medication even at small doses (1% or 2% decreases). The wds are becoming difficult. Plus it seems confusing being on 2 different ssris.

[ChessieCat]

the-prozac-switch-or-bridging-with-fluoxetine

 

[DiscJockey]

Hi @ChessieCat, thank you for that, but is there anyone on here (moderator) that would know if what my doctor suggested is the correct way? I know the link says start low then increase slowly while tapering slowly off the other drug. But for my case it is 2 types of ssris. I dont want to run the risk of being stuck on 3 ssris, technically I will be starting by taking 3 ssris all together in the beginning If I were to try this. 

 

I want to compare what others recommend to what my doctor suggested. I am not sure if what my doctor instructed is fully correct, could it be too long? too short? The doctor wants me to get rid of the Lexapro first, which I find odd since Paxil is the worst one and since I am now at 8.82 mg, so I would think that we should get rid of the Paxil first. But I would like to see what someone would do in this situation. Get rid of the Paxil while introducing Prozac, then slowly remove the Lexapro? And the duration, do I wait a week for each change or just a couple of days. 

 

Thanks.

[ChessieCat]

I doubt very much that you will find someone who is in the same situation as you trying to get off two ADs to go on Prozac.  It was extremely bad medical advice that you were given which caused you to end up on Paxil and Lexapro.  I hope that this doctor is a different one from the one who oversaw your previous failed switch.  If it is not, then if it was me I would be finding a doctor with more knowledge about doing a switch before starting the process.

 

These are just some of my thoughts:

 

If there is one drug which gives you worse side effects then you might eliminate that one first.  But another option would be to reduce one by a bit and then reduce the other one (alternate the reductions).  And another option, reduce both drugs at the same time.

 

Whatever you end up doing you are going to have to be very careful.  It will be VERY important to ensure that the dose of the current drug/s ARE REDUCED and only a small dose of Prozac added otherwise you could very well end up with serotonin toxicity.

 

Because this is a very complicated situation I am not going to say any more on the subject.  If you decide to follow your doctor's advice and things go badly, I think that it is only fair that he take responsibility for the results as he is getting paid.

[Altostrata]

On 3/16/2021 at 3:52 PM, DiscJockey said:

My doctor said that I would start with 5mg Prozac (liquid) then take 15mg Lexapro and 8.82mg Paxil for 1 week. 2nd week would be 10mg Lexapro  8.82mg Paxil and then 10mg Prozac (liquid). 3rd Week 15mg Prozac, 5mg Lexapro, 8.82mg Paxil. Then 4th week would be 20mg Prozac, no Lexapro, and 8.82mg Paxil. 

 

Your doctor is saying to drop 5mg of Lexapro and substitute 5mg Prozac, then progressively trade Prozac for Lexapro. This is a cross-taper, which is better than a cold switch.

 

Going off Paxil can be extraordinarily difficult. It may be if you switch to Prozac, you might be able to go off it. But Lexapro isn't that much different.

 

I see you haven't posted daily notes since December. Would you mind sharing your drug schedule and symptom pattern? I am wondering if you might be having an adverse reaction from the combination of Lexapro and Paxil. If so, the fix is a lot easier.

[ChessieCat]

On 3/20/2021 at 11:56 AM, Altostrata said:

I see you haven't posted daily notes since December. Would you mind sharing your drug schedule and symptom pattern? I am wondering if you might be having an adverse reaction from the combination of Lexapro and Paxil. If so, the fix is a lot easier.

 

[DiscJockey]

Hi @Altostrata and @ChessieCat , sorry for the late response. I have been trying to do life and enjoy life even though I have some symptoms that are extremely difficult to deal with from time to time. My job has all of us employees working back onsite. I usually stare at a computer screen, spreadsheets, and graphs all day. I am always tired when I end my shift and have no energy to look at my phone or computer screen. I usually take my dogs out for a walk at that time, and take a nap if I can fall asleep. When I do get on here I try to drop comments and questions on others' threads.

 

During December I did not do any reductions. I did however started taking the doses at separate times like you suggested. Lexapro first at around 10:30am, then my Paxil dose at 12:30pm. This has been helping, thank you. 

 

After the holiday I did do a 2% decrease of my Paxil on 1/19/21. So I went from 8.8mg to 8.6mg. I shaved the pill with a nail file and precisely weighed it using the Gemini Scale that was recommended on here. The first few days after that drop were ok and manageable. I would say they were wd normal to me. Slight brain fogginess, nausea, minor anxiety. This wd normal feeling reminded me of when I was successfully tapering back last year before the doctor had me switching from liquid to tablet numerous times. I thought to myself that I can do this, that I would be ok, as long as I do it this slowly. The wd normal symptoms from that decrease lasted a week. After that week I felt great, hopeful, and that things would be possible. BUT......

 

On 2/8/21, I up dose back to 8.8mg Paxil. A week prior to that up dose, I was getting severe wd symptoms. Waking up with anxiety and terror in the morning. Burning sensation on my upper back. Severe restless legs, similar to akathisia, my heart beating real fast, and I can hear it. It was terrifying. I did try to put up with it for a week, but just could not. In that week I did nothing to disrupt my nervous system. I refrain from even doing my light walking with my dogs because I was afraid that elevating my heart rate would cause some type of withdrawal. 

 

Within a week of up dosing back to 8.8mg Paxil I started feeling stable again. So I just remained there until my upcoming video appt with my psychiatrist at Kaiser. So after I had that video appt I came here asking for advice on the Prozac bridge (see above threads). I am currently not happy having this doctor. At first I thought this doctor would help, but this doctor is the reason why I am now stuck on 2 types of ssris. Before the Prozac bridge idea the doctor wanted to add a mood stabilizer because I was mentioning about the terrible wd symptoms I was having trying to come off slowly, but I said no to that. In fact one thing that bothered me is the doctor said that my underlying anxiety condition was coming back up and that is the reason they suggested a mood stabilizer.  

 

So now I am trying to find a new doctor outside of Kaiser. I know that I am going to have to pay a lot out of pocket, but I believe no doctor at Kaiser can help, I have been through so many of them at this point. I actually read on here the recommended doctors thread. Hopefully I will be getting a first consultation appt with Dr. Mike Abramson, it's just his schedule is full at the moment his assistant says and they will get back to me as soon as they can. I even called Stanford University and inquired if they would have Dr. Lembke take me on as a patient if Kaiser is willing to pay for it. They said yes, but then I asked Kaiser for a letter and recommendation, they refused, of course! They believe they can help my situation in house, which I doubt at this point.

 

So out of curiosity and slight desperation I decided to try to decrease the Lexapro first instead of doing the Prozac bridge. 

 

On 3/16/21 I did a 10% decrease of the Lexapro. Shaved a 20mg tablet with a nail file and weighed it with my Gemini scale. 18mg Lexapro. So the same thing is happening again like the 2% drop with Paxil back in January 2021. The day of the 10% drop of the Lexapro I felt it. Slight wave of anxiety the day of at around 4pm. The next few days I felt were WD normal. I would wake up with slight anxiety, but that would go away as I would get up and going and get to work. The anxiety was not severe, but manageable as I can go about the day. During the day I would feel spaced out, and not really focused on things. There were no intrusive thinking. The restless legs were not intense, and only some burning sensation. All these symptoms lasted only for about 3 days. I thought ok, maybe this way will work, taper the Lexapro first then the Paxil last. Not so much.....

 

Just starting yesterday 3/28/21. I woke up in the morning feeling that terror/anxiety feeling again. More intense restless legs and burning sensation. Since it was Sunday, I did not have work, I went back to sleep. I slept for an extra hour. The symptoms did subside. It felt strange, but I got up and went about the day. By around 12pm that day, a huge wave of anxiety/terror came over my body. This feeling lasted all day and night. I luckily was able to fall asleep. I will updated with more symptoms after today.

 

So from I what I described I feel like there is a pattern. I get immediate wd symptoms the day of, days after, then they go away and I feel great. Then it seems about around 2 weeks of feeling better after a decrease, the symptoms come back but even stronger. I know that healing is not linear as I read on here. At the beginning I would be hopeful because I would think ok the wds are immediate, they are here, I would wait it out and then they would go away. But when they do come back they are really strong. They are strong enough to scare me and feel like this whole thing is not possible to do.

 

So I am really confused at this point on how to go about tapering. I know my situation is not helping of being on 2 different ssris. Sometimes I feel like I should just go ahead and take all Paxil and git rid of the Lexapro, at least I will be on one drug. But Paxil is the worse to come off of, so getting to 8.8mg was a success for me. At this point it seems that no matter what drug I decide to taper first is going to be really difficult. Too difficult that I will be stuck on both of them now. The wds are manageable in the beginning but become too intense after that. I feel like being on both paxil and lexapro is confusing, and I will be stuck on them now forever. Hence why I feel like attempting the Prozac bridge, but too scared, because  I might get stuck on 3 ssris. What to do then if that happens. 

 

If I do the Prozac bridge, should I be attempting to get rid of the Paxil first? Then the Lexapro? The doc recommended the Lexapro first, but I feel that it should be the Paxil first, like getting rid of the worst of the worst first kind of thing. I am also not sure how to go about when starting to add Prozac, how long I stay on a dose, 4 days? A week? I did ask for my doctor to excuse me from work for a week. I had to really convince them that I am not sure what this will do to me. I did get a week off but did not start the Prozac switch. Unfortunately, life situations happened that week (car troubles, dog got sick) so I tended to those first before tapering. In a way I am grateful those life situations happened when they did, I could of been in another tailspin again. 

 

So instead of the Prozac bridge I decided to try the Lexapro taper first to see if that would help. And possibly do an every other taper. Do one decrease of Lexapro, stabilize, then decrease Paxil, and so on. But I am not sure.

 

Should I go ahead and try the Prozac bridge? I still have the Prozac liquid.

 

Wait and see if I can stabilize on this current Lexapro decrease, if successful, then do an every other taper? Like decrease Lexapro, then decrease Paxil?

 

Or get rid of the Lexapro all together and substitute it with more Paxil? At least I will be on one drug, but would suck to be on all Paxil since I am now down to 8.8mg already. 

 

My next video appt with the psychiatrist is this Wed 3/31/21. To be honest I do not know what we will be discussing. We usually do a video appt every month to check in, but for this appt I am not sure what I will be saying or checking in about. I am actually dreading it, because if I mention any of my wd symptoms, I will most likely get recommended for more medications to take. 

 

Oh! Just to let you guys know I do eat very clean. Over the holiday I finished reading Dr. Kelly Brogan's book. Her dietary plan she lays out is sort of what I already follow prior to tapering. I just added more red meat, ghee, sweet potato pancakes, and probiotic foods. This eating style does help my mental state a lot. I exercise moderately now. I have been cutting back on the days and intensity, I always fear that withdrawals can come about if I push too much. It sucks because being at my gym even during the pandemic with limited capacity was my escape and way of safely socializing with some friends. I try to stay active because I am trying to balance that these drugs are causing me weight gain despite eating healthy. I have accepted that in the mean time the weight will stay when I am still on these drugs and that when I do get off them the weight will come off. If I ever get off of them!

 

My current talk therapist will no longer be my talk therapist starting this Oct 2021. I currently get my talk therapy through a third party Magellan Health through my work benefits. They have a contract with Kaiser that will be ending this October. Kaiser will be doing their own talk therapy system, they offered several outside doctors to be part of it including my current doctor, but they do not like the terms and conditions of the partnership. So my current doctor informed me that if I am willing to pay a high price out of pocket, that our last session will be in October of this year. I am partly sad about this, and also see it as a blessing. I have been with this talk therapist for years now. They have given me great advice on general life stuff and coping mechanisms. They know me, but when it comes to any type of medication withdrawal topic, they are not fully on board with it. They agree with any medication change if it comes from my doctor. But not really knowledgeable about the harms of these drugs.

 

Recently I did add a coach/counselor though. I found this coach through the inner compass website. They live here in the SF Bay Area and has personally gone through psychiatric drug withdrawal themselves. They were also kind enough to let me pay a sliding scale fee per session. Only a had one video appt thus far, but it seems hopeful. They recommended the sleep aid Calms Forte, which I now take every night. It has help tremendously. I use it instead of melatonin. Never really liked melatonin, always made me real groggy in the morning. The Calms Forte helps me stay asleep. I never had a problem falling asleep, it was always staying asleep that was the problem. 

 

Thank you!

 

 

 

[Altostrata]

8 hours ago, DiscJockey said:

I did however started taking the doses at separate times like you suggested. Lexapro first at around 10:30am, then my Paxil dose at 12:30pm. This has been helping, thank you. 

 

How did this help?

[DiscJockey]

@Altostrata the splitting of the doses has helped.

@ChessieCat when you get the chance, can you send me a link for weighing and crushing tablets.

 

I might be overthinking right now but would like to try a different method when I feel ready to make a decrease again.

 

Currently I am weighing each tablet by cutting with a razor blade and then shaving off some to get the exact weight. So I have a 20mg Tablet of Lexapro and 10mg tablet Paxil that I would cut then shave. 

 

I am reading on here that some grind about 10 pills, get the average weight, stir it to even out the active ingredient, then pour out the powder in 00 gel capsules.

 

Could this be the reason I am having a hard time tapering even at a small cut? The active ingredient is not evenly distributed even though I am razor cutting, shaving, and weighing for preciseness the whole tablet? Maybe I should try to grind 10 tablets, and pour the powder in empty capsules? I already have a big bag of empty capsules. 

 

So everyday that I am taking these cut and shaved pills I think are at the right dose/weight are actually now 

wrong, wrong meaning the active ingredient is now not evenly distributed? They all have the same weight but one pill may have more of an active ingredient than the next one.

 

Or lol.... its just my situation, I know! I am on 2 different SRRIs, and that is a problem. It's like im mixing dark and light liquor! 

 

Please let me know what you think @Altostrata and @ChessieCat. Thanks!

[ChessieCat]

3 hours ago, DiscJockey said:

can you send me a link for weighing and crushing tablets.

 

Have you tried to find it yourself?

 

I've done a site search using the word weighing and managed to find the topic quite easily.

[ChessieCat]

3 hours ago, DiscJockey said:

The active ingredient is not evenly distributed

 

myths-about-your-drugs

 

[Altostrata]

On 4/1/2021 at 9:31 PM, DiscJockey said:

I am reading on here that some grind about 10 pills, get the average weight, stir it to even out the active ingredient, then pour out the powder in 00 gel capsules.

 

Could this be the reason I am having a hard time tapering even at a small cut? The active ingredient is not evenly distributed even though I am razor cutting, shaving, and weighing for preciseness the whole tablet? Maybe I should try to grind 10 tablets, and pour the powder in empty capsules? I already have a big bag of empty capsules. 

 

No. Please do not worry about distribution of active ingredient. Crushing and weighing is a highly error-prone method.

 

Both Paxil and Lexapro come in liquid forms for tapering.

 

 

[DiscJockey]

Hi @Altostrata and @ChessieCat So my doctor and I are currently attempting to do the Prozac bridge. I did read up on here on the Prozac bridge.

 

We started with 1mg in liquid form on Sunday 4/25/21. I take the liquid Prozac first thing in the morning which is usually 0730am. Then the rest of the other ssris at my normal time.

 

1030AM 18mg Lexapro

1230PM 8.82mg Paxil

 

We did try to increase to 2mg in liquid yesterday, but that felt too strong and intense. The whole day I was slightly more anxious, tingling, burning, and very spaced out.

 

So today I went back to 1mg liquid Prozac in the morning. 

 

My doctor is trying to first get me off the 8.82mg Paxil first. Then the 18mg Lexapro next.

 

Should I be attempting to drop the Paxil completely by the end of this week in order to avoid my body adjusting to all 3 meds? 

 

Is it possible that my body chemistry can only handle 1mg Prozac, and would that 1mg Prozac be enough? Enough to cut out the Paxil? Our goal is to try to get to 5mg Prozac first before we cut out a little of the Paxil or cut out completely. But it seems that going up on Prozac is too much for me, since going on 2mg yesterday. The 1mg seems all I can take at the moment with all the other ssris in the mix.

 

I am nervous now, but would like to know what you guys think. Hopefully I do not end up on 3 ssris. 

 

I also feel now that I started the liquid Prozac, that there is no turning back. It is only 1mg I know, but I feel that since starting it, my body is now being accustomed to it. I am just hoping that I can get rid of the Paxil or Lexapro like a direct swap. 

 

Thank you

[Altostrata]

After we discussed why it wasn't a good idea to take Paxil with Lexapro, you added a third SSRI?

 

Why are you not asking your doctor these questions? He or she is the one responsible for this plan, and getting paid for it.

 

 

[brassmonkey]

@DiscJockey I have removed your recommendation as you requested.

[Altostrata]

@DiscJockey, how are you doing?

[DiscJockey]

Hi @Altostrata, I am hanging in there.

 

Got a new psychiatrist from UCSF, Dr. Tara Collins. Doctor knows about tapering, but does the Prozac bridge method. 

 

I am currently in the middle of the bridging process. Been off work on medical disability to do the bridge but also my doctor said to make sure I am doing more therapy sessions, daily meditation, intensive outpatient program classes, daily journaling, keeping my diet clean, which I am doing. My doctor was ok to take me off work to attempt the bridge but wants to make sure I just don't sit in my misery day in day out.

 

Prior to getting this new doctor, I was already in terrible withdrawals. It felt like the Lexapro was not working.  Based on my history, I have been on Lexapro 2 times in the past. It would stabilize me for a few months then I would be in terrible withdrawals, like it pooped out. I was having a difficult time getting my Kaiser doctor to give me time off work. I was basically gas lighted and said that what I was feeling was not drug withdrawal and that it was my baseline. It was really frustrating. They proposed more meds like they do, but I refused. I was barely getting out of bed, and had to be at work sick, barely there and present, but they did not believe me. 

 

So my new doctor started the bridge end of May, we were able to eliminate the Lexapro quickly.

 

So now I am just stabilizing after completely dropping the Lexapro, then we will start on the Paxil next. We are doing the whole add 1mg of liquid Prozac, wait a few days to see how I feel, then make a 1mg to 2mg cut. 

 

Last week we attempted to cut the Paxil right away after I completed the Lexapro cut. But then I was in a terrible tailspin for 2 days. So my doctor decided to go back up on the original Paxil dose I was on (8.82mg). My body is still probably getting adjusted to not having Lexapro and the addition of Prozac.

 

So we just decided to hold for now, and just add 1mg of Prozac every 4 days, but only add if withdrawal symptoms become too much. Then well proceed depending how I feel. Our goal is to get up to 10mg to 15mg of Prozac, and to completely drop the Paxil. But my doctor is monitoring and making sure we take the necessary time to do so, but also making sure I don't get stuck, because the goal is to get off the Paxil and be on one drug. 

 

Thats it for now, Ill try to update as I move forward. I will update my signature too.

[Altostrata]

On 7/13/2021 at 7:53 PM, DiscJockey said:

So we just decided to hold for now, and just add 1mg of Prozac every 4 days, but only add if withdrawal symptoms become too much.

 

Paxil is very difficult to go off. You might remind your doctor that an increase in Prozac takes about 2 weeks to ramp up to steady-state, because of the drug's half-life. Increasing Prozac every 4 days risks your finding you are taking more serotonergic than you need to do the job.

 

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