dream: relapse due to Paxil reduction

[dream]

hello, i have been taking paroxetine (paxil) discontinuously for 15 years. I tried several times to quit, but the withdrawal symptoms always return and I start taking the dose again. last chance: May18-June 2018 5mg July 3 mg then relapsed then Aug -Sep2018 6mg Oct-Nov 5mg Dec 4mg Jan 2019 3mg then stop. I was fine without medication until July 2019, then relapsed, then July 2019 10 mg Aug2019 7mg Sept. 2019 6 mg Oct 2019 5mg Nov 2019 4mg Dec 2019 3 mg then stop. I was well without medication until May 13, 2020, then again very strong symptoms and I started to take it back. I tried 5 mg for 10 days but I was sick, so for 5 days I am at 10 mg. every time the change of season makes me sick. what can I do? did I have to intrude smaller amounts of medication?

 

Edited October 28, 2021 by ChessieCat
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[Gridley]

Welcome to SA, Dream.  Thank you for the clear explanation.

 

All of your tapers of Paxil were too fast and you stopped taking the drug at much too high a dose.  Also, what happened that made you start the drug again was not "relapse" but rather withdrawal.  As you have seen, withdrawal symptoms often do not occur immediately and are often delayed.  

 

Please answer these questions:

1. During the times you describe as "relapse," what were your symptoms?  

2. How are you feeling now?

3. Did the increase to 10mg help?

 

So that you have a better understanding of what you're experiencing, here is some information on withdrawal.

 

What is withdrawal syndrome.

 

Daily Checklist of Antidepressant Withdrawal Symptoms (PDF) 

 

When we take psychiatric medications, the CNS (central nervous system) responds by making changes over the months and years we take the drug(s). When the medication is discontinued, the CNS has to undo all the changes it made. Rebuilding the neurotransmitter production and reactivating the receptor and transporter cells takes time -- during that rebuilding process symptoms occur.  

Before you taper again, you need to stabilize.  When you've answered my questions, I'll be better able to advise you.

When the time comes for you to taper again, we recommend tapering by no more than 10% of your current dose every four weeks.

 

Why taper by 10% of my dosage?

 

This link is specifically about tapering Paxil, including how to get the nonstandard doses you'll need for your 10% taper.

 

Tips for tapering off Paxil (paroxetine)

 

We don't recommend a lot of supplements on SA, as many members report being sensitive to them due to our over-reactive nervous systems, but two supplements that we do recommend are magnesium and omega 3 (fish oil). Many people find these to be calming to the nervous system. 

 

Magnesium, nature's calcium channel blocker 

 

Omega-3 fatty acids (fish oil) 

 

Add in one at a time and at a low dose in case you do experience problems.

 

This is your Introduction topic, where you can answer my questions, ask your own questions and connect with other members.  We're glad you found your way here.

 

 

 

 

 

 

 

 

[dream]

Thanks for the reply. as already said the symptoms always return in the change of season. I begin to feel anxiety, a sense of tightness in the chest, a strong knot in the stomach, tremors, tiredness and finally the insomnia that knocks me out. I don't know how to manage them and the only remedy is to resume paxil. I help myself with xanax drops to calm the side effects. now that I am at 10 mg after 17 days you feel better, still ups and downs but I am more stable. Will I ever be able to remove it? I'm demoralized ..

 

Edited October 28, 2021 by ChessieCat
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[Gridley]

7 hours ago, dream said:

begin to feel anxiety, a sense of tightness in the chest, a strong knot in the stomach, tremors, tiredness and finally the insomnia that knocks me out.

These are typical withdrawal symptoms.

 

7 hours ago, dream said:

I don't know how to manage them and the only remedy is to resume paxil

Withdrawal is definitely difficult, but there are many success stories on this site of members who got off these drugs.  Here is a link.

 

Success stories: Recovery from withdrawal

 

We recommend non-drug coping skills to deal with withdrawal.

 

Non-drug techniques to cope

 

This restorative yoga pose is helpful with anxiety.

 

10 minute Restorative Yoga for Relaxation | Up the wall

 

It's very encouraging that you're feeling more stable.  My suggestion would be that you make no further changes in dose and wait to stabilize at 10mg.  You will improve but it will be a slow process and you have to be patient.  It is not helpful to keep changing doses.  Your body needs stability.  Then, when you are feeling stable, and this may take several months, you can begin a 10% taper of Paxil as described in the link in my previous post.  Do not try to taper now.  You need to stabilize.  

 

I'd recommend you read through the non-drug techniques to cope link and also that you try magnesium and omegas as I described in my previous post.

 

Yes, it is very possible to come off these drugs.

 

[dream]

I seem to be better, but today I have many negative symptoms, anxiety and strong tacchicardia ... I am also so tired ... will I ever get a better look? I am very discouraged

...

 

Edited October 28, 2021 by ChessieCat
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[mustafa]

Hello dream,

As gridley said,

The bad symptomts may be withdrawals not a relapse; stopping paroxetine may be the cause of your suffer and here on SA, you are given plans to help you stop the antidepresdant yours, safely.

Try to find non drugs ways to cope with the stress from changing season, dont use a drug for it, relaxing methods and even talking to a friend or parents may help you be assured and dont have depression.

Dont be discouraged, alot of members here are suffering and we are all with you.

You should also know that nothing will happen in a day and a night, it may take some time for u to be ok ( as i think ) but every one is unique and we have different bodies.

Have a look at the links that gridley gave u in your introduction reply, they are very very helpul.

I hope the best for u❤️

Edited October 28, 2021 by ChessieCat
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[dream]

Ho ripreso 15 mg di paxil da 19 giorni, può essere normale sentirmi ancora male?

 

deepL Translation:

 

I have been back on 15 mg of paxil for 19 days, can it be normal to still feel sick?

 

Edited October 28, 2021 by ChessieCat
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[dream]

I have been taking paxil for 19 days. Is it normal to still feel bad? still have anxiety and tacchicardia?

 

Edited October 28, 2021 by ChessieCat
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[mustafa]

Well, i must wait for @Gridley to give you the information, iam not a moderator nor experienced but up on reading others' topics i can say, yes; lots of probabilities are there, your brain may respond well to a drug for a time and respond bad in another time.

I think you should follow what gridley advised u with, did he advise you to stay on paxil? And at what dosage!?

The direct answer for your question is of course yes, you may still feeling bad.

[dream]

Buongiorno qualcuno conosce nel nord Italia un centro o un medico che mi possa aiutare nella sospensione di paxil?

 

deepL Translation:

 

Good morning does anyone know of a center or doctor in northern Italy who can help me with the suspension of paxil?

 

Edited October 28, 2021 by ChessieCat
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[Gridley]

22 hours ago, dream said:

I have been taking paxil for 19 days. Is it normal to still feel bad? still have anxiety and tacchicardia?

You tapered very fast, resulting in withdrawal.  Please see my first post for an explanation of withdrawal.  There is no way to predict how long withdrawal will last.  Are you still taking 10mg Paxil?  As I suggested, I would hold there at 10mg and make no further changes.

[dream]

good morning, I did 10 days at 5 mg and 11 days at 10 mg. to date, anxiety and tacchicardia have increased a lot, enough to make me take 50 drops of xanax to be able to sleep a few hours a night. How is it possible? maybe paroxetine is no longer effective? I don't know what to do anymore ... should I increase? I seem to go crazy ...

 

Edited October 28, 2021 by ChessieCat
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[mustafa]

Hello, 

Please mention gridley or quote his reply in order for him to follow your post and reply to u .

U arent going crazy and please dont panic, you are in withdrwal and may have bad effects of the drugs this time and this is unfortunately all what i know❤️

@Gridley

 

Edited October 28, 2021 by ChessieCat
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[dream]

@Gridley  

I'm getting worse ... but what's happening to me? The other times after all these days of hiring I had stabilized ... why am I getting worse now ???

 

Edited October 28, 2021 by ChessieCat
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[Gridley]

1 hour ago, dream said:

... why am I getting worse now ???

Every time you make big changes in your drugs, your system becomes more and more sensitized.  That explains why the other times you were able to stabilize and why this time it is difficult.  You need to make no changes to your drugs.   Time is the cure, and we can't predict how long it will take.  We can say you will get better if you hold where you are and make no further changes.

 

Have you tried the magnesium and omegas that I recommended in my first post to you?  Many people find that they are calming to the nervous system.

 

On 5/28/2020 at 1:12 PM, Gridley said:

 

We don't recommend a lot of supplements on SA, as many members report being sensitive to them due to our over-reactive nervous systems, but two supplements that we do recommend are magnesium and omega 3 (fish oil). Many people find these to be calming to the nervous system. 

 

Magnesium, nature's calcium channel blocker 

 

Omega-3 fatty acids (fish oil) 

 

Add in one at a time and at a low dose in case you do experience problems.

 

 

[dream]

@Gridley 

Thanks for the answer. What mean “Every time you make big changes in your drugs, your system becomes more and more sensitized”

 

 

Hai provato il magnesio e gli omega che ti ho raccomandato nel mio primo post? 

 

deepL Translation ^:   Have you tried the magnesium and omegas I recommended in my first post?

 

yes, but It’s the same.

 

 

what i can Aldo do?

 

 

Could it be that paxil no longer works?

 

 

Edited October 28, 2021 by ChessieCat
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[Gridley]

17 minutes ago, dream said:

What mean “Every time you make big changes in your drugs, your system becomes more and more sensitized”

In June-July, 2018 you did a fast taper from 5mg to 3mg.  In Jan., 2019  you went cold turkey at 3mg.  Later that year you went from zero to 10mg, then cold turkeyed at 3mg later that year.  Then in May  of this year you reinstated with 5 mg then jumped up to 10mg.

 

That's 5 major changes since July, 2018.  These changes are very hard on your central nervous system, which has to try adapt to the changing doses and cold turkeys, and every time it has to do this it becomes more and more destabilized.  That's why you need to make no further changes and let your system stabilize at your current dose.

[dream]

@Gridley

buongiorno, l'anno scorso dopo essermi stabilizzata a giugno 2020 su 10 mg paxil, ho provato a ricominciare la riduzione graduale del 10%. a volte sentivo un pò i sintomi legati alla riduzione, ma tutti gestibili. sono arrivata gradualmente a maggio 2021 a 3,5 mg, tutto abbastanza bene.

volevo chiedere se è normale essere cosi iper-sensibile a tutto, mi stanco e mi stresso con qualunque cosa, sono delicatissima; il mio sistema nervoso si altera appena gli stimoli sono leggermente fuori dalla media normale.

inoltre sto iniziando ad avvertire dei segnali che ormai conosco legati al cambio di stagione (umore nero, ansia, stanchezza, tacchicardia) che come ogni anno potrebero preannunciare una crisi.. eppure ho cercato di togliere il farmaco gradualmente.. cosa mi succede? cosa posso fare? mi sto aiutando con il rivotril... 

 

deepL Translation:

 

 good morning, last year after having stabilized in June 2020 on 10 mg paxil, I tried to restart the gradual reduction of 10%. sometimes I felt a bit of the symptoms related to the reduction, but all manageable. i gradually arrived in May 2021 at 3.5 mg, all quite well.

I wanted to ask if it's normal to be so hyper-sensitive to everything, I get tired and stressed with everything, I'm very delicate; my nervous system alters as soon as the stimuli are slightly out of the normal range.

In addition, I am beginning to experience signs that I now know are related to the change of seasons (black mood, anxiety, fatigue, heart rate) that, like every year, could herald a crisis... yet I have tried to gradually take off the medication... what is happening to me? what can I do? I am helping myself with rivotril...  

Translated with www.DeepL.com/Translator (free version)

 

Edited October 28, 2021 by ChessieCat
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[Gridley]

@dream

 

Here is the Google translation of your post.  Please translate your posts before posting.

 

 

Quote

good morning, last year after stabilizing in June 2020 on 10 mg paxil, I tried to start the 10% gradual reduction again. sometimes I felt some symptoms related to the reduction, but all manageable. I gradually reached 3.5 mg in May 2021, all quite well. I wanted to ask if it is normal to be so hyper-sensitive to everything, I get tired and stressed with everything, I am very delicate; my nervous system becomes altered as soon as the stimuli are slightly out of the normal range. also I'm starting to feel the signs that I know by now related to the change of season (black mood, anxiety, fatigue, tacchycardia) that like every year could herald a crisis .. yet I tried to remove the drug gradually .. what happens to me? what can I do? I'm helping myself with rivotril ...

 

Yes, the symptoms you describe are normal for withdrawal during tapering as long as they are manageable and fade before your next reduction. It is very good that your symptoms are manageable. If the symptoms become intolerable or do not fade before your next reduction, it means you are tapering too fast. If the change of season situation worries you or if your symptoms worsen and are not manageable, you might want to lessen the percentage amount of your taper to 5% or hold longer between reductions. The usual time to hold at a dose during a taper is 4 weeks but you might want to extend that to six.

 

In the last sentence in your post, which did not appear in the translation, you wrote that your are managing symptoms with the benzo Rivotril, known also as Clonazepam.  Please be aware than benzos like Rivotril cause physiological dependence in a short time, within 2 to 4 weeks of regular use and also with intermittent use.  How often do you take Rivotril and at what dosage?  If you become dependent on Rivotril, you will need to taper off it.  That would be something you would do after you've completed your Paxil taper, not at the same time, because we recommend making only once change at a time.

 

Edited October 28, 2021 by ChessieCat
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[dream]

grazie @Gridley per la risposta.

purtroppo in questi giorni sto subendo una forte crisi come immaginavo dovuta al cambio di stagione. il rivotril l'ho sempre usato in modo intermittente a dosaggi molto bassi, mi aiutava a gestire i passaggi durante le riduzioni.

ora il dottore mi ha consigliato di prenderlo in modo costante ogni 8 ore per provare a superare la crisi.

secondo te faccio bene?

quando secondo te dovrò arrendermi e risalire con la paroxetina? di quanto mg? io non vorrei, ma le crisi sono molto forti... tu consigli sempre di resistere?

grazie

 

deepL Translation:

 

thanks @Gridley for the reply.

unfortunately these days I am suffering a strong crisis as I imagined due to the change of season. rivotril I have always used it intermittently at very low dosages, it helped me manage the transitions during the reductions.

Now the doctor has advised me to take it consistently every 8 hours to try to overcome the crisis.

do you think i am doing the right thing?

when do you think i should give up and go back on paroxetine? how much mg? i don't want to, but the seizures are very strong... do you always recommend to hold out?

thanks

Translated with www.DeepL.com/Translator (free version)

 

Edited October 28, 2021 by ChessieCat
added translation

[Erell]

Hello @dream

 

On 5/13/2021 at 12:08 AM, Gridley said:

@dream

 

Here is the Google translation of your post.  Please translate your posts before posting.

 

[Gridley]

@dream

 

I have again translated your post using Google translate, but I will not be able to do this in the future.  You will need to post in English if we are going to respond.

 

Quote

unfortunately these days I am undergoing a strong crisis as I imagined due to the change of season. I have always used rivotril intermittently at very low dosages, it helped me manage the steps during the reductions. now the doctor advised me to take it constantly every 8 hours to try to overcome the crisis. do you think I'm doing well? when do you think I'll have to give up and go back on paroxetine? how much mg? I don't want to, but the crises are very strong ... do you always advise to resist?

 

Here is my response to your post:

 

You will have to decide what to do about the Rivotril.  You need to know that physiological dependency to a benzodiazepine like Rivotril can begin within 2 to 4 weeks of regular use and also from intermittent use.  

 

We don't always advise to resist.  If you can tolerate the symptoms until the seasonal change difficulties pass, holding where you are at 3.5mg is one possible course of action.  Alternatively, it is possible that a small updose (increase) from 3.5mg to 4.5mg of Paroxetine will help alleviate withdrawal symptoms.  I would not recommend more because too much of an updose can overwhelm your system and destabilize you further.  It takes 4 days for an updose to reach full strength in your blood stream and a few more days for it to register in the brain.  If this helps symptoms, I would hold on 4.5mg Paroxetine for several months to allow your system to stabilize.  Once your system has stabilized, you can begin to taper again but more slowly than before.  

 

 

Edited October 28, 2021 by ChessieCat
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[dream]

hi @Gridley, thanks as always for the support. the May crisis came back thanks also to the use of rivotril; after years it is the first time that I have not increased paroxetine after the crisis due to the change of season; I have continued to take rivotril at a very low dose, but it is helping me in paroxetine reduction. the withdrawal symptoms are there but bearable; I'm now at 2mg. I wanted to ask you, the worst symptom is irritability and mood swings, and often low mood. are they due to the drug? when will they go away? I'm even afraid it's my character trait ...

 

Edited October 28, 2021 by ChessieCat
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[Gridley]

dream,

 

I need to take a break from moderating, so I'm not active on the site at this time.

 

The symptoms you describe are typical withdrawal symptoms.  It's good that they're bearable.  

 

Edited October 28, 2021 by ChessieCat
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[dream]

Hi @Gridley, I apologize so much for the inconvenience, can I just ask you who do you advise me to talk if I have any doubts? My crisis never passes.. thank you thank you, sorry for the inconvenience

[ChessieCat]

Gridley is not available at this time.  I have asked the other moderators to assist you.

We need to know what medications you are currently taking.

Please write a simple list of changes you have made in the last 6 months.  Please list the name of the medication, the date, and the dose.

Thank you.

 

 

deepL Translation:

 

Gridley non è disponibile in questo momento.  Ho chiesto agli altri moderatori di assisterti.

Abbiamo bisogno di sapere quali farmaci stai prendendo attualmente.

Per favore, scrivi una semplice lista dei cambiamenti che hai fatto negli ultimi 6 mesi.  Si prega di elencare il nome del farmaco, la data e la dose.

Grazie.

[ChessieCat]

On 9/14/2021 at 8:12 PM, dream said:

I have continued to take rivotril at a very low dose

 

NOTE TO MODS:  Rivotril = clonazepam

[dream]

@ChessieCat Thank you. I started reducing paroxetine in June 2020 starting at 15mg. in December 2020 I was at 6 mg. in March 2021 I was at 3.5 mg. in June 2021 I was at 3 mg. (with the change of season I always have my crises), but that of June 2021 I overcame it, I helped with 10 drops of clonazepam which I then removed without problems. in August I was at 2 mg. on 21 September I switched to 1.5 mg, I started abstinence, I resisted (thanks also to 15 drops of clonazepam a day). I stayed still like that, I endured it, but now the abstinence has increased, with strong tacchycardia, a knot in the stomach, agitation, internal anxiety, a lot of tiredness, and it has worsened after a little more intense physical activity. what can I do?

 

in August I was at 2 mg

on 21 September I switched to 1.5 mg, I started abstinence, I resisted (thanks also to 15 drops of clonazepam a day). I stayed still like that, I endured it, but now the abstinence has increased, with strong tacchycardia, a knot in the stomach, agitation, internal anxiety, a lot of tiredness, and it has worsened after a little more intense physical activity. what co?

 

Edited October 28, 2021 by ChessieCat
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[ChessieCat]

Dream, please follow these instructions when you post.  It will make your posts easier to read.

After pasting the translation into the reply box there will be an option that appears below the box.

"Paste as plain text"   Please click on it.  This will make your text normal.  Thank you.

 

deepL Translation:

 

Dream, per favore segui queste istruzioni quando posti.  Renderà i tuoi post più facili da leggere.

Dopo aver incollato la traduzione nella casella di risposta ci sarà un'opzione che appare sotto la casella.

"Incolla come testo normale".   Per favore cliccaci sopra.  Questo renderà il vostro testo normale.  Grazie.

[Altostrata]

@dream, going off paroxetine can be extraordinarily difficult, especially tapering the lower doses.

 

8 hours ago, dream said:

in August I was at 2 mg. on 21 September I switched to 1.5 mg,

 

This is a rather large decrease in paroxetine, amounting to a 25% reduction. Can you put your dose back to 1.75mg and see if that helps?

 

Have you also been taking clonazepam since June? Do you take clonazepam at the same times each day?

[dream]

@Altostrata

Do you recommend this increase even if a month has already passed? could i have any benefits? I use the drops: 4 drops = 2 mg, 3 drops = 1.5 mg, how can I make 1.75 mg with the drops? or return to 4 drops?

 

yes I have always taken clonazepam since June 5 drops every 8 hours, but a few weeks I tried to decrease .. but since the beginning of October I am constant at 5 drops every 8 hours ... maybe I have to increase them?

[dream]

@ChessieCat

thanks sorry for the mistake

[ChessieCat]

Thank you dream.  That is much easier for us to read.

[Altostrata]

@dream, measuring with the dropper is not going to be exact enough. Please ask your pharmacist for a 5mL oral syringe or 2mL if they have it. Veterinarians may also carry them. 

 

Ask your pharmacist to show you how to measure out 1.75mg of the paroxetine liquid.

[dream]

@Altostrata

Do you recommend this increase even if a month has already passed? Could I have any advantages?

[dream]

@Altostrata

But from your experience, resisting, sooner or later the symptoms pass?