Thehardway: not quite halfway off paroxetine and hit the wall

[Thehardway]

My name is Todd and a week ago today things started to go haywire for me.  I've been cutting from 20 mg .  Total pill weight was 288mg and I got down to 175 mg.  I was hospitalized in 2012 from jumping off the way wrong way and learned my lesson.  

 

Basically I've bumped up my dose and am taking Ativan as needed right now when things get bad.  I'm seeing a counselor and have an appointment for a psychiatrist this month.  I've never actually dealt with any psychiatrists other than the one when I was hospitalized in 2012.  I'm here just trying to get what I can to get back on track and stave off the fear. Thanks

 

Also I'm not sure how where my signature is located.

[Gridley]

Welcome to SA, Thehardway.

 

If you hit the wall, it means you re tapering too fast and went into withdrawal.  I would hold where you are now and make no further changes until you stabilize.  What were your symptoms?  Have they improved after the updose?

 

What pill weight are at now after your updose?  Can you tell me how much that is in mg of active ingredient?  We taper using pill weight (mgpw) and keep track of our dosage using active ingredient (mgai).  I find it helpful to keep track of my taper with a chart on some notebook paper.  When you started out your chart would look like this: 

 

DATE          pill weight (mgpw)            active ingredient (mgai)       taper rate

  ?                 288                                      20

 

At what rate are you tapering?  We recommend tapering by no more that 10% of current dose every four weeks.

 

Why taper by 10% of my dosage?

 

This link is specifically about tapering Paroxetine.

 

Tips for tapering off Paxil (paroxetine)

 

Please be careful with the ativan.  Benzo dependency can begin after 2 to 4 weeks of regular use and also with intermittent use.  Once you become dependent you no longer receive the original benefit of the drug and are taking it only to stave off withdrawal.

 

For your visit to the psychiatrist, you should know that the vast majority of psychiatrists know nothing about safe tapering or withdrawal, which they don't believe exists.

 

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.

Your signature is located just below your post.  Could you add what dosage (in active ingredient, not pill weight) you were at when you hit the wall and what dosage you're at now?  Here's the link to make changes:

 

Account Settings – Create or Edit a signature.

 

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

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

[Thehardway]

Ok.I didn't have a specific rate of taper.  Total weight was  288 so I'd drop to like 280 for a month.  I did it like this over the course of almost two years.  The only change I made recently was quitting nicotine gum.  I was at 175mg tpw when this happened  and I've bumped up to 230 total weight.  I'm worried about the ativan as well but not sure how to cope with theses symptoms...i am taking magnesium and fish oil.  Not sure how to calculate drug  weight from total weight

 

[Thehardway]

BTw....I'm trying g to stay away from. The trazadone for sleep cuz of how it makes me feels so drugged so I've only taken it one time when I got really bad earlier this week.  Perhaps that is safer than the ativan? The ativan I take is 2mg

 

[Gridley]

30 minutes ago, Thehardway said:

Perhaps that is safer than the ativan?

There are problems with both.  There's the physical dependency problem with Ativan.  Trazodone has a major drug interaction with Paroxetine.  

Interactions between your drugs

Major

Using traZODone together with PARoxetine can increase the risk of a rare but serious condition called the serotonin syndrome, which may include symptoms such as confusion, hallucination, seizure, extreme changes in blood pressure, increased heart rate, fever, excessive sweating, shivering or shaking, blurred vision, muscle spasm or stiffness, tremor, incoordination, stomach cramp, nausea, vomiting, and diarrhea. Severe cases may result in coma and even death. You should seek immediate medical attention if you experience these symptoms while taking the medications.

-----

What are your symptoms? Are you doing better since you increased the Paroxetine?

 

 Regarding coping with Paxil withdrawal symptoms, we recommend non-drug techniques.  Take a look at the links in the following link and see which you think might be helpful to you.

 

Non-drug techniques to cope

 

 

 

 

 

 

 

[Thehardway]

Hmmm...i used trazadone for about two years with paroxetine.    I wonder with that history if it didn't happen then...but who knows.  Im aware you're just trying g to help. I appreciate it too.  I. Just hoping to make it to work in the morning and not be suffering like I was early last week.  I know it can take a bit before the added does of paxil can take effect right?

[Gridley]

 

 

7 minutes ago, Thehardway said:

I know it can take a bit before the added does of paxil can take effect right?

 

It takes a little more than a week for the updose to reach full state in your system.  

 

Edited June 7, 2020 by Gridley

[Thehardway]

Thanks gridley...I just want to get some sleep before I have to work in the morning....having no sleep wracked with anxiety is very damaging to me.  Thnks for the help

 

[Gridley]

2 minutes ago, Thehardway said:

wracked with anxiety

 

Sleep is one of the toughest aspects of withdrawal, for sure.

 

I found this restorative yoga pose very helpful with withdrawal anxiety.  I don't know how limber you are (I'm not), but if it's difficult to get your legs onto the wall, you can hook your lower legs onto a chair and it will also work.

 

10 minute Restorative Yoga for Relaxation | Up the wall

[Thehardway]

I just realized I never answered your question about what my symptoms were.  Started with anxiety attacks...lack of sleep.   Then I dont know how to describe the worst of it other than I couldn't sit or stand still...extreme anxiety that wouldn't relent came Tuesday two days after the first panic attack.   I took a trazadone for sleep and felt better the next day.  I only took that one traz and an ativan per day when anxiety kicked up.  I did workout each day and had a long hot walk this morning.  Today I've been feeling  worse but not nearly like Tuesday. 

 

Thanks for the yoga it helped

[Cocopuffz17]

Hey Hardway. I know everyone is different but paroxetine is hell to get off. I was on it for 11 years at 20mg. I needed to changed my nutrition to get off and repair my gut and heal my microbiome. I tried 3 times (2 CTS and 1 Fast Taper all were very tough and i reinstated). This is my 4th time and I did a 3 month fast taper and I am now almost 16 months off and know if I did not change my nutrition I would of not have gotten off of it. All the best to you in healing. Each day that passes is one day closer to being healed. 

[Thehardway]

Has anyone here done a taper that takes years to complete?

 

I'm just curious if anyone has taken the very slow road.  Like longer than a year or more and if it would possibly help with long term withdrawal symptoms.

 

Edited June 15, 2020 by ChessieCat
added topic title

[DataGuy]

Hi Thehardway,

 

There are definitely many people who need to taper very slowly. Your taper should be dictated by symptoms and functionality. If you find your symptoms are increasing in intensity and not leveling off after a cut, you are probably cutting too much. Cuts should be made so that you remain as stable and functional as possible. Even if you are cutting as recommended (10% every month), you'll see that this translates to well over a year of tapering. The most important thing is to remain stable and functional (ie your sleep is ok, not overly fatigued or symptomatic). 

 

One person who did a long (1 year+) taper is James Moore from the UK. He has a blog about it and a podcast called "Let's Talk Withdrawal" where he interviews experts and patients about their experiences with antidepressants and other psychotropics. https://www.letstalkwithdrawal.com/about-me/

 

Here is a post from Altostrata with various links and questions answered about tapering, which may be helpful: 

 

[Thehardway]

Ok thanks DataGuy.  Let me look these over.

[ChessieCat]

4 hours ago, Thehardway said:

Has anyone here done a taper that takes years to complete?

 

I'm just curious if anyone has taken the very slow road.  Like longer than a year or more and if it would possibly help with long term withdrawal symptoms.

 

 

Yes.

 

Yes.

 

Yes.

 

I'm towards the end of my taper.  I was on 100mg Pristiq, started tapering October 2015, currently at 0.875mg and still have about 1 year to go.  During that time my symptoms have been minimal and bearable.

 

BrassMonkey completed a long, slow Paxil taper.  He developed his own tapering method, which takes 1.5 times the length of time it takes to complete a 10% taper.  He decided to do it this way to keep withdrawal symptoms to a minimum.  He worked during all that time.

 

And there are others too.  See this area of SA:  success-stories-recovery-from-withdrawal

 

This might help you to understand the process better:

 

  

On 8/31/2011 at 5:28 AM, Rhiannon said:

This is something I posted somewhere else and then saved. I know it's all stuff I've said before, but it bears repeating and further discussion. A lot of people, including healthcare practitioners; in fact, I guess, most people-- are operating from entirely the wrong paradigm, or way of thinking, about these meds. They're thinking of them like aspirin--as something that has an effect when it's in your system, and then when it gets out of your system the effect goes away.

 

That's not what happens with medications that alter neurotransmitter function, we are learning. What happens when you change the chemistry of the brain is, the brain adjusts its chemistry and structure to try to return to homeostasis, or biochemical and functional balance. It tries to restabilize the chemistry. For example: SSRI antidepressants work as "serotonin reuptake inhibitors." That is, they cause serotonin to remain in the space between neurons, rather than being taken back up into the cells to be re-used, like it would be in a normal healthy nondrugged brain. So the brain, which wants to re-establish normal signaling and function, adapts to the higher level of serotonin between neurons (in the "synapse", the space between neurons where signals get passed along).

 

It does this by removing serotonin receptors, so that the signal is reduced and changed to something closer to normal. It also decreases the amount of serotonin it produces overall. To do that, genes have to be turned on and off; new proteins have to be made; whole cascades of chemical reactions have to be changed, which means turning on and off OTHER genes; cells are destroyed, new cells are made; in other words, a complex physiologic remodeling takes place. This takes place over time. The brain does not grow and change rapidly. This is a vast oversimplification of the amount of adaptation that takes place in the brain when we change its normal chemistry, but that's the principle.

 

When we stop taking the drug, we have a brain that has designed itself so that it works in the presence of the drug; now it can't work properly without the drug because it's designed itself so that the drug is part of its chemistry and structure. It's like a plant that has grown on a trellis; you can't just yank out the trellis and expect the plant to be okay. When the drug is removed, the remodeling process has to take place in reverse. SO--it's not a matter of just getting the drug out of your system and moving on. If it were that simple, none of us would be here. It's a matter of, as I describe it, having to grow a new brain. I believe this growing-a-new-brain happens throughout the taper process if the taper is slow enough. (If it's too fast, then there's not a lot of time for actually rebalancing things, and basically the brain is just pedaling fast trying to keep us alive.) It also continues to happen, probably for longer than the symptoms actually last, throughout the time of recovery after we are completely off the drug, which is why recovery takes so long.

 

With multiple drugs and a history of drug changes and cold turkeys, all of this becomes even more complicated. And if a person is started on these kinds of drugs at an early age before the brain has ever completely established normal mature functioning--well, it can't be good. (All of which is why I recommend an extremely slow taper particularly to anyone with a multiple drug history, a history of many years on meds, a history of past cold turkeys or frequent med changes, and a history of being put on drugs at a young age.)

 

This isn't intended to scare people, but hopefully to give you some idea of what's happening, and to help you respect and understand the process so you can work with it; ALSO, because you are likely to encounter many, many people who still believe these drugs work kind of like aspirin, or a glass of wine, and all you need to do is stop and get it out of your system. Now you can explain to them that no, getting it out of your system is not the issue; the issue is, you need to regrow or at least remodel your brain. This is a long, slow, very poorly understood process, and it needs to be respected.

 

Edited June 15, 2020 by ChessieCat
reworded taper time

[Thehardway]

Thank you for this Chessiecat.   Maintaining my ability to function is imperative.  I'm a single dad.  I have to keep my life going and still be useful as a father and son and worker.  I dont know where I went wrong on my slow taper. I know I felt very comfortable until I hit the 60% of full dosage mark. Then I had a small anxiety attack...no biggie. Week later I had another small one....2 days after that woke up having one and next starting feeling it hit.  I took a 9 year old xanax that I still had.  That made it worse.   Next day got worse took an ativan I had.  Felt worse than before.  Ended up feeling absolutely crushed for the whole week.  Started back on full dose of paxil and it all went away.  See, I've always felt fine on paxil since I was 18.  But when I try to get off its a living hell. Just trying to find the right method . 

[ChessieCat]

Please understand that it has nothing to do with how strong or determined you are as a person.  It's your brain having adapting to getting the drug.

 

You might consider doing the the-brassmonkey-slide-method-of-micro-tapering

 

Instead of tapering 10% every 4 weeks, you reduce by 2.5% every week for 4 weeks then you hold for 3 weeks (instead of 1) after the 4th reduction.  So a 5 year 10% taper/4 weekly would take 7.5 years because you are tapering 10% over 6 weeks instead of 4.

 

[Thehardway]

I like the sound of that method.  I'm gonna check it out.  I have more of a support system around me now.  I will hold where I'm at for a little bit...let the sting of this last crash die down and then start working on it again. Thanks

[ChessieCat]

I've merged your new topic with an existing one:  testosterone-therapy

 

Before creating a new topic, please do a search to see if one already exists.  I like to use a search engine and add site: survivingantidepressants.org to my search term.