Victor1: Paxil withdrawal

[Victor1]

Hi. I've been struggling with paxil withdrawal for 7 months and I'm in need of some serious advice. I have been on paxil since March 2015 and I worked my way up to 40 mg. I was not on any other medication except paxil. In January 2019, I started my journey to taper off of it. This is what my taper looks like:

 

January 31, 2019 - Decreased from 40 mg to 30 mg

June 6, 2019 - Decreased from 30 mg to 20 mg

September 6, 2019 - Decreased from 20 mg to 10 mg

November 12, 2019 - Cold turkeyed 10 mg

 

My psychiatrist was telling me to taper at 10 mg at a time which I now know is way too steep of a drop. I didn't know at the time because, surprisingly, I did not experience any withdrawals jumping from 40 to 30, 30 to 20, or 20 to 10. I might have experienced some very slight changes when I dropped from 20 to 10 but they were so subtle that I didn't attribute it to the drop in my dosage at the time.

 

The cold turkey off of 10 mg was when everything fell apart. It was a gradual worsening of symptoms. At 3 weeks off was when I noticed that the withdrawal has become severe. I did not reinstate because I thought it would go away and I did not know another way to get off of it until I found this website and the 10% taper in February 2020.

 

After 3 months off paxil, I felt like I couldn't hold on any longer. On February 12, 2020, I saw a psychiatrist and reinstated back to 10 mg paxil. I was on it for 17 days and I saw no improvement with my withdrawal symptoms. I read so much online about how reinstatement this far out might not work. I panicked and made the decision to stop reinstatement on February 29, 2020. In hindsight, I probably should have stuck with it because I might have been better by now. 

 

Now it's June 15, 2020 and I'm really struggling to hold on. In summary, my taper journey was 3 months off from cold turkey of 10 mg paxil, 2.5 weeks reinstatement of 10 mg paxil before quitting again, and now I'm 3.5 months off paxil after quitting reinstatement. I know this withdrawal might potentially last a very long time and reinstating again has recently crossed my mind because I've been going psychotic for many days. I know if I reinstate, it would be a big commitment. One, it might not work but I'd still have to commit to being on it since I can worsen my withdrawal by jumping off of it again. Two, I'd have to hold for 6 months to a year and then do a slow taper that may last 2 years or more. There are just times when it's so tough, it feels like I can't handle it anymore, and I'm desperate for relief that I don't know if I should hang on or try reinstatement again. I just need to be able to function normally and right now I'm not even close to being that way. 

 

Both times when starting paxil, I didn't get any real adverse startup effects. I got the yawning all of the time but other than that, it seemed fine. From these two past experiences, if I start it again, I don't really think I'd get an adverse reaction to it. The only problem is the idea of it not alleviating the withdrawal. If there is anyone who can give me advice on what I should do, it would be much appreciated because I can't even decide myself. 

 

 

[DataGuy]

Hi Victor,

 

Sorry you've had to go through this, I gather you are feeling pretty bad. Could you describe your symptoms, how your symptoms have progressed over time, and whether they have become more intense or less intense? I assume you find them pretty intolerable from your introduction. Can you describe how functional you are relative to normal? Are you able to exercise? Go to the grocery store? Work? How is your eating? Your sleep? 

 

Just to clarify: you saw no improvement at all after reinstating the 10mg of Paxil? It can take months to feel better for some people, unfortunately. 

 

Another clarification: when you say you've been "going psychotic", does that mean actual psychosis, or you just feel like you are totally out of control?

 

Have you read this guide to reinstatement? Since you have been off for months now, reinstatement would only need to be 1/10th of the dose you jumped off at (1mg). This is to try and avoid adverse reactions and kindling. There is really no good way of knowing if it will work, but your last attempt would seem to indicate you may need to hold for quite awhile if you are to feel any relief. I would wait for some input from another moderator about reinstatement as I don't quite have as much experience with Paxil. 

Have you been trying any non-drug coping techniques to deal with your symptoms? Here is a list and description of some which may help:

 

 

Glad you found the site, Victor. Hopefully we can provide you with some guidance about how best to deal with the withdrawal and get your nervous system back to normal. 

 

[Gridley]

@Victor1

 

Welcome to SA, Victor1, from me too.  I'm sorry you're going through this.

 

The last 10mg of an SSRI are the most potent, which may explain why you jumped off at 10mg was when withdrawal hit.

 

Reinstatement works most predictably within 3 months after your last dose, and you're now 7 months out.  That makes it risky.  It could help or it could make matters worse.  Please be sure to answer DataGuy's question about the effect of the 10mg you took for 17 days.  Were there any changes in your symptoms, better or worse?

 

If you do decide to reinstate, you should, as DataGuy suggested, reinstate 1mg Paxil--no more.  Your system is sensitized and too large a dose can overwhelm it and destabilize you further.  This link about tapering Paxil gives you information about how to get the 1mg Paxil you'll need if you decide to reinstate.

 

Tips for tapering off Paxil (paroxetine)

 

It takes a little more than a week for the reinstatement to reach full strength in you system.  If after reinstatement you feel worse, you should stop the reinstatement immediately.

 

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.   If you decide to reinstate, I wouldn't add in these supplements at the same same. You only want to make one change at a time.  You could start with the supplements and see if they help before reinstating.  Or you could reinstate and after a week or so add in one, then the other.

 

Please be sure to answer DataGuy's other questions.

 

 

 

 

 

 

 

Edited June 15, 2020 by Gridley

[Victor1]

Hi @DataGuy and @Gridley. Thank you for responding. 

 

My symptoms are worse enough to affect my daily functioning. It takes a lot of effort for me to make food, drive a car, and even responding to text messages like these so sorry if I respond late. I've been out of work for 4 months and counting because of this. My employer is holding my job for me for 1 more month. Symptoms include dizziness, heavy twitching eyes with vision out of focus, light headedness, feeling on edge and hard to relax (might be akathisia) that makes me want to scream or do something stupid, and OCD type thoughts around my condition because I think about it everyday. I also had a problem with my head feeling like it drops. Sometimes I lay down on my bed and my head feels like it drops and I get disoriented and a bit dizzy for a few seconds. I don't know if this is what people call brain zaps but it doesn't feel like I'm being electrocuted though. I'm very tense as well. I guess some of these symptoms got better but other symptoms pop up or persist. It's hard to tell. 

 

When I reinstated the 10 mg paxil for 17 days, I noticed no signs of improvement whatsoever. I kept getting those dizzy spells where my head drops and I get disoriented for a few seconds. I got the dizziness and lightheaded feeling still. All of those things made me really question the reinstatement. If I saw even mild improvement, I would have stuck with it.

 

When I say that I'm going psychotic, I meant that I'm very mentally unstable and hardly functioning and it makes me break down some days and tell my mom and other family members and they're very worried about me.

 

I'm very scared to do another reinstatement. I'm just desperate right now for relief. The gym just opened back up so maybe if I implement exercise, it would be better. I also think my employer will work with me and somehow I can survive this without reinstatement. At the present, I don't think I can make a decision to reinstate due to fear.

[Victor1]

I forgot to add that another symptom is cognitive impairment. I'm not as mentally sharp as before when I dropped the 10 mg paxil. I guess you can call it confusion. It's hard for me to make decisions and things that I normally did and found easy, it seems like I can't do it anymore. Maybe the sensory disturbances that I experience with the vision out of focus, heavy strained eyes, and light headedness is what causes the cognitive impairment but I'm not too sure. 

[Gridley]

17 minutes ago, Victor1 said:

At the present, I don't think I can make a decision to reinstate due to fear.

 

I understand your concerns, and you absolutely need to do what you think is best.  I wish I could tell you when you're going to start feeling better, but it's impossible to predict.  I do suggest you try the magnesium and omegas, one at a time and at a low dose.

 

Regarding the exercise, many members in withdrawal find strenuous exercise to to be overstimulating (too activating).  When you go to the gym, I'd suggest you take it easy at first and see what level of exercise is best for you at this point.

 

We recommend avoiding stress, caffeine and alcohol.  Sugar is often not well-tolerated in withdrawal.

 

The symptoms you describe, including cognitive impairment, not being able to do what you previously could, and vision issues are very typical withdrawal symptoms.  So that you have a better idea of what you're experiencing, here is some information on withdrawal and the healing process.  It's a lot of information.  Just take your time and read as much as you feel capable of.

 

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.  

 

These explain the healing process really well:

 

Video:  Healing From Antidepressants - Patterns of Recovery

 

Brain Remodelling 

 

Feel free to ask any questions you may have.

 

 

[Victor1]

@Gridley Can I ask what you would do in my situation? I just want to get some opinions. I'm deeply depressed. I struggled with social anxiety since I was a teenager and now I see myself not wanting to talk most of the time and it feels like I really have to force myself to talk whenever I'm in public. My quality of life is garbage right now. My social anxiety and depression was nowhere near this bad pre-meds so I know the withdrawal is really amplifying it. 

[Gridley]

15 minutes ago, Victor1 said:

Can I ask what you would do in my situation?

You have to keep in mind that this is temporary and will get better.  Withdrawal is really unpleasant, and you are not alone in feeling you way you do.  When you emerge from this you will be a stronger person.

 

Do try the supplements I suggested.  A gentle walk, preferably in nature, can help (though I know that sometimes you don't even want to get out of the house).  Take a look at the coping skills for withdrawal in this link and see which one you think might help you.

 

Non-drug techniques to cope

 

You didn't mention anxiety as one of your symptoms, but if you have it, I've found this simple restorative yoga pose helpful with withdrawal anxiety.

 

10 minute Restorative Yoga for Relaxation | Up the wall

 

Try the non-drug techniques, try the supplements, always remembers you will get better, the damage is not permanent.  And read the success stories on this forum for encouragement.

 

Success stories: Recovery from withdrawal

Edited June 15, 2020 by Gridley

[Victor1]

It's been 8 months since I got off paxil and 4 months since my last dose from my short term reinstatement and I'm still having trouble holding on. I wouldn't have imagined that it would be 8 months and still in pretty severe withdrawal but maybe the reinstatement really had an effect on my recovery. I think my symptoms peaked 1-2 months off from reinstatement. I think I see a slight improvement since that time but it's really hard to tell sometimes since it's still severe. 

[Gridley]

16 minutes ago, Victor1 said:

I think I see a slight improvement since that time

You've made several changes since last September, and it's going to take a while for your system to stabilize from the various dose changes and CT's.  The fact that you see an improvement, however slight, is  very encouraging.  It's just going to take a bit of time but you're healing every day.  Just be kind to yourself, be as patient as you can and give a try to the non-drug coping skills I mentioned in my previous post.

[Rusty1]

On 6/15/2020 at 2:20 PM, Victor1 said:

@Gridley Can I ask what you would do in my situation? I just want to get some opinions. I'm deeply depressed. I struggled with social anxiety since I was a teenager and now I see myself not wanting to talk most of the time and it feels like I really have to force myself to talk whenever I'm in public. My quality of life is garbage right now. My social anxiety and depression was nowhere near this bad pre-meds so I know the withdrawal is really amplifying it. 

Hi Victor1, just wanted to chime in and say best wishes.  I am in the process of discontinuing Paxil and know how difficult it is.  You made a lot of changes in a short amount of time and that absolutely will take time for your body and brain to settle down.  My advice is to take advantage of the knowledgeable people here and rely on them for advice.  Also, do not panic, things will get better!  Too many people get tired of seemingly no progress or slow progress and think a major change will solve their problems.  Once you start having severe symptoms slow and steady wins the race, you don't want to compound what you are experiencing with even more changes to try and cope with.

 

Keep posting your symptoms and take advantage of the advice people will provide.  Make sure to be patient with yourself.  All of us who have gone through this realize the pain of wanting this to change and feel normal immediately.  Unfortunately that is not how this experience most often plays out.  Be patient and you will find the strength to continue to get through this. Although it doesn't seem like it now, things will get better.