freeaway: adrenaline rush and withdrawal?

[freeaway]

Hello, I am 39 years old female who used to be on Celexa for 10 years and switched over to Pristiq about 2 years ago.

I had anxiety and rarely any panic attacks.

- 2007 Celexa 20mg

- 2012 Celxexa increased to 40mg

- 2017 Celexa decreased to 20mg

- 2018 (April) Switched to Pristiq 50mg

- 2018 (September) Increased to 100mg of Pristiq

- 2020 July Decreased Pristiq to 75mg

 Currently on Pristiq on 25mg. 

 

The reason how I switched to different med was when I asked my doctor I wanted to come off the celexa after 10 years since I was getting better he told me to reduce the typical way by cutting my dosage 40mg to 20mg.

And after that I started having panic attacks, which I know now it is actually or could be withdrawal reaction.

It wasn't like the typical panic attacks where I thought I was going to die or something it was more of sudden adrenaline rush which doctor said it was panic disorder.

This was right after having a second child with c-section.

I would wake up with panic attacks and nervousness (high increase in my cortisol) and doctor just kept telling me it is panic disorder and tried to give sedative on top of what I was taking and I refused.

After finding another doctor, he witched me to Pristiq but my panic attack like or the adrenaline rush was still around.

 

It has been such crazy and scary time of my life thinking that I was dealing with constant panic disorder.

But I never gave up and searched and searched and did all the work up with my health condition. I was healthy as ever but still had these random rush.

I used to have hot flashes like feeling, jittery sensation, of course night mares or vivid dreams you name it all kinds of feelings and sensation.

 

And I made a promise to myself to stop this medication which was given to stop my panic attacks but it never really helped.

All they wanted to do was add more meds and sedative and I am so grateful I never took anything else.

 

I started Pristiq 100mg until this past July 202 and I manually have cut it down to 75 to 50 to 25mg now. (Which I found out I wasn't supposed to since my medication is extended pill) I was able to tolerate the symptoms and made it this far. \

I have been using meditation, breathing, and cutting sugar  to deal with my anxiety.

I also have learned panic attacks are nothing to be afraid of and not to react to it.

I am reading about neuroplasticity and teaching myself our brain can heal which has been so helpful to deal with my sensation.

 

But one thing I am curious about is these sudden adrenaline rush I get before bed or sometimes randomly caused by antidepressant withdrawal?

How common is this? 

 

Thank you for reading my long story and I am so good at writing so I apologies in advance.

 

[manymoretodays]

Hi freeaway,

Could you do a signature for us:

Please summarize your withdrawal history in your signature

^ and then we will have a bit more context to go on, I'm wondering just when you made that last reduction

That will help us a lot.  And then we'll get you approved and started as soon as possible.

 

Thank you.

[Shep]

Hi, @freeaway

 

Please note I added a signature for you based on what your wrote in your first post.

 

However, as Manymoretoday's posted, we really need more information on your last reductions for the Pristiq. 

 

Please go to your signature and add in the months (and days if you know them) where you were at 75mg, 50mg, and 25mg. 

 

Your signature is here:

 

Account Settings - Create or Edit Your Signature

 

Once we have this information, we can better guide you in a possible updose. 

 

 

[freeaway]

Hi, can I also add a question?

 

So I understand that withdrawal symptoms are happening and I get these ups and down of sudden anxiety and fear for no reason.

Is there such thing or such symptoms for others? 

I mean as long as I know time will eventually heal this sensation I can confidently disregard my fear but I keep doubting myself.

I hope my questions are not so confusing and thank you for your precious time.

 

[Shep]

12 hours ago, freeaway said:

So I understand that withdrawal symptoms are happening and I get these ups and down of sudden anxiety and fear for no reason.

Is there such thing or such symptoms for others? 

 

Yes, the ups and downs pattern is very common. Please see:

 

The Windows and Waves Pattern of Stabilization

 

 

How psychiatric drugs remodel your brain

 

Healing from antidepressants. Patterns of recovery video (4 minutes)

 

 

Quote

  2018 (September) Increased to 100mg of Pristiq

- 2020 July Decreased Pristiq to 75mg

- 2020 September 50mg

- 2020 December 6th, 25mg (current)

 

 

 

Thanks for adding a signature, Freeaway.

 

Your decreases have been very large. We recommend going no faster than 10% a month, based on the previous' months dose (not the original dose). Please see:

 

Tips for tapering off desvenlafaxine (Pristiq)

 

Why taper by 10% of my dosage?

 

 

You may benefit from an updose, but please don't make any changes yet. I'm going to ask the moderators most familiar with Prestiq to give you some guidance.

 

 

 

[freeaway]

Thank you for your information.

 

You see, I didn't know about reducing it down 10% is recommended until about 2 months ago I think.

And as you know Pristiq does not come in small dosage and I have asked or called the compounding pharmacy and they said they couldn't do it.

I do not wish to switch to Effexor. 

 

To be quite frank, my withdrawal symptoms has gotten much weaker compare to when I initially dropped my dosage.

It was just the thought of fear "what if" thoughts of the outcome.

Plus, I DO NOT KNOW WHAT ELSE TO DO?

 

I am reading the options that was tagged but there seems to be no correct answer.

 

 

[freeaway]

It may seem my only option is to crush it myself and make into capsule? 

Thank you again for all your help.

I truly appreciate it.

I feel like there is no one I could talk to about how to come off this Pristiq without adding or changing to another medicine.

 

[Altostrata]

Welcome, freeaway.

 

It sounds like when you decreased Celexa, you got withdrawal symptoms. They were those sudden waves of "anxiety". This is a very common symptom of antidepressant withdrawal.

 

On 12/24/2020 at 7:19 AM, freeaway said:

To be quite frank, my withdrawal symptoms has gotten much weaker compare to when I initially dropped my dosage.

It was just the thought of fear "what if" thoughts of the outcome.

 

100mg Pristiq is quite a lot of Pristiq. It could be that taking too much Pristiq was also giving you drug-induced anxiety, and reducing it has reduced that adverse effect.

 

As I understand it, you are taking half a 50mg Pristiq tablet now, correct?

 

If you've read the Tips for Tapering Pristiq topic, you know that when the tablet is broken, Pristiq has a shorter half-life and may be leaving your body faster. Since you reduced to 25mg Pristiq, how has your symptom pattern changed? What time of day do you take it? How do you feel before and after you take it? How's your sleep?

[freeaway]

Omg thank you replying... 

I had a very rough ride today with the withdrawal symptoms.

 

So right now I'm taking 25mg which i have manually cut out. I take it around 9pm every night. 

 

When I wake up I'm usually nervous from cortisol spike. And it gets better around afternoon and by evening I get these rough sensations.

 

So even though I can't be cutting pristiq since it becomes half life I'm afraid to adjust anything.

 

Please help me. 🙏

[freeaway]

My sleep used to be rough where I'll wake up middle of the night and feel very nervous but now it has subside and most of the night I do get ok sleep. 

 

Today, I felt so scared thar I messed up my own body by cutting it like that and I couldn't stop myself from fearing what would happen. 

[Altostrata]

When you cut up Pristiq, it essentially becomes something close to immediate-release venlafaxine (Effexor). which usually is taken twice a day. But you seem to be tolerating once-a-day dosing. It's unusual, but @ChessieCat is tapering Pristiq by cutting it up.

 

What are the "rough sensations" you get in the evening? Because the Pristiq you're taking is immediate-release, the prior day's dose may have worn off by evening, causing interdose withdrawal.

 

Pristiq may be affecting your sleep. If I were you, I would gradually move it earlier by an hour each day until you're taking it at noon or earlier. The "rough sensations" may move earlier as you move the dose. Please keep daily notes of times of day you take your drugs, their dosages, and your symptoms throughout the day. 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 show if your symptoms are adverse effects from Pristiq.

[freeaway]

Thank you Altostrata.

 

Ok, so to make things little more clear I am pretty much using Pristiq as Effexor by cutting it right since it won't be extended form. So it wears off quicker and then I am dumped with these horrible sensations?

 

I am not so good at writing or expressing things properly but I'll try to describe the sensations.

Feeling like I'm on the edge and nervous as if I am about to panic/ panic attacks, jittery sensation, my shoulder and arms get these needle/tingling sensation.

Dry mouth, loss of  appetite, and feeling like my sight changed little blurry time to time.

 

How I go through it is extremely difficult but I do it for the better cause, where I know I am coming off toxic chemical that was built in my body.

As these sudden sensation rises I just practice sitting with it or just let it pass.

I was told by the one of my favorite anxiety news letter reacting just makes it worst and learning to accept it heals. 

 

https://nickwignall.com/anxiety-myths/?ck_subscriber_id=1059655165

 

This was the website I have learned so much on how to deal with my fear.

 

I will definitely take your advise and keep track of my symptoms.

 

 

 

 

 

 

[freeaway]

Also I need to add, I get these lower back pain. 

[ChessieCat]

Hi freeaway,

 

You can contact the places mentioned in Post #1 to find a compounding pharmacy near you.  Or go to the compounding website and search for location:  https://www.pccarx.com/Resources/FindACompounder

 

getting-compound-custom-dosages-at-compounding-pharmacies-us-uk-canada-and-elsewhere

 

I got slow release formula added to mine but that still doesn't cover the 24 hour period.  Once I got below 10mg I started taking my dose twice daily.  However, I realised at that time that I should have been doing that after I got below 50mg (25mg isn't available in Australia).

 

Recently I discovered that I can dissolve the contents of a compounded capsule in water and I have been using that to "top up" my dose so I can taper by close to 10%.  The lowest dose my compounder could make at a reasonable cost was 0.125mg so until I discovered that I can make a liquid I was going to have to reduce by larger amounts and hold for longer.

 

I've posted a lot of information about my taper in:

 

tips-for-tapering-off-pristiq-desvenlafaxine

 

 

 

 

[freeaway]

Thank you very much for your time and information.

 

So I did use the link to find compounding pharmacy but no one will do it for Pristiq.

Right now I am doing much better and my WS has been easier to deal with and this has been the pattern ever since I have been cutting it down manually myself.

Now that I know 10% is what's recommended I have purchased digital scale and capsule so that I can manually make it down equal amount of 25mg.

Once I do this for next month, I will use the weight distribution to make in 10% decrease.

 

As far as dealing WS, I also take supplements to be healthier such as vit B, C, D and zinc etc...

At night after dinner I have been using Magnesium Lysyl Glycinate Chelate, Di-Magnesium Malate) of 830mg Di-Magnesium Malate | Formulated for Enhanced Absorption

which helps me to sleep much better. 

 

I am so thankful I was able to obtain so much information through this website before I could have been doing something worst.

 

I am a true believer with the term "it doe get better" because decreasing my meds if fact made me feel better than when I was on such high dosage.

 

Thank you @ChessieCat for your amazing help and information. 

 

I'll keep posted of how I am doing through this as well.

 

 

 

[ChessieCat]

Seems like some of the compounders in the USA are not aware that Pristiq can be compounded.  It can be.  Myself and another member in Australia have made enquiries with quite a large number of compounding pharmacistshere to get quotes and none of them have said that it cannot be done.  I have also contacted pccarx directly in the USA.  See below.

 

I suggest that you contact pccarx and ask for the pharmacy name and/or advise the compounding pharmacy to contact the pccarx like the email response states.

 

Another member was having difficulties getting Pristiq compounded in the USA and I contacted pccarx directly and received the following response (see post here) :

 

Quote

 

 

And received the following response:

 

I have not provided Ranel's address because it may change in the future if this person leaves the organisation but this is the one I used and you can send it   Subject:   ATTN:  Clinical Compounding Pharmacist

 

customerserviceexternal AT SYMBOL pccarx DOT com

 

Thanks so much for contacting us regarding this.  There are definitely some options on compounding this product and we are happy to assist a pharmacy with the knowledge on how to do this.  We have many member pharmacies within the state of Washington that are PCCA members and would be able to assist this patient.  Do you know where in Washington State your contact is located?  If you can provide that information I can direct them to a pharmacy that is a PCCA member.  That pharmacy is welcome to contact me through our members only website or by calling customer service and I can assist them with a formulation. 

Thank you and have a wonderful day!

Ranel A. Larsen, Pharm D, RPh | Clinical Compounding Pharmacist

PCCA | 9901 South Wilcrest Dr. | Houston, TX 77099-5132

Ph: 800.331.2498    

Fax: 800.874.5760 | PCD Fax: 713-234-6009

www.pccarx.com

 

 

[freeaway]

You are so amazing @ChessieCat!

I can't thank you enough for your help and information.

Yeah, I contacted at least 10 pharmacies and all of them said no.

It was extremely frustrating.

 

Thank you again 💖

God bless you and your family.

 

 

I'll get you touch with them right away.

 

[freeaway]

Also, can I ask you one more question?

One of the withdrawal symptom that scares me is when I get this sudden brain shaking feeling that makes think I'm having a seizure but I'm sure I'm not. 

It's not a brain zap it's little more intense than that. What do you think? Or did you ever experience this?

[Shep]

10 hours ago, freeaway said:

Also, can I ask you one more question?

One of the withdrawal symptom that scares me is when I get this sudden brain shaking feeling that makes think I'm having a seizure but I'm sure I'm not. 

It's not a brain zap it's little more intense than that. What do you think? Or did you ever experience this?

 

Yes, there are all sorts of brain sensations that can occur. Please see:

 

Head noise and other symptoms in the head

 

Brain zaps

 

By "more intense," is it like a loud banging sound? That could be exploding head syndrome:

 

Exploding head syndrome

 

Please don't be afraid of any of the weird brain sensations. They will fade away in time. 

[freeaway]

Thank you very much @Shep.

I am extremely grateful 🙏

 

[freeaway]

My brain zaps are not around anymore.

But every other day I'll say at evening time while watching tv or something I get these jolts or brain shakiness for like short period.

It is time around when I usually take me pristiq medication. 

Which makes me nervous and scared that I might be having a seizure.

I even had brain MRI about 9 months ago and it was normal.

______________________________________________________________________________________________________________________

This was also found:

 

Abstract at http://www.ncbi.nlm.nih.gov/pubmed/12741444

Full text at http://www.mediafire.com/?05lths70n67kcsm

Pharmacotherapy. 2003;23(5)

Shock-Like Sensations During Venlafaxine Withdrawal.

Roy R. Reeves, D.O., Ph.D., James E. Mack, Ph.D., John J. Beddingfield, M.D.

 

e-mail: roy.reeves@med.va.gov

 

Abstract

 

Electric shock-like sensations may occur after cessation of treatment with serotonin selective reuptake inhibitors but are reported in the literature only rarely with discontinuation of venlafaxine. Two patients experienced severe shock-like sensations during venlafaxine withdrawal. For both patients symptoms occurred with lowering of the dosage and persisted for 5 days after complete discontinuation of the drug. These sensations may represent significant alteration of neuronal activity in the central nervous system.

______________________________________________________________________________________________________________________________

 

Is that what I went through? Severe brain shock? 

 

I just saw the video that was linked and I heard @Altostrata mentioning brain zaps are not a mild thing it is form of epilepsy.

So here I am scared as hell again about my symptoms.

 

=(

 

[freeaway]

@ChessieCat Good news! I have just found out Pritiq in NY has 25mg!

 

But that is the lowest dosage so my problem is after that.

I have contacted PCCA and they couldn't help me.

The answer was for me to find a pharmacy to contact them to help but the pharmacy here doesn't do such thing.

[freeaway]

Hey everyone! I actually found a compounding company that is able to do any form of dosage for Prsitiq with extended formula!

I just spoke to them and they can alter it with extended release with any dosage! So they can literally make it into micro dosages!

 

Please share if anyone needs this type of service!

 

https://valorcompounding.com/

 

The girl I spoke to was name Lauren, she was very nice and helpful.

 

 

[Shep]

@freeawayThanks for listing the compounder - I've quoted your post in the compounding thread here. 

 

 

21 hours ago, freeaway said:

I just saw the video that was linked and I heard @Altostrata mentioning brain zaps are not a mild thing it is form of epilepsy.

So here I am scared as hell again about my symptoms.

 

This symptom can be alarming, but that doesn't mean we don't heal from this. Please see the success stories as proof:

 

Success stories: Recovery from withdrawal

Edited December 30, 2020 by Shep
fixed typo

[Altostrata]

freeaway, do you get these shocks before or after you take Pristiq in the evening?

[freeaway]

I got them before I took the pristiq.

It's been two days since I haven't had any. Through out the day I was going through minor flu like symptoms and anxiety will rise here and there. But it was manageable.

It was just those brain shock that really scared me making think I was about have seizure. 

Good news is, it did get better or subsided. 

 

As of yesterday I started taking Pristiq 25mg in a extended tablet.

I didn't need to take the ones that were manually cut anymore since now they carry lower dosage.

Also, the pharmacy that I found is mailing out the 22.5mg with extended form today.

 

So hopefully, this 10% decrease will not cause such brain shocks or other horrible sensations.

 

I still can't believe how patients are told to discontinue this Pristiq from 50mg.

 

I thank God for having me find this website and to help me guide through this.

I also hope and pray that I can help others with their healing.

 

 

[freeaway]

quick question 🤔

Any idea if it is safe to use supplement called cortisol and adrenal support by Dr.berg? I'm attaching the picture of it.

I have been using it but I stopped like 2 weeks ago. I think it was really helping me personally with my anxiety.

Any thought or anyone else using this?

Thank you always 💓💛💖

 

[ChessieCat]

I suggest you do a search for the individual ingredients.  Use a search engine and add site:survivingantidepressants.org

 

https://www.bestlifesupplements.com/dr-bergs-adrenal-cortisol-support-ingredients-reviews/

[freeaway]

@ChessieCat @Shep @Altostrata

Dear members, I have failed on making it through 25mg.

I thought once brain zaps were gone it will get better but it actually got worst.

For the past 2 weeks has been hell of needles and pin on skin plus anxiety and constant panic attacks.

 

I have tried so hard not to go back higher on my dosage but last night was the final where numerous panic attacks kept happening I had to take extra 25mg of pristiq to make it back to 50mg.

 

I'm so disappointed at myself and feel like total failure 😞

Also scared as hell with the panic attacks.

 

I feel burnt and hopeless of what I'm going to do. 

Maybe I should start back to 50mg and one month later drop it to 45mg?

 

Hope there is a way... 

 

Thank you with all my heart for listening. 

 

 

[freeaway]

@ChessieCat @Shep @Altostrata

Dear members, I have failed on making it through 25mg.

I thought once brain zaps were gone it will get better but it actually got worst.

For the past 2 weeks has been hell of needles and pin on skin plus anxiety and constant panic attacks.

 

I have tried so hard not to go back higher on my dosage but last night was the final where numerous panic attacks kept happening I had to take extra 25mg of pristiq to make it back to 50mg.

 

I'm so disappointed at myself and feel like total failure 😞

Also scared as hell with the panic attacks.

 

I feel burnt and hopeless of what I'm going to do. 

Maybe I should start back to 50mg and one month later drop it to 45mg?

 

Hope there is a way... 

 

Thank you with all my heart for listening. 

 

P.s. when will be the best time to take pristiq? I tend to have more panic attacks at night... 

 

 

[freeaway]

I need to rephrase panic attacks.

What I'm feeling sudden surge of adrenaline. It just rises while I'm just relaxing or even on the phone with a person or for nothing.

Is this adrenaline pumping from chemical reaction I'm having in my brain while reducing my dosage? 

 

It's nothing to worry about right? 

[Shep]

22 hours ago, freeaway said:

I have tried so hard not to go back higher on my dosage but last night was the final where numerous panic attacks kept happening I had to take extra 25mg of pristiq to make it back to 50mg.

 

Since you haven't been on 50 mg since last September (4 months ago), going back up to 50 mg is too high an increase. 

 

On 12/29/2020 at 1:36 PM, freeaway said:

I actually found a compounding company that is able to do any form of dosage for Prsitiq with extended formula!

I just spoke to them and they can alter it with extended release with any dosage! So they can literally make it into micro dosages!

 

Have you started using the compounding formula with extended release or are you still cutting up a Pristiq pill and dosing once a day? 

 

Please start a drug and symptoms journal. Also include your supplements and the number of hours you sleep at night. Below gives more information about the format. 

 

On 9/27/2016 at 2:49 PM, Altostrata said:

In the course of discussion in your Introductions forum topic, you may be asked to keep notes on paper of your daily symptom pattern, including when you take your drugs, their dosages, and any symptoms. We ask this because there may be something we can do to reduce the symptoms.

 

What we need to see for every single day over several days is what symptoms you get before and after you take your drugs. If you're not taking any drugs and have withdrawal symptoms, we still need to see your symptom pattern throughout the day:

 

The time of day, dosage, and severity of symptoms are essential information. Include

 

- Time and dosage for all drugs taken throughout the day, psychiatric and non-psychiatric.

- Following each dose, note any symptoms. If you are having a reaction to the drug, it may take hours for a symptom to show up -- that's why we ask you to keep notes all day long.

- If you're not taking any drugs, your symptoms throughout the day.

- Your sleep pattern. Since so many drugs disturb sleep, if you find you're waking in the middle of the night, it could be from a drug you took earlier in the evening. If you're not taking any drugs, there may be ways you can improve your sleep.

And so forth. A diary, in chronological order, looking something like this:
 

Example:

DATE:

 

6 a.m. Woke with anxiety
8 a.m. Took 2.5mg Lexapro
10 a.m. Stomach is upset
10:30 a.m. Ate breakfast
11:35 a.m. Got a headache, lasted one hour
12:35 p.m. Ate lunch
4 p.m. Feel a bit better
5 p.m. Took 2.5mg Lexapro
6 p.m. Ate dinner
9:20 p.m. Headache
10:00 p.m. Took 50mg Seroquel
10:20 p.m. Feeling dizzy
10:30 p.m. Fell asleep
2:30 a.m. Woke, took 3mg Ambien (NOT "took 1/2 tablet Ambien")
2:45 a.m. Fell asleep
4:30 a.m. Woke but got back to sleep

 

[freeaway]

Good morning, thank you for your reply @Shep.

 

So last day I took 50mg is December 5th, 2020. 

And I took 25mg as of December 6th, 2020.

 

Yes, I have found the compounding pharmacy and they have sent me 22.5mg which I was going to take once 25mg was done in about 2 weeks.

However, due to my horrible side effect of reducing I started struggle strongly with anxiety, cortisol spike, pins and needle pain and adrenaline attacks.

 

One thing I do not understand is how come coming down from 100mg to 50mg wasn't this hard. But dropping 50 to 25mg my withdrawal symptoms are much worse. I thought it was going to be easier. 

 

Starting Tuesday (1/12/20) I have now taken 50mg since I didn't know what else to do. Lot of the symptoms subsided feeling better than before. 

 

I will start the journal but what dosage do I start with? 

Also, do you know any doctors that helps you to wean off?

None of the doctors here that I have met knows how to properly help.

 

 

[Altostrata]

15 hours ago, freeaway said:

One thing I do not understand is how come coming down from 100mg to 50mg wasn't this hard. But dropping 50 to 25mg my withdrawal symptoms are much worse. I thought it was going to be easier. 

 

Hello, Freeaway. It was easier for you to reduce from 100mg to 50mg because there was a lot of excess in that dosage. There's not much difference in neurological effect between 100mg to 50mg.

 

How do you feel since you've been taking 25mg for more than a month?

[Shep]

21 hours ago, freeaway said:

One thing I do not understand is how come coming down from 100mg to 50mg wasn't this hard. But dropping 50 to 25mg my withdrawal symptoms are much worse. I thought it was going to be easier. 

 

6 hours ago, Altostrata said:

It was easier for you to reduce from 100mg to 50mg because there was a lot of excess in that dosage. There's not much difference in neurological effect between 100mg to 50mg.

 

This thread may help explain:

 

Why taper? SERT transporter occupancy studies show importance of gradual change in plasma concentration

 

From the first post in that thread:

 

On 3/28/2014 at 12:20 AM, dcrmt said:

Now a couple of interesting things:

-at minimum therapeutic doses in every case, there was about 80% SERT occupancy. That shocked me personally. Even the minimum doses are locking down 80% of your brains reuptake ‘capacity’. Higher doses do more but it’s obviously not linear – they actually have plotted curves, and they’re quite a good fit statistically, particularly for the blood concentrations. Really good in fact. 

Point here though is that there’s a long way between 0% at no drug and 80% at the minimum dose.

 

A lot of the drug is actually contained in the lower dose ranges. So some people do find tapering from the high doses to be easier than when they get to the lower doses. 

[freeaway]

Thank you both @Shep @Altostrata for your precious time again. 

 

I started feel little better with than before panicky feeling and severe nervousness has been decreased.

 

So I spoken to the doctor and he said pristiq is very hard to come off since it's short life in our system and he recommended using Paxil as a bridge to help come off the pristiq.

After pristiq is out then come off Paxil.

I'm scared to try any other meds and not sure what will happen.

 

Any suggestions? Or recommendations?