Matheus: Has someone been on two antidepressants at the same time?

[Matheus]

Hi, im from Brazil, so my english is not very good. 

Id like to know if anyone ever took two antidepressants togheter. The reason i ask is because im on paroxetine 40mg and venlafaxine 37.5. 

I have been on paroxetine since 2017 on and off, always trying to quit, but recently i changed the doctor, i was in severe WD from paroxetine,( i CTed from 20 mg, initiali i was taking 40 mg and started lowering dosage and was feeling so good, i was so stupid i couldturkeyd from 20 mg), and he asked me to try venlafaxine, but  had no reliefe, made me so anxious, like akathisia.

Now i went back to my old doctor, and he asked me to go back to paroxetine, and i went, but he said o should stay o venlafaxine too, otherwise id have some problems.

Now im taking both along with zolpiden( sleeping piil, not benzo) and dont know much what to do.

My plan is to continue taking both AD untill i stabilize and then start tappering venlafaxine. And then much time later start tappering paroxetine again( witch is the drug im more sensible to, since im taking it for more or less 3 years.)

Any advices would be so helpfull, im from brazil and doctors here have no ideia what is withdrawal.

My worst symptom is severe dizziness.

[getofflex]

Hello, and welcome to SA.  We are a peer owned and run forum of people who have been or are getting off of psychiatric drugs.  It sounds like you may have sensitized your system by jumping on and off the paroxetine.  Adding the other drugs may have just destabilized your system further and confused your nervous system.  unfortunately, in my own experience, most doctors in the USA also have no idea about psych med withdrawal.  What other symptoms are you having currently besides severe dizziness?  Are you able to do normal daily activities?  How is your sleep?  

 

If your symptoms are bearable, it may be best to hold for a while and stabilize.  This means keeping your drugs and their dosages the same every day for a while.  

 

First of all, can you please give us specific information about your drug history?  Please read the link below for instructions.  This will allow us to give you the best guidance.  Please just list dates, drugs, and dosages, including each time you made a dose change. 

 

How to List Drug History in Signature

 

This helps you understand what withdrawal syndrome is: 

 

What is Withdrawal Syndrome?

 

Here is some information about how these drugs actually work.  

 

How Psychiatric Drugs Remodel Your Brain

 

Tapering is best done extremely slowly, and we taper by 10% of the current dose, so that the taper becomes exponentially smaller.

 

 Why Taper by 10% of my Dosage  

 

Also, as we are tapering, we suggest keeping things slow, simple, and stable. 

 

Keep it Simple, Slow, and Stable

 

 

When we recover, there are times of feeling OK mixed in with times of feeling bad.  This is called windows and waves.

 

Windows and Waves Pattern of Stabilization

 

Here are some techniques to cope with symptoms: 

 

Non Drug Ways to Cope with Withdrawal Symptoms

 

 

We don't suggest many supplements, but 3 that many of us find helpful are magnesium, omega-3, and melatonin. Here are the links for info about those. It is suggested to add one at a time, and start with a low dose to see how it affects you. 

Magnesium

Omega 3 Fish Oil

Melatonin

 

 

I've given you quite a bit of information here.  Please read through it, and mull it over, and we will take it from there. In the meantime, take care of yourself, and take heart.  We in this forum have been through this, and we understand first hand the pain and discomfort you are going through.  Please know that the brain is amazing in it's healing abilities.  It takes time, but healing can and will happen. 

 

[Matheus]

Hi, thanks for the feedback. Ok, ill edit my profile( drug history).

When i CTed 20mg paroxetine, in the end of october 2020, i thought i could handle withdrawal. Turns out i couldnt be more wrong. Already in the first days i had flu-like symptons( i thought i had covid), everyday diarrhea, umbearable anxiety, severe depressiom( i couldnt stop crying). I spent like one month thinking i had covid, when i realized this could be withdrawl, this made me loose a lot of time.

In thw beginining of december i reinstated paroxetine, and my simptons slightly improved( diarrhea stoped), but i still had a lot of crazy simptoms( dizzynes was the worse).

I stood december and january like this.

Then, i went see another doctor, and he asked me to try venlafaxine to see if id feel better.

Venlafaxine didnt help at all, making me feel agitated.

I stood only on venlafaxine for @ a month.

Then i decides i couldnt stand it anymore, and get back to paroxetine, but my old doctor told me i should stay on venlafaxetine too, otherwise id feel worse.

I am so frustrated, cause now i have two ADs to deal with. One of this days i tried to reduce my venlafaxine dosage by half, it was hell, i started vomitating and panic.

I should never have started venlafaxine but now its too late.

I am doing what u said: im taking my meds in the same dosage at the sime time in the day: paroxetine 40 mg 10 am,( this is when i wake) and venlafaxine at lunch ( 12:00).

Oh, i almost forgot. Im taking zolpiden, its like a sleeping pill, to help me get some sleep.

My sleep is slightly better, i can sleep like six hours per night. 

I am not able to do barelly anything, because i feel so bad. Had to stop studying too. 

Ive read somewhere venlafaxine is a nasty drug too, very hard to quit, im so afraid.

[Matheus]

Im feeling so gulty... i shouldve never stop paroxetine cold turkey. I was feeling so good, i decided to quit cold turkey. If i could just rewind the clock...

Another thing: i wish i knew all the info in this site before i made that decision. I went from heaven to hell in a few days...

[getofflex]

On 3/29/2021 at 1:15 PM, Matheus said:

...... 

My plan is to continue taking both AD untill i stabilize and then start tappering venlafaxine. And then much time later start tappering paroxetine again( witch is the drug im more sensible to, since im taking it for more or less 3 years.)

Any advices would be so helpfull, im from brazil and doctors here have no ideia what is withdrawal.

My worst symptom is severe dizziness.

I think you have come up with a pretty good plan.  That is what I would do.  I suggest that you take your time, and give you system at least several months to stabilize.  Then, we can come up with a very cautious and gradual tapering plan.  Please keep us posted with how you are doing.  Try some of the non drug coping techniques (see link above).  

 

This link talks about a lot of the issues that you are currently dealing with: 

 

How Long is Withdrawal Going to Take

 

I appreciate you giving me all your drug information.  However can you please put the information in your signature?  If you click on this link it will tell you exactly how.  Please give us only drugs, dates, and dosages in a concise list format.  That way, other moderators can come in here and help you as well.  

 

How to List Drug History in Signature

Edited March 31, 2021 by getofflex

[Matheus]

@getofflex hi. I editted my drug history, but dont know if did it right.

How long do u think i should wait before i begin tapering venlafaxine?

The reason im asking is because even though i know i should wait and stabilize first so i can start any tapper, the more time i wait, the more my body becomes addicted to venlafaxine and therefore harder to quit.

[Colonial]

Hello Friend,

 

I was on 2 drugs at once, Paxil and Wellbutrin. 

Luckily I had no problems being on them together, only trying to get off like everyone else.

Do not worry about taking the your time to stabilize before you start to taper.

To be honest, it only takes a month for the drug to re wire your brain, so you will not be more "addicted" to it later.

So you do not need to worry about it being harder later.

Take your time and rest up before You worry about trying to taper.

 

[Matheus]

Hi, @Colonial. Thank you for your response, it means a lot to me.

But my fear is: what if i dont estabilize with this two drugs? What if they are rather acting against each other than acting togheter. Thats my fear, friend.

 

[Colonial]

There is a risk for serotonin syndrome, but that is not the same thing as working "against" each other towards stabilization.

As long as you do not have the syndrome reaction, together they will not prevent stabilization.

Do however be aware of the symptoms and report any problems to your Doctor immediately.

 

 

Using PARoxetine together with venlafaxine 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. 

[Matheus]

Ok, @Colonial. So i think ill just have to wait...

I dont think i have this serotonin syndrome. 

I just have to be patient. But sometimes is just so hard when youre feeling like this.

[Matheus]

Helo, guys. Hope youre doing fine.

Think i neee to say what im feeling...i trying to syabilize like id said i would do( im doing it: paroxetine 40mg when get up the bed and venlafaxine at lunch time; and stillnox to sleep).

But what i keep thinking is: i walked i looong road, before i crashed this last time... i thouht i would never fall again... i did everything, i really was healing. I started taking 40 mg paroxetine and reduced by half( wich i know now is wrong, but i didnt know this site at that time). And even after that reducion, i felt good( first day i felt a little irritated but soon passed). And then i stayed on 20 mg paroxetine again. I felt amazing, i was in my long jorney to recovery. Im my mind i was so sure i could atop paroxetine all togheter, because of how i felt and i knew i could deal with feeling bad, cause i had a path. But, turns out i was totally wrong... i couldn deal with wd. It was so overwhelming. I cant help but feeling weak... if i only knew this some months before... 

Maybe the decision to stop paroxetine 20mg cold turkey was too big of a jump...

[Matheus]

Im so frustrated because now i have two ADs to get rid...

[Colonial]

4 minutes ago, Matheus said:

I started taking 40 mg paroxetine and reduced by half( wich i know now is wrong, but i didnt know this site at that time). And even after that reducion, i felt good( first day i felt a little irritated but soon passed). And then i stayed on 20 mg paroxetine again. I felt amazing,

 

I also was able to drop from  37.5mgs to 25mgs no problem either.  (This was three 12.5 mgs pills.)

The 25mgs I was taking was enough to completely lock down all my receptors and I didn't have any symptoms like yourself.

What I could NOT do, was drop from 2 pills down to 1, from 25mgs to 12.5mgs.

 

Those bigger cuts up top give us and doctors a false sense of good tapering success, since each mg is NOT equal in how it's interacting in our brains and therefore withdrawing from the drug completely is more complicated the lower we go in Our dosages. 

 

[Matheus]

Yeah, thats true... so bad when i knew it was too late.

 How are u doing now? Hows your taper? 

[Colonial]

I've had a bad year myself after a bad crash last April, which I'm assuming was from dropping too much Paxil within 30days.

 I tested negative for covid 2 times and negative for antibodies later. 

I dropped what to anyone in the medical field would say is a low amount: from 0.36 mg to 0.24mg in 2 drops over 30 days.

Basically 1/3rd of a mg down to 1/4th.

 

I've never fully recovered  even though I don't have a lot of symptoms all the time the last 6 months.

I think it has a lot to do with not being able to get reliable doses with such a concentrated liquid at small amounts.

If our dosages are not consistent it is hard for your body to recover.

So this weekend I will be starting my taper again after a year by diluting the liquid with distilled water and hoping for the best!

 

 

[Matheus]

Wow it seens a hard work tappering is such small dosages...

I hope it works well for you.

How was your crash? It has had a big impact in your life? Can you do your daily activities?

[Colonial]

I had a lot of diarrhea , difficulty breathing, swallowing, urinating, legs going numb, neurological issues, allergic reaction type issues. etc.

Everything but the allergic reaction type issues I had before so it's not known if I did have Covid and just didn't test positive or not.

Or my body was just overwhelmed by too many med drops kindling my system at this point, it's hard to say.

I have had anaphylactic issues pre wd that gave me a cardiac arrest so I'm not surprised.

 

I can do things but I'm pretty much a text book case of Chronic Fatigue Syndrome at this point.

Maybe once I get the taper done in a few years I will start to feel better.

 

Edited April 6, 2021 by Colonial

[getofflex]

@MatheusI'm glad you are trying to stabilize. The reason we suggest an exponential taper (cutting the dose by smaller amounts as we taper) is because there is a high rate of receptor occupancy at low doses of the drug.  That is to say, even on low doses of the drug, it is still having a major effect on the brain.  Please see this link: 

 

SERT Transporter Occupancy Studies

 

This process takes a long time and can be frustrating.  However, going too fast can cause major problems and suffering, and can take even more time for the nervous system to sort itself out.  The good news is that there is healing at the end of all this.  The success stories attest to that. 

 

 

[Matheus]

@getofflex, thankyou for your response. I wish i could go back on time with this information i know now. 

Think im on the middle of a wave, symptons feel worse...

Sleep wasn good this night. 

 

[Erell]

Hello Matheus,

 

I'm really sorry you're going through this.

Please don't be too harsh with yourself : we are all here because we trusted our doctors at one point, and you can't beat yourself for having tried to do the best choices following doctors' guidelines.

 

The good news is now you have access to infos, and you'll have all the tools to do a carefull and slow taper once ready ☺

 

Take care

[Matheus]

Hello, my friends @Colonial, @getofflex and @Erell. Hope youre doing fine.

I had to change my 20mg paroxetine from brand name to generic,( brand name was too expensive) and a notice some difference.

There is a generic from the same manufacturer as brand name and when i bought it in the past it felt tje same as their brand form( dont know if im being clear here lol).

 

I had to buy this generic because in the pharmacy i buy my medicines they only had these, so ill have to stick with it.

I dont know either if there is a diference in the release( extended or normal release), although in the box nothing is mentioned.

 

I dont know when is the right moment to taper venlafaxine, i do thinko shouldnt be taking both, but as said before, before i try to estabilize i cutted venlafaxine dose by half and in the next day i was vomiting...

 

Im doing my best to try to estabilize( take the medication about the same, and keep at least a minimun routine, but sometimes is very hard. My dizzines is a little worse, i think is because i had to go to apointments and had to leave the house to do some stuff( groceries, etc)... so is hard to know youre in the right direction or no( what is the right direction?) Should i try to live life at least by a minimun or should i keep all day in my bed so thr dizzines dont get worse?

Everytime i try to do something i feel a little regret because later i feel more dizzines and anxious...

 

Another thing im worryng about is tappering. It seens like a lot of hard work weighting pills, measuring liquids etc... i really never thought of that. That is like a new world to me... if i say this to people here they will think im crazy because they probably think such small amounts make no diference...

[Matheus]

@Colonial, im sorry you've been through this... but as youe profile pic says: this too shall pass. And you will recover! How are things today?

[Matheus]

@Erellthank you for the message. Yeah i know i shouldnt beat on myself, but when you dont feel good is hard not to.

Yeah, the good part is now i have more knowledge.

How are u coping?

[Matheus]

@getofflex, ok. Thankyou for the link. Ive readed it and is very interesting. I wish i knew this a couple months ago.

[Colonial]

"I dont know either if there is a diference in the release( extended or normal release), although in the box nothing is mentioned."

 

There is a big difference in how extended release and all release interacts with your brain.

You should find out if you were on extended release in the past and what is the new formulation.

Please contact the pharmacy to find out and let us know.

 

There may be symptoms in changing from name brand to generic, but that is a separate discussion from extended vs. all release at one time.

Both can cause symptoms but when changing from extended release to all release many find taking half of the daily dose 2X a day necessary.

Otherwise they suffer Interdose WD.

 

Even if the name brand was "all release", it may take some time to get adjusted to the new pills.

 

When did the dizziness start?

Was it after you stopped the Paxil, or did it not begin until after you added the 2nd medication?

 

Edited April 10, 2021 by Colonial

[Matheus]

Hi @Colonial! I dont think the name brand of paroxetine was extended release because otherwise that was mentioned in the box, right? The reasom im asking is because i was googling this brazil manufacturers and on their site( the same generic that makes the name brand), it mentions" slow release adtitive", something like that.

But the thing is in the box has nothing said about it...

 

No, the dizzines started when i stopped paxil and zolpiden...

 

Another question: is this zolpiden similar to a benzo? Every doctor says it is not a addictive, but i couldnt stop it either, and is my relieve, cause makes me sleep at night.

[Colonial]

 

 

12 minutes ago, Matheus said:

i was googling this brazil manufacturers and on their site( the same generic that makes the name brand), it mentions" slow release adtitive", something like that.

It may be a language translation issue but I am not sure what you are saying about which medication.

It's best not to make assumptions and confirm with the pharmacy on both medications rather than guess.

Eventually you will need the regular release when you begin to taper, so if that is what you are receiving now that is good.

The issue is what were you on before.

 

"Another question: is this zolpiden similar to a benzo? Every doctor says it is not a addictive, but i couldnt stop it either, and is my relieve, cause makes me sleep at night."

 

Please list all your current medications, herbs and over the counter items you are taking at the bottom of your drug signature.

It is difficult to give good advice without knowing all the items involved.

 

It may be the reason for your dizziness, as using it with EITHER paxil OR Venlafaxine can cause dizziness, you are now taking it with BOTH.

 

"Using FLUoxetine together with zolpidem may increase side effects such as dizziness, drowsiness, confusion, and difficulty concentrating, impairment in thinking, judgment, and motor coordination."

 

Using zolpidem together with venlafaxine may increase side effects such as dizziness, drowsiness, confusion, and difficulty concentrating. Some people, especially the elderly, may also experience impairment in thinking, judgment, and motor coordination.

 

Side effects of medication cocktails can show up at any time.

 

Zolpidem belongs to a class of medications called sedative-hypnotics.

It works by slowing activity in the brain to allow sleep. 

Zolpidem may be habit-forming. Zolpidem is for short-term use only.  

The sedative effect of zolpidem may include dizziness and passing out.

 

[Matheus]

Ok, @Colonial! I will change my drug signature!

 

I dont take anything more. Just paroxetine 40mg, venlafaxine 37.5 and zolpiden 6,25.

 

I take no supplement whatsoever.

 

I know zolpiden is for short- term use but i use it regularly( every night). But i dont thinks it is causing my dizzines because i had it before when i ctd paroxetine years before. It is WD. Sometimes gets better, sometime gets worse but is always there as long as i am in withdraw.

 

I know ill have to tapper zolpiden too. I tried to stop it cold turkey and couldnt sleep. 

 

Speaking about the extended release thing: i am taking venlafaxine and paroxetine normal release. What i was trying to say is i changed paroxetine from name brand( pondera) to generic yesterday.

 

The name brand i was taking before said nothing on the box about release, so i think it was normal release. The thing is i was searching in the manufacturer site from the brand i was taking and there they mention something like( " it has slow release aditive) and i was questioning if this would make difference.

 

But the fact is in the end it doesnt matter, cause as u said eventually o would have to change to imediate release, and i cant afford namr brand too( they have a similar generic, from the same manufacturer, ill search for it cause is more affordable).

 

I apreciate youre trying to help me. It means a lot, since youre having your own problems. I saw your signature. 

 

[Matheus]

[Matheus]

I think zolpiden is the same as ambien for people in the us. Idk where u from. 

[Colonial]

44 minutes ago, Matheus said:

I know zolpiden is for short- term use but i use it regularly( every night). But i dont thinks it is causing my dizzines because i had it before when i ctd paroxetine years before. It is WD. Sometimes gets better, sometime gets worse but is always there as long as i am in withdraw.

 

I know ill have to tapper zolpiden too. I tried to stop it cold turkey and couldnt sleep. 

 

Yes, the reason it is for short term use is because it is easy to become dependent on it, then you have "rebound" insomnia from stopping it.

I do not know what website that screen shot is from but other sites disagree on those facts.

 

I understand you may have had the dizziness before taking the Venlafaxine, but that does not mean it is not currently related.

You are taking a lot of medications that can be problematic together, so if a symptom continues after you have stabilized it can be a side effect.

A symptom may have started for one reason but be continuing for another.

 

"The name brand i was taking before said nothing on the box about release, so i think it was normal release."

 

That is an assumption.

 

The thing is i was searching in the manufacturer site from the brand i was taking and there they mention something like( " it has slow release aditive) and i was questioning if this would make difference."

 

Are you referring to the old medication you were taking yes?  "Was" in english is past tense.

So you are saying the "old" medication has a "slow release additive", but above it you had the first medication said nothing on the box.

This seems to contradict. It is why I suggested talking with the pharmacy to confirm which is what and not just assume.

 

If you do not want to double check with the pharmacy, that is fine, but I would not be able to answer your question, since assumptions may or may not be correct, and I do not know which prescription, the new or the old, you are referring to when you type "slow release additive"

 

For your drug signature, if you can put the month a day (as best as you can remember) you have been on each med that you are currently taking, at at what times.. "March" is very recent, and depending on what med you started at what time, complications can develop.

 

Also if you are taking certain medications at the same time it may be problematic.

 

A good site for checking for drug interactions is  www.drugs.com/drug_interactions.html

 

Good luck

 

 

 

Edited April 10, 2021 by Colonial

[Matheus]

Hi @Colonial! Yeah youre right zolpiden is very addictive at least for me lol. 

 

Answering your question: yes,the old one COULD be extended release ill check it properly this week.

 

Hope u guys r doing fine.

My dizzines is almost umbearable... i try to sit still to watch futebol and it makes me even more dizzy... i have to stay laid down all the time.

 

About venlafaxine: i dont know. All i know is when i tried to reduce it like by half a dose, next day i was vomiting... so i decided ill have to taper it too( even though im taking it just for two and a half months).

 

[Matheus]

Hello to everyone!! Im wondering if i should try to tapper a little bit of venlafaxine to see if i get any improvement... 

 

Im feeling intense dizziness, this is by far my worst symptom in WD.

 

Any help would be very apreciated!!

[Colonial]

Since the zolpiden is likely to cause dizziness as an interaction with both Paxil and the Venlafaxine perhaps you may want to think about tapering that first. Done correctly it would lessen the chance of  rebound insomnia. 

 

[Matheus]

@colonial @getofflex

 

I really dont think zolpiden is causing this dizziness. Its been here since this wd started. Phsicall exertion like walk makes ir worse. I think the best thing for me is just stay in the bed or in the couch untill it ceases. In fact, in my plans, zolpiden is the last drug ill get off, because is the one wich preserves my sleep and dont cause me much problems.

 

People say exercise is good, and of course usually it is, but in my case the less movimentation i make is the best.

 

Im trying my best to reduce stress and avoid desperation, but the dizziness just dont go away. Its like im on a permanent boat. I ve seen a lot of people have this sympton.

 

I really dont feel right im taking venlafaxine along with paroxetine... it just dont feel right, is just too ativacting. I cant wait to start tapering this drug. Im ok with taking paroxetine, im used to it( i ve been taking it for 3 and 1/2 years... so im ok with it) what gets me down is that im taking two drugs very hard to get off...

 

I know im just rambling and being negative here, but  thats how i feel. This site really helped me to understand what ive been through. I had no ideia.

[Matheus]

Hello to everyone!

 

Im just wondering why im even more dizzy this days... i didnt change anything except for the paroxetine brand name to generic. This could be the reason?