Alltheworldisastage Preparing to cross taper after 18 years on SSRI Seroxat to SNRI Duloxetine

[Alltheworldisastage]

Seroxat stopped working years ago and I was very wary about tapering.

 

6 months ago, I began tapering Seroxat 30mg using liquid and am now at 20mg/10ml. Not experiencing any serious tapering symptoms so far.

 

Spinal consultant has advised that I switch to Duloxetine to help with nerve pain, depression and sleep.

 

My question is: At what point can I introduce Duloxetine at 30mg?

[Altostrata]

Welcome, Liz.

 

If I were you, I would not cross-taper from paroxetine to duloxetine at this time. Making a drug switch can upset the apple cart, and paroxetine can be extraordinarily difficult to taper. If I were you, I'd consider a switch should you run into difficulties with paroxetine reduction.

 

Duloxetine is promoted for pain but has questionable efficacy for nerve pain, depression and sleep.

 

I'd also go very carefully in reductions from 20mg. Please see Tips for tapering off paroxetine (Paxil, Seroxat)
 

Please let us know if you have any questions about tapering.

 

To help us out, follow these instructions Please put your drug and withdrawal history in your signature You may need to use a computer to do this.

[Alltheworldisastage]

Hello,

Thank you for your message.

 

When you say: I'd consider a switch should you run into difficulties with paroxetine reduction.

 

Does this mean a direct switch to another SSRI or SNRI? 

 

If so, would it be safe to switch when I reach 10mg of Seroxat?

 

My depression is lifelong and I am now 60.

 

[Altostrata]

Drug switches always carry elevated risk. The second drug may not "take" and then you have withdrawal symptoms from paroxetine anyway. Or, you could have an adverse reaction to the second drug. The gentlest way to make a drug switch is a gradual cross-taper, but it's not guaranteed to be problem-free.

 

I would attempt a drug switch only if you run into problems reducing paroxetine. Then, the switch is usually to fluoxetine or citalopram, another SSRI, not an SNRI like Cymbalta (which, by the way, is another drug at top of the list of antidepressants that are difficult to go off).

 

As this is a site for going off drugs, we do not counsel people in making drug switches for the purpose of treatment with another psychiatric drug. That is what your doctor is paid to do.

 

Please let us know if you would like peer support in tapering a psychiatric drug.

[Alltheworldisastage]

Thank you for your very helpful, detailed response.

 

I have found the guidance that I need here on SA and will continue to taper off Paroxetine at 10% per month.

 

This site offers the most comprehensive guidance and peer support and I am so grateful to have found it.

 

Thank you to you and your team

[brassmonkey]

Hi Alltheworldisastage-- welcome to SA.

 

If you are going to continue to taper at 10% might I suggest that you consider doing a Brassmonkey Slide. It will add some time to the length of the taper, but, in my mind, the benefits really outweigh that. Paxil can be very hard to taper with unpredictable symptom spikes. With a traditional 10% taper there is usually a large spike of symptoms a day or two after a reduction. Many members have found that spike to be quite debilitating for several weeks. With the Brassmonkey Slide the 10% reduction is spread out over four weeks and because of the smaller reductions so is the symptom spike. I won't say that the reductions are symptom free but many members report very reduced and manageable symptoms following a reduction. I highly recommend it, if you want more information of how to do it, just let me know.

[Alltheworldisastage]

I have studied how to the implement the Brassmonkey Slide of tapering and will begin using the method from next week. I have used the calculator provided.

I will update my signature and report on how I progress.

Thank you so much for your advice.

 

[Heath]

@Alltheworldisastage welcome to sa! You will find a ton of information here not found anywhere else! I agree totally with brass monkey the slide is safer and easier. If you want to keep your life as normal as possible the slide is way to go! I have experienced both. Wish you well on your journey!

[Alltheworldisastage]

Hello Heath,

 

Thank you for your welcome.

 

Yes, I am so glad that I found SA.

 

I hit a wall for a few weeks when I reached 20 mg of Paroxetine. I have been holding and I am settling back down now.

 

Starting Brass Monkey slide in a week or two.