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


Alltheworldisastage

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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?

2001 - Paroxetine 30mg

 

2020 - December, Began taper

 

2021 - June, now at 20 mg/10ml oral liquid

            June/July/August - Holding 

 

            September - 18mg/9ml

 

 

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  • Administrator
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.

This is not medical advice. Discuss any decisions about your medical care with a knowledgeable medical practitioner.

"It has become appallingly obvious that our technology has surpassed our humanity." -- Albert Einstein

All postings © copyrighted.

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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.

 

2001 - Paroxetine 30mg

 

2020 - December, Began taper

 

2021 - June, now at 20 mg/10ml oral liquid

            June/July/August - Holding 

 

            September - 18mg/9ml

 

 

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  • Administrator
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.

This is not medical advice. Discuss any decisions about your medical care with a knowledgeable medical practitioner.

"It has become appallingly obvious that our technology has surpassed our humanity." -- Albert Einstein

All postings © copyrighted.

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  • Altostrata changed the title to Alltheworldisastage Preparing to cross taper after 18 years on SSRI Seroxat to SNRI Duloxetine
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

2001 - Paroxetine 30mg

 

2020 - December, Began taper

 

2021 - June, now at 20 mg/10ml oral liquid

            June/July/August - Holding 

 

            September - 18mg/9ml

 

 

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  • Moderator
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.

20 years on Paxil starting at 20mg and working up to 40mg. Sept 2011 started 10% every 6 weeks taper (2.5% every week for 4 weeks then hold for 2 additional weeks), currently at 7.9mg. Oct 2011 CTed 15oz vodka a night, to only drinking 2 beers most nights, totally sober Feb 2013.

Since I wrote this I have continued to decrease my dose by 10% every 6 weeks (2.5% every week for 4 weeks and then hold for an additional 2 weeks). I added in an extra 6 week hold when I hit 10mg to let things settle out even more. When I hit 3mgpw it became hard to split the drop into 4 parts so I switched to dropping 1mgpw (pill weight) every week for 3 weeks and then holding for another 3 weeks.  The 3 + 3 schedule turned out to be too harsh so I cut back to dropping 1mgpw every 4 weeks which is working better.

Final Dose 0.016mg.     Current dose 0.000mg 04-15-2017

 

"It's also important not to become angry, no matter how difficult life is, because you can loose all hope if you can't laugh at yourself and at life in general."  Stephen Hawking

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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.

 

2001 - Paroxetine 30mg

 

2020 - December, Began taper

 

2021 - June, now at 20 mg/10ml oral liquid

            June/July/August - Holding 

 

            September - 18mg/9ml

 

 

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  • 3 weeks later...

@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!

09/2000 paxil 20mgs, 06/2006 stopped Paxil crashed, 10/2006 progressed back up to Paxil 20mgs, 

2012 -2013 Paxil 12 month taper crashed, 

09/2013 Zoloft 50 - 100, 

2015-2016 Zoloft taper crash, 

2016 cymbalta, 

01/2017   lamictal , 

05/2017 Prozac 20 mgs, 06/2017 Prozac 40mgs, 02/2018 Prozac 20 mgs, 05/2018 Prozac 30 mgs, 

11/2018 lexapro 10 mgs, 01/2019 lexapro 15 mgs, 12/07/2019 lexapro 13.75 mgs ,01/04/2020 lexapro 12.5 mgs, 02/08/2020 lexapro 11.25 mgs, 03/07/2020 lexapro 10 mgs, 07/25/2020 7.5mg pill&2.5ml liquid, 08/04/2020 5mg pill&5ml liquid, 08/17/2020 2.5mg pill 7.5 ml liquid, 08/24/2020 10 ml liquid lexapro, 09/05/2020 9 ml liquid lexapro, 10/05/2020 8.5 ml liquid lexapro,10/12/2020 9 ml, 04/17/2021 8.78 ml, 04/24/2021 8.56 ml, 05/02/2021 8.34 ml, 05/09/2021 8.10ml, 05/29/2021 8 ml, 06/15/2021 7.80 ml, 06/21/2021 7.60ml, 06/27/2021 7.40 ml, 07/03/2021 7.20 ml, 07/24/2021 7 ml, 10/02/2021 6.90 ml,

2000 to present Celebrex 200 - 400 mg daily as needed

2015 to 2021 Prilosec 20-40 mg daily as needed

Present pravastatin 10 mg, Pepcid 20 mg, zinc L carnosine 

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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.

2001 - Paroxetine 30mg

 

2020 - December, Began taper

 

2021 - June, now at 20 mg/10ml oral liquid

            June/July/August - Holding 

 

            September - 18mg/9ml

 

 

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