olderinoregon: 40 Paxil history transitioning off (new member)

[olderinoregon]

Hi new member here.  40 years ago I started Paxil in 1981.  It was a new medication.  It worked like a charm for me.  I was young and in nursing school at a major university.  The psychiatry chief resident in the student clinic started me on it.  She said "oh all the students are taking ssris".  She made it sound like no big deal.  It wasn't a big deal at first.  Fast forward 40 years later.   My primary care MD told me there is a FDA black box warning about Paxil.  She insists I must get off.  Apparently it is not considered safe in those over 60!!!??!!!    

 

So why have I been on Paxil so long?   Every time I tried to go off it it made me awful. I experienced the frightening feelings of very emotional, bizarrely suicidal (simultaneously feeling gratitude my life)  anxious and sickness.   I thought this was because my body needed the SSRI medication.  I took withdrawal symptoms as signs I was low in serotonin and needed the Paxil.  I think I was wrong.

 

Originally I was at 20mg for many years.  I decreased my dose to 15 mg about 5 years ago.  Then I cut my dose to  10 mg daily last year ago.  I tried going cold turkey but quickly restarted at 10mg after feeling horrible with an abrupt stop.  I very briefly tried other SSRIs and felt terrible.  Since the decrease to 10mg .  I have had long term issues of ringing in the ears (?tinnitus or ?brainbuzz) on and off.  Truth is I probably haven't need an antidepressant in years.  I have learned to deal with anxiety of life in other ways.   I am a generally happy person.  Successful and retired from practice now.  I am a wife, a grandma.    Living the good life except...this.

 

I came to this site because I am now this week I am starting taking 5mg of Paxil daily.   I am experiencing symptoms of Paxil withdrawal.   I am having migraine headaches along with dizziness/balance issues, nausea/poor appetite and anxiety.   I do have a good therapist who helps with mindfulness and support during this transition.   She says she doesn't deal with anything about medications.    Some how knowing this is all part of what happens when you transition off Paxil I feel relieved.   At least there is nothing unusual.  

 

My fine husband is very supportive.   Family are all supportive.  

 

It is my hope to slowly transition to no more medicine.   My doctor has been pretty unreachable due to covid.   I honestly feel badly taking her away from the truly sick people.   Still I did book a next available phone appt in 2 weeks.    I have not been able to speak with a medication management psychiatrist yet.   This is because my health plan has me on a waiting list.  (3 wks of waiting and counting just to be able to book an appt)    Without professional guidance searched and found this site.    I would be willing to pay out of pocket for psychiatry medication management.   The question is who is knowledgeable about this issue?

 

My plan is to continue Paxil 5mg for about 4 to 6 weeks.  Then I will try go to 2.5mg for the same amount of time.  I understand slower is better.  I understand the smaller the dosage the more intense the side effects.  This plan is all pending me feeling ok.   I have got anti nausea Zofran medication on had for vomiting with the migraines.  

 

 Anyone else with migraines triggered by Paxil withdrawal?    

 

 

Edited August 24, 2021 by manymoretodays
name to title

[brassmonkey]

Hi Olderinoregon-  Welcome to SA, I'm so glad you found us. The site is staffed entirely by volunteers, most of whom are still in the throws of ADWD, while a few of us have made the jump to "0". We currently have over 14000 members so the staff can get spread pretty thin at times, but we try to get to everyone as quickly as possible.

 

It looks like you have started several different Introduction threads. Please do not start any more, we only allow one per member. As time permits we will merging them all into this thread. This will be your home base for asking questions, keeping notes and making friends.

 

I can say right off the bat that the way you are stating to taper your paxil is going to cause big problems. Paxil is a very powerful drug and has a reputation for being one of the hardest to get off of. But it can be done. I took 40mg for 18 years when I started my taper and have been drug free for many years now.

 

We need some more information, first if you could fill out a signature block it would be quite helpful

 

https://www.survivingantidepressants.org/topic/24613-how-to-list-drug-history-in-signature/

 

Then there are a few links that you should read to get some background information.

 

https://www.survivingantidepressants.org/topic/1024-why-taper-by-10-of-my-dosage/

https://www.survivingantidepressants.org/topic/405-tips-for-tapering-off-paxil-paroxetine/

https://www.survivingantidepressants.org/topic/17671-the-brassmonkey-slide-method-of-micro-tapering/

 

There is a huge amount of information on the site, but I don't want to overload you right at the start.

 

I will approve both posts on this thread so you can see what is going on and be able to post further. Again Welcome to the site.

[Altostrata]

Welcome, @olderinoregon

 

Paroxetine is a very difficult drug to go off. Ordinarily, when people have withdrawal symptoms as you do, we recommend increasing the dose to get to a place where you don't have withdrawal symptoms any more.

 

Do I understand you were taking 10mg and just decreased to 5mg? Did you feel better when you were taking 10mg? 

 

If you were taking 10mg and already had withdrawal symptoms from prior decreases, it's probably premature to cut your dose to 5mg.

[olderinoregon]

Hi all,

Yes I initially for the majority of the years was on Paxil 20mg.   I have been on Paxil 10mg for about a year.   I started Paxil 5mg at the suggestion of my PCP (primary care provider).   I am now on day 3 of 5mg.  The first day was yucky with a mighty severe migraine.   I took Zofran as prescribed in the past for the vomiting with migraine.    I slept 12 hours.   No more migraine.  I have been taking Advil or Tylenol as needed for headache.  I am surprisingly not having any emotional symptoms.  The only really worrisome symptom is dizziness.  At my age falls are not a little thing.

 

I want to stay with the 5mg Paxil dose IF I can tolerate it.   My sleep is good as always but some vivid dreams.  Nothing too unbearable.  I do wish I had more medical support.  Thank you all for the support here.   

 

What am I doing to cope with the side effects of withdrawal :  mindfulness,  dbt skills,  positive thinking,  gardening, cooking and breathing.     I eat a very healthy diet.   I am fortunate to not have sleep interference.  The tinnitus is annoying but what can you do?  I have had it for the past year since initially decreasing from 20mg.    I am still optimistic for ultimately leaving Paxil in the past.  I am in no particular hurry.

 

 

 

[Cheeky]

Hi there,

I thought I’d come past to give you some support. You have come to a great place that will help you taper off Paxil . The moderators are wonderful and have a lot of knowledge with these drugs. I have been on Paxil for 26 years years and have gotten down to 20mg from 40mg. It is possible if we go slowly. I have tried many times myself trying to come off too quick and it’s lead to a disaster. Have a read around and you will notice there’s a lot of people that have been on these drugs for a long time and have been tapering with success. 

[Altostrata]

15 hours ago, olderinoregon said:

The tinnitus is annoying but what can you do?  I have had it for the past year since initially decreasing from 20mg.

 

What other withdrawal symptoms have you had since decreasing from 20mg?

[olderinoregon]

This past year at half my original dose (10mg)  my symptoms have been purely physical.   I have remained up beat and okay emotionally.  My physical symptoms over the past year have been dizziness occasional head buzzing, and  memory mentation issues (quick recall way diminished).   

 

Since decreasing my dose again by half (5mg) I am experiencing awful migraines, head buzzing, waves of dizziness and balance issues.    I woke up last night with extreme nausea.  Took some Zofran for nausea and went back to sleep.  

 

Current plan going forward:  stay at 5mg Paxil until I speak with my PCP next week.   I expect to be at this dose for a good bit.

I will ask for liquid Paxil to taper my dose in a much more pricise manner.

 

I am very grateful to you all here at the site.   My anxiety is much less now that I know the symptoms I am experiencing are common in persons withdrawing from Paxil.  Now that I know these are expected side effects I am not so worried.   Less worry, less anxiety better taper and transition.    It doesn't make it less unpleasant, just not terrifying.  

 

Thank you all.

[Altostrata]

The physical symptoms of withdrawal are important! If you continue to reduce when you have physical symptoms, they are likely to get worse. That is what happened when you reduced to 5mg.

 

Paroxetine is perhaps the most difficult SSRI to taper. You have a couple of options: 1) Try increasing paroxetine to 7.5mg, see if that helps; 2) instead of adding 2.5mg paroxetine, add 2.5mg citalopram or fluoxetine instead, in preparation for a gradual cross-over to a different SSRI for tapering.

 

See Tips for tapering off paroxetine (Paxil, Seroxat)

 

The Prozac switch or "bridging" with fluoxetine
 

Why did your PCP tell you that you had to go off Paxil?

 

It is likely your PCP won't know how to deal with withdrawal syndrome. See 

 

[olderinoregon]

Today I had a chat with a kind pharmacist when I picked up some other medication.  I told her I was having paxil withdrawal issues.   I was picking up the Zofran anti-emetic for the migraines with withdrawal.    The pharmacist heard my doctor's plan for 5mg for a week then discontinue Paxil.   She said that is way to short.  I asked her to call my doctor.  Hence the email today.

 

 

So I get a quick email message from my doctor stating I should go back to 10mg Paxil a day.  Ugh really?   So honestly.  I think she is just so busy with Covid she wants to post this for 3 months.  Heck maybe that is a good idea?   What do you all think.  

I have been on 5 mg Paxil for 5 days.  Should I stay or should I go back?  Opinions please.  

 

My doctor suggested starting Zoloft.   The thing is I don't have any depression!!!  WTH? I do have anxiety from the drug withdrawal. lol.   I don't want it.  Would it help with withdrawal??

Edited August 26, 2021 by olderinoregon
clarity

[Altostrata]

I think your doctor does not know what to do. This is not unusual.

 

Why did she want you to stop taking paroxetine? She doesn't even know that doctors usually want to switch people to fluoxetine when they have trouble going off paroxetine. Switching to Zoloft makes no sense at all, it's purely random on her part.

 

If you read the links I gave you above, you will get a better understanding of what to do. If you ask her directly for paroxetine, citalopram, or fluoxetine liquid -- tell her you want to make a change gradually -- she is more likely to give you a prescription rather than argue about it. She'll probably be delighted to hear you'll switch to another antidepressant. 

 

Once you have the liquid, you have a lot more control over tapering. However, paroxetine will be difficult to go off even with a liquid.

[manymoretodays]

Hi there olderinoregon and welcome,

I just moved one of your recent posts to a topic that we already have going on "accidents with dosing".

Here it is below, just click on the arrow at the upper right of the quote and you'll find it in topic.

  

3 hours ago, olderinoregon said:

Opps I upped my dose accidentally today, now what?

 

Should I call the pharmacy?   Trying to get through to my prescribing doctor is a real hassle.  

 

Bit of history.  I have been at 5mg for 2 months now and stabilized after a year at 10mg.

 

My doctor prescribed liquid.  

I  finally switched finally to liquid from half 10mg tablets.   I misread the label for my first dose and gave myself too much today my first time using the liquid.  I misread the syringe and gave myself the wrong amount.  Instead of 2.5ml I gave myself 4.5ml.  Now what?  I will return to my normal dosage tomorrow.  Has anyone else accidentally given themselves too much?  

 

Pretty stupid since I am a nurse.   I guess it just goes to show how nervous I am about this taper stuff.   Anyone accidentally gone up for one day.   What did it do to your side effects.   

 

My plan from here is to decrease back to  2.5ml for another week before beginning the taper now that I made the flub up.   Any suggestions?

 

Suggestions, concerns........yes. 

I see from your signature(the portion under all your posts) that you've been on Paxil since 1981, that's 40 years plus......and you just might be going a bit too quickly still with your taper. 

 

My first concern is that if you have gone directly from a 5 mg solid dose to a 5 mg liquid dose.....that may be too fast for you.  We often suggest that members do a more gradual shift from solid form to liquid form of their medications.

Please see:  Cross Over: Changing form(e.g. tablet to liquid) of drug........

 

What is the concentration of your liquid Paxil suspension, is it 2 mg/1 mL?  So that the 2.5 mL measurement gives you 5 mg dosage still?

 

AND it is definitely to your advantage as far as long term success with tapering/minimizing harm/minimizing WD(withdrawal) symptoms to just do one change at a time, adjust to it for a couple to several weeks before making any additional changes.

The rule of 3KIS: Keep it simple, slow, and stable.

 

So......I would advise cross over from tablet to liquid, as well as a nice long adjustment period...... to see how you do on the liquid for more than a week, before any further tapering. 

 

And what is with these idea's of tapering by 50% of your dose?   Is that coming from your doctor?  It sure could cause trouble and more WD symptoms than you want.  (I'm seeing this in your signature and from previous posts above)

 

I'm hoping that the inquisitive human in you, has taken a good look at the Why taper by 10% topic(brassmonkey gave it to you above as well), and it does help to continuously review and plan.

 

Also I'll include a few more links to information on WD, here on your Introduction page too today, for your perusal now or at another time:

What is withdrawal syndrome?

Brain Remodelling

Dr.Glenmullen’s withdrawal symptom list.

The Windows and Waves Pattern of Stabilization

 

Here is the link specific to tapering Paxil again too:

Tips for tapering Paxil(paroxetine)

 

Best to you oio, my best advice sincerely......is to slow down, you've already tapered or just plain cut down substantially from your starting dose since late August.

 

Please let us know how you are doing right here from time to time too.  Here on your Introduction. 

Please note what kind of WD symptoms you are presently experiencing, when you reply here.  It's been a couple months now since you've posted.  And we do want to know and help if we can. 

 

Love, peace, healing, and growth,

manymoretodays(mmt)

 

Edited November 1, 2021 by manymoretodays