SugarCookie: paroxetine withdrawal

[SugarCookie]

Hi fellow fighters! My first post here and doing this as I am in a dark place the last days. Quick introduction before I go to the topic; 27M, studying, working and living together with the person I love and is supporting me in the fullest imaginable extents.

For the matter of the topic, this is the history of my SSRI use.

August 2016 (age of 22) introduced to Escitalopram after collapsing at work and developing GAD as an aftermath, introduced first to 5mg - 5 days later to 10mg
August 2016 prescribed Alprazolam 0.25mg for adaptation and to use per need
July 2017 started smoking pot more than recreationally (I know, not a great cocktail)
May 2018 first taper from to 5mg - two weeks later to 2.5 - two weeks later off
July 2018 - Supposed drug related relapse (ecstasy).
July 2018 - Reinstatement of Escitalopram 5mg for 5 days and then 10mg afterwards
July 2018 to February 2019 no improvement in symptoms (also didn't quit weed at that point)
February 2018 tapering off again and rejecting other form of SSRIs (still smoking almost every day)
February 2018 & March 2018 5mg of Escitalopram
April 2018 2.5 mg Escitalopram
May 2018 off to 0
End of December 2019 introduced to 20mg Paroxetine after period of complicated case of pneumonia - GAD relapse and Depressive Disorder
January 2020 until November 2021 20mg Paroxetine (weaned myself off weed cold turkey, however, over the course of the almost two years I would join a circle at special occasions and enjoy it - didn't smoke since Setember this year)
2nd week of November 2021 significantly quick taper from 20mg to 10mg
3rd week November 2021 after one week from 20mg to 10mg, reduction to 5mg
December 2021 5mg and massive withdrawal symptoms

How it came to the switch: As I have been moving countries, the unfortunate situation of coming closer to run out of the medication (purely my mistake) hit me unexpectedly, which made me reach out to my physician. Together, we decided that it wouldn't be a bad moment to try tapering down now after almost 2 years given that I have a great job, a great financial situation, am in the second year of my masters, moved in together with the girl I have been in love with for years and have a great psychologist that has been supporting me with sessions over the course of taking Paroxetine.. The first week I halved the pills in order to extend the amount of how many I got, but due to medication taking longer to arrive by post (I am originally outside the EU and providing proof of treatment requirements is extremely pesky and slow), I had to cut to 1/4 (5mg of Paroxetine) within 5 days. Some of you who maybe already went through with Paroxetine withdrawal are potentially already concerned, as this is... well super quick in comparison to what should probably be done. Fortunately, my medication arrived just as I was about hitting 0 pills and I forwarded to my physician that I would try and continue with 5mg given that I had made this switch already.

Development pattern:
- Week 1 and 2 Mostly physical symptoms, tiredness, trouble sleeping, upset tummy, racing heartbeat and brain zaps with rapid eye movement (especially moving my eyes to the side), psychological symptoms irritability and sensitivity to minor sad situations (I would see a super shallow but somewhat emotional scene in a movie or tv show, and it would get me crying; I didn't mind, crying helped)
- Week 3, significant reduction of physical symptoms except for cold spells now that would be followed with emotional imbalance. Sad moments were fading, brain zaps were there but to a lesser extent.
- Week 4, I woke up by the sun on what seemed the most beautiful morning since humankind set foot on earth, feeling as if the load of the world was lifted off of me and I felt motivated with a feeling of having things under control for the beginning of week 4 (that feeling lasted maybe 3-5 days).

- Closing in to end of week 4 and entering week 5 (currently there), I am woken up around 1 AM and can't simply fall asleep again, anxiety is knocking at my door hard, but I manage to fall asleep around 4 AM again after popping 0.25 Alprazolam (that was last Thursday). The next days start to become an all too familiar motion of shakiness, anxiety, panic attacks and something that can be categorized as suicidal ideation (I never actually wanted to nor tried, but intrusive thoughts don't care). I manage to make myself go climbing/bouldering on Sunday as it had taken the edge off before and felt much better throughout the day. Monday, full-blown anxiety, I am crying on the bed at night with my girlfriend providing me all the support one can imagine. I can't muster focused sentences without popping 0.25 again. Tuesday and Wednesday are followed with good and bad moments throughout the day (mostly bad, but I try to appreciate the good more) Today I feel shaky during the morning but very well throughout the day, by the end of my shift, anxiety starts taking the best off me and I resort to popping another 0.25 Alprazolam to calm me down as it is enough to pull me out of the darkness but without masking what I am going through as I can't even enjoy the Liv'pool game now without feeling doom and danger all around me..

 

Not gonna lie, I feel like giving up today and reinstating the full dosage. I will reach out to my physician first thing tomorrow, but it just feels as if this will repeat only the cycle, and it just feels like defeat that I am not looking forward too. I am concerned that I will need adaptation time to the 20mg again, and I remember strongly how much of a hustle the first two weeks were once I introduced paroxetine to my body. Furthermore, in the first weeks, I felt immediate sexual improvement (except for the last week obviously) and I am really not looking forward of throwing away these 5 weeks (I am aware it takes people months, years and more than a decade, so weeks are maybe too naive from my side). Also, starting again in the future with going through the pattern of exhausting symptoms is such a dealbreaker.. I feel not only as if I don't have enough strength now to push through, but I also feel like I am at square 1 where I was two years ago (and I don't understand why ffs, then I understood that my body was drained of a complicated sickness that not so long ago used to be even fatal, but now I am in a completely different place). It goes unsaid that concerns of reported occurrences that the body can decide to stop responding to certain SSRIs without warning after some time mixed with the unwanted side effects places me in a stalemate right now. 

I am supporting my body with some supplements: Plant-Based Omega 3 Fatty Acids + B-Complex, vitamin C, Magnesium and Pantoprazole for the stomach issues. I decreased caffeine to one cup in the morning (which is for me a form of withdrawal as well as I love coffee, but it is triggering I know..), Valerian Root tea in the evening; Chamomile Tea and Green Tea during the day. Also, I am trying to muster up to do challenging physical exercise at least once a week and do yoga twice a week, but it's getting harder by the day (I thought it should be the opposite).

I know I am not this sickness (or these), I achieved so many things I am proud off, prior to the first introduction of SSRI and I feel like I need to cut them some slack as they did support me in dire times stabilizing me in order to pull myself up and helping me pursue both the studies and career of my dreams. However, I am frustrated to a point of true anger on how withdrawal warnings aren't brought too attention extensively (the only thing I was told, "yee Paroxetine should be gradually decreased..")... and to be frank, I feel afraid of what the coming days, weeks and also the future holds, with or without them in my life.

Sorry for the long read, and if you made it to the end, I am lifting my hat to you in sheer respect.

[ChessieCat]

Hi SugarCookie and welcome to SA,

 

I'm just welcoming you and getting you started off in this post and will provide more information in the following post.

 

Please create your drug signature following these instructions:

 

Instructions:  Withdrawal History Signature

 

This is your own Introduction topic.  Each member has only ONE Introduction topic.  Your Introduction topic is the best place to ask questions and where you journal your progress.  This keeps your history in one place an means you don't have to repeat your story.

 

Please update your drug signature whenever you make a change.

 

Edited December 16, 2021 by ChessieCat

[ChessieCat]

1 hour ago, SugarCookie said:

anuary 2020 until November 2021 20mg Paroxetine (weaned myself off weed cold turkey, however, over the course of the almost two years I would join a circle at special occasions and enjoy it - didn't smoke since Setember this year)
2nd week of November 2021 significantly quick taper from 20mg to 10mg
3rd week November 2021 after one week from 20mg to 10mg, reduction to 5mg
December 2021 5mg and massive withdrawal symptoms

 

As you already realise you are experiencing withdrawal symptoms.  This is because you have reduced your paroxetine too quickly.

 

Q:  What date did you reduce to 5mg?

 

Q:  Are you taking any other drugs / supplements at this time?

 

My suggestion would be to make a small increase.  If you have only just reduced to 5mg in the last couple of days, then going back to 10mg might be okay.  However, if you reduced at the beginning of December, ie 2 weeks ago, then going up to 7.5mg might be enough.

 

The idea of updosing is not to get rid of withdrawal symptoms completely but to bring them to a bearable level.  It is better to start with a small increase and make small increases if needed than to risk taking too much.

 

It takes about 4 days for a dose to get to full level in the blood and a bit longer for it to register in the brain.  You might feel a bit of improvement in you symptoms during the first day or two.

 

Keep notes on paper of your symptoms, what improves / worsens which can help you to see if updosing is helping.  You will need to be patient during this time and try not to panic.  When we panic we can make poor decisions because we are trying to fix things quickly.  When it comes to psychiatric drugs, quick fixes can make things worse.  So we need to be patient and give our brain a chance to get use to the updose.

 

Please let us know what you decide to do.  Please continue posting about what is happening with the updose if you decide to do that, so that we can reassess whether you need to increase by a bit more.

[ChessieCat]

2 hours ago, SugarCookie said:

December 2021 5mg and massive withdrawal symptoms

 

Dr Joseph Glenmullen's WD Symptoms Checklist

[SugarCookie]

12 hours ago, ChessieCat said:

Q:  What date did you reduce to 5mg?

 

Q:  Are you taking any other drugs / supplements at this time?
 

Hey ChessieCat, that was quick and thank you so much for the response!   

First Q:
My first switch from 20 to 10 happened on the 14th of November
My switch from 10 to 5 happened 5 days later on the 19th of November to have enough before my prescription was approved by the authorities here so that I don't end up cold-turkey. So I have been on 5 mg almost a month already.

Second Q:

Any additional drugs?
I was prescribed Alprazolam 0.25 back in 2016 already, to be taken as needed. It helped me as a fast-acting anxiety and panic reliever on different occasions (especially during acclimatization for the first time I used a SSRI and for the time I was getting off it). I would use it in the last two years very sporadically and if, then when I knew that I would confront stressful situations (exams, presentations, job interviews..) or already happened to be in a very stressful situation (not enough sleep from studying, after the process of moving to different cities or after an extremely exhausting week to knock me out and fall asleep for 10-12 hours). Now, I have noted that I used it weekly once when withdrawal was hitting hard. But in the last 7 days I used it thrice (Thursday last week, then Monday, then yesterday again as they were hitting harder). While I was prescribed 0.25, I was told that I can up it to 1 mg if observed necessary but so far that wasn't the case and I have some healthy respect towards Benzos as to further increase them (I know that there are also some conflicting information and experiences with them).. My mother had been prescribed 1.5 mg Bromazepan for lowering blood pressure and as a sleep medication for a month with no problems whatsoever after just stopping it, but I also know people who became pretty much dependent on it. I am not doing any recreational drugs now, and I stopped with alcohol for the time being (although I was never much of a drinker) because it's triggering me the next day. I do however smoke tobacco (and have been since I was 16), and honestly, I am not thinking on giving them up during this time (maybe once I have overcome this withdrawal).

Supplements yes: 
Plant-Based Omega 3 Fatty Acids + B-Complex, vitamin C, Magnesium and Pantoprazole for the stomach issues. I decreased caffeine to one cup in the morning (which is for me a form of withdrawal as well as I love coffee, but it is triggering I know..), Valerian Root tea in the evening (thinking about possibly decreasing it to only once or twice a week because I know that VR can be hard on the stomach); Chamomile Tea and Green Tea during the day. Also, I am trying to muster up to do challenging physical exercise at least once a week and do yoga twice a week for the moment being, as I don't want to overexercise (happened after Escitalopram).

 

What of course troubles me now is whether these are withdrawal symptoms or relapse, as I feel my anxiety had been picking up in intensity over the last week instead of going down. On the other hand I don't feel depressed as I was two years ago, so I take that as a huge victory  

P.S. I will add my timeline as you suggested to my signature after my shift ends. I grabbed a moment during my break to answer your questions but would now be heading to my cigarette and lunch break 😇

P.S.2 when I click on the link provided in your last answer, nothing happens. Can it be browser or access related?

Edited December 17, 2021 by SugarCookie

[ChessieCat]

12 hours ago, SugarCookie said:

I feel my anxiety had been picking up in intensity over the last week instead of going down

 

This might be caused by this:

 

12 hours ago, SugarCookie said:

But in the last 7 days I used it thrice (Thursday last week, then Monday, then yesterday again as they were hitting harder).

 

It is good that you have not been taking alprazolam too often.  Hopefully you have not become dependent on them.

 

Benzos are notorious for causing anxiety when the drug wears off.  And it doesn't take much to become dependent on them.  My personal opinion (ie not as a moderator) would be to updose the Paxil and try not to take the benzo.  If you continue to use it 3 times a week then you will most likely end up having to take it every day (to overcome the interdose withdrawal) and then taper off it after the Paxil taper is complete (SA recommends tapering the activating drug before the sedating drug).  The big issue with benzos is that you can become dependent in as little as two weeks of regular use and that they very quickly lose their effectiveness (and you might find that you end up increasing the dose) and you can end up having to stay on them just to stop the withdrawal symptoms caused by them, not because they are helping.

 

12 hours ago, SugarCookie said:

First Q:
My first switch from 20 to 10 happened on the 14th of November
My switch from 10 to 5 happened 5 days later on the 19th of November to have enough before my prescription was approved by the authorities here so that I don't end up cold-turkey. So I have been on 5 mg almost a month already.

 

Because you have been on 5mg for 4 weeks, I think it would be better to start by only making an increase to 6mg.

 

Please read Post #1 of this topic much of which is also relevant to updosing:

 

about-reinstating-and-stabilizing-to-reduce-withdrawal-symptoms

 

You would stay on 6mg for 1 week and monitor your symptoms.  If symptoms start to improve, then wait another week and then reassess.  Remember that the idea is to bring symptoms to a bearable level.  Some members have kept updosing and tried to find that "sweet spot" where they felt their best before the withdrawal symptoms and they have ended up making things a lot worse which is why I urge you to be cautious.  There is no quick fix or magic pill or potion.  You need to go slowly and patiently.

 

If after the first week on 6mg you notice no improvement (and no worsening) then you could try increasing by another small amount, perhaps 0.5mg but no more than 1mg increase.  It is better to increase by small amounts than to risk taking too much.

 

Post #1 of this topic explains how to get non standard doses:

 

Tips for tapering off paroxetine (Paxil, Seroxat) 

 

Please continue to post letting us know how you are doing.