Margaret1: an attempt to discontinue paroxetine

[Margaret1]

This is my 2nd attempt to discontinue paroxetine. The first attempt was unsuccessful as 3 months after I took last dose of paroxetine I began having panic attacks and could not sleep. I never had these issues before I took paroxetine. 
 

[Margaret1]

Tinnitus in right ear

 

Tinnitus comes and goes in right ear. Never had this symptom before I took paroxetine. Went to doctor and was told this is something that a lot of the population in general suffers from. 

 

 

Edited June 26, 2022 by ChessieCat
added Intro topic title before merging with intro topic

[ChessieCat]

Hi Margaret and welcome to SA,

 

We need to know more about when you last tried to stop paroxetine so that we can give you an idea of when you might be able to try tapering again.  It is strongly recommended that you are stable before making a reduction.  What symptoms are you currently experiencing?  Have they improved since they were at their worst?  How is your sleep?

 

SA's tapering rate is to reduce the current dose (not the starting dose) by no more than 10% and hold on that dose for about 4 weeks to allow the brain to adapt to not getting as much of the drug.  The idea is to keep withdrawal symptoms to a minimum.

 

Why taper by 10% of my dosage?

Dr Joseph Glenmullen's WD Symptoms Checklist

 

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

 

Tips for tapering off paroxetine (Paxil, Seroxat)

 

This topic has links to helpful topics on SA:

 

Important topics in the Tapering forum and FAQ

 

Please create your drug signature following these instructions.  Please include ALL current and previous drugs, even if only taken as needed:

 

Instructions:  Withdrawal History Signature

 

This is your own Introduction topic and is where you ask questions about your own situation and journal your progress.  This keeps your history in one place and means you don't have to repeat your story.

[Margaret1]

Hi

The first time I attempted to quit paroxetine was in 2012. I went from 40 mg daily to nothing. I did fine until about three months later when I developed panic attacks. Then I went back on 40 mg paroxetine along with seroquel 300 mg daily, trazodone 150 mg daily, and gabapentin 300 mg daily. The doctors diagnosed me with bipolar type two, anxiety, and depression. In February of this year, I stopped taking the seroquel, gabapentin, and the trazodone but have since been taking the trazodone as needed maybe about once a week at a 12.5 mg dose. I am still taking the paroxetine at 20 mg. Over the course of 6 months I lowered the 40 mg paroxetine to 20 mg. My current withdrawal symptoms are tinnitus in right ear, insomnia, anxiety, sensitivity to sounds, smells, and light. Irritability, low moods then pleasant moods. I can taste food again which is good and I don’t sleep all the time anymore. I am more sensitive to tv shows and movies. 
Basically, I want to stop taking paroxetine for good but want to do it slowly, at 10% each month, and would  appreciate the support of others who have experienced this. 
Also, I take omega fish oil, complex b, zinc, magnesium, biotin and vitamin c supplements daily. I walk around three miles a day and do stretches. 
 

[Margaret1]

I would like to begin taking 18 mg of paroxetine on 11-25-22. I don’t know if I can get the liquid form in the United States. If I can’t, I’ll cut the 20 mg pill into four pieces and then cut one of the pieces in half. Then I will be able to take close to 18 mg. 
one other withdrawal symptom I have noticed is my head aches a lot. Sometimes it aches on the top and then the sides. I do hear ringing in my ears at times and my neck muscles are very sore. 

[ChessieCat]

As requested above, please create your drug signature.  We need to be able to see your drug history at a glance (this will show below every post and is different from the information you provided when you joined, which is only visible to staff).  Thank you.

 

On 6/27/2022 at 12:27 AM, Margaret1 said:

3 months after I took last dose of paroxetine I began having panic attacks and could not sleep.

 

This is called delayed withdrawal.  I had the same thing happen to me when I cold turkeyed citalopram.  I felt great for a few months and then became bedridden for 2.5 weeks and lost 8kgs because I couldn't eat.  I ended up on Pristiq, which I have now successfully been off for 7 months.

 

It is important to try and get your dose as consistent and accurate as possible.  You can make a liquid from tablets.  Post #1 of this topic explains how to get non standard doses:

 

Tips for tapering off paroxetine (Paxil, Seroxat)

6 hours ago, Margaret1 said:

In February of this year, I stopped taking the seroquel, gabapentin, and the trazodone

 

SA suggests waiting until you are stable before reducing your drug.  One thing that is very important to understand is that the effect of psychiatric drugs is cumulative . There are SA members who have been on/off drugs and up/down in dose multiple times with no issues, then one day they do the same thing that worked before and their nervous system cannot cope with it.

 

When you do make your first reduction my suggestion would be to start with a smaller reduction as a test to see if you have stabilised enough.  If it was me I would not be reducing by more than 2.5% to start.  That is only reducing to 19.5mg (from 20mg).  This way if your nervous system is not stable then you will not be stressing it more by trying to do a full 10% reduction.  If this goes okay then you could make a larger reduction the next time.

 

Stability

 

WDnormal

 

And Brassmonkey talks more about it here:

 

tao-of-the-brassmonkey

[Margaret1]

Drug signature 

Paxil 40 mg on/off since 1993, currently on 20 mg attempting to taper down will begin taper 11-25-22

Trazodone 150mg since 2005? Currently taking 12.5 mg as needed 2x weekly 

Seroquel 300 mg since 2005? - 2-2022 quit

Gabapentin 300 mg 2015? - 2-2022 quit 

Lamotrigine 2015-2018? Quit 

Abilify - took once made me nauseous and almost passed out, quit 

Clonazapam .5 mg 2018-2022 quit 

Risperdal - made feel sick only took a few times, quit

Hydroxyzine  2015? - 2021 quit

Lithium - 2014? Do not remember dosage, quit 

Depakote - 2012? Do not remember dosage, quit 

Citalopram - 2004? Do not remember dosage, quit

Haloperidol - given once

Clonidine - 2022, quit 

Lorazepam- 1996?, quit 

 

 

 

 

 

 

 

[ChessieCat]

Thank you.  I have used that information and created your drug signature for you.  This will appear below every post you make.

[Margaret1]

The tinnitus in my right ear is getting worse since I tapered down from 40 mg paroxetine to 20 mg. Will this go away eventually? 
I am scared to attempt to taper my dose of paroxetine down anymore but reading your post about tapering down to just 19.5 mg helps. I need to figure out how to take a 20 mg paroxetine pill and convert it to 19.5 mg. 
I am having low moods but have come to accept these. 

[ChessieCat]

Can you remember roughly when this occurred?   Haloperidol - given once

[Margaret1]

The doctors have hopefully made educated decisions based on past experiences and education to prescribe these medications but do they really have any idea what these chemicals are doing to the human body?

[ChessieCat]

3 minutes ago, Margaret1 said:

from 40 mg paroxetine to 20 mg

 

When did you reduce from 40mg to 20mg?  Did you reduce by 1/2 all in one go?

[Margaret1]

I was given Haloperidol as a shot in 2020? I was having anxiety and asked if there was something I could be given for this. When the nurse attempted to give me an injection I was dumbfounded as to why I was being given this instead of a anti-anxiety pill. Is this important? What does haloperidol do?

[Margaret1]

I reduced the paroxetine from 40 mg to 30 mg on 4-23-22. I reduced it again from 30 mg to 20 mg on 5-24-22.

[ChessieCat]

1 minute ago, Margaret1 said:

The doctors have hopefully made educated decisions based on past experiences and education to prescribe these medications but do they really have any idea what these chemicals are doing to the human body?

 

No, they don't know.  It's all guess work and the medical professionals get their information about drugs from the pharmaceutical companies.

 

Gwen Olsen was a pharmaceutical representative for 15 years and made these:

 

Interview:  Confessions of an Rx Drug Pusher (51 minutes Gwen Olsen - ex pharmaceutical representative)
 

Video:  Ex-Big Pharma Rep:  We’re Trained To Misinform -The Drugs ARE Dangerous (6 minute video)
 

Video:  Ex-Big Pharma Rep:  Manipulating Doctors to Sell More Drugs (10 minute video)

 

If you want to learn about the history of psychiatric drugs, the book by Robert Whitaker - "Anatomy of an epidemic: magic bullets, psychiatric drugs and the astonishing rise of mental illness in America" is well worth reading.

 

Also Your Drug May Be Your Problem by Dr Peter Breggin.

[ChessieCat]

2 minutes ago, Margaret1 said:

I was given Haloperidol as a shot in 2020? I was having anxiety and asked if there was something I could be given for this. When the nurse attempted to give me an injection I was dumbfounded as to why I was being given this instead of a anti-anxiety pill. Is this important? What does haloperidol do?

 

I'm just getting all the information in your drug signature.

 

As I wrote before the effect on the nervous system is cumulative.  You will see that I have highlighted the last 3 years in red so it is easier for the staff to see the drugs you were taking more recently.

[Margaret1]

Since I made the reduction from 30 mg paroxetine to 20 mg I noticed low moods after about 2 days off if it. When I fall asleep, I generally wake up 3 hours later and then go back to sleep again. The sleep does not seem as deep as it was when I was taking 150 mg of trazodone and 300 mg if seroquel at night. Also, I remember the subject matter of my dreams now and can recall them late in the day. 
After a few days of getting this light unfulfilling sleep I will take 12.5 mg of trazodone, a 50 mg pill cut into four sections. My doctor stated that 50 mg is the lowest pill available of trazodone. 
Overall, anxiety, depression, and sleep issues have worsened but I worry about my liver and life expectancy issues and would like to figure out why my brain is the way it is through thorough examination instead of adding chemicals to the equation at this time. 

[Margaret1]

Ideally, I want to stop taking paroxetine. This is why I reduced it from 40 mg down to 20 mg over a two month period. I do not plan to lower from 20 mg until 11-25-22. I am hoping my mind can reach homeostasis before then. As of now, I do not think I am ready to lower paroxetine dose any more. Quitting the seroquel, gabapentin, and lowering trazodone and paroxetine in 2-2022 had been a process. 
 

[ChessieCat]

Margaret we need the details of the dose reductions you have made with the paroxetine.

 

The date you changed the dose and the dose you took on that date.  From what you write above in the last 2 posts it looks like you went from 40mg to 30mg and then to 20mg.  Please tell us the dates that you did these changes.

 

This information is important.  Thank you.

[Margaret1]

I went from 40 mg paroxetine to 30 mg on 4-23-22 and 30 to 20 on 5-24-22.

[ChessieCat]

Thank you for providing the information about your paroxetine reductions.  I have added that information to your drug signature.

 

Please continue to let us know how you are doing.  Also, when you are ready to start tapering BEFORE you make the first reduction please post letting us know and we can assess your symptoms and give our opinion about whether you are stable enough to reduce the paroxetine.

[Margaret1]

Trying to take it slow these days. I know my mind has been through a lot coming off what I have this far. This morning I went on a walk. I had one cup of coffee beforehand but this could be enough to cause me to not sleep tonight. Over the last few days I have been taking trazodone at night to sleep. I wish I hadn’t of because it is hard to stop taking it again and sleep. I am still at 20 mg paroxetine dosage. I thought I was going to have a panic attack the other night but I was able to do some deep breathing to cause cessation. Exercise is very helpful as well as eating healthy meats and vegetables and avoiding grains. I also take supplements which I believe help.  Getting out In the sun has helped too. 
I am having fears of lowering the paroxetine dose in November but have learned so much from this site about tapering that I think it should be ok. I want to quit coffee entirely but enjoy drinking the one cup in the morning to alleviate depression.

The depression I have comes and goes. When it comes I am afraid of it, it seems so powerful and loud. I think, I need to get back on the medicines I quit now, then I come out of it and think that I will go for another day without them. 
The psychiatrist that I see has a nurse who checks you in when you go for visits. Last time I was there, she was very unsupportive of my discontinuation of the medicines and lowering in dosage of paroxetine. She also said that any symptoms I was having was not from withdrawal because that only lasts for two weeks. I told her about the tinnitus in my right ear in which I never had before I took these medicines. I would have thought she would have been more supportive of my journey. The psychiatrist said I could get back on them if need be but to see me back in six months. She was kind but not informative of the process my body and mind would go through. 
This site, Reddit, and quora have been informative. I do hope that people on this site will support me through this process. Also, I pray that everyone on here finds true peace and happiness. 
 

 

 

[Margaret1]

The last few days have been really hard. I’m trying and I’m pulling through. What doesn’t kill you makes you stronger. Experienced some family stressors. 
But overall, I don’t watch tv all day anymore and sleep 12 hours a night. I get up in the morning and go on a long walk and then I go to a job. I’ve held a job now for 5 months which is the longest in many years. For years I couldn’t work while I was so drugged on these medicines. I couldn’t taste food or smell properly. I had no real caring for others. Now I spend time playing with my cat and talking with others. I want to get my life back!

[Margaret1]

One other thing I remember about the last time I tried to go off paroxetine and after I stopped it, three months later was when the panic attacks started. I had started using st Johns wort as a tincture after I quit paroxetine. Could this have caused the panic? 
Also, I’m off trazodone again. I want to sleep naturally. 

[ChessieCat]

1 minute ago, Margaret1 said:

I had started using st Johns wort as a tincture after I quit paroxetine.

 

Were you taking it all the time or just every now and then?

 

If you were taking it regularly and then stopped it, di the panic attacks start after that.

 

See:

 

st-johns-wort-hypericum-perforatum

 

and

 

On 2/28/2014 at 1:39 PM, Altostrata said:

Note: St. John's Wort is a monoamine oxidase inhibitor (MAOI). If you are taking it, you may have odd reactions to a substance called tyramine in some foods. You may wish to go on a restricted diet for MAOIs http://www.mayoclinic.org/diseases-conditions/depression/expert-answers/maois/faq-20058035

 

[ChessieCat]

 

On 4/1/2019 at 5:40 AM, Altostrata said:

People have different reactions to St. John's Wort, some of them bad. We don't recommend it for withdrawal symptoms.

 

About reinstatement for withdrawal symptoms:

  

On 10/9/2012 at 10:17 AM, Altostrata said:

What is reinstatement?

Reinstatement means resuming the drug or its equivalent when withdrawal symptoms appear.

 

According to what medicine knows about psychiatric drug withdrawal syndrome, reinstatement is the only way to alleviate withdrawal symptoms. All the papers about withdrawal symptoms allude to how symptoms usually resolve after reinstatement. This is considered a hallmark of withdrawal syndrome.

 

[Margaret1]

Maybe slept one hour last night. I didn’t take the trazodone. I am getting ready to go on my morning walk and then will try to go to grocery store. I hope I sleep better tonight. 
I believe I was still taking St. John’s wort when the panic started. Thanks for the links. This time around I won’t start taking it. In fact, I’m thinking of going off the supplements I take to minimize any negative effects I could be having from them. 
I am tired but I know from what I’ve read on here about sleep that it’s best to go to bed at the same time and wake up at the same time. Have a good day.

[Margaret1]

I went for a long walk this morning after not sleeping last night. When I got home I had a low moment that felt horrible and anxious and fearful and it lasted about 5 seconds. Then it passed and I was able to nap for an hour. I’m not going to take trazodone again tonight because I know good regular sleep should return after I’ve been off it for a while. It’s tempting to take it though but when I take it I will feel anxiety and my heart will beat quickly so I would rather stay away from it. 

[Altostrata]

On 7/2/2022 at 5:59 AM, Margaret1 said:

I went from 40 mg paroxetine to 30 mg on 4-23-22 and 30 to 20 on 5-24-22.

 

Very possible you are currently suffering withdrawal symptoms from this decrease of 50% in 2 months.

[Margaret1]

I haven’t started getting panic attacks yet so I haven’t increased the paroxetine dosage. I wish I had read more about tapering before I did that. 

 

[Margaret1]

It has been almost two months since I went from 30 mg paroxetine to 20 mg. When I feel the depressed moods now they are worse but when I am not feeling them I feel more stable and calmer now. It is a relief to feel this way. I take a deep breath in and think how fortunate I am to of gotten off the  psychiatric medications I was on and being able to lower the paroxetine dose from 40 mg to 20 mg. I have not gone into panic mode and am grateful for this. My sleep is good when I walk about 8 miles in a day but otherwise it is fleeting. I am tempted to begin taking the trazodone again for sleep sometimes but know this will only make sleeping well in the long term difficult. I am showing up for work, which is not intellectually challenging, which is probably good in this first year of withdrawing. I do not drink alcohol because it is a depressant. And I try to eat a plant based diet with some meat. I listen to relaxation videos on YouTube and try to engage in mindfulness activities. 
mid I go into panic attacks again I will probably raise my paroxetine from 20 to 30 mg but until then I plan to stay at 20 mg. Beginning 11-25-22, assuming all is going well, I will begin to taper off from paroxetine from 20 mg to 17.5 mg. I have been thinking of upping my exercise from walking three miles per day to 5 but don’t want to over do it. Also, I am still drinking one cup of coffee a day and sometimes go over that amount which then causes insomnia unless I have excessively exercised. 
I am considering going to talk therapy. Also, my neck muscles are painful  and I have been having issues with muscle tightness. 

[ChessieCat]

2 hours ago, Margaret1 said:

mid I go into panic attacks again I will probably raise my paroxetine from 20 to 30 mg but until then I plan to stay at 20 mg.

 

NO!  Please do not return to 30mg.  That may be too much for your nervous system and could make things much worse.

 

SA strongly encourages members to learn and use non drug coping techniques. 

 

Non-drug techniques to cope

 

 

 

[Altostrata]

@Margaret1, your symptom description still sounds like you have withdrawal symptoms from your reduction 2 months ago. Two months is not a long time for these symptoms to persist.

 

It also sounds like they are very gradually going away in a waves and windows pattern, which is what we would expect from withdrawal symptoms.

 

If I were you, I would not anticipate updosing paroxetine, but continue to take 20mg at the same time each day until the withdrawal symptoms fade away. This may take months more.

 

You may consider gradually replacing your coffee with decaf. Caffeine can affect sleep, as you have observed, and even cause surges of activation you might interpret as panic attacks. You should consider your system sensitized by withdrawal.

[Margaret1]

It has been almost two months since I went from 30 mg paroxetine to 20 mg. When I feel the depressed moods now they are worse but when I am not feeling them I feel more stable and calmer now. It is a relief to feel this way. I take a deep breath in and think how fortunate I am to of gotten off the  psychiatric medications I was on and being able to lower the paroxetine dose from 40 mg to 20 mg. I have not gone into panic mode and am grateful for this. My sleep is good when I walk about 8 miles in a day but otherwise it is fleeting. I am tempted to begin taking the trazodone again for sleep sometimes but know this will only make sleeping well in the long term difficult. I am showing up for work, which is not intellectually challenging, which is probably good in this first year of withdrawing. I do not drink alcohol because it is a depressant. And I try to eat a plant based diet with some meat. I listen to relaxation videos on YouTube and try to engage in mindfulness activities. 
mid I go into panic attacks again I will probably raise my paroxetine from 20 to 30 mg but until then I plan to stay at 20 mg. Beginning 11-25-22, assuming all is going well, I will begin to taper off from paroxetine from 20 mg to 17.5 mg. I have been thinking of upping my exercise from walking three miles per day to 5 but don’t want to over do it. Also, I am still drinking one cup of coffee a day and sometimes go over that amount which then causes insomnia unless I have excessively exercised. 
I am considering going to talk therapy. Also, my neck muscles are painful  and I have been having issues with muscle tightness. 

[Margaret1]

Thank you for your reply. I do not plan to increase my dosage of paroxetine thus far. I have not begun having panic attacks. My desire is to be free from all medicine. I had a back and neck massage today. The left hand side of my neck is very tight. The massage helped this. 
I have started eating meat again on a regular basis. I was vegetarian for years and wonder if this may have been a factor in the anxiety and depression. I do want to improve my overall gut health and think this is important. 
The tinnitus in my right ear is still here especially when I bend my head over or lay down. I hope this goes away. Listening to my heart beat loudly is not pleasant. At times I hear the whoosh whoosh of my heart, I’m assuming the valves, as it moves the blood through. I do not want to have to listen to this for the rest of my life. 
 

[Altostrata]

We recognize those as withdrawal symptoms that we've seen many times before. We have seen them very gradually go away in a waves-and-windows pattern.

 

The Windows and Waves Pattern of Stabilization