Jump to content
SurvivingAntidepressants.org is temporarily closed to new registrations until 1 April ×

Lulu1: Can Paxil withdrawal and reinstatement cause a cyclical mood disorder / bipolar depression?


Lulu1

Recommended Posts

Hi, I'm new to this site. As far as my background, in 2018, after 25 years of taking Paxil and feeling good and stable, I decided to reduce my dose of 40 mg. down to 20 mg. over the course of three months (May-Aug) as I wanted to get rid of sexual side effects. After some back and forth with the dose, I reduced my dose to 20 mg in August and began to experience bad SSRI withdrawal and particularly intense anxiety. It got so bad I eventually ended going back up to my baseline dose of 40 mg of Paxil but it no longer was working to control my anxiety, etc. In addition, I began to experience a new cyclical mood disorder, whereby I could feel fine for several weeks or a month or more and then I would have an episode where for 7-10 days I would wake up with intense suicidal depression that would generally start lifting a few hours after waking. I have been working with a cadre of psychiatrists and other healthcare providers to get stable again, my anxiety is under control but so far nothing has worked to address this mood disorder which has been diagnosed as an atypical presentation of cyclothymia and which has been life-altering. In addition to reinstating the 40 mgs of Paxil, I am now on Seroquel (300 mg), Lamotrigine (75 mg) and recently started Lithium Carbonate (300 mg). 

 

My questions: is it possible that my attempts to go off Paxil (including some back and forth with increasing and then lowering dose) after so many years could have instigated this new mood disorder I'm dealing with? 

Link to comment
  • ChessieCat changed the title to Lulu1: Can Paxil withdrawal and reinstatement cause a cyclical mood disorder / bipolar depression?
  • Moderator Emeritus

Hello, and welcome to SA.  We are a volunteer-run community of people who have been or are getting off of psychiatric drugs.  I'm sorry that you have been put in this situation.  

 

On 7/9/2022 at 1:43 PM, Lulu1 said:

is it possible that my attempts to go off Paxil (including some back and forth with increasing and then lowering dose) after so many years could have instigated this new mood disorder I'm dealing with? 

Yes, absolutely.  This is not uncommon, and we've seen this pattern in many other people.  They try to get off a psychiatric drug, go into withdrawal, go back to the doctor, s/he denies withdrawal, blames the symptoms on the mental health issues of the patient, and puts them on even more drugs. 

 

Can you please give us specific information in your signature about your drug history for all drugs you are on and have been on, especially for the past 18-24 months?  It would be especially helpful to have the details of your drugs in a concise vertical list (no symptoms), only drug names, specific dates (as best you can say for example early March if you don't recall the day) and dosages of each medication decrease or increase.  Use this format:

 

Drug name: date, dose, date, dose, date, dose…

Drug name: date, dose, date, dose, date, dose…

Etcetera

 

Please read the link below for instructions.  This will allow us to give you the best guidance.  

 

How to List Drug History in Signature

 

Here is some important information about how these drugs actually work.  This explains why we get symptoms from going off of these medications, and why it's so important to taper slowly and carefully, and be very cautious about changing our doses: 

 

How Psychiatric Drugs Remodel Your Brain

 

 

This helps you understand what withdrawal syndrome is: 

 

Video on Recovery from Psych Drugs

 

This link below talks about windows and waves, which means that while we are tapering and withdrawing from the drug, see have times where we feel good (windows) and times where we feel bad (waves).  This is how so many people get falsely diagnosed as having bipolar. 

 

Windows and Waves Pattern of Stabilization

 

When you dropped your dose by 50%, that was too much for your nervous system to handle all at once.  We here suggest taper ing by 10% of the current dose no more than once every 4 weeks, so that the reduction becomes exponentially smaller.

 

 Why Taper by 10% of my Dosage  

 

 

Here is a link with checklists of common WD symptoms: 

 

Dr Joseph Glenmullen Withdrawal Symptom Checklists

 

 

Here are some techniques to cope with symptoms: 

 

Non Drug Ways to Cope with Withdrawal Symptoms

 

Another thing you did, was when you were going up and down in your dose, this tends to further destabilize and confuse the nervous system.  Stability is really important when we are tapering off psych meds.  Please read the link about stability:

 

Keep It Simple, Slow, and Stable

 

 

We don't suggest many supplements, but 2 that many of us find helpful are magnesium and omega-3 fish oil. Here are the links for info about those. It is suggested to add one at a time, and start with a low dose to see how it affects you. 


Magnesium

Omega 3 Fish Oil

 

Nervous system instability can take years to correct itself, so it is quite possible that your "cyclical mood disorder" is actually post acute withdrawal syndrome from your attempts to get off the Paxil in the past.  Here is what another member of our forum says about this: 

 

On 12/15/2014 at 2:36 PM, Rhiannon said:

I was diagnosed as bipolar because of antidepressant use and withdrawal. That happens to a lot of people. 

 

What you describe, going on and off meds without a lot of trouble then suddenly it just doesn't work any more, is very common. Alto says our nervous systems are not made of rubber. I say, we only get so much "slack" and sooner or later we use it all up and run out. 

 

Everything you describe sounds very much like withdrawal symptoms and the kind of symptoms people get after going on and off meds a lot, the general destabilization that happens over the long term on psychiatric meds. You can read Anatomy of an Epidemic by Robert Whitaker (translated into many languages) for more information about that.

 

If you want to embrace your "diagnosis" of bipolar, that's up to you, but it sounds from what you've written like you're actually aware that your symptoms have been caused by meds. And certainly what you describe is very much like what hundreds of other people have described here.

 

The thread from which this was quoted is here: 

 

Bipolar, Mood Swings, Mania, Hypomania, Depression

 

Please let us know if you ever wish taper off your drugs in the future in a safe and effective way, and we will be glad to help you with that. 

Edited by getofflex

Please do not private message me.  Only tag me for urgent questions about tapering and reinstating - thank you.  

 

***Please note this is not medical advice.  Discuss any decisions about your medical care with a doctor who understands psych meds and how to withdraw from them, if you can find one.

 

Lexapro   Started Apr 15 2010 - 10 mg;  started taper August 2017, recent taper info: Apr 2 '20  0.18 mg; Jul 16  0.17 mg, Aug 23  0.16 mg, Oct 7  0.15 mg, Nov 8 - 0.14, Jan 16 '21 - 0.13, Feb 7 - 0.12, Feb 22 - 0.11, Mar 26 - 0.10, May 21 - 0.09, June 15 - 0.08 Aug 16 - 0.07, Oct 6 - 0.06, Nov 21 0.05, Dec. 17 0.04, Jan 14 '22 0.03, Feb 19 0.02, Apr 18 0.01, May 15 0.005,  Jul 8, 0.00.  Psych Drug Free as of July 8, 2022!!  Woohoo!!!

other meds: Levothyroxine 75 mg

magnesium in small amounts at 4 AM, before bed

suppl AM: fish oil, flax oil, vit C, vit E, multivitamin, zinc

suppl 8 PM: magnesium 350 mg, extended release vitamin C, melatonin 2 mg

 

Paxil 2002 - 2010, switched to Lexapro 2010 

Trazodone 50 mg. 2002 - 2019, fast tapered in 2019 

Xanax 0.5 mg as needed 2002 - 2019, up to 3x weekly 

Link to comment
  • Moderator

Hi @Lulu1

as @getofflexhas pointed our earlier - this is not a new mood disorder. What you describe sounds more like the 'windows and waves' pattern of recovery from withdrawal from psychiatric drugs. 

 

I also like the first post in this thread What is happening in your brain? - Symptoms and self-care - Surviving Antidepressants

 

In the meantime make sure to avoid things that stress your nervous system - we recommend people stay away from alcohol and other psychoactive substances such as pot, street drugs, supplements (St John's Wort, Sam-e) as well as some vitamins (some Bs and D tend to be activating) as our systems tend to be very sensitive in withdrawal. The introduction of new drugs and psychoactive substances can sometimes make things worse rather than better. Likely why the newly introduced cocktail of drugs is not working for you. 

 

This may be helpful as well: 

You will recover from this slowly if you allow your nervous system stability. 

OMW 

Edited by Onmyway

"Nothing so small as a moment is insurmountable, and moments are all that we have. You have survived every trial and tribulation that life has thrown at you up until this very instant. When future troubles come—and they will come—a version of you will be born into that moment that can conquer them, too." - Kevin Koenig 

 

I am not a doctor and this should not be considered medical advice. You can use the information and recommendations provided in whatever way you want and all decisions on your treatment are yours. 

 

In the next few weeks I do not have a lot of capacity to respond to questions. If you need a quick answer pls tag or ask other moderators who may want to be tagged. 

 

Aug  2000 - July 2003 (ct, 4-6 wk wd) , citalopram 20 mg,  xanax prn, wellbutrin for a few months, trazodone prn 

Dec 2004 - July 2018 citalopram 20 mg, xanax prn (rarely used)

Aug 2018 - citalopram 40 mg (self titrated up)

September 2018 - January 2019 tapered citalopram - 40/30/20/10/5 no issues until a week after reaching 0

Feb 2019 0.25 xanax - 0.5/day (3 weeks) over to klonopin 0.25 once a day to manage severe wd

March 6, reinstated citalopram 2.5 mg (liquid), klonopin 0.25 mg for sleep 2-3 times a week

Apr 1st citalopram 2.0 mg (liquid), klonopin 0.25 once a week (off by 4/14/19- no tapering)

citalopram (liquid) 4/14/19 -1.8 mg, 5/8/19 - 1.6 mg,  7/27/19 -1.5 mg,  8/15/19 - 1.35, 2/21/21 - 1.1 (smaller drops in between), 6/20/21 - 1.03 mg, 8/7/21- 1.025, 8/11/21 - 1.02, 8/15/21 - 1.015, 9/3/21 - 0.925 (fingers crossed!), 10/8/21 - 0.9, 10/18/21 - 0.875, 12/31/21 - 0.85, 1/7/22 - 0.825, 1/14/22 - 0.8, 1/22/22 - 0.785, 8/18/22 - 0.59, 12/15/2022 - 0.48, 2/15/22 - 0.43, 25/07/23 - 0.25 (mistake), 6/08/23 - 0.33mg

 

Supplements: magnesium citrate and bi-glycinate

Link to comment

Please sign in to comment

You will be able to leave a comment after signing in



Sign In Now
×
×
  • Create New...

Important Information

Terms of Use Privacy Policy