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Altostrata

Tips for tapering off Paxil (paroxetine)

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Altostrata

aka Aropax, Paroxat, Deroxat, Rexetin, Sereupin, Seroxat, Xetanor

Paxil and Effexor have long led the list of antidepressants notorious for difficult withdrawal, the others being Zoloft and Luvox. (But this may be because Paxil and Effexor have been very widely prescribed for a long time; Lexapro and Cymbalta are certainly also very difficult to taper.)

From the July 2011 Medication Guide from GlaxoSmithKline here (PDF) http://us.gsk.com/products/assets/us_paxil.pdf

 

Quote

Discontinuation of Treatment With Paxil

Recent clinical trials supporting the various approved indications for Paxil employed a taper-phase regimen, rather than an abrupt discontinuation of treatment. The taper-phase regimen used in GAD and PTSD clinical trials involved an incremental decrease in the daily dose by 10 mg/day at weekly intervals. When a daily dose of 20 mg/day was reached, patients were continued on this dose for 1 week before treatment was stopped.

With this regimen in those studies, the following adverse events were reported at an incidence of 2% or greater for Paxil and were at least twice that reported for placebo: Abnormal dreams, paresthesia, and dizziness. In the majority of patients, these events were mild to moderate and were self-limiting and did not require medical intervention.

During marketing of Paxil and other SSRIs and SNRIs, there have been spontaneous reports of adverse events occurring upon the discontinuation of these drugs (particularly when abrupt), including the following: Dysphoric mood, irritability, agitation, dizziness, sensory disturbances (e.g., paresthesias such as electric shock sensations and tinnitus), anxiety, confusion, headache, lethargy, emotional lability, insomnia, and hypomania. While these events are generally self-limiting, there have been reports of serious discontinuation symptoms.

Patients should be monitored for these symptoms when discontinuing treatment with Paxil. A gradual reduction in the dose rather than abrupt cessation is recommended whenever possible. If intolerable symptoms occur following a decrease in the dose or upon discontinuation of treatment, then resuming the previously prescribed dose may be considered. Subsequently, the physician may continue decreasing the dose but at a more gradual rate....

....
Discontinuation of Treatment With Paxil

Symptoms associated with discontinuation of Paxil have been reported (see PRECAUTIONS: Discontinuation of Treatment With Paxil). Patients should be monitored for these symptoms when discontinuing treatment, regardless of the indication for which Paxil is being prescribed. A gradual reduction in the dose rather than abrupt cessation is recommended whenever possible. If intolerable symptoms occur following a decrease in the dose or upon discontinuation of treatment, then resuming the previously prescribed dose may be considered. Subsequently, the physician may continue decreasing the dose but at a more gradual rate.

 

From FDA prescribing information at http://www.drugs.com/pro/paxil.html

 

  • Regular Paxil comes in 10, 20, 30, and 40 mg tablets (also true of generic paroxetine).
  • Paxil CR comes in 12.5, 25, and 37.5 mg tablets.
  • Paxil Oral Suspension (liquid) comes in a concentration of 10 mg/5ml   (NOTE:  contents to be discarded 1 month after opening - see this post)

 

Reduce by 10% per month to start
The 10% rule holds for Paxil, like other psychiatric drugs: Reduce by 10% per month, calculated on the last dosage. (The amount of the reduction gets progressively smaller.)

See Why taper by 10% of my dosage?

Cutting up tablets
To reduce your dosage, cut regular Paxil tablets up with a pill cutter, available at any drug store.

If you get your prescription filled with the 10mg tablets, you may be able to cut them in half or quarters to reduce by 5mg or 2.5mg at a time.

Precisely weighing tablet pieces or crushed tablets with an electronic digital scale
You may wish to precisely measure your dosage with an electronic scale that measures milligrams. These are available for under $30 US. See Using a digital scale to measure doses

Use Paxil liquid to taper

(NOTEPaxil Oral Suspension is stable until expiry date when stored correctly - see this post; Seroxat contents to be discarded 1 month after opening - see this post)


This is the easiest and most accurate way to taper Paxil.

See FDA prescribing information at http://www.drugs.com/pro/paxil.html

In the US, the ordering code for Paxil Oral Suspension (liquid),10 mg/5ml., in 250 ml bottles is

NDC 53873-043-00 (GlaxoSmithKline Paxil liquid) https://www.hipaaspace.com/medical_billing/coding/national.drug.codes/53873-043-00

NDC 60505-0402-5 (Apotex generic paroxetine liquid) https://www.hipaaspace.com/medical_billing/coding/national.drug.codes/60505-0402-5

 

Some people are sensitive to changes in the form of the drug. If you are taking tablets, you may wish to take part of your daily dosage in tablet form and part in liquid for a few days to ease the transition from tablets to liquid.


Use oral syringes to taper with the liquid, see http://survivingantidepressants.org/index.php?/topic/235-tapering-techniques/

 

Using a combination of tablets or capsules and liquid

Rather than switch directly to an all-liquid dose, you may wish to take part of your dose in liquid and part in lower-dose tablets or capsules, gradually converting to all liquid as you get to lower dosages. This can be very convenient and reduce any problems switching from one form of the drug to another.

 

To gradually convert to liquid, you might want to start taking 3/4 or 1/2 your dose in tablet form and the rest in liquid form for at least a week, to get used to the new combination. Then you can start tapering the liquid portion.

 

If your doctor prescribes liquid and tablets or capsules at the same time, most likely, he or she will have to indicate "divided doses" in the prescriptions to get the drugs covered by insurance.

 

Make your own liquid
You can make your own liquid with water. See How to make a liquid from tablets or capsules

 

Tapering the controlled-release (CR) version of paroxetine
The half-life of regular paroxetine is estimated at about 20 hours, while paroxetine CR’s half-life is 15 to 20 hours — there’s not much difference.

 

According to FDA Prescribing Information for Paxil CR, which can be found on the insert in the drug packets,

Quote

Each enteric, film-coated, controlled-release tablet contains paroxetine hydrochloride…. One layer of the tablet consists of a degradable barrier layer and the other contains the active material in a hydrophilic matrix.

 

The CR matrix formulation slows the dissolving of the tablet slightly, releasing the drug into your system a little more gradually. There is no magic in this matrix. If you cut up the tablet, it may dissolve faster like regular paroxetine. The change in release rate probably won’t be apparent to most people and if it is, most likely will go away in a few days. So you can cut up the tablet to reduce the dosage. (You cannot make a liquid from a matrix tablet; when you add water, it will turn into a gluey glob.)

 

However, to taper at 10% per month (calculated on the most recent dosage), you will want to be more precise in your dosage measurement. This may be accomplished by gradually switching to paroxetine liquid and using an oral syringe to draw small amounts of the drug.

 

To gradually convert to liquid, you might want to start taking 3/4 or 1/2 your dose in tablet form and the rest in liquid form for at least a week, to get used to the new combination. Then you can start tapering the liquid portion.

 

You could also use a combination of lower-dosage paroxetine CR tablets with liquid to taper. For example, if you are taking 20mg paroxetine, you may wish to take half your dose in tablet form and half in liquid for a week, to get used to the combination.

  • First, get used to the tablet-liquid combination: Take part of your dose in tablet form and the rest in liquid form, such as 12.5mg paroxetine CR tablets with 7.5mg paroxetine liquid  for at least a week.
  • Reduce from the liquid portion. Your initial 10% reduction of 20mg/day would be 2mg, for a dosage of 18mg. You can take 12.5mg paroxetine CR tablets with 5.5mg paroxetine liquid for a total daily dose of 18mg.
  • Your next 10% reduction on 18mg would be 1.8m, for a daily dosage of 16.2mg: 12.5mg paroxetine CR tablets with 3.7mg paroxetine liquid.
  • Your next reductions would be to 14.6mg, then to 13.2mg (always round up to the larger dosage).
  • As your next 10% reduction would take your dosage below the 12.5mg paroxetine CR tablet, convert your dose again: Take 1/2 a split tablet (6.25mg) and the rest (6.95mg) in liquid for a week, then resume the 10% taper from 13.2mg.
  • Your next 10% reduction on 13.2mg would be 1.32mg, for a daily dosage of 11.9mg: 6.25mg paroxetine CR tablets with 5.6mg paroxetine liquid adding up to 11.9mg.
  • And so on. When your next reduction takes your daily dose under 6.25mg, you will want to switch your entire dose to liquid paroxetine.

 

Please be aware than any transition from one form of the drug to another may be a little bumpy but usually works out over a few days.

 

Have a compounding pharmacy make up capsules of smaller paroxetine dosages
With a prescription, a compounding pharmacy will accurately weigh small doses and put them into capsules for you. This is usually somewhat expensive. See http://survivingantidepressants.org/index.php?/topic/235-tapering-techniques/page__p__3001#entry3001

 

Edited by Altostrata
updated

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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KatyM

I was on 12.5 for 3 years...After my son went in the Army and my boss was awful to me.....I quit my job and started a new one...Then my son went to Iraq...Wow they bumped me up to 25....Now Im doing ok my son is coming home and I love my job...Also I have Colitis for about 10 years....Big flare up when they bumped me up to 25...I am 56 years old and gaining weight like crazy....Want off of Paroxitine now...Doctor sais take the 25 for 2 more weeks....Then go down to the 12.5 for 2 weeks than every other day....Like i said yoyo...I was told I cant cut these pills cause they are time released....I dont think there is a smaller dose than what i am taking? Help!!!!

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Brandy

Your doctor is giving you a common taper schedule that DOES NOT WORK for most people! This is something doctors just don't know about yet. Withdrawal schedules that work for some other kinds of medications are disasters with medications like paroxetine and so many others. Most people who follow taper schedules like that one end up with big problems - not always immediately, but fairly soon.

 

Then doctors think their "original condition" is worse and tell them they have to go back on medication - often switching them to a newer, allegedly "better" med which compounds the problems because they often don't help the withdrawal but create a new addiction and its own set of side effects and sooner or later (often sooner!) another withdrawal on top of the first one. Aaaaargh! But fortunately you realized there were problems sooner than many of us did, so you can avoid this medication merry-go-round.

 

Please be sure and read the entire thread about tapering that I linked to in my response to your other post. (That thread explains a lot of things far better than I could!) Don't let it overwhelm you! Just get familiar with the concepts and options, and then you'll get lots of personal responses to help you find what's suitable for you, and help and support as you do a slow, safe taper where you won't be a human yo-yo! (And will have a lot less problems in the future!)

 

It never hurts to go slower, and it gives your body much better circumstances for healing from the changes the med makes while taking it. That's the key issue to recovering well and having quality of life while you do! Your doctor is right that you can't cut the "CR" extended release ones, but that's not a problem! In order to do a slow taper that will avoid the problems you're having (and many more!), you need to switch to regular paroxetine. It's the same medication, and the "extended release" of the CR seems to be deceptive. I've never used that form, but from what I've read, it's simply coated to delay it's absorbing into your system.

 

People don't have problems switching from cr (extended release) to regular; it's switching to other meds, even in the same drug family, that so often causes new problems. I'd suggest you switch to the liquid (suspension) form of paroxetine. You don't need to do that right away, but pretty soon that will be the best way to accurately measure out the small doses to do 10% (or whatever percentage works for you; some people need to drop by even less) drops after stabilizing on each new dose after taking each dose for 3-6 weeks or more to stabilize on it and be ready to drop further.

 

Your doctor will need to prescribe the form of paroxetine you'll need. See if he'll prescribe it in the liquid suspension form for you. 20 mg. will be the equivalent of 25 mg cr's as far as I know. Once you get that (let us know if your doctor refuses, but he or she should accept that you feel more comfortable tapering very slowly, and if they don't, remind them that it can't hurt to go slow!), take 20 mg. every single day (no alternating days!!!!) and then we'll help you learn how to taper safely from there. By the way, I'm not surprised your colitis got worse on the higher dose.

 

Digestive problems often are exacerbated by these meds. But don't rush your taper! Tapering too fast would make it far worse than the med itself does. That's because the lining of the intestine needs to heal, and too-fast tapering interferes with that healing. It's very common to gain weight on this med. You most likely will lose the weight you gained in a while, but that can't be rushed by faster tapering. And it can take a while after tapering, but it will happen!

Edited by KarenB
added paragraph spacing

I was "TryingToGetWell" (aka TTGW) on paxilprogress. I also was one of the original members here on Surviving Antidepressants

 

I had horrific and protracted withdrawal from paxil, but now am back to enjoying life with enthusiasm to the max, some residual physical symptoms continued but largely improve. The horror, severe derealization, anhedonia, akathisia, and so much more, are long over.

 

My signature is a temporary scribble from year 2013. I'll rewrite it when I can.

 

If you want to read it, click on http://survivingantidepressants.org/index.php?/topic/209-brandy-anyone/?p=110343

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Shanti

My doctor wasn't cooperating with me to get Liquid Paxil so I talked to my Pharmacist and he said he doesn't need a new prescription from my Doctor. So he is ordering it for me. I just thought others should know this in case their Doctors aren't cooperating.

 

Does anyone know how much it costs? I'm only concerned now that I'll have to pay out of pocket for it and it'll be too expensive.


Taper from Cymbalta, Paxil, Prozac & Antipsychotics finished June 2012.

Xanax 5% Taper - (8/12 - .5 mg) - (9/12 - .45) - (10/12 - .43) - (11/12 - .41) - (12/12 - .38)

My Paxil Website

My Intro

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Altostrata

Google and you shall find. When you do, please post here.

 

Shanti, you can combine a half-tablet with liquid to make up your dosage, if your insurance will cover the tablet but not the liquid. That will make the liquid go farther.


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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Shanti

 

I Googled. And it looks like around $200. I hope it's covered! Or maybe there's a generic of it and cheaper. I'll post how much it is when I get it.

 

Unfortunately, I believe that price is for the generic liquid. The brand is even pricier! That's why a lot of people who can't afford it (like me) wait until they are at a lower dose so the liquid lasts longer. They usually come in 250ml bottles and 2.5ml=5mg. At your current dose a bottle will last you 27 days. If you were at 10mg a bottle would last you 50 days.

 

Wow. If my insurance doesn't cover it then I'm just gonna have to get digital scales and use the tablets. That's just crazy!

Taper from Cymbalta, Paxil, Prozac & Antipsychotics finished June 2012.

Xanax 5% Taper - (8/12 - .5 mg) - (9/12 - .45) - (10/12 - .43) - (11/12 - .41) - (12/12 - .38)

My Paxil Website

My Intro

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Altostrata

You can combine tablets and liquid, use the liquid for the odd bits of dosage.

 

For example, you can cut a 30mg tablet in half and take the 15mg tablet piece with 3.5mg liquid to make 18.5mg.

 

If you can get a full prescription for 30mg tablets, the tablets will last you 2 months.


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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Shanti

Well, my insurance doesn't cover the liquid and it's $600! Wow. So I'm going to get a digital jewelers scale at eBay or somewhere.


Taper from Cymbalta, Paxil, Prozac & Antipsychotics finished June 2012.

Xanax 5% Taper - (8/12 - .5 mg) - (9/12 - .45) - (10/12 - .43) - (11/12 - .41) - (12/12 - .38)

My Paxil Website

My Intro

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Shanti

I was able to get a jeweler's scale and a pill crusher all under $25. Much better than $600! Anyone that is shopping for one, make sure it measures to mg. I saw a lot that only measured grams.


Taper from Cymbalta, Paxil, Prozac & Antipsychotics finished June 2012.

Xanax 5% Taper - (8/12 - .5 mg) - (9/12 - .45) - (10/12 - .43) - (11/12 - .41) - (12/12 - .38)

My Paxil Website

My Intro

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Athena

Both my doctor and pharmacist told me liquid Paxil was impossible to get here in Canada, more specifically Québec. Has anyone from around here found any?

 

Thank you very much!

 

Athena


2000-2001: Effexor              2005-2012: Celexa, Zoloft, Effexor, desipramin, Wellbutrin, mirtazepin, Lamictal, Remeron, Abilify, nortriptylin, Cipralex, Cymbalta, and others I don't remember. Really bad side effects to all.
Sept-Nov 2012: Paxil 20mg, Wellbutrin 100mg, Imovane 5mg      Nov 2012: Paxil 20mg --> 10mg
Dec 2012: Paxil 10mg-->0; 1 week later: HUGE WD symptoms. Started to get informed on the internet and back to 10mg Paxil.
Dec 2012-Jan 2013: Paxil 10mg, Wellbutrin 100mg, Imovane 2.5mg        End Jan 2013: P 9mg, W 100mg, I 2.0mg
Feb 2013: P 8mg, W 100mg, I 1.5mg      April 2013: P 7mg, W 100mg, I 1.25mg       May 2013: P 7mg, W 90mg, I 1mg    

June 2013: P 7mg, W 80mg, I 0mg       July 1/2013: P 7, W 70     July 22/2013: P 7, W 60             Aug 2013: P 7, W 50       Sept 2013: P 6.1, W 50     Oct 2013: P up to 6.3, W 50     Nov 2013: P 6.2 to 5.9, W 50      Dec 2013: P 5.9, W 40      Jan 2014: P 5.3, W40        Feb 2014: P 5.3, W 30      March-April 2014: P 5.3, W 26    May 2014: P 5.3, W 20        June 2014: P 5.3 W 15     July 2014:  P 5.3, W 14       Aug 2014: P 5.3, W up to 15     Sept 2014: P 5.3, W 14    Oct 2014: P 4.8, W 14      Nov 2014: P 4.3, W 14     Dec 2014-Jan 2015: P 3.9, W 14     Feb 2015: P 3.9, W 12    March 2015: P 3.6, W 12   April-May 2015: P 3.3, W 12    June 2015: P 3.3, W 10    July 2015: P 3.3, W 8   Aug-Sept 2015: P 3.3, W 6   Oct 2015: P 3.0, W 6   Nov 2015: P 2.7, W 6   Dec 2015: P 2.4, W 6   Jan-Feb 2016: P 2.4, W 5  March 2016: P 2.2, W 5   April 2016: P 2.2, W 4   May-June 2016: P 2.2, W 3  July 2016: P 2.2, W 2  Aug 2016: P 2.2, W 1  Sept 2016: P 2.2, W 0!!  Oct 2016: P 2.0   Nov 2016-Jan 2017: P 1.8  Feb-Mar 2017: P 1.9  April-May 2017: P 1.8   June 2017: P 1.6 July-Dec 2017: P 1.5  Jan-April 2018: P 1.6

Others: Cytomel 25mcg (thyroid), vit. C, vit D, Omega-3 fish oil, Magnesium bisglycinate , Melatonin 1mg, 81mg Aspirin, Milk peptides, L-theanine, Valericalm tincture mix, scullcap tincture, Suan Zao Ren (jujube seeds)

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Altostrata

I suggest you Google "paroxetine liquid". You may find you can get it through mail order.


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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omgwtf

I would like to know if you find any good resources in this area!  Hope it's going well.


16 yrs ago started zoloft for fatigue & bodily pains

went off 4-ish yrs ago

suffered major symptoms of mostly waves of anxiety & panic, also some mania & depression approx. 6 mo's later

went back on effexor 150,

down to 75,

went off to have a baby, off for about 6 months no symptoms

back on 25, then 50 a month post baby with major postpartum depression & anxiety waves,

finally okay on 75 but wondering if I'll be on for the rest of my life

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Athena

Thank you Alto. I will Omgwtf.


2000-2001: Effexor              2005-2012: Celexa, Zoloft, Effexor, desipramin, Wellbutrin, mirtazepin, Lamictal, Remeron, Abilify, nortriptylin, Cipralex, Cymbalta, and others I don't remember. Really bad side effects to all.
Sept-Nov 2012: Paxil 20mg, Wellbutrin 100mg, Imovane 5mg      Nov 2012: Paxil 20mg --> 10mg
Dec 2012: Paxil 10mg-->0; 1 week later: HUGE WD symptoms. Started to get informed on the internet and back to 10mg Paxil.
Dec 2012-Jan 2013: Paxil 10mg, Wellbutrin 100mg, Imovane 2.5mg        End Jan 2013: P 9mg, W 100mg, I 2.0mg
Feb 2013: P 8mg, W 100mg, I 1.5mg      April 2013: P 7mg, W 100mg, I 1.25mg       May 2013: P 7mg, W 90mg, I 1mg    

June 2013: P 7mg, W 80mg, I 0mg       July 1/2013: P 7, W 70     July 22/2013: P 7, W 60             Aug 2013: P 7, W 50       Sept 2013: P 6.1, W 50     Oct 2013: P up to 6.3, W 50     Nov 2013: P 6.2 to 5.9, W 50      Dec 2013: P 5.9, W 40      Jan 2014: P 5.3, W40        Feb 2014: P 5.3, W 30      March-April 2014: P 5.3, W 26    May 2014: P 5.3, W 20        June 2014: P 5.3 W 15     July 2014:  P 5.3, W 14       Aug 2014: P 5.3, W up to 15     Sept 2014: P 5.3, W 14    Oct 2014: P 4.8, W 14      Nov 2014: P 4.3, W 14     Dec 2014-Jan 2015: P 3.9, W 14     Feb 2015: P 3.9, W 12    March 2015: P 3.6, W 12   April-May 2015: P 3.3, W 12    June 2015: P 3.3, W 10    July 2015: P 3.3, W 8   Aug-Sept 2015: P 3.3, W 6   Oct 2015: P 3.0, W 6   Nov 2015: P 2.7, W 6   Dec 2015: P 2.4, W 6   Jan-Feb 2016: P 2.4, W 5  March 2016: P 2.2, W 5   April 2016: P 2.2, W 4   May-June 2016: P 2.2, W 3  July 2016: P 2.2, W 2  Aug 2016: P 2.2, W 1  Sept 2016: P 2.2, W 0!!  Oct 2016: P 2.0   Nov 2016-Jan 2017: P 1.8  Feb-Mar 2017: P 1.9  April-May 2017: P 1.8   June 2017: P 1.6 July-Dec 2017: P 1.5  Jan-April 2018: P 1.6

Others: Cytomel 25mcg (thyroid), vit. C, vit D, Omega-3 fish oil, Magnesium bisglycinate , Melatonin 1mg, 81mg Aspirin, Milk peptides, L-theanine, Valericalm tincture mix, scullcap tincture, Suan Zao Ren (jujube seeds)

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arcticmonkey

Is making a liquid solution from paxil a good idea ?

Anyone had any success with this ?

In what paxil/water ratio should the solution be ?

 

I'm currently down to 5 mg paxil,and I need a way to make very small reductions in dosage,which is not possible by cutting the pill.So I need someone to elaborate the method of making a liquid solution from paxil.

 

Also has anyone here gotten visual snow because of antidepressant withdrawal ?

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primrose

Is making a liquid solution from paxil a good idea ?

Anyone had any success with this ?

In what paxil/water ratio should the solution be ?

 

I'm currently down to 5 mg paxil,and I need a way to make very small reductions in dosage,which is not possible by cutting the pill.So I need someone to elaborate the method of making a liquid solution from paxil.

 

Also has anyone here gotten visual snow because of antidepressant withdrawal ?

Hi

 

I get visual snow if I haven't slept well.

 

As for making a liquid out of paxil in order to make tiny reductions, I can only share my experience of doing the same thing but with seroquel, the drug I am currently tapering from.

 

Im not saying my way is right, but it's working for me.

 

My starting dose was 25mg four times a day.

My cut is 2mg a day.

I got four small jars, and using a big marked syringe, I squirted 50ml in each jar.

So 50ml = 25mgs and one ml = 0.5mgs.

To achieve my 2mg a day cut, I cut one more ml of liquid each day from each of the 4 dose jars.

That's half a mg from each 6hrly dose jar, times that by four to give 2mg for each day.

I use smaller syringes to measure out my doses.

I am sure to shake each jar, get the lid off and plunge my syringe in there as fast as I can to draw my daily dose, because when the drug is in suspension, the particles can settle on the bottom, so keeping them suspended and moving makes for as accurate a dose as possible.

 

I will admit, I've forgotten a few doses and therefore havnen't stuck to every 6 hrs strictly, but, so far, its been cool, no withdrawal symptoms, but like I said, I am on the constant  lookout for the telltale sneezes and runny nose, which are the withdrawal symptoms I have got, before tapering, about a day after not taking my dose, for whatever reason.

 

This way is experimental for me, I am my own guinea pig.

Nothing ventured, nothing gained.

 

My thinking behind it was to keep as even a level of seroquel in my blood as possible, by taking every 6hrs. The half life is 6 ish hours, hence me dosing every 6hrs.

 

The daily cut means that the taper is a smooth descent.

 

I previously tapered from 200mg to 100mg in weekly 10mg steps.

If you were to plot my previous stepped taper, and this current smoother daily taper on a graph, the stepped one would look just that, a jagged, stepped line down.

The daily taper would look like a smooth curve.

 

So far, it's working for me.

I know what to do if symptoms appear.


pregan taper 600mg down to 240mg, daily cuts since xmas

valium, just over 75mg, tapering 0.1 a day, will keep this more udated, cos amounts going down

i have borderline personality, chronic ptsd, and suspected adhd and substance misuse as a symptom, which i am addressing with help of medical staff, drugs agencies & mh sta

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Altostrata

arcticmonkey, please see the first post in this topic and the other discussion in this topic.

 

primrose, making a liquid from Paxil and tapering is much more simple than the method you're using to go off Seroquel.

 

Also, reducing 2mg a day from 40mg Seroquel after being on it for years and recently going off benzos -- that's probably way too fast. I hope it doesn't catch up with you in a bad way.


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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primrose

arcticmonkey, please see the first post in this topic and the other discussion in this topic.

 

primrose, making a liquid from Paxil and tapering is much more simple than the method you're using to go off Seroquel.

 

Also, reducing 2mg a day from 40mg Seroquel after being on it for years and recently going off benzos -- that's probably way too fast. I hope it doesn't catch up with you in a bad way.

Hi Alto

 

Thanks for  your concern. :)

 

I have tapered down from 100mg not 40mg. (sorry, you looked at my sig, I'll change that to 28mg.

 

I'll be sure to reduce my cut if those sneezes and that runny nose comes back.

As I said above, these two things are an early warning sign of seroqeul withdrawals.

 

So far so good though, thankfully. :D


pregan taper 600mg down to 240mg, daily cuts since xmas

valium, just over 75mg, tapering 0.1 a day, will keep this more udated, cos amounts going down

i have borderline personality, chronic ptsd, and suspected adhd and substance misuse as a symptom, which i am addressing with help of medical staff, drugs agencies & mh sta

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SetMeFree

Im down to 7 MG of Paxil.. Dropping 10 % reductions every 6 weeks.. I notice the more I cut the pills and expose the raw side of the pill.The more and more it irritates my Gi tract.Feels like my insides get beat up. Does anyone have these issues???


2002 22.5mg paxil Cr for anxiety 2003 22.5 quit cold nighmare 2004 30mg paxil 2005 30mg quit cold nightmare 2006-2010 40mg-50mg generic paxil 2011 20mg 2011 MAY 10mg paxil then swithched to prozac failure..bad GI ISSUES 2011 sept back too 25 paxil .. major GI Issues 1 year and a 1/2..2012 15mg ..figuring it out. 2012 june paxil liquid to 14mg GI Issues disappeared!!2012 oct 13mg..1 mg a month weaning. 2013 Feb. 9mg headaches.Mar 2013 8.5mg, 3/27 7.6mg 4/24 7 Mg.. Made it back to 7mg 2015 but Im not using Liquid it irritated me to much.. Cutting the pills down..Bad GI Issues..

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Altostrata

You might put it in a gelatin capsule and see if that helps.

 

Please update your Introductions topic.


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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MapleleafGirl

i used compounded pills from the pharmacy...my doctor gave me the prescriptions and i took them to a compounding pharmacy and they would make me up the exact doses..worked really well..


Michele aka MapleLeafGirl

Paxil Free Since June 1st 2014

Was on Paxil for 8.5 years on and off from 2001

Did a 4 year successful taper off 20mgs of Paxil

My Successful Tapering Story: http://survivingantidepressants.org/index.php?/topic/7812-mapleleafgirl-successfully-tapered-off-paxil/

Tapering Schedule:

3rd attempt at withdrawal going slow..compounded pills
05/27/2010 - 03/12/12: Tapered From 20mgs - 6.2 (2nd year into Taper)
04/11/2012 - 6.0 - 3.4 - 05/05/2013 (Third year into Taper)
06/04/2013 - 3.2 - 1.0 - 05/31/2014 (Fouth and Final Year of Taper)

February 9th 2016 month 20 off paxil and four year taper..experiencing a horrible wave bad bad bad

May 2016 Made the decision to go back on an SSRI  - Currently on Escitalopram 10mgs but planning to taper at some point in the near future

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Cheeky

My pharmacy is going to make me a liquid Paxil, I will be eventually tappering from 40mg of paxil, what ml should I ask ? I can half and quater the tablets and will add the liquid paxil to it.


-1995 started paxil 20mg for depression, over the years slowly increasing to 50mg up until 2014 

-2014 I decided to tapper myself not knowing how to

and crashed and doctor added 50mg of Seraquel 

I then tried again to stop taking both and ended up in hospital trying all different drugs, I soon realised after searching the internet that I was going through withdrawal, I then reinstated 40mg paxil and 50mg Seraquel 

-2015 tried tapering again too quickly and CRASHED

2/11/16  -43mg Seraquel   -40mg Paxil           

17/1/17   -43mg                   -New Paxil Brand                   

14/03/17  -43mg                   -39.5mg 

23/05/17  -43mg                   -39mg 

08/07/17  -43mg                   -38.5mg

01/09/17 -37.5mg               -37.5mg 

12/10/17  -37.5mg             - 37mg

28/10/17 -37.5mg               -36mg
19/01/18- 37.5mg               -35mg
2/05/18 -  37.5mg               -34.8mg
15/05/18 37.5mg                -34.5mg
24/05/18  37.5mg              -34mg
12/07/18 37.5mg               -33.mg
3/08/18 37.5mg                  -32.5mg  
28/08/18  37.5mg.              -31mg
16/12/18 37.5mg                -30mg
10/3/19  36.25mg              -30mg
17/3/19  35mg                   -30mg
26/3/19  33.75mg              -30mg
4/04/19 32.5mg                -30mg
21/04/19  30mg                -30mg
16/07/19  28.75 mg         -30mg
5/08/19   27.5mg             -30mg    
19/08/19 25mg                -30mg
20/10/19  25mg              -29mg
17/11/19 25mg              -28mg
7/01/20    25mg               -27mg
12/02/20   25mg             -26mg
7/03/20   25mg             -25mg
11/04/20   25mg           -24mg
4/05/20   -25mg         -23mg
5/06/20    -25mg          -22mg
23/06/20  -25mg         -21mg
15/07/20  25mg         -20mg 
04/08/20 23mg           -20mg
18/08/20 22.5mg        -20mg

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ladybug

My pharmacy is going to make me a liquid Paxil, I will be eventually tappering from 40mg of paxil, what ml should I ask ? I can half and quater the tablets and will add the liquid paxil to it.

 

With the ready-made liquid Paxil 2.5ml=5mg. Most people are able to make small drops with this ratio if they use a 1ml syringe. Hope this helps!


a.k.a JMarie

Paxil since Mar.1998

2006-2007:40-20mg
2009: 20mg to 14mg 2010: 14mg to 10.5mg 2011: 10.5 to 7.6mg  2012: 7.5 to 6.8mg

2013: 6.7-6.3mg 2014: 6.2mg-5.8mg 2015: 5.7 to 5.15mg 2016: 5.1-4.6mg

1/19/17: 4.5mg 3/17/17: 4.4mg

6/15/17: 4.35mg 8/10/17: 4.3mg

1/29/18: 4.1mg 5/07/18: 4.0mg

7/31/18: 3.9mg

 

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Altostrata

If your pharmacy is going to make it, you can get it any concentration you wish. Probably 1mg per milliliter is the easiest to calculate: If you are reducing by 4mg, you would take 4mL using an oral syringe that holds 5mL.

 

Discuss this with your pharmacist.


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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JessicaEva85

How low should you go when doing a 10% taper every 28 days with Paxil?


Paxil since 2004

2004 - Started at 25mg CR

2005 - Upped to 50mg CR

2008 - Reduced by 5mg a month to 25mg CR (it was the worst thing ever!) :wacko:

2012 - Switched to non-CR Paxil at 20mg

2014 - Discovered PaxilProgress and started a 10% every 28days 

April 2014 to Sept. 2014 - 18mg to 9.6mg

Sept. 2014 to March 2015 - 9.6mg

March 2015 - 8.6mg

 

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Altostrata

Jessica, you need to see how dosage reductions affect you. Most people need to reduce to under 1mg before discontinuing completely.

 

Please start a topic for yourself in the Introductions forum to track your progress and questions.


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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DLB

Exactly Alto, I have been under 1mg. since the beginning of December and I initially thought I would have been off by Christmas but here it is 3 months later and now at about .14 mg and doing ok. This is a real tricky part of the tapering process.


Paxil start September 2003 due to Fluoroquinolone adverse reaction that I wish doc. knew what it was. 10mg. most of the time with a few short runs of 20mg. FAST tapered 3 times and finally hit poop out or a reaction to nsaid's in Nov.2013. Started a 10% taper Jan. 2014 and have been ok until Sept 14 and went through a short hell. Now plodding through and looking for the light with unrelenting insomnia and pain, fog, loss of interests....<p>12/20/14 - .8mg.

1/01/15 - .75 mg.

1/15/15 - .42 mg. better sleep now, hope it continues...

2/11-15 - .25 mg. doing really good!! 2 weeks feel 85% of old me!

3/17/15 .14 mg. Knee pain bad!

4/07/15 .05 mg. this is so small now that I am estimating and just licking it off palm small as a "." 

4/13/15 NOTHING !!!! Took my last little micro dose on 4/12/15. ????????????????

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Altostrata

I agree, DLB. Thank you for adding your experience here.


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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Toulouse

OK - I'm biting the bullet and just doing the liquid suspension to try to get off these last couple of mg.s safely. (i'm down to 2.5 and have shaved off a bit with a razor so I'm not sure exactly where I'm at these last 2 days - 1.75??)  Being that it's hard for me to figure out correctly the dosage I'm at, I ordered, and am getting the Paxil oral suspension - and will try it tomorrow for the first time.

My question is that being on the generic for so long, and switching to the name brand PAXIL - will this effect me negatively? 

 

Also, what kind of syringe should I ask the pharmacist for?

Thanks for your time, and I will post updates on how my final tapering is coming along for any future taperists.

 

 


Been on Paxil 14 years. 40mg for the bulk of those.

20mg in 2014

10mg March of 2015 - then tapered to 5mg

Then to 2.5 to 1.5 - to 1mg, from Mar-August.

As of August 23 2015, I am flying without a net.  Paxil free!

WD symptoms since tapering mid- 2015:

Short temper, hostile. Brain zaps. Bruxism. Wild vivid dreams  Hives Food intolerance Lump in throat, . Joint pain. Knees, elbows.  Pain in feet. Numbness in hands. Shaking, like I'm cold. Trembling. Tremors, muscle twitches all over. Facial tics. Eye, lips. Head.  Floaters in my eyes. Severe Insomnia (between months 4-5)  then returned from March-October 2016. I'm sleeping better now. Dreams have returned to normal (month 7) High levels of anxiety when around large crowds or in large rooms. Intestinal spasms, heartburn.  Dizzy spells.  Panic/Anxiety Attacks suddenly developed months 8 out.  4 years out, 98% feeling back to normal.  (October 9 2019)

 

 

 

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Toulouse

Thank you Altostrata - but I also need help figuring out my taper numbers.  10mg = 5ml of the suspension.  Am I just dividing the mg in half to make the ml?


Been on Paxil 14 years. 40mg for the bulk of those.

20mg in 2014

10mg March of 2015 - then tapered to 5mg

Then to 2.5 to 1.5 - to 1mg, from Mar-August.

As of August 23 2015, I am flying without a net.  Paxil free!

WD symptoms since tapering mid- 2015:

Short temper, hostile. Brain zaps. Bruxism. Wild vivid dreams  Hives Food intolerance Lump in throat, . Joint pain. Knees, elbows.  Pain in feet. Numbness in hands. Shaking, like I'm cold. Trembling. Tremors, muscle twitches all over. Facial tics. Eye, lips. Head.  Floaters in my eyes. Severe Insomnia (between months 4-5)  then returned from March-October 2016. I'm sleeping better now. Dreams have returned to normal (month 7) High levels of anxiety when around large crowds or in large rooms. Intestinal spasms, heartburn.  Dizzy spells.  Panic/Anxiety Attacks suddenly developed months 8 out.  4 years out, 98% feeling back to normal.  (October 9 2019)

 

 

 

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Altostrata

10mg = 5ml means there is 1mg in 0.5mL of the liquid. If you want to take 2.5mg, for example, you would take 1.25mL of the liquid.

 

You can always ask a pharmacist to help you with the calculations.

Edited by Altostrata
corrected math error

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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Toulouse

10mg = 5ml means there is 1mg in 0.5mL of the liquid. If you want to take 2.5mg, for example, you would take 5mL of the liquid.

 

You can always ask a pharmacist to help you with the calculations.

Thank you Alto. My dr helped me figure it out. Basically divide the ml by 2 to get the mg. So 5mg is equal to 2.5ml. 2.5 mg is equal to 1.25ml and so on.


Been on Paxil 14 years. 40mg for the bulk of those.

20mg in 2014

10mg March of 2015 - then tapered to 5mg

Then to 2.5 to 1.5 - to 1mg, from Mar-August.

As of August 23 2015, I am flying without a net.  Paxil free!

WD symptoms since tapering mid- 2015:

Short temper, hostile. Brain zaps. Bruxism. Wild vivid dreams  Hives Food intolerance Lump in throat, . Joint pain. Knees, elbows.  Pain in feet. Numbness in hands. Shaking, like I'm cold. Trembling. Tremors, muscle twitches all over. Facial tics. Eye, lips. Head.  Floaters in my eyes. Severe Insomnia (between months 4-5)  then returned from March-October 2016. I'm sleeping better now. Dreams have returned to normal (month 7) High levels of anxiety when around large crowds or in large rooms. Intestinal spasms, heartburn.  Dizzy spells.  Panic/Anxiety Attacks suddenly developed months 8 out.  4 years out, 98% feeling back to normal.  (October 9 2019)

 

 

 

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Altostrata

That's correct. I fixed my error.


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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Rachelina

Maybe this belongs in an existing topic but I'm not sure which. 

 

I'm not sure how to store my liquid Paxil. I searched online and found the manufacturer's info sheet which says to store below 77 degrees F. But several other sources, such as drugs.com, said to store at room temperature. I also have an ancient (2008) bottle of liquid Paxil that says store between 65 and 77 degrees. 

 

I don't have air conditioning and it's starting to get hot, so the only option to keep it below 77 degrees is the fridge. But with all the conflicting information I'm not sure if this is OK.  I did stick it in the fridge yesterday when I saw the thermostat had reached 77. But when I researched further and saw several sources saying room temperature, I pulled it out (since by that time the temperature had gone down). Now I'm afraid I wrecked it somehow by putting it in the fridge. 

 

Last summer I didn't even think about this and kept it in my room, where I'm sure the temperature got into the 90's frequently. Sometimes I wonder if this could have played a part in the crash I had starting in November. Probably not, because that would be quite a delayed reaction, and usually I feel it sooner if there is some big change. But to be on the safe side I want to pay attention to proper storage. Any advice welcome!

Edited by KarenB
merged similar topics

Trying to get off Paxil since 2007. Was tapering by 0.1 mg every 4-5 weeks. Had awful crash in November 2015 at .5 mg; updosed gradually to 2 mg. 

 

Doing better and tapering again, much slower this time.  2016: Dropped from 2 mg to 1.62 mg.  2017:  1.62 mg to 1.2 mg. 2018: 1.2 mg to .76 mg. 2019: .76 mg to .56 mg. CURRENT DOSE: 9/21/20 .39 mg 

 

Started Klonopin in November 2015 to deal with crash. 1/10/16 started milk titration taper from .5 mg. Finished taper 12/6/17. Still take Klonopin for agoraphobia 2 - 3 times a week. 

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SquirrellyGirl

Hmm, I don't have an obvious answer for you, other than to perhaps ask a pharmacist about the best approach...You get into the 90's in New Hampshire?  I had no idea!  I know that probably includes humidity in your neck of the woods!  We get triple digits here but usually dry.

 

SG


Started ADs back around 1995 after bad break-up, starting with Prozac.  Switched to Wellbutrin, and then to Effexor in 2002
Effexor XR 2002-2014 up to 225 mg at one point, down to 37.5 mg towards end but back up to 75 mg in 2014; now realize I had W/D as I dropped down, memory very poor about history.  Extreme emotions, poor concentration as I stepped back down, didn't connect the dots!
Summer 2014 reduced to 0 very quickly, was sick of anhedonia/sexual dysfunction due to meds, depression never controlled if not worse. Didn't recognize WD since symptoms built slowly (thought I had ADD! and menopausal on top of it), starting with severe sweats, very bad cog-fog and memory issues, culminating in weight loss, severe anxiety and depression, panic, severe apathy and insomnia by eight months off.  Saw p-doc who put me on Remeron, increased from 7.5 mg/day to 37.5 mg by May 22, 2015; still doing very badly though able to sleep.

June 1. 2015 Reinstated Effexor XR 37.5 mg, Remeron dropped to 30 mg PM. Immediate relief of symptoms, like nothing had ever happened!  Joined SA and began on advice of friend who recognized it was WD all along! Began tapering in July 2015.

Been tapering both meds ever since, focusing on one more than the other or doing no more than 5% of each per month.

12 mg Effexor and 5.8 mg Remeron (mirtazapine SolTabs to make a solution with OraPlus) as of 5/4/2017 

Update 3/14/18: 2.9 mg Remeron and 6 mg Effexor; 6/10/18:  2.6 mg Remeron and 4.9 mg Effexor

 

My intro: http://survivingantidepressants.org/index.php?/topic/9313-squirrellygirl-effexor-withdrawal-etc/page-2#entry196679

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

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Rachelina

Thanks Squirrelly Girl! Yes it gets into the 90's, not quite often enough to be worth buying an air conditioner, but still too often for me! And yes the humidity is awful too. I'll ask the pharmacist I guess, but I'm also curious how other people store their liquid. And how important it is not to go above 77 at all. At least I have it downstairs now which is cooler than my bedroom and cooler than outside, but it's still going to get into the 80's sometimes. 


Trying to get off Paxil since 2007. Was tapering by 0.1 mg every 4-5 weeks. Had awful crash in November 2015 at .5 mg; updosed gradually to 2 mg. 

 

Doing better and tapering again, much slower this time.  2016: Dropped from 2 mg to 1.62 mg.  2017:  1.62 mg to 1.2 mg. 2018: 1.2 mg to .76 mg. 2019: .76 mg to .56 mg. CURRENT DOSE: 9/21/20 .39 mg 

 

Started Klonopin in November 2015 to deal with crash. 1/10/16 started milk titration taper from .5 mg. Finished taper 12/6/17. Still take Klonopin for agoraphobia 2 - 3 times a week. 

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ChessieCat

Just did a search and found this:

 

https://www.apotex.com/us/en/products/downloads/pil/paxil_irtb_ins.pdf

 

How should I store PAXIL?
Store PAXIL Tablets at room temperature between 59º and 86ºF (15º and 30ºC).
Store PAXIL Oral Suspension at or below 77ºF (25ºC).
Keep PAXIL away from light.
Keep bottle of PAXIL closed tightly.

 

I imagine if it it was not to be stored in the refrigerator it would be stated, especially since the tablet temp is stated as "between".

 

But yes, you could check with the pharmacist or ring the number on the sheet:  For more information about PAXIL call 1-800-706-5575.


Being very patient.  I'll get there - slowly.  ETA mid 2021

ADs:  25 years - 1 unknown, Prozac (caused muscle weakness), Zoloft/sertraline; citalopram (pooped out) CTed (very sick for 2.5 wks a few months after)

Pristiq:  50mg 2012, 100mg beg 2013 (mild Serotonin Toxicity)

Began tapering Oct 2015  Current from 17 Oct 2020:  Pristiq 0.56 mg (compounded + liquid)

My tapering program

My Intro (goes to my tapering graph)

My website - includes my brief history + links to videos & information on the web

PLEASE NOTE:  I am not a medical professional.  I provide information and make suggestions.

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