Mattyb78 Halfway there but still so far away?

[Mattyb78]

Hi everyone,

I won't go into a long boring history, just the basics. I went on Seroxat (paxil/paroxetine) for stress, anxiety back in 2007 i think. After a couple of years of feeling better i started to taper slowly but hit an unexpected crash at about 15, massive panic. I reinstated at 20mg and remember crying as the numbing of emotions began again. But at least I could function again.

I started a long, slow withdrawal. Tapering the dose down by just a couple of mg each year by taking half a tablet every 2 weeks, then every week, then every other day etc.

Forward to 2014 and I have a baby son and a new job. I started the year at about 13mg (taking 10mg, 10mg, 20mg consecutive days). I began to feel the stress and confused brain which i felt was caused by the changes in dose each day. After moving to 10mg, 10mg, 10mg, 20mg ( averaged around 12.5mg i think) i took the plunge and dropped to a straight 10mg. I had only done tiny drops before and for some reason I felt brave enough to try something bold. (Idiot)

6 weeks ago i started taking 10mg exclusively. I immediately felt better. No horrible dread feelings, paranoia or confusion. Then, a week later, followed (yeah you guessed it) the withdrawal symptoms. I had all the physical stuff, flu in the limbs but a strangely clear head. Headaches. So hot and sweaty. Confusion. Nausea and lack of appetite. This lasted about 2 weeks overall, and wasn't nice, however i actually felt better mentally so i toughed it out.

Now i feel physically fine apart from being a bit hot and the odd headaches. Oh and my appetite has gone, but i put on weight years ago so I'm not concerned by that!

The last 2 weeks have seen a return of my old friend anxiety. Horrible anxiety which comes in waves through the day and doesn't seem to have a pattern. I have started to try Mindfulness meditation, take exercise and 'get on with life' anyway. A bit of depression has also crept in, which is the icing on the cake.

A doc gave me propanalol for the anxiety, which doesn't really work but it could be because i'm only taking it 'as needed' and only half doses.

I felt better after a counsellor told me that the hardest part is done and that 10mg is just a therapeutic dose. She also said i could try to switch to Prozac. The better feeling didn't last too long though, and the anxiety is making it really hard in my new, horrible job.

At the moment I don't know what to do. Sometimes i feel like upping my dose a bit to see if i will feel better, and sometimes i feel ok and think 'i'll tough it out and i will feel better'.

Do you think the anxiety is the remaining symptoms of wd and i will adjust? Or is this just 'a funny dose' and i will feel better when i eventually drop a tiny bit lower?(I have heard a lot of people struggle around this level) Is this life below 10mg? Or is this just my anxiety coming through?

All opinions welcome, but please keep it positive and sensitive please, i am incredibly fragile right now!

And thanks for letting me join.

Matty

Edited September 25, 2016 by JanCarol
tags added

[mammaP]

Hi Mattyb, welcome to SA.  Tapering needs to be consistent and with small cuts. You tried hard

but alternating doses will have destabilised your nervous system.  This is NOT a criticism, you did

what you thought was right and the best you could. You have been at 10mg for 6 weeks and have

recently started having withdrawal symptoms, which sounds like the windows and waves pattern

that goes along with withdrawal and tapering.  You can read about windows and waves here

http://survivingantidepressants.org/index.php?/topic/82-the-windows-and-waves-pattern-of-recovery/

 

I think I would stay put for a while to allow your brain and nervous system to stabilise,

this can take a few months but you will stabilise and feel better again.  Once you have stabilised you

can start a safe, slow taper to get you off the rest.  Someone else might have other suggestions but

mine is based on my own experience with ADs.  

 

Personally I wouldn't switch to another AD at this point but others have and managed to taper. I am 

thinking that there has been a lot of chopping and changing with doses and you need stability, changing 

drugs could make things worse.  I have to say that I disagree with your counsellor that the hardest part is done! 

Many doctors and therapists think that smaller doses are easy to stop but they are badly mistaken! Sadly they 

know only what the drug companies have told them, and the drug companies don't want you to stop their drugs! 

 

There are discussions in the symptoms and self care section of the forum that deal with anxiety, I'm sure you

will find some good tips there to help deal with it. 

Congratulations on the new job and new baby,  I'm glad that you are able to keep working, and a new baby 

is delightful, sleepless nights aside!  

[dalsaan]

Hi Mattyb

 

Welcome to the forum. I have to say I agree with MammaP. Stability is your friend. Give your system time to reach that goal. I won't do the Prozac switch, you could have an adverse reaction to it and still be in withdrawal. It works for some but it's a gamble and one not worth taking at this point

 

D

[Mattyb78]

Thank you guys. Anyone else with an opinion or experience of a similar situation?

[Rhiannon]

I agree with the previous opinions. "Tapering" with fluctuating doses is hard on your nervous system and it has caught up with you. Paxil's a hard one to taper anyway. And the fluctuating doses don't really produce a taper effect, they actually just make things worse by causing roller coaster blood levels.

 

I would say hang on, it's going to be a while but your withdrawal symptoms will settle down eventually.

 

Keep a daily journal of symptoms and rank them on a scale of 1 to 5. See how much you can reduce stress in your life, stress really aggravates withdrawal, and with a new baby and a new job that's probably a factor. (Are you getting enough sleep, gentle exercise, good diet?)

 

I would read through the Symptoms and Self Care area, and hang in there and get all the support you can. It's going to be bumpy for a while and during the bad waves you'll probably feel scared and hopeless and overwhelmed and not sure it will ever get better, but if you can take care of yourself and give it lots of time, you will gradually stabilize on the 10 mg.

 

Please check out the charts in this paper, starting on page 4: http://survivingantidepressants.org/index.php?/topic/6036-why-taper-paper-demonstrates-importance-of-gradual-change-in-plasma-concentration/

 

You will see that actually the lowest doses are the hardest to taper, not the easiest. If you need to you can print those out and take them to any healthcare provider or therapist who says 10 mg is a low dose (it is very much not!)

 

Welcome to the forum. Hang in there, things will settle down, you just need to give your nervous system some healing time.

[Rhiannon]

If you look at figure 4, which is paroxetine (Paxil), you can see that at 10 mg is when the receptor occupancy really starts to take a sharp drop downwards. Most of the undoing of what Paxil has done takes place under 10 mg. It's actually important to taper extra slowly under 10 mg.

[Mattyb78]

Up 'till 3am last night trying to sleep

 

I'm going to see my doctor this afternoon, as an emergency appointment. I can't handle work at the moment, too much to plan and stress and think about, hopefully doc will suggest signing me off for a week or two. The problem is that i'm new to this job so i'm still on probation. If i could just quit i would but there are bills to pay and my wife is part time with our baby.

 

I'm going to ask his opinion on what to do, i have a few ideas:

 

Do i get liquid seroxat to add to the dose i'm currently taking and bring it up slightly (say 12mg every day) to lift me out of this so i can start again slowly? At least that way I can try and function again while sorting out the issues with work etc?

 

Do i attempt to tough out the anxiety, depression in the hope I will stabilise at 10mg and will feel better soon? It's been 7 weeks since i dropped to 10mg every day.

 

Do i attempt to swap over to Prozac? I know we don't like to suggest it but I've come so far, wouldn't swapping to a greater dose of Prozac be better in the short and long term?

 

He has given me Propanolol, 40mg tabs to take as needed, or every day. i haven't really used them, is there any point? Could i get around my anxiety on 10mg with propanolol each day too?

 

I'm really stuck here. I can't drop the drugs, I can't give up work. If i knew i would start feeling better tomorrow, or even next week, then i would tough it out.

[Mattyb78]

Well i spoke to the doctor. She didn't really know any more than me but at least acknowledged that changing doses every day had not been a good idea (you should tell the other doctor at the same practice who TOLD me to alternate, i said). She suggested upping my dose to stablise, which is what I'm going to do. It worked when this happened to me at 15mg a few years ago.

 

She suggested 15mg but i bartered with her and we ended up agreeing on 12mg a day, so 20% more than the dose i'm currently suffering with. A step backwards but I just can't function with this anxiety, she's also signed me off work for a week, although how they'll react is another thing.

 

Best news is that she prescribed me the liquid so i can take 10mg tablet and supplement it with 2mg liquid. Any known problems with this, people?

 

Although I feel calmer the anxiety is still hitting me in waves when i think about the mess I am in, any suggestions to help with this messed-up-dose-drop anxiety?

 

Please?

[Mattyb78]

And thank you so much for the reply, Rhi. I have looked at everything you linked to.

[Altostrata]

Welcome, Matty.

 

I think your plan to supplement at 10mg tablet with 2mg liquid Paxil is a good one. Give this at least 5 days, then assess the effect -- unless you have an immediate dramatic bad reaction, then back down.

 

If I were you, I'd put off considering the Prozac switch until you find you can't get off Paxil by gradual reduction. Your irregular dosing has gotten you into a bad spot. You might be able to stabilize now.

[Rhiannon]

Matty, this is the hardest part we see with people--trying to trust and hope and be patient while you give your nervous system time to settle down.

 

What you are experiencing now is the result of a course of action taken in the past (the alternating dose thing) and that will continue to play out for a while.  And you have just started a wise course of action (I agree, the 10 mg plus 2 mg liquid sounds reasonable) but it will be a while before you really experience the benefits.

 

And unfortunately the fallout of the past taper is actually a hefty dose of anxiety that for all of us causes a tendency to want to react--that "do something, anything, ANYthing!" feeling. And usually when we react to that, what we do just makes the problem worse.

 

Please read through Symptoms and Self Care and read our section on neuro-emotions (I think it's in there somewhere, look at the topics pinned at the top, I think there's a link to it). Come in here for support when you get panicky, we really understand and we can all relate. It's not you. It's very challenging. Those anxiety attacks make it so hard to control our thoughts, it feels so real.

 

But the reality is, you are already doing what you need to do, and it's just going to take some time to take effect.

 

Meanwhile, yes, if you can get reduced work hours or a work break, that might be good. Reduced stress is good, and probably hard to achieve with a new baby. Go for slow, gentle walks if you can. Get lots of hugs. Eat well. Try to keep as regular of a schedule as you can. Absolutely avoid caffeine for a while, alcohol too--caffeine is most important, or any other stimulants.

 

Take it one day at a time. I think there are suggestions for breathing, self-calming in the Symptoms section, so try those when the panic comes on.

 

Also, many of us have found a little supplemental magnesium to be helpful.

 

But really there is no easy trick. Time is going to be your ally, here. Hang in there.

[Rhiannon]

Oh and the "wave" pattern of anxiety and other symptoms is very normal. We call it "windows and waves" and the waves can last anywhere from minutes to months. It just seems to be characteristic of psych drug withdrawal, that there is this sort of roller coaster kind of thing.

 

It's also normal for mornings to be worse and to feel better later in the day and into the evening, due to the diurnal variation in cortisol levels. The good thing is that when you're feeling like crap in the morning you can remind yourself you will feel better later.

 

Again, hang in there. You're taking the necessary actions to remedy things, now you just need to "do the time" as a friend of mine once said to me when I was in a similar position.

[Mattyb78]

I think I'm starting to feel the effects of the 20% increase in dose, even though it has only been a couple of days. I'm slightly less anxious and getting windows in the day where i feel 'normal' for a while. Othe other hand when the waves hit i'm reminded that this particular part of the withdrawl process (the 'oops i went too fast' part) is like being trapped in a nightmare. Then I feel hopeless and very frightened and alone. I know you all understand that horrible feeling. I forgot how nasty the up-dosing can feel after a crash. Now I remember this from my time when i crashed at 15mg and went up to 20mg.

 

Other than that though, I am moving away from the worst day, when i started this post. I wish i could help my nervous system though, a few minutes after waking each morning i feel tingles running over my brain and the high noise returns in my ears. Fortunately it doesn't make me panic and I try to snooze again while keeping my breaths slow. Through the day it goes up and down, when it is worst i jump at sudden noises like coughs, and when my baby cries out it goes right through me, cuts me in half.

 

Any suggestions on what I can do to calm my nerves/nervous system? I am trying to avoid stresses but it is literally the tiniest things which set me off.

 

Thanks for any advice and encouragement.

[Karma]

Hi Matty,

 

I'm sorry you are experiencing this.  Have you tried the magnesium that Rhi suggested? 

 

Another thing you might try is to add Omega-3?  You might start with a low dose and see how you do, then you can gently increase and see if that helps.  http://survivingantidepressants.org/index.php?/topic/36-king-of-supplements-omega-3-fatty-acids-fish-oil/

 

When I was suffering withdrawals I found that Omega-3 did help and I've remained on a relatively high dose of it for several years.

 

Unfortunately, there really isn't much you can do about the startle response you are having when you hear someone cough or when your baby cries.  Over time as your system begins to heal this will settle down. 

 

Karma

[Mattyb78]

Thanks Karma,

 

I am taking Espom salt baths every evening to relax me for sleep and also to get the magnesium through the skin, and I have started taking Omega 3 fish oil tablets. I'm not sure of the right dose of these though. They are 1000mg omega 3 with 165mg EPA and 100mg DHA. No idea what the last two are, guess I have some homework to do. I never dreamed I would be someone who 'needs' mental health supplements, i started taking the tablets for anxiety-related physical symptoms (chest pain, palpitations etc) and now look at me! Mind you I'm sure they are beneficial to even the healthiest, strongest mind

 

Can i ask if anyone reading this can relate to having the startle responses and ringing ears as a result of meds or wd? I'm unsure if this is a wd symptom of going too fast or a result of alternating doses for a few years now. Or just a result of increased stress (new job, baby, wd problems all at the same time)

[augustiny]

I am very new to tapering and this site but I will say that I am having the startled feeling too.  Every time my dog barks I jump.  My husband came in last night and hugged me from behind and I had not heard him and I nearly passed out my heart was pounding so hard.  I skimmed your thread and am not sure if you have ever tried yoga but this seems to be helping me.  Even 15 minutes of yoga I feel a little more settled for at least a few hours.  

[Rhiannon]

Increased startle response and tinnitus are both very common withdrawal effects, if peoples' reports in this forum are anything to go on.

 

Also fear, anxiety, feeling on edge, sense of impending doom, hopelessness, aloneness...see our section on neuro-emotions.

[Altostrata]

The startling may be too much stimulation overall. You may wish to reduce noise, light, etc. around you, particularly light. This helps your nervous system to settle down.

 

Please seach for our topics on light and amber glasses in the Symptoms and Self-care forum.

[Mattyb78]

It's a strange one. One week after increasing my dose from 10 to 12.5mg, i feel far more relaxed and don't get the anxious feelings anymore, however the tinnitus is constant. It feels like a completely different system is suffering. I've never had tinnitus before, except after a gig but it doesn't sound like that, its high frequency. I'm sure its my nervous system but i wonder why the increase in dose hasn't affected it.

[bubble]

Hello Matty.

 

Reinstating can't fix us immediately, actually there are no quick fixes. Reinstatement in your case brought a very significant relief which is a great sign. I believe that over time tinnitus will also follow the suit of other symptoms.

 

You may want to update your signature with this latest change. It will be a useful reference for you and us.

 

best,

 

bubble

[Mattyb78]

Thanks Bubble

[Mattyb78]

Can I ask your advice on my tapering schedule please? I'm currently on 12.5mg Paroxetine, hoping to stabilise soon. In the meantime I have just planned my reduction to near-zero based on a 5% taper (of that month's current dose) every month. This means I will be reaching near-zero in ... Around 4 years!!!!!

 

I have also planned out a 10% taper which would see me down to 2mg by the end of next year, which sounds much better.

 

I have only experienced problems after my last reduction, (13-10mg which was a whopping 23% -oops) every other reduction has been smaller without problems at all.

 

Because of the severe reaction after that last drop I want to be careful, but does 5% sound overly conservative to anyone? I don't really want another 4 years of this drug in my system, i know the longer you're on it the more problems it can cause, I also hear that your brain begins to heal below 10mg, is this true?

 

Also, is 4 weeks between drops too short at either 5% or 10%?

 

Amy experiences of similar drops would be great.

[dalsaan]

In my experience it's best to through out your calendar and listen to your body rather than the passage of time. I recommend you wait until you are well stabilised and then try a 10 per cent drop, wait 4 weeks if you are stable again make your next drop. The key is to make decisions based on how your body is reacting. If at some point you need to do a longer hold, do it. If you find you need to drop by less, now or perhaps as you get closer to zero, do it.

[Rhiannon]

Agree with dalsaan about "throwing out" the calendar.

 

If you had a broken bone, you wouldn't insist it had to heal at exactly a certain percent per week, and then you were going to start jumping on it no matter how it felt. Healing doesn't follow our Excel spreadsheet schedules, much as we might like it to! Your body is your best advisor and guru, learn to listen to it carefully. 

 

I recommend you start the taper slow--try a 10% or smaller cut, wait a few weeks, and keep your daily journal ranking your symptoms daily as they come on and play out and resolve. If that was tolerable for you, do it again; if it was too rough, make a smaller cut the next time. Go through a few cycles of modest cuts and long holds, so that you can learn how your own pattern of symptoms is going to play out. 

 

Once you've done a few cycles you'll have a sense of how your own body is going to react to tapering, and you can choose to tweak it up or down as required. You can adjust the taper based on what's going on in your life, too, so that if you know you have a stressful period coming up you can plan ahead and have minimal withdrawal going on during that time, and if you know you have an especially mellow period coming up you can push it a bit and deal with a little more withdrawal during that time.

 

Please try not to think about how many years it's going to take, or whatever. That will just discourage you and is also misleading. As you get down to lower doses you will find that the effects of the drugs and the side effects become minimal and you'll be able to get your life and yourself back, and your feelings about the taper itself will change and evolve over time.

 

There's no point in trying to plan how you're going to feel and what you're going to be thinking a year from now. Just focus on now, now.

[Mattyb78]

Rhi- "As you get down to lower doses you will find that the effects of the drugs and the side effects become minimal and you'll be able to get your life and yourself back, and your feelings about the taper itself will change and evolve over time."

 

I think this is what I need to hear right now. I am so confused over how I feel right now, I'm trying to judge what is being caused by the taper, the drop, the updose, general anxiety coming through etc etc. i get the feeling that 10mg is a really difficult part of the taper.

 

I'm trying to relax, give the new dose time and let my brain heal but at the same time I have to make serious decisions about my career. The anxiety is making me ask myself "will i ever get off this drug, or is the damage already done?" "What if it is harder and harder as I go along the taper?"

 

It was nice to hear that i may feel more normal and in control. I just need reassurance. It's scary when you realise that the doctors know less than you do.

[Rhiannon]

Once you get stable, if you take the taper slowly enough and learn your own body's needs and responses, you will definitely be more in control. You'll be able to plan ahead and work your taper around your life. And as you get to the lower doses (slowly!) you'll find yourself getting back your original personality. I've really been enjoying that.

 

I'm at the point now where I hardly notice the effect of the citalopram any more, although I do notice withdrawal if I try to cut too fast.

[Mattyb78]

I can't wait. You are very encouraging, Rhi.

 

Right now I am still seeing a gradual increase in my 'nervous' symptoms. Tinnitus is still present, and my over-reaction to sounds has increased, but it does come and go through the day. Otherwise I feel relatively relaxed. I went to see a doctor today, he said it is a by-product of anxiety but dismissed my questions as to why i have never experienced it before, and why it is increasing even though i feel my anxiety decreasing and the familiar numbing of an up-dose in full effect.

 

In fact, he said that the very fact that i'm worrying about it is a sign that I have anxiety, and that we were going around in circles, and refused to talk about it any more! He dismissed the possibility that I could have caused nervous or brain damage from tapering or alternating doses, and also said there were 'no experts' in getting off ssris, as everyone has a different reaction.

 

In short, he was absolutely no help whatsoever, and kindly added "i haven't dispensed Seroxat (Paxil) for over 15 years because of the problems getting off it" ... but had nothing to offer me except i should keep trying to relax and my symptoms will go.

 

I will keep trying, then, but I am still uneasy at the slow increase in severity of my reactions.

[Altostrata]

That's about as much understanding as you can expect from a doctor!

[Mattyb78]

I forgot to add, he did give me one suggestion for the anxiety. Kalms.

 

As in the herbal multi-suppliment you can buy in pharmacies.

[Altostrata]

Look up the ingredients and then check our Symptoms and Self-Care forum for discussions about them.

[Mattyb78]

I feel my physical symptoms ramping up now. I haven't felt these since before I started taking Paroxetine about 7 years ago. On top of the tinnitus and startle reflex to sounds, which are new to me, as I said, I can feel the old familiar chest pains coming through, a strange pressure behind my sternum which is affecting my breathing... My initial reaction is to want to up my dose again so the symptoms go away again, but this is so annoying because I don't FEEL anxious and i don't want to go backwards any more, but i remember saying "it can't be anxiety' to the doctors all those years ago, and the pills took away the symptoms after a few weeks.

 

I want to believe this is just a wave, but I am afraid that it will get worse and I will regret not doing something about it now. Are these physical symptoms common after a crash, even 6 weeks after and 2 weeks after upping my dose again?

[Altostrata]

You may experience waves and windows for quite a while.

[Mattyb78]

Do these sound like usual symptoms to you? Thanks, by the way, you won't believe how grateful I am for support right now.

[Rhiannon]

You may experience waves and windows for quite a while.

 

This.

 

Everything you describe sounds normal. You're pretty destabilized, it's going to take a while for your CNS and body to get settled back down.  Do all the stuff you can to support your nervous system and reduce stress. I think I went over that above somewhere. What you're experiencing is about what I would expect and sounds fairly typical.

 

Your doctor is a dingbat who obviously has not even one clue about withdrawal. (I want to say something harsher, believe me). Get yourself a copy of Anatomy of an Epidemic by Robert Whitaker, ASAP. 

 

Hang in there, this is the hardest time. It will totally get better (as long as you don't panic and do something crazy like cut drastically or start taking a bunch of new meds).

[Mattyb78]

Well I had a window! Yesterday i woke after having the best night sleep for weeks and weeks, and after the usual low level anxiety of waking up faded, I felt normal. This lasted all day. I was due to speak to my boss in the morning (i've been off work for two weeks now) and i was prepared to tell him how I was going to have to leave in order to recover, as the stress is too great. He didn't call, and by the end of the day I felt so much better that i emailed him a list of things we could try to make things better when I return to work next week!

 

At 9am i was going to quit, by 9pm i was volunteering to come back to work next week, as 'the old me' again!

 

Fast forward to last night, the window ended. I had another bad night, with anxiety crawling over my brain as i lay awake in bed. I tried to fight it or distract myself but the crawling sensations didn't listen and freaked me out every time I was about to drop off.

 

This morning I feel grateful for the window yesterday and I long for another one, one that doesn't stop this time! The problem is that I need to make a decision with work. Risk returning to the stressy job next week, where If i can manage we don't have to worry about money, or take a chance with something unknown but will mean a massive drop in funds? Will the stress of worrying about money be as bad as the current job? I just don't know. I wish I didn't have to work and could just concentrate on getting well again.

 

P.s. Tinnitus and jumpy sound reflex still there, jumpy at more sounds now, although I still actually feel pretty calm! Anyone got and experience of this or pearls of wisdom please? I'll be a nervous wreck if this continues.

 

 

Thanks for reading.

[Athena]

Hi Mattyb,

 

I understand very well what you are feeling right now, and I have felt almost all the symptoms you are describing. I unfortunately don't have any pearl of wisdom to share, and am pretty much unable of wisdom right now, especially in English! But I will say like the others have, try not to make any plan about the withdrawal, and take one day at a time. Respect your body and what it is feeling right now, but when you are feeling better, do not push it and try to make up for the "lost time". I sometimes tend to forget I am in recovery and try to do too much or taper too fast when I feel better but this is a huge mistake. You WILL feel better, but give it time, and rest, and calm, and breathing, and meditation, and slowness, and taking it easy!

 

Hang in there!