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pearl75 - My continuing Paxil Taper


pearl75

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Hello! I'm glad I found this forum because I was a little devastated when Paxil Progress shut down. Of course it was the day after I started having a complete meltdown!

 

Here's my situation. It's taken me about 3 1/2 years to get from 10 mg to just above 5 mg of Paxil. During that time I had minimal symptoms, nothing that I couldn't handle. Now, at just above 5 mg I have severe anxiety, panic and depression. Does anyone have a recommendation with regard to updosing? I loathe the idea of going all the way back up to 10 mg and risk losing 3 1/2 years of progress. I'd appreciate your feedback. I did updose just slightly, like about 3% but is this enough? Right now I am not functional and I need to be!

 

My doctor wants me to quit the Paxil and take Escitalopram (Cipralex/Lexapro). He says I can just stop the Paxil and start taking the Escitalopram right away with no trouble. I have a hard time believing him. Plus, I don't want to be on drugs.

 

I'm taking Zopiclone each night right now to sleep, and I have some Ativan but I've not taken it yet. I really really need to stabilize. I have little support and I have to be alone a lot of the time, which is absolutely terrifying to me.

 

Any feedback would be much appreciated, especially on how much I should updose the Paxi. Last night I updosed to about 6 mg.

 

Not sure if I should put my name, I'll just start with my initial.

 

W.

  • 20 mg Paxil daily since approx 2003

Tried tapering twice unsucessfully (fall 2005/summer 2006)

Tried tapering again between Feb 2009 and Feb 2010 unsuccessfully but stabilized at 10 mg

Started super slow taper Jul 2011 (approx 3-4% reductions every 2-3 months)

Last reduction on Nov 27/14 of about 4% to just above 5 mg - since then I am back into severe anxiety, panic and depression

Updosed to 5.5 mg on Dec 21/14, then to 6 mg on Dec 26/14 out of desperation

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Hi there,

 

I am in a similar predicament although my taper was not quite as slow as yours.  I had slowly tapered over a year from 35 mg Celexa to 12.6 and crashed with severe anxiety.  I slowly increased to 16 mg and am staying there to try to stabilize.  I have been reading others stories that are similar and seems that increasing a small amount (probably less than I did) is what is recommended since we have been at lower levels for awhile and just staying there for as long as it takes to stabilize.  I have been feeling really miserable (severe anxiety, depression, insomnia, suicidal thoughts, loss of appetite, etc.)  - it has been really hard to function.  It is difficult to imagine stabilizing but others have eventually come out the other side so I am trying to remain hopeful that I (and you) will too.  So perhaps the recommendation would be to stay where you are with the 3% increase and stick it out there and eventually you will stabilize.  I wanted you to know that you are not alone!

 

Michele

-1/06 - 3/07 Cymbalta. Fast taper; withdrawal symptoms after 4 mos (didn't realize was WD)

-10/07: 100 mg Zoloft; 1 mg Klonopin - tapered off Klonopin
-Tried several times to slowly taper Zoloft by 10%, then 5% every 4-6 weeks; could never get below approx. 40 mg - spring 2012 experienced major WD symptoms due to stress; tried to updose but no relief, back on Klonopin 1 mg.
-Switched over 5-6 mos from Zoloft to Citalopram. Finished Zoloft 1/13; Citalopram 35 mg and 1 mg Klonopin.
-8/13: 27 mg Citalopram; 1 mg Klonopin

-11/14: 12.6 Citalopram - began to have bad withdrawal symptoms; out of desperation increased to 1.25 mg Klonopin at the beginning of December.  12/13/14 16 mg Citalopram - going to stay here to try to stabilize; stabilized on 16 mg Citalopram after 4-5 months

-7/15 - 3/16: reduced to 15 mg; ~ 2 months later w/d hit hard (probably r/t stress); 6/16 updosed to 20 mg Citalopram and trying to stabilize. Updosed to 1.5 Klonopin as well. Stabilized on 20 mg Citalopram after 4-5 months

8/17-9/17: feeling withdrawal symptoms at 20 mg Citalopram (due to stress) - slowly increased to 25 mg. No change in symptoms after 6 months (? tolerance ?)  - decided to start citalopram taper February 2018 (still on Klonopin 1.5 mg).

Supplements: fish oil; magnesium; vitamin D3; curcumin

Citalopram taper:  2/2018 - 12/2019: 25 mg - 11.03 mg I 2020: 10.89 mg - 7.9 mg I 2021: 7.8 mg - 5.26 mg

2022: 1/5/22: 5.2 mg; 1/12/22: 5.1 mg; 1/19/22: 5.07 mg; 1/26/22: 5.0 mg; 5/1/22: 4.9 mg; 5/8/22: 4.88 mg; 5/15/22: 4.8 mg; 5/22/22: 4.76 mg; 6/5/22: 4.7 mg; 6/12/22: 4.6 mg; 6/19/22: 4.58 mg; 6/26/22: 4.5 mg; 7/10/22: 4.47 mg; 7/17/22: 4.4 mg; 7/24/22: 4.36 mg; 7/31/22: 4.3 mg; 8/21/22: 4.25 mg; 8/28/22: 4.2 mg; 9/4/22: 4.1 mg; 9/11/22: 4.09 mg; 9/25/22: 4.0 mg; 10/2/22: 3.99 mg; 10/9/22: 3.9 mg; 10/16/22: 3.89 mg; 10/30/22: 3.8 mg; 11/6/22: 3.77 mg; 11/13/22: 3.7 mg; 11/21/22: 3.6 mg; 12/5/22: 3.57 mg

 

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Thanks so much Michele!  I did updose to 6 mg but I don't think that's too much.  Especially if I can stabilize.  I'm having the same symptoms as you - severe anxiety, depression, insomnia, suidical thoughts, loss of appetite.  I just can't stop my mind.  I'm afraid of everything.  Especially of being left alone.  And I have little family support.  My husband got a new job and he's working all the time.  My mom effectively told me that she's not available.  I need to find a community to go to for support.  Not sure where to find that (other than here). 

 

It's so frustrating because my doctor of course doesn't believe that Paxil withdrawal could cause this.  He just thinks I need more meds.  And my family just wants me to take the meds so it takes the pressure off them.  Is anyone else struggling with having to be alone while they go through all of these horrible symptoms?

 

Wendy

  • 20 mg Paxil daily since approx 2003

Tried tapering twice unsucessfully (fall 2005/summer 2006)

Tried tapering again between Feb 2009 and Feb 2010 unsuccessfully but stabilized at 10 mg

Started super slow taper Jul 2011 (approx 3-4% reductions every 2-3 months)

Last reduction on Nov 27/14 of about 4% to just above 5 mg - since then I am back into severe anxiety, panic and depression

Updosed to 5.5 mg on Dec 21/14, then to 6 mg on Dec 26/14 out of desperation

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  • Moderator Emeritus

Hi Pearl75

 

Welcome to SA. Sorry to hear you have been struggling of late. I have a couple of questions just to try and understand a little more what us happening for you.

 

Were you stable before your last drop?

If so, have you started taking any other medication/supplements that you might be reacting to?

If you weren't stable before your last drop, what was the dose you were last stable on?

 

If it was me I wouldn't up dose any more nor would I be swapping drugs. You need to give your system some time and the opportunity to restabalise

 

Dalsaan

Please note - I am not a medical practitioner and I do not give medical advice. I offer an opinion based on my own experiences, reading and discussion with others.On Effexor for 2 months at the start of 2005. Had extreme insomnia as an adverse reaction. Changed to mirtazapine. Have been trying to get off since mid 2008 with numerous failures including CTs and slow (but not slow enough tapers)Have slow tapered at 10 per cent or less for years. I have liquid mirtazapine made at a compounding chemist.

Was on 1.6 ml as at 19 March 2014.

Dropped to 1.5 ml 7 June 2014. Dropped to 1.4 in about September.

Dropped to 1.3 on 20 December 2014. Dropped to 1.2 in mid Jan 2015.

Dropped to 1 ml in late Feb 2015. I think my old medication had run out of puff so I tried 1ml when I got the new stuff and it seems to be going ok. Sleep has been good over the last week (as of 13/3/15).

Dropped to 1/2 ml 14/11/15 Fatigue still there as are memory and cognition problems. Sleep is patchy but liveable compared to what it has been in the past.

 

DRUG FREE - as at 1st May 2017

 

>My intro post is here - http://survivingantidepressants.org/index.php?/topic/2250-dalsaan

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  • Moderator Emeritus

Agree with Dalsaan, unless there are other factors involved (like new meds etc) I would say just hold on that 6 mg now and focus on doing as much as you can with lifestyle factors. It sounds like isolation is an issue for you, so you might see if you can make some baby steps around that (post frequently and make friends here, call friends every day, maybe look into support groups and meetups in your area, etc). Make sure you're eating right (no sugar, white flour etc--we sometimes get in trouble around the holidays with all the "goodies.") Stay away from caffeine and alcohol. Try to get some gentle exercise every day (gentle walking can be very helpful). Keep stress to a minimum, postpone stressful projects for a while if you can, that sort of thing.

 

Also check our Symptoms and Self-Care area for all kinds of discussions of various things people have found helpful.

 

And hang in there. Don't change your dose, just hang in there. You will stabilize and this will pass and you'll be back on track.

 

When it comes time to start tapering again, you might want to consider doing a microtaper (even smaller cuts, but more often probably). But that's not anything to concern yourself with just yet.

 

Good luck, keep us posted.

Started on Prozac and Xanax in 1992 for PTSD after an assault. One drug led to more, the usual story. Got sicker and sicker, but believed I needed the drugs for my "underlying disease". Long story...lost everything. Life savings, home, physical and mental health, relationships, friendships, ability to work, everything. Amitryptiline, Prozac, bupropion, buspirone, flurazepam, diazepam, alprazolam, Paxil, citalopram, lamotrigine, gabapentin...probably more I've forgotten. 

Started multidrug taper in Feb 2010.  Doing a very slow microtaper, down to low doses now and feeling SO much better, getting my old personality and my brain back! Able to work full time, have a full social life, and cope with stress better than ever. Not perfect, but much better. After 23 lost years. Big Pharma has a lot to answer for. And "medicine for profit" is just not a great idea.

 

Feb 15 2010:  300 mg Neurontin  200 Lamictal   10 Celexa      0.65 Xanax   and 5 mg Ambien 

Feb 10 2014:   62 Lamictal    1.1 Celexa         0.135 Xanax    1.8 Valium

Feb 10 2015:   50 Lamictal      0.875 Celexa    0.11 Xanax      1.5 Valium

Feb 15 2016:   47.5 Lamictal   0.75 Celexa      0.0875 Xanax    1.42 Valium    

2/12/20             12                       0.045               0.007                   1 

May 2021            7                       0.01                  0.0037                1

Feb 2022            6                      0!!!                     0.00167               0.98                2.5 mg Ambien

Oct 2022       4.5 mg Lamictal    (off Celexa, off Xanax)   0.95 Valium    Ambien, 1/4 to 1/2 of a 5 mg tablet 

 

I'm not a doctor. Any advice I give is just my civilian opinion.

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I've been weaning at such a crazy slow rate.  The last time I was stable was at about 5.3-5.4 mg.  I literally went down to about 5.1-5.2 mg and that's when the trouble started.  I was stable before I went down to approx 5.1-5.2 mg.  I did not start any other medications.  However, I did start taking a lot of apple cider vinegar, probiotics and other vitamins around the same time as the trouble started.  My sinuses have been congested for about 4 years and it has been really getting to me, so I though cleaning up my diet and taking the apple cider vinegar etc. might help.  My theory is that my sinus congestion is related to too much sugar intake resulting in Candida yeast.

 

I hope this sounds clear.  I'm really foggy in the head today.

 

Wendy

  • 20 mg Paxil daily since approx 2003

Tried tapering twice unsucessfully (fall 2005/summer 2006)

Tried tapering again between Feb 2009 and Feb 2010 unsuccessfully but stabilized at 10 mg

Started super slow taper Jul 2011 (approx 3-4% reductions every 2-3 months)

Last reduction on Nov 27/14 of about 4% to just above 5 mg - since then I am back into severe anxiety, panic and depression

Updosed to 5.5 mg on Dec 21/14, then to 6 mg on Dec 26/14 out of desperation

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Just to clarify, I was at approx 5.1-5.2 mg dose when I started having symptoms.  I updosed to about 5.5 mg a few days ago, and then last night I updosed again to 6 mg.  I think I'll just stick to the 6 mg for now and see what happens.

  • 20 mg Paxil daily since approx 2003

Tried tapering twice unsucessfully (fall 2005/summer 2006)

Tried tapering again between Feb 2009 and Feb 2010 unsuccessfully but stabilized at 10 mg

Started super slow taper Jul 2011 (approx 3-4% reductions every 2-3 months)

Last reduction on Nov 27/14 of about 4% to just above 5 mg - since then I am back into severe anxiety, panic and depression

Updosed to 5.5 mg on Dec 21/14, then to 6 mg on Dec 26/14 out of desperation

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  • Moderator Emeritus

Some people experience vitamins as troublesome. What vitamins did you start taking?

Please note - I am not a medical practitioner and I do not give medical advice. I offer an opinion based on my own experiences, reading and discussion with others.On Effexor for 2 months at the start of 2005. Had extreme insomnia as an adverse reaction. Changed to mirtazapine. Have been trying to get off since mid 2008 with numerous failures including CTs and slow (but not slow enough tapers)Have slow tapered at 10 per cent or less for years. I have liquid mirtazapine made at a compounding chemist.

Was on 1.6 ml as at 19 March 2014.

Dropped to 1.5 ml 7 June 2014. Dropped to 1.4 in about September.

Dropped to 1.3 on 20 December 2014. Dropped to 1.2 in mid Jan 2015.

Dropped to 1 ml in late Feb 2015. I think my old medication had run out of puff so I tried 1ml when I got the new stuff and it seems to be going ok. Sleep has been good over the last week (as of 13/3/15).

Dropped to 1/2 ml 14/11/15 Fatigue still there as are memory and cognition problems. Sleep is patchy but liveable compared to what it has been in the past.

 

DRUG FREE - as at 1st May 2017

 

>My intro post is here - http://survivingantidepressants.org/index.php?/topic/2250-dalsaan

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  • Moderator Emeritus

oh, yes, the vitamins and probiotics could have set things off, for sure. 

 

There's a strong and complex interaction between our emotions and the bacteria in our guts, and when you perturb that with probiotics, even though they're good bacteria, it can cause disruption. We've had people have bad reactions to probiotics before. What seems to work better for folks in withdrawal is to change your diet and use "food" probiotics like yogurt, kefir, fermented sauerkraut, that sort of thing. (And even with those, take it slowly.)

 

I think there are a LOT of discussions about this on the forum. The best way to search here is to use Google. Type into the Google search "surviving antidepressants <topic>" (in this case I would suggest for the topic "gut" or "enteric").

 

You can also find a lot of info on the Internet about the gut's nervous system, under things like "second brain, gut brain, enteric nervous system" stuff like that. Basically, the gut has its own nervous system which sends messages to the brain. For me, getting the gutbrain thing under control (by diet in my case, mostly) has made a big difference, and when I go off the wagon I can really tell (intense anxiety and feelings of hopelessness, especially in the morning).

 

Also, yes, many of us find that we are very sensitive to vitamins and supplements, especially B vitamins, but sometimes others as well.

Started on Prozac and Xanax in 1992 for PTSD after an assault. One drug led to more, the usual story. Got sicker and sicker, but believed I needed the drugs for my "underlying disease". Long story...lost everything. Life savings, home, physical and mental health, relationships, friendships, ability to work, everything. Amitryptiline, Prozac, bupropion, buspirone, flurazepam, diazepam, alprazolam, Paxil, citalopram, lamotrigine, gabapentin...probably more I've forgotten. 

Started multidrug taper in Feb 2010.  Doing a very slow microtaper, down to low doses now and feeling SO much better, getting my old personality and my brain back! Able to work full time, have a full social life, and cope with stress better than ever. Not perfect, but much better. After 23 lost years. Big Pharma has a lot to answer for. And "medicine for profit" is just not a great idea.

 

Feb 15 2010:  300 mg Neurontin  200 Lamictal   10 Celexa      0.65 Xanax   and 5 mg Ambien 

Feb 10 2014:   62 Lamictal    1.1 Celexa         0.135 Xanax    1.8 Valium

Feb 10 2015:   50 Lamictal      0.875 Celexa    0.11 Xanax      1.5 Valium

Feb 15 2016:   47.5 Lamictal   0.75 Celexa      0.0875 Xanax    1.42 Valium    

2/12/20             12                       0.045               0.007                   1 

May 2021            7                       0.01                  0.0037                1

Feb 2022            6                      0!!!                     0.00167               0.98                2.5 mg Ambien

Oct 2022       4.5 mg Lamictal    (off Celexa, off Xanax)   0.95 Valium    Ambien, 1/4 to 1/2 of a 5 mg tablet 

 

I'm not a doctor. Any advice I give is just my civilian opinion.

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Still having a really tough time.  It's been a couple weeks since I updosed, and so far no improvement.  Severe anxiety, panic, depression, suicidal thoughts.  I'm wondering if I'm desperate enough to do what the doctor wants and start taking Cipralex?  My doctor would never believe that what I'm going through has anything to do with withdrawal from Paxil and/or effects of taking probiotics and vitamins.  I can hardly eat anything.  I'm existing on protein shakes, yogurt and scrambled eggs, only liquid or mushy things.  I've lost quite a bit of weight.  I've stopped all vitamins, and now I'm worried about getting sick, as this is the time of year for flu/colds.  I think if I got sick that might push me over the edge.  I'm supposed to start back to work on Monday.  I'm not sure at this point if I can.  I'm afraid to drive.  I'm afraid of pretty much everything right now.  And of course I can't sleep without taking Zopiclone, but don't want to keep taking that as I don't want to get addicted to any more drugs.  I feel pretty hopeless right now.

  • 20 mg Paxil daily since approx 2003

Tried tapering twice unsucessfully (fall 2005/summer 2006)

Tried tapering again between Feb 2009 and Feb 2010 unsuccessfully but stabilized at 10 mg

Started super slow taper Jul 2011 (approx 3-4% reductions every 2-3 months)

Last reduction on Nov 27/14 of about 4% to just above 5 mg - since then I am back into severe anxiety, panic and depression

Updosed to 5.5 mg on Dec 21/14, then to 6 mg on Dec 26/14 out of desperation

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  • Moderator Emeritus

The last time I was stable was at about 5.3-5.4 mg.  I literally went down to about 5.1-5.2 mg and that's when the trouble started.  I was stable before I went down to approx 5.1-5.2 mg. 

 

A similar thing happened to me during my previous (failed) taper.  I thought I was doing fine on 5mg, went to 4.5mg and then three and half weeks later crashed really badly.  I updosed back to 5mg immediately but it did nothing.  I struggled on for a few months but eventually gave in and updosed back to my original dose and started all over again.

 

Around 5mg is a very difficult dose range for some people.  I believe there is a point where the drug suddenly goes from "working" to "not working" - this point and how sudden it is varies between individuals, but many people have trouble around the 5mg area. 

 

Your slow taper plan looked pretty conservative to me, but I am a bit concerned that you described your doses as "about 5.3-5.4" and "about 5.1-5.2".  How are you measuring these?  You need to know whether it is 5.3 or 5.4. 

 

If 6mg hasn't helped at all, you might consider a larger updose, e.g. 7.5mg.  An updose would be better than trying to switch to another med, which can be risky - it works for some but is a disaster for others. 

 

When I crashed I also used zopiclone for a while to help me sleep.  Try to use the minimum effective dose and you can taper off it when you stabilise.

2001–2002 paroxetine

2003  citalopram

2004-2008  paroxetine (various failed tapers) 
2008  paroxetine slow taper down to

2016  Aug off paroxetine
2016  citalopram May 20mg  Oct 15mg … slow taper down
2018  citalopram 13 Feb 4.6mg 15 Mar 4.4mg 29 Apr 4.2mg 6 Jul 4.1mg 17 Aug 4.0mg  18 Nov 3.8mg
2019  15 Mar 3.6mg  21 May 3.4mg  26 Dec 3.2mg 

2020  19 Feb 3.0mg 19 Jul 2.9mg 16 Sep 2.8mg 25 Oct 2.7mg 23 Oct 2.6mg 24 Dec 2.5mg

2021   29 Aug 2.4mg   15 Nov 2.3mg

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Thanks Songbird.  When I say the dose is approximate, that's because I've really been going by a weight value rather than a dose value since I've been weaning.  I mean, I carefully cut and weigh each pill using a jewelers scale.  So the doses I was describing were my best guess for the gram weight I was taking at the time.

 

I'm curious, how long did you use the zopiclone.  I've been using it for a couple weeks, but am concerned about using it anymore because I believe that along with all the other drugs for anxiety/depression/sleep etc, zopiclone is addictive.  I don't think I can handle being addicted to more than one drug at a time.

 

I've also been using ativan to get through the daytimes, especially when I have to be alone for the day, and I have the same concerns about that drug.

  • 20 mg Paxil daily since approx 2003

Tried tapering twice unsucessfully (fall 2005/summer 2006)

Tried tapering again between Feb 2009 and Feb 2010 unsuccessfully but stabilized at 10 mg

Started super slow taper Jul 2011 (approx 3-4% reductions every 2-3 months)

Last reduction on Nov 27/14 of about 4% to just above 5 mg - since then I am back into severe anxiety, panic and depression

Updosed to 5.5 mg on Dec 21/14, then to 6 mg on Dec 26/14 out of desperation

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I am so sorry you are still struggling.  Me too.  :(  I am feeling the exact same way as you.  I am still trying to hang in there with the updose but it is hard to continue like this. 

-1/06 - 3/07 Cymbalta. Fast taper; withdrawal symptoms after 4 mos (didn't realize was WD)

-10/07: 100 mg Zoloft; 1 mg Klonopin - tapered off Klonopin
-Tried several times to slowly taper Zoloft by 10%, then 5% every 4-6 weeks; could never get below approx. 40 mg - spring 2012 experienced major WD symptoms due to stress; tried to updose but no relief, back on Klonopin 1 mg.
-Switched over 5-6 mos from Zoloft to Citalopram. Finished Zoloft 1/13; Citalopram 35 mg and 1 mg Klonopin.
-8/13: 27 mg Citalopram; 1 mg Klonopin

-11/14: 12.6 Citalopram - began to have bad withdrawal symptoms; out of desperation increased to 1.25 mg Klonopin at the beginning of December.  12/13/14 16 mg Citalopram - going to stay here to try to stabilize; stabilized on 16 mg Citalopram after 4-5 months

-7/15 - 3/16: reduced to 15 mg; ~ 2 months later w/d hit hard (probably r/t stress); 6/16 updosed to 20 mg Citalopram and trying to stabilize. Updosed to 1.5 Klonopin as well. Stabilized on 20 mg Citalopram after 4-5 months

8/17-9/17: feeling withdrawal symptoms at 20 mg Citalopram (due to stress) - slowly increased to 25 mg. No change in symptoms after 6 months (? tolerance ?)  - decided to start citalopram taper February 2018 (still on Klonopin 1.5 mg).

Supplements: fish oil; magnesium; vitamin D3; curcumin

Citalopram taper:  2/2018 - 12/2019: 25 mg - 11.03 mg I 2020: 10.89 mg - 7.9 mg I 2021: 7.8 mg - 5.26 mg

2022: 1/5/22: 5.2 mg; 1/12/22: 5.1 mg; 1/19/22: 5.07 mg; 1/26/22: 5.0 mg; 5/1/22: 4.9 mg; 5/8/22: 4.88 mg; 5/15/22: 4.8 mg; 5/22/22: 4.76 mg; 6/5/22: 4.7 mg; 6/12/22: 4.6 mg; 6/19/22: 4.58 mg; 6/26/22: 4.5 mg; 7/10/22: 4.47 mg; 7/17/22: 4.4 mg; 7/24/22: 4.36 mg; 7/31/22: 4.3 mg; 8/21/22: 4.25 mg; 8/28/22: 4.2 mg; 9/4/22: 4.1 mg; 9/11/22: 4.09 mg; 9/25/22: 4.0 mg; 10/2/22: 3.99 mg; 10/9/22: 3.9 mg; 10/16/22: 3.89 mg; 10/30/22: 3.8 mg; 11/6/22: 3.77 mg; 11/13/22: 3.7 mg; 11/21/22: 3.6 mg; 12/5/22: 3.57 mg

 

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  • Moderator Emeritus

I've used zopiclone a number of times in my life and found it very helpful, but I've tried to limit the period of use to about six weeks.  As it is a z-drug, which are similar to benzos, it can be addictive.  I've found lack of sleep can really keep the nervous system sensitised and careful use of a sleep med can help to break that cycle, allowing things to calm down somewhat.  My approach is to always use the minimum effective dose and adjust the dose as needed.  The usual advice here is to keep a daily consistent dose of whatever med, but I think for short term use of a sleep med it's best to take the minimum you need, aiming to taper off as soon as you can to avoid withdrawal issues.  Here is how it worked for me:  In the beginning I might need a whole pill to get to sleep, but after a few days my sleep would stabilise and I would start chipping down the pill a little, trying, say, three-quarters and if it worked, stay there for a few days until sleep stabilised.  By sleep stabilising I mean good quality sleep.  After each drop, sleep quality might be not quite as good for a few days, but I would still sleep okay, then my body would adjust to the lower dose and sleep better.  Eventually I was able to use melatonin and valerian for sleep instead of meds.  Of course, this approach may not work if your sleep does not stabilise due to ongoing severe w/d.  I found it helpful during the period after updosing when I was waiting for the updose to work and restabilise.

 

I would be more concerned about the Ativan, although I have no personal experience with it.  I believe it has a short half-life and can quickly cause rebound anxiety.   You could check out books and recordings by Dr. Claire Weekes for dealing with anxiety.  Also I found regular relaxation exercises very helpful to calm down the nervous system, particularly gentle yoga stretches and progressive muscle relaxation.  See if you can get out for some gentle walks too.  These are the things that helped me most during my 'crash' period.

 

Regarding the weighing of doses, there is a spreadsheet here that can convert doses to weights:

 

http://survivingantidepressants.org/index.php?/topic/7601-excel-spreadsheet-to-calculate-dose-weights-using-a-scale/

2001–2002 paroxetine

2003  citalopram

2004-2008  paroxetine (various failed tapers) 
2008  paroxetine slow taper down to

2016  Aug off paroxetine
2016  citalopram May 20mg  Oct 15mg … slow taper down
2018  citalopram 13 Feb 4.6mg 15 Mar 4.4mg 29 Apr 4.2mg 6 Jul 4.1mg 17 Aug 4.0mg  18 Nov 3.8mg
2019  15 Mar 3.6mg  21 May 3.4mg  26 Dec 3.2mg 

2020  19 Feb 3.0mg 19 Jul 2.9mg 16 Sep 2.8mg 25 Oct 2.7mg 23 Oct 2.6mg 24 Dec 2.5mg

2021   29 Aug 2.4mg   15 Nov 2.3mg

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  • Administrator

Great info, Songbird, thanks. You might start a "Reasonable use of Z-drugs for sleep" topic in Symptoms so this doesn't get lost.

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

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Hi Pearl - I wanted to check-in with you to see how you are doing?  I have been thinking about you.  I am feeling the same, still hoping to stabilize.  It has been a rough time.  I hope you are feeling better!

-1/06 - 3/07 Cymbalta. Fast taper; withdrawal symptoms after 4 mos (didn't realize was WD)

-10/07: 100 mg Zoloft; 1 mg Klonopin - tapered off Klonopin
-Tried several times to slowly taper Zoloft by 10%, then 5% every 4-6 weeks; could never get below approx. 40 mg - spring 2012 experienced major WD symptoms due to stress; tried to updose but no relief, back on Klonopin 1 mg.
-Switched over 5-6 mos from Zoloft to Citalopram. Finished Zoloft 1/13; Citalopram 35 mg and 1 mg Klonopin.
-8/13: 27 mg Citalopram; 1 mg Klonopin

-11/14: 12.6 Citalopram - began to have bad withdrawal symptoms; out of desperation increased to 1.25 mg Klonopin at the beginning of December.  12/13/14 16 mg Citalopram - going to stay here to try to stabilize; stabilized on 16 mg Citalopram after 4-5 months

-7/15 - 3/16: reduced to 15 mg; ~ 2 months later w/d hit hard (probably r/t stress); 6/16 updosed to 20 mg Citalopram and trying to stabilize. Updosed to 1.5 Klonopin as well. Stabilized on 20 mg Citalopram after 4-5 months

8/17-9/17: feeling withdrawal symptoms at 20 mg Citalopram (due to stress) - slowly increased to 25 mg. No change in symptoms after 6 months (? tolerance ?)  - decided to start citalopram taper February 2018 (still on Klonopin 1.5 mg).

Supplements: fish oil; magnesium; vitamin D3; curcumin

Citalopram taper:  2/2018 - 12/2019: 25 mg - 11.03 mg I 2020: 10.89 mg - 7.9 mg I 2021: 7.8 mg - 5.26 mg

2022: 1/5/22: 5.2 mg; 1/12/22: 5.1 mg; 1/19/22: 5.07 mg; 1/26/22: 5.0 mg; 5/1/22: 4.9 mg; 5/8/22: 4.88 mg; 5/15/22: 4.8 mg; 5/22/22: 4.76 mg; 6/5/22: 4.7 mg; 6/12/22: 4.6 mg; 6/19/22: 4.58 mg; 6/26/22: 4.5 mg; 7/10/22: 4.47 mg; 7/17/22: 4.4 mg; 7/24/22: 4.36 mg; 7/31/22: 4.3 mg; 8/21/22: 4.25 mg; 8/28/22: 4.2 mg; 9/4/22: 4.1 mg; 9/11/22: 4.09 mg; 9/25/22: 4.0 mg; 10/2/22: 3.99 mg; 10/9/22: 3.9 mg; 10/16/22: 3.89 mg; 10/30/22: 3.8 mg; 11/6/22: 3.77 mg; 11/13/22: 3.7 mg; 11/21/22: 3.6 mg; 12/5/22: 3.57 mg

 

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