KAR's paxil withdrawal

[Kar]

Hi All

Over the past almost two years have reduced from 40mg paxil to 25/27.5mg paxil.

 

What I mean by that is currently I am alternating between 25mg and 27.5mg every other day in effort to slowly get to 25mg.  This means Monday I take 25mg, Tuesday I take 27.5mg, Wednesday I take 25mg and so on.  This is my second attempt to get down to 25mg.  If possible, I'd like to get down to 20mg.  If not, then so be it.

Have been on paxil close to 20 years, on 40mg the second ten years.

Current withdrawal symptoms are what seems to be a lot of muscular back pain, also joint pain, general aches and pains, fatigue, depression and anxiety, hot and cold.  All except the back pain are consistent with what I've experienced before as withdrawals.  This time also I am extremely sensitive to the cold.  Feel cold a lot of the time.

 

Also since I started withdrawing, I've had quite severe food sensitivities emerge.  I am sensitive to salicylates, amines and glutamates.  These cause eczema and also swelling on my face if I eat too much of them.  I am under a dietician's guidance with respect to diet.

 

Regards
K

[dalsaan]

Hi kar,

 

Welcome to SA and congratulations on the progress you have made so far.  Well done.

 

We don't advocate alternate doses as you have described.   Our philosophy is based on providing your system with a stable platform for it to wean itself off its adaptations to the presence of drugs in the system.

 

I would encourage you to read this thread and then perhaps come back and discuss some more or ask questions.  http://survivingantidepressants.org/index.php?/topic/6632-the-rule-of-3kis-keep-it-simple-keep-it-slow-keep-it-stable/

 

Once again, 

 

Welcome to SA

 

Dalsaan

[Kar]

Thanks Dalsaan for your quick reply.

 

I have had a quick read of the link but will have a slower read later.

 

The approach recommended by my doctor was as follows:

* week one - reduce dosage by one on day per week until stable

* week two - reduce dosage on two days per week (non consecutive) until stable

* week three - reduce dosage on three non-consecutive days per week until stable

and so on until you are taking the new lower level every day.

 

This is the method I have used to reduce from 40mg to my current point where I am on alternate doses as detailed in my first post.

I will read the information on your site and consider switch to 25mg every day.

Thanks again.

 

regards

k

[dalsaan]

Hi Kar,

 

We also recommend a percent reduction, 5-10% of your previous dose, rather than a set/same drop each time.

 

I think your current strategy becomes more risky for withdrawal the lower you go.   This thread explains why - http://survivingantidepressants.org/index.php?/topic/6036-why-taper-paper-demonstrates-importance-of-gradual-change-in-plasma-concentration/

 

dropping 5 mg off a 50mg starting dose is not the same as dropping 5mg from 25 to 20

 

D

[Kar]

Thanks Daslaan.  That is what I have been doing - 10% or less each time I've reduced.  Thanks.

[dalsaan]

Hi Kar,

 

That's great. If you've struggled to get past this point previously you might want to consider reducing your percentage to 5 percent or explore a micro taper There is some discussion on that here http://survivingantidepressants.org/index.php?/topic/2878-micro-taper-instead-of-10-or-5-decreases/

 

There are options if you struggle

 

Dalsaan

[Kar]

Thanks Dalsaan.

[Fresh]

Hi Kar , welcome from Sydney.     This site has so much information from others who've been through this too.   All of us have been given incorrect or dangerous advise from doctors at some stage.  They don't seem to know better.

It sure sounds like you're having some withdrawal symptoms on your current protocol.    Would you consider sitting on 27.5mg every day until things stabilize?

That's what I would do.     Then you can work out the least disruptive way to go down from there.

Best  wishes ,   Fresh

[Kar]

Thanks Fresh. This is actually my second attempt at getting to 25mg and so far it's been a lot less worse than the last attempt (Probably 6 months ago).

 

When the withdrawal symptoms eventually pass I often get improvements such as improved ability to think clearly.

 

I will persevere a bit longer. One positive is also that I am able to sleep a lot. So I can sleep through some of the worst symptoms! Just not helpful for working! ; )

[Fresh]

Wow , if you're able to work then it's not a good time to be battling withdrawals.    What do you think about the idea of the same dose every day , rather than alternating?

[Kar]

I have worked full time throughout my reductions.

 

I am seriously considering going to 25mg every day. But the approaches I have outlined above is how I have gotten to where I am now.

[Altostrata]

Welcome, KAR.

 

This topic contains more detail about titrating Paxil Tips for tapering off Paxil (paroxetine)

 

Since you are having some withdrawal-related symptoms, you may wish to hold off on tapering for a while and let your nervous system settle down.

[Kar]

Thanks Altostrata. I have been reading that thread.

 

I always have withdrawal symptoms with reductions - it's a matter of degree. So far, these withdrawal symptoms are not as severe as previously. So I will persevere for a bit longer before making any further changes. They seem to be abating a little.

 

Thanks!

[Altostrata]

At this point, your system may be telling you to slow down and make even smaller reductions.

 

Are you using Paxil liquid?

[Kar]

My withdrawal symptoms have continued to reduce over the last few days.

 

Not onto liquid paxil yet but plan to get it.

 

Thanks

[Fresh]

Hi Kar , how are things going for you?

 

Good to hear you were improving at time of your last post.  ; )

[Kar]

Hi Fresh

Thanks for the post.

I'm feeling great.  This is consistent with my previous experiences of reducing my paxil dose - I go through a bit of a rough patch, but then I come out the other side and feel better than I have in years.  I am calmer, I think more clearly, and physically I feel great - lots of energy.

cheers

k

[Kar]

Hi Everyone

A brief update - I stablised at 23.5mg (i.e. feeling good).  So am about to commence another 1mg reduction to 22.5mg. 

 

My specialist has said that once I get to 20mg paxil, then I can switch to Zoloft (equivalent dosage).  She said get up one day and stop taking paxil and start taking the Zoloft and take two weeks off work.

 

My specialist is very experienced.  But I am interested in the experiences of others here on the website of changing drugs in this way.  If anyone can point me to individual threads I would be grateful.

Thanks.

Regards

KAR

[DLB]

Why would she switch you while you are doing so well? Makes no sense you will have to deal with a cold turkey off 20 paxil and startup effects from Zoloft! Bridging rarely works and why do it if you are doing ok? Don't step onto the "merry go round".

[LoveandLight]

When I read that I thought omg - to zoloft? Zoloft ime is a terrible drug and you would have the fallout of the paxil withdrawal to deal with. However, sometimes things do work for people but since your 'boat' so to speak is stable I would hate to see it rocked!

[AmyK]

Hi!

I had a terrible time on zoloft. I would not change. They dont equal in doses either. 20 mg paxil= 50 mg zoloft.

I think it's better to stay with one drug.

All the best!

[Kar]

Hi Everyone

Thanks for sharing your experiences and views.

 

The reason for switching to Zoloft is because it is safer than paxil for pregnancy according to my specialist.

 

I also don't have a lot of time because I only 18 months off turning 40.  Originally I had thought I would have to wean completely off paxil but my specialist said I could switch from paxil to Zoloft once I hit 20mg of paxil.

 

If you know of anyone who has switched from paxil to zoloft, I'd be grateful if you could let me know and I'll read their thread.

THanks.

 

regards

k

[Altostrata]

Kar, if I were you, I would double-check your specialist's statement about all psychiatric drugs.

 

I don't believe Zoloft is any safer for pregnancy. They're all about the same risk.

 

Switching to another SSRI always incurs the risk of nervous system destabilization. We recommend switching to another drug as only a last resort, if you have difficulty reducing the first drug.

 

I am sorry you are faced with these choices while pregnant.

[Kar]

Thanks Alostrata.  

 

The specialist went through in great detail the risks associated with paxil as compared to zoloft in pregnancy (the exact conditions that are at increased risk for the both the mother and the baby, the percentages of those increased risks, the studies on which these statistics are based and the and the limitations of these studies).  The risks were higher for paxil than zoloft.  On the basis of the conditions that are risks to mother and baby, my partner and I decided to attempt to switch to Zoloft.

 

Also, just fyi, I'm not pregnant.  We are trying to do these changes, and if we can do them, then we will attempt to have a child.  If I'm not up to the changes, then we probably won't have a child.

 

I'm still interested in anyone's experiences of switching from paxil to zoloft.  Searching the net I've found some horror stories, but also stories of people who changed without any problems.

Thanks.

 

regards

Kar

[Altostrata]

I would use Google to read up on Zoloft pregnancy risks compared with Paxil. Read it with your own eyes.

[Kar]

Hi All

I seem to be experiencing the return of severe PMS with my paxil reductions.  Is this familiar to anyone?

Any suggetions on things that might help?  (In the past I've tried the pill, evening primrose oil - neither made any difference).

 

cheers

kar

[Kar]

Hi All

Past the PMS.

 

Ongoing withdrawal symptoms of: almost constant generalised anxiety, lots of depressive thoughts, very pessimistic, grumpy, I feel scared a lot of the time - of all sorts of things (scared of getting out of bed, scared of having to interact with people, scared of going to work, scared of driving the car), obsessed with food and just want to eat eat eat all the time (have put on a bit of weight).

 

This is the first time I have experienced the food obsession and eating more. I also haven't had the constant anxiety as a withdrawal symptom before. 

 

I've been at 22.5mg paxil for three weeks now. 

 

I'll see how things go over the next week days. (When my withdrawal symptoms lift they often do so quite suddenly and then I feel fantastic - mentally 'normal' and physically lots of energy and strength).  But am considering going back up to 23mg for some relief.  (In the past, going back up has brought me relief - and then when I try to go down again, it is usually easier than the first attempt).

 

Thanks.

 

regards

kar

[Songbird]

I seem to be experiencing the return of severe PMS with my paxil reductions.  Is this familiar to anyone?

 

Any suggetions on things that might help?  (In the past I've tried the pill, evening primrose oil - neither made any difference).

 

I've had success with vitex capsules, however responses to herbs and supplements vary hugely between individuals, so YMMV.

 

I've been at 22.5mg paxil for three weeks now. 

 

I'll see how things go over the next week days. (When my withdrawal symptoms lift they often do so quite suddenly and then I feel fantastic - mentally 'normal' and physically lots of energy and strength).  But am considering going back up to 23mg for some relief.  (In the past, going back up has brought me relief - and then when I try to go down again, it is usually easier than the first attempt).

 

I'd probably stick it out another few weeks at the current dose.  I'd only updose if things got really unbearable.  If withdrawal symptoms after each drop are so bad you feel like you need to updose to get relief, you might consider doing smaller drops, which should make it a bit easier.

[Kar]

Thanks Songbird.

[Nathalou]

I would not switch to zoloft either. As alto said all new SSRIs have about the same risks. I encourage you to send an e-mail to Dr. David Healy about the matter, he is a specialist in SSRIs and their risks. I've heard he responds rather quickly to patient e-mails.

 

Good luck!

[Kar]

Thanks Silverstar.

 

So I had a break in my depression, anxiety and other withdrawal symptoms and felt really good for a few days.

 

However, now I'm completely exhausted again and emotionally wrought. Also had a diarrohea episode.  Not sure if these are withdrawals, or I've just caught a bug.

But I sleep and sleep and sleep and sleep and sleep!  It's quite amazing.  On weekends I typically sleep 12 hours per day.  On weekdays, 10 hours.

regards

k

[coldturkmama]

I did a CT not realizing I would have WD, and anyway, even now 17 months out I'll have flu-like symptoms that typically involve stomach issues and bejng reallllllly cold.

[Songbird]

However, now I'm completely exhausted again and emotionally wrought. Also had a diarrohea episode.  Not sure if these are withdrawals, or I've just caught a bug.

But I sleep and sleep and sleep and sleep and sleep!  It's quite amazing.  On weekends I typically sleep 12 hours per day.  On weekdays, 10 hours.

 

All fairly normal stuff for withdrawal.  Don't worry about the sleep, sleep is a good thing.

[Kar]

Thanks Songbird and Coldturkmama for sharing your experiences and thoughts.  Much appreciated.

I have that feeling really really really cold thing too!  It's always an indicator to me I'm in withdrawals!

 

cheers

[Prestorb]

Hi Kar! I can identify with wanting to sleep so much and also the worsening of the PMS symptoms. I probably sleep almost 10 hours a night, sometimes interrupted, and still do not want to get up. I think that will change when our doses get lower, but maybe our bodies really need that extra rest for healing? I don't know. And I was extremely irritable, angry and resentful for several days about a week before my cycle this time, which is unusual. I will have to better manage that next time, my poor so and husband!

 

Oh, I had a bad experience with trying to switch to Zoloft in January, which is how I found SA. You can look at my signature, but I don't recommend it. And I had successfully switched ADs before with very little trouble, but I could tell as soon as I was completely off the Paxil that Zoloft was not going to work for me. I'll be following your thread to see how you are doing. I am holding at 10 mg for now after a too fast taper from 40 mg. Best wishes to you, hang in there!

[Kar]

I stabilised for a bit and so have dropped another 1.5mg.

 

Interestingly, often in the first week of a drop I feel a lot better MENTALLY (though wobbly physically). Often takes a week before I get mental withdrawal symptoms.