Vonnegutjunky: Paxil 10 mg for 8 years - partial wean with reinstatement

[nz11]

Sorry to ask but Vonnegutjunky have you considered doing the survey?

Nz11

[Vonnegutjunky]

Already did - thanks 

[nz11]

You're the best ...great stuff.

[Vonnegutjunky]

Well I have been down to 9 mg for 2 days now- I feel that flu sickness, dizzy head, but I also feel better in other ways- I no longer feel like I'm losing my mind- I will stay here until I stabilize, no matter how long that may be, unless I feel the akathisia comeback - also I am going to be back on my 24 hours dose from tonight on out - next drop will be less than 10% - I only did that to rid myself of the akathisia and it seems to be helping thus far 

[Vonnegutjunky]

So I have been down to 7.8mg for 1 day now - was at 8mg for the last 10weeks 

 

i am am wondering if alto can reply to this post? I would love her insight - 

 

i had had an adverse reaction at 20mg of Paxil (never took any other meds)  

And the adverse reaction would come in waves and windows (at that point the windows were only slightly better than the waves)  

 

now that I am down to 7.8mg 

i have windows where I feel completely normal - but the waves are almost as bad!!! 

 

My question is this - 

 

how might I be able to tell the difference between an adverse reaction, and withdrawal effects? 

 

Because if what I’m starting f to feel is withdrawal, I am going to slow my taper - if it’s still adverse reaction, I won’t hold it for an extended period of time- (I won’t hold for longer than 3 months of its an adverse reaction) if it’s withdraw effects I will hold longer - 

 

just need some advice 

 

thanks 

[nz11]

This is not a post or a reply simply an interlude of thoughts while Alto gets a coffee and squeezes in some last minute Christmas/holidays eve shopping and a visit to her many amazing elves at the sa office staff  party.

 

Congratulations on doing some great safe tapering 7.8 is a great new low.

 

I would be tempted to just lump everything into the wdl basket myself.

I mean if you can hold an adverse reaction for 3 months then maybe its not an adverse reaction. What do you mean by a.r. ? 

So you are having an adverse reaction then what ?...quit the drug real fast...then get slammed so hard by wdl it will make a.r. look like a sunny day so you ri ?

 

So what I think you are saying is you are getting some windows and then you are also getting some waves. It sounds like wdl to me.

Not sure an  adverse reaction would have windows?

 

Try not to stress. 

Maybe some more long holds are in order.

 

nz11

 

[Altostrata]

LOL, those elves, so much fun when they're tipsy.

 

VJ, an adverse reaction would come at a fairly predictable time after you take the drug, likely to be more intense shortly after ingestion. If your symptoms occur at random times, they're more likely to be withdrawal symptoms or a shaky autonomic nervous system.

[Vonnegutjunky]

I like your logic nz - 

my ar was increasing horror and urges to move my face and hands on the 20mg - I had many many other symptoms and because of this I got it in my head that the drug was “poisoning”and causing acute irreversible brain damage - 

 

but your right, I don’t have much of a choice whether it’s ar or wd- 

 

i guess i would feel better knowing it was wd, and knowing the waves will pass- inseaed of worrying that the poison is building up in my system and causing brain damage - 

 

i felt really good last week 

 

and this past week I have just felt horrible, I genuinely thought I was going to lose my mind yesterday- and the feelings or doom and fear and depersonalization are just so overwhelming again - and it really upset me because I was feeling so much better  

 

thanks for your replies 

ill keep going slow and pray that I find some extended stability after 3 years of this up and down. 

[Vonnegutjunky]

Hi all, just checking in.

i am currently on 7.5mg of Paxil - you can see I’m taking my taper at a snails pace. 

 

After extensive blood work last month I was diagnosed with myalgic encephalomeylitis - 

 

my liver enzymes are elevated and my crp levels are double the normal - 

 

curretly changing my diet - to try to reduce the inflammation- I can’t say if the paxil caused this or just stress and trauma from my life - but I’m 100% sure it’s the reason I had such a bad reaction to my reinstatement and updose years ago- 

 

many many people in the M.E. community have an abnormally reduced metabolism- some researchers suggest ME is a form of “hibernation” where you don’t properly use your energy? Or something to that effect. 

 

I am much improved - still struggling but much improved- 

[dreamspirit]

Hi, what was your liver enzymes number? Mine have been elevated by 8 points. Mine always go up and down. 

Whats crp? 

Glad to hear you have improved ❤️

[Vonnegutjunky]

Hey, sent you a dm too, 

27 is my last test score for the GGT, 

 

CRP is a test that they do to see if,you have systemic inflammation. They don’t know what is causing the inflammation per se, but it’s one of the tests  they use to diagnose CFS/ME 

[Vonnegutjunky]

So I’m taking another cut in my Paxil (the pill that turned on me and gave me horrible akathisa ) I am so nervous, so it will be a another microdrop making it a total of a 1mg drop in 7 months. I am so afraid . I am so scared. I remember trying to go off this before and the horrible horrible withdraws. But right now I am not doing well and I feel like it’s because the med is still so strong in my system 😞  Pray for me. 

Right now I am at 3.8mg off a 12.5 mg pill 
The 10mg weighs 12.5 on the scale. So I’m not sure my actual dose at 3.8 off, it’s around 6.8 I think, because of the fillers. 3.125 off a pill is 7.5 mg 

Anyone good with math?

[ChessieCat]

mgai is mg active ingredient     mgpw is pill weight (the physical weight of the tablet)

 

10 mgai = 12.5 mgpw

 

1 mgai = 1.25 mgpw

 

OR

 

0.8 mgai = 1 mgpw

 

 

Multiply the (physical) weight of the tablet you are taking by 0.8 mgai to find out what dose you are taking.

[Altostrata]

Vonnegutjunky, how are you doing?

[Vonnegutjunky]

Hello Alto. 

 

I have a lot more normal days now. I can now tell that the medication is leaving my body and I am now experiencing withdrawals, but they aren’t as bad as the adverse reaction. 

 

Most days i feel normal, fatigued, depressed, anxious, but normal. 

 

I seem to to be good for 2-3 weeks at a time now, then I have about 5-7 days of anxiety, insomnia, and what seems to feel like ocd. Then I start feeling better again. 

 

I currently take progesterone cream, and folate but no other supplements at the moment. 

 

[Vonnegutjunky]

Hello - I need some math help with my taper please - 

 

When I weigh my pills the 10mg pills actually weigh anywhere between 12.3-13.0 mg 

 

What I have been doing is taking 3.7mg off of each pill regardless of weight - because I know there is 10mg in each pill that means filler is the only difference - 

 

Anyway I think I’m doing this wrong - as I get lower and lower on my dose I’m afraid this will affect me - 

 

I dry cut and weigh my pills - 

Could someone let me know if I’m doing this right? 

 

Thank you

[ChessieCat]

You need to work with averages.  Check out the posts by BrassMonkey in this topic: using-a-digital-scale-to-measure-doses

 

 

          active ingredient in a tablet is abbreviated mgai

 

          pill weight of tablet abbreviated mgpw

 

 

Weigh 10 tablets and divide by 10. 

 

To give you an example to follow I'll pretend that the average = 12.5mg.  You will need to substitute the actual average weight and recalculate the numbers using the example.
 

10 mgai = 12.5 mgpw = 0.0125 gpw (scale reading)     1,000 mg = 1 g so you divide 12.5 mgpw by 1,000 to get the scale reading

 

Divide all parts of the equation by 10

 

1 mgai = 1.25 mgpw = 0.00125 gpw (scale reading)

 

Multiple by all parts of the equation by 7

 

7 mgai = 8.75 mgpw = 0.00875 gpw (scale reading)

[Altostrata]

Wow, very impressed by those maths, Chessie!

 

VJ, do those 5-7 days coincide with the same part of your menstrual cycle? We have some topics about this. There must be some  way to manage it.

 

Did you find you couldn't tolerate Paxil liquid? This might be a good time to start a crossover.

[Vonnegutjunky]

Thanks chessie - ok yes my average is definitely 12.5 my pills are almost always either 12.5 or 12.7 mg 

 

so how I’ve been doing it is take 3.7mg off every pill no matter what it reads - and in 6 months I’ll go down to 4mg off my pill - because I’ve been making such small cuts I’ve not bothered  doing a percent reduction yet - I’ve been taking off a few milligrams every few months - 

 

so taking off the same amount on each pill is ok? I know on my scale it reads .0125 or whatever and that’s 12.5 and I will cut 3.7 off and it will read .088 

 

but im more concerned when im weighing a 12.9 pill and taking 3.7 off that too - am I taking the nearly the  same dose? 

 

Alto, liquid isn’t an option for me - I’m too afraid to try it and I would have to jump through hoops to get it - when I get that low I will either reconsider trying the liquid or dissolve it in water, or just lick the crumbs off the damn scale 😂😂😂

 

im getting a better, scientific scale when I get below 5mg 

 

also I haven’t had my menstrual cycle in almost 4 years - I went into early menopause my integrative medicine doctor believes I did due to my ME - that and menopause could be the cause of my setbacks every few weeks - I am being patient to see if it’s residual effects of my adverse reaction - I don’t think it’s withdrawal related at all- 

[Vonnegutjunky]

Really needing help right now. This depression hit, nearly out of the blue. And it’s heavy, and I feel awful, and I don’t know what to do to cope. I am barely functional, I feel like I did before I ever took the Paxil. 

 

Any coping mechanisms would help. I feel horrible, it’s nit akathisia, thank goodness, but it’s heavy heavy depression. 

 

Any suggestions are wlcome. 

[Gracee]

Hi @Vonnegutjunky, I just saw your post.  I am not much help to you, sorry to say.  I suffer from anxiety big time but not much depression.   When I'm miserable, I distract myself as much as possible with movies, tv and games, soaking in a tub, preparing food.....anything to take my mind off my mood.   I wish I could help.  If you need someone to talk to about what you are feeling, feel free to message me.

 

[Vonnegutjunky]

Thanks Gracee, thank you so much for your reply -  I am usually pretty anxious, but not recently, just down mood, but I think It May be menopause making things worse.  I’ve been taking some hrt, and I think it might be too much. 

 

Normslly i can distract , but this chem out of the blue and it hard, I was holding back tears and could barely talk, I needed to sleep. I feel a little better sine I slept but it was intense. Now I have restless legs, reminiscent of my akathisia, I may be having some residual effects. 

[Vonnegutjunky]

So I was put on progesterone cream last November.... about 9 days ago, out of the blue, I crashed with a horrible wave of depression and almost akathisia like symptoms again, something I hadn’t felt in a couple of years now. Then today, it’s lifted and I feel much better. 

 

Menopause, chronic fatigue, metabolic issues and withdrawal are making things really bad for me at the moment - but increase trying to stay positive and not so scared. 

 

Still at 3.7 off my 10mg pills 

[Vonnegutjunky]

I feel like I’m in the same boat as you ladies 

I am tapering my paxil (it caused my akathisia which is now gone) I am down to 6 mg now and getting suicidal depression again (which is why I got put on it to begin with) 

 

I see a therapist a good one (but like last time it’s not helping with the severe depression and intrusive thoughts )  

 

Everything I’ve read about major depressive disorder is that it will last for years if you don’t get on medication. 

 

Well I can’t take medication, I know the chances of me getting akathisia from a new med is too great for me to risk it. 

 

I was so good on my paxil - I stupidly went off it because it’s messing with my liver - I can say 100% I’d rather have liver damage than this - 

 

the med gave me cfs too. 

 

I dont know what what to do - I feel so stuck - I would use another med if I knew it would help 

 

Edited February 9, 2019 by ChessieCat
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[savinggrace]

Vonnetgotjunky,

 

Looking at your tapering schedule, I am sure I would not have survivied that fast of a taper.  To many, it was appropriately paced, but with you experiencing CFS and major depression, your brain is telling you to STOP and let it adjust.  A 50% reduction in less than 3 months at the outset is huge for a sensitized person.  I know you just want off, like we all do, but your chances of being successful are way better if you hold, possibly for a long time, and then resume a much slower taper. (forget about 10% of the current dose; listen to your body and its symptoms)   I am tapering so slowly that most people would accuse me of not tapering, but it is all I can handle and still participate in life.  Yes, I am having terrible symptoms, but I have better days once in a while.  I WILL NOT take any other medication, or up my dose of anything.  It is too late for that.  Did you stay on 7 mg. for a while and feel better or did you decide to just taper anyway since you don't feel better.  I have just resumed my taper of trileptal (2% cut) and it might has well have been 10%....my brain is soooo sensitized.  You are lucky.  You are much younger than me.  I urge you to try and stabilize even if stabilizing means feeling miserable most of the time.  I suspect things can get better, but will get worse if you don't....unless you JUST made the cut from 7-6 mg (your signature doesn't indicate when or how you did this cut).  Then, if it hasn't been too long, you could consider updosing back to 7, but that is for you and the mods to decide.  I have never upped my dose once I cut it, but I have never made large cuts either.  7 down to 6% is a 14% cut.

 

I know how stuck you feel.  I have felt that way for 10 years.  I am just gonna keep chipping away until I die, accepting that that is how it is.  Believe me, I understand.  I just can't imagine going that fast.  It's time to slow down.  Maybe alternative therapies would help you.  I am sorry to not able to tell you what you want to hear.  You have a lot of courage to do what you've done.  Use some of that courage to slow down.  Perhaps that is your only choice now, unless you want to chance throwing other drugs in the mix...which will land you in the same place eventually.

 

As always, this is just my opinion.  I am suffering on the slowest taper ever.  I think I would have been totally incapacitated by a faster taper.

 

Grace

[Rachellynn]

I’m stuck too. I’m on 7.5 remeron for sleep and my friends/family/Dr.s are urging me to go back on Prozac after i CT in 2015 - they told me there was no withdrawal - how dumb am I?!?! The remeron stopped working and i sleep maybe 2 hours per night. I thought i was healing but any stress at all is a setback and in life you can’t avoid stress. I guess i have to ride this out. It’s my birthday and I’m really discouraged today...

[Gracee]

7 hours ago, Rachellynn said:

I’m stuck too. I’m on 7.5 remeron for sleep and my friends/family/Dr.s are urging me to go back on Prozac after i CT in 2015 - they told me there was no withdrawal - how dumb am I?!?! The remeron stopped working and i sleep maybe 2 hours per night. I thought i was healing but any stress at all is a setback and in life you can’t avoid stress. I guess i have to ride this out. It’s my birthday and I’m really discouraged today...

 

Happy Birthday Rachellynn,  It is your birthday so you must feel better and celebrate today.   Here are my three steps for feeling better during WD:

1.   Distraction

2.  Distraction

3.  Distraction

Hugs,

G.

[Gracee]

16 hours ago, Vonnegutjunky said:

 

I see a therapist a good one (but like last time it’s not helping with the severe depression and intrusive thoughts )  

 

 

 Hi Vonnegutjunky, Does your therapist use CBT in his/her practice?   I've found CBT helps with intrusive thoughts.  

 “Laughter and tears are both responses to frustration and exhaustion. I myself prefer to laugh, since there is less cleaning do to do afterward.” 

[Vonnegutjunky]

Happy birthday rachelle! 

 

Yea, he does cbt, 

 

i dont know if people can really read my signature right, it’s taken me almost 4 years to get down to 3.7 off from 10mg - I am going really really slow, about 1mg per year. 

 

However I think I should stop tapering for now. 

 

Really have a difficult time coping with suicidal depression, which is why I loved Paxil, it kept it away for years! But my metabolism isn’t working ow,and my liver is becoming damaged. I don’t want to fight with my brain anymore. 

 

That being said, I feel I could take some steps to help reduce severe depression in the future, some lifestyle changes will be helpful. 

 

I had that akathisia for so long, I let myself go. I quit eating healthy, I quit meditating, I quit everything. So maybe getting back to taking good care of myself will be helpful in coping. 

 

And i know amino acids could be beneficial. 

 

I guess because for the first time in my life, after taking Paxil my anxiety went away completely, I feel like that was the only thing that will ever really work. I started having anxiety attacks when I was a toddler. I clearly remember them, panic attacks started in the 2nd grade. 

So I guess I feel doomed, like no matter what I did growing up, I always had them, when I was 30 years old is when I was put on Paxil for the first time, and it made me feel so nomal. I wasn’t afraid  to go to the beach, the worrying and abstract intrusive thoughts abated. 

I guess I feell Ike since the only relief I ever got was from a pill, that will be the only way I will ever be able to get relief. And now that’s gone, it no longer an option. 

 

Just feleing sorry for myself. 

[savinggrace]

Hi Vonnetgutsky,

 

I am following you and am now indeed very confused about your taper...sorry if I am  not getting it, as you are clearly trying.  You mentioned on Saturday that you were down to 6 mg. paxil and yesterday you mentioned being down to 3.7.  Yes, 4 years is indeed a slow taper from 10 down to 6 or 3.7?  I think there was some jumping around in there (we all do it...trying to find our way).  I think updating your signature would really help.  The current signature has you at 7 mg. so still a 14% cut if you are at 6 mg. and way more if you are at 3.7.

 

i think you have right concluded that you need to stop changing everything and hold OR if you really are at 3.7 maybe a small updose would help?  That would be advice given by a moderator though.  I apologize if I came off too strong but your previous signature show a lot of big cuts fairly close together.

 

It seems like 1 mg. a year is very doable, though not from a place of bad destabiization.  If you are not advised to up-dose at all, throw out the calendar.  It has no relationship with you rmind/body.

 

Grace

 

 

[Vonnegutjunky]

Thanks grace. 

 

I was down down to almost 6mg, that was at 3.7 off a 10mg pill, but the pills actually weigh around 12.5mg so I’m never really sure what dose I’m at, just how many mg I cut off the pills. 

 

I did updose a few days ago, back up to 3.4 off instead of 3.7 off. It puts my just above 7mg now, somewhere around there. 

 

I am 1000% convinced 99% of my problems with the medication is liver related. I am not always metabolizing themed correctly, also I got genetic tests to show I am an ultra rapid metabolizer of meds that use the  cyp450 pathway. And for a few weeks I feel fine, then bam I feel awful for weeks. 

 

So so I am starting to bee a little better today, I go to Therapy and talk about my fears and anxiety and try to calm myself down. But it is really hard, everything is really hard. But I keep fighting each day. 

 

I suspect, a new medication will just cause me another adverse reaction due to my metabolism, so now the only way to the other side of all of this is through it. I fight through the constant fear every day, the feelings of being actively psychotic, and terrified of losing my mind. I fight though it each day. I quit working, becuse I can’t when I barely  feel like I’m in reality. If I didn’t have my husband I would be in an institution, drugged up and permanently committed. Becuse life, showering, dishes, it’s all too much right now, but I keep doing it. 

 

Needed to rant. Xoxox

[Vonnegutjunky]

Sorry mods if I can’t post this here, just looking to see if anyone has access and can post it for me. 

(Mod Note:  moved from Journals forum)

 

Is there anyone who may have access to this article? 

 

https://www.sciencedirect.com/science/article/pii/B978012813333000007X

 

Edited February 15, 2019 by ChessieCat
added mod note

[ChessieCat]

I've found these:

 

https://www.researchgate.net/publication/230796335_Monoamine_Theories_of_Depression_Historical_Impact_on_Biomedical_Research

 

Monoamine Theories of Depression: Historical Impact on Biomedical Research

 

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3282597/   The discrediting of the monoamine hypothesis

 

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3981571/  Revisiting the Monoamine Hypothesis of Depression: A New Perspective

[Vonnegutjunky]

Oh thank you! I bet these are what they used to write the chapter in the book - thanks a lot Chessie!! 

[ChessieCat]

You're welcome.  I glad I was able to find them for you.

 

I've moved the information to your Intro so it doesn't clutter the Journals forum.

[Vonnegutjunky]

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