Carmen's Story: Tapering Paxil

[Carmen]

Hello. I'm Carmen and I am 55 years old. I live in Kansas City, MO. I have been married for 32 years. I have a very supportive husband and family. I was so happy to find this group at a time when I need it most. This is a long story but I'm going to condense it as much as I can. As you can see from my signature, this past year has been a whirlwind of medication changes. 

 

I was first prescribed Paxil in 1998 because I was stressed and depressed from dealing with my (then) 13 year old daughter. She was also prescribed Paxil. We both felt better awhile, but after a few months the medication seemed to stop working for both of us. We both did a very rapid taper and suffered some pretty severe withdrawal symptoms, including "brain zaps".  

 

In April, 2014. I had outpatient surgery to have a new pain pump installed. (I already had a pain pump since 2008 but it was time to change it for a new one). After surgery I was fine. I went home and felt pretty good until the next day. I woke up in the morning feeling sick and shaky so I went back to bed. I had a hard time getting out of bed for 3 days. I had most of the symptoms of withdrawal so my husband took me to the pain clinic. At that time, we were thinking my pump was not working right. My pain management doctor tested my pump and told me it was working fine. He was pretty sure that my problem was anxiety so he prescribed Klonopin. We went home and I took a whole pill and slept for 36 hours, almost straight through.  

 

I felt much better after that episode and I felt pretty good until August. Another episode of all the same symptoms left me unable to function for 5 days. It was then that I had to seek out psychiatric care. I had been having these episodes at least once a month and they would last from one to three days. My Paxil taper in November was very rough because I was still having episodes, plus going through withdrawal from tapering too fast.

 

I have not had an episode since March 30 but I am going through withdrawals from the 10mg Paxil I was put on last March. I have been breaking the pills into halves and quarters. The first week after a drop has not been bad. Just a little nausea and dizziness off and on. The second week has been when the symptoms increase and get worse. Last time I was able to make another drop after 3 weeks. That will not be happening this time. It will be 3 weeks this Friday and I'm still not feeling well. I want to feel well for at least a week before attempting another decrease. My psychiatrist (who is new for me) had suggested half pills for 2 or 3 weeks and then skipping every other day. I told her that wasn't working. I need a much slower taper. Luckily, she is not going to rush me. She told me there is no hurry. Buspar has been helping. I have been needing to take Klonopin more often lately because that is the only thing that helps when I get shaky.  I'm trying really hard not to take it much because I don't want to get dependent on it. 

 

 I have been reading in here for weeks so I decided it was time to post my story. Thank you for reading!

 

Carmen

[Fresh]

Hi Carmen , welcome to the site.  Thank you for posting your story.

 

You probably know by now that the safe way to taper that's recommended here is by doing drops of no more than 10% , and

waiting 3 or 4 weeks at each level.  

It's a good idea to wait until symptoms reside and then allow yourself to be stable at each dose , regardless of how long that is.

It's nice to hear you're discovering for yourself to listen to your body rather than the calendar.

 

Try reading the pinned topic at the top of the Tapering section , "Why Taper By 10%".

 

Best wishes ,  Fresh

[Petunia]

Welcome Carmen and thank you for posting an introduction.

 

Also, thank you for filling in your signature, but I'm a little confused. Were you given lexapro, gabapentin, remeron and klonopin in December all at the same time to treat your paxil withdrawal?

 

Then in January your gabapentin dose was raised. Then in February you switched back to paxil and buspar was added?

 

I'm sorry this has happened to you and I'm glad you have a new doctor now who is helping you get off the drugs, rather than adding more. But unfortunately, it sounds like she doesn't have much experience with how to taper people safely. I'm glad you found us.

 

I put all of your drugs into the interactions checker and there are some potential major interactions:

 

http://www.drugs.com/interactions-check.php?drug_list=1147-0,441-206,703-357,1800-1156,1640-1015

 

Interactions between your selected drugs

buspirone ↔ paroxetine

Applies to: BuSpar (buspirone), Paxil (paroxetine)

Using busPIRone together with PARoxetine can increase the risk of a rare but serious condition called the serotonin syndrome, which may include symptoms such as confusion, hallucination, seizure, extreme changes in blood pressure, increased heart rate, fever, excessive sweating, shivering or shaking, blurred vision, muscle spasm or stiffness, tremor, incoordination, stomach cramp, nausea, vomiting, and diarrhea. Severe cases may result in coma and even death. You should seek immediate medical attention if you experience these symptoms while taking the medications. Talk to your doctor if you have any questions or concerns. Your doctor may already be aware of the risks, but has determined that this is the best course of treatment for you and has taken appropriate precautions and is monitoring you closely for any potential complications. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.

Switch to professional interaction data

buspirone ↔ mirtazapine

Applies to: BuSpar (buspirone), Remeron (mirtazapine)

Using busPIRone together with mirtazapine can increase the risk of a rare but serious condition called the serotonin syndrome, which may include symptoms such as confusion, hallucination, seizure, extreme changes in blood pressure, increased heart rate, fever, excessive sweating, shivering or shaking, blurred vision, muscle spasm or stiffness, tremor, incoordination, stomach cramp, nausea, vomiting, and diarrhea. Severe cases may result in coma and even death. You should seek immediate medical attention if you experience these symptoms while taking the medications. Talk to your doctor if you have any questions or concerns. Your doctor may already be aware of the risks, but has determined that this is the best course of treatment for you and has taken appropriate precautions and is monitoring you closely for any potential complications. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.

Switch to professional interaction data

paroxetine ↔ mirtazapine

Applies to: Paxil (paroxetine), Remeron (mirtazapine)

Using PARoxetine together with mirtazapine can increase the risk of a rare but serious condition called the serotonin syndrome, which may include symptoms such as confusion, hallucination, seizure, extreme changes in blood pressure, increased heart rate, fever, excessive sweating, shivering or shaking, blurred vision, muscle spasm or stiffness, tremor, incoordination, stomach cramp, nausea, vomiting, and diarrhea. Severe cases may result in coma and even death. You should seek immediate medical attention if you experience these symptoms while taking the medications. Talk to your doctor if you have any questions or concerns. Your doctor may already be aware of the risks, but has determined that this is the best course of treatment for you and has taken appropriate precautions and is monitoring you closely for any potential complications. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.

Switch to professional interaction data

clonazepam ↔ paroxetine

Applies to: Klonopin (clonazepam), Paxil (paroxetine)

Using clonazePAM together with PARoxetine may increase side effects such as dizziness, drowsiness, and difficulty concentrating. Some people may also experience some impairment in thinking and judgment. You should avoid or limit the use of alcohol while being treated with these medications. Avoid driving or operating hazardous machinery until you know how the medications affect you. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.

Switch to professional interaction data

buspirone ↔ gabapentin

Applies to: BuSpar (buspirone), gabapentin

Using busPIRone together with gabapentin may increase side effects such as dizziness, drowsiness, and difficulty concentrating. Some people may also experience some impairment in thinking and judgment. You should avoid or limit the use of alcohol while being treated with these medications. Avoid driving or operating hazardous machinery until you know how the medications affect you. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.

Switch to professional interaction data

paroxetine ↔ gabapentin

Applies to: Paxil (paroxetine), gabapentin

Using PARoxetine together with gabapentin may increase side effects such as dizziness, drowsiness, and difficulty concentrating. Some people may also experience some impairment in thinking and judgment. You should avoid or limit the use of alcohol while being treated with these medications. Avoid driving or operating hazardous machinery until you know how the medications affect you. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.

Switch to professional interaction data

clonazepam ↔ mirtazapine

Applies to: Klonopin (clonazepam), Remeron (mirtazapine)

Using clonazePAM together with mirtazapine may increase side effects such as dizziness, drowsiness, and difficulty concentrating. Some people may also experience some impairment in thinking and judgment. You should avoid or limit the use of alcohol while being treated with these medications. Avoid driving or operating hazardous machinery until you know how the medications affect you. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.

Switch to professional interaction data

gabapentin ↔ mirtazapine

Applies to: gabapentin, Remeron (mirtazapine)

Using gabapentin together with mirtazapine may increase side effects such as dizziness, drowsiness, and difficulty concentrating. Some people may also experience some impairment in thinking and judgment. You should avoid or limit the use of alcohol while being treated with these medications. Avoid driving or operating hazardous machinery until you know how the medications affect you. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.

Switch to professional interaction data

 

Please see:

 

Why taper by 10% of my dosage?

 

Tips for tapering off Paxil (paroxetine)

 

Please feel free to write whenever you want, you will find a lot of friendly help and support here.

 

Petunia.

[mammaP]

Hi Carmen, welcome to SA. I am a bit surprised too at the drugs you have been prescribed in such a short time. Sadly there are several members in similar situations with multiple drugs but it still shocks me when I see others posting similar experiences. As you have had so many changes and been tapering paxil very quickly I would suggest that you hold where you are for several weeks to stabilise. Your nervous system is struggling if you are having withdrawal symptoms and needs stability.  You say you have been taking klonopin more often lately, is that once or twice a week?  

 

When you are stable and ready to start tapering again, I would recommend getting the paxil liquid as it is much easier to get accurate doses for tapering. Petunia has given you the link for tapering paxil. 

 

Many people find that fish oil and magnesium help with symptoms. 

http://survivingantidepressants.org/index.php?/topic/36-omega-3-fatty-acids-fish-oil/

http://survivingantidepressants.org/index.php?/topic/1300-magnesium-natures-calcium-channel-blocker/

[Carmen]

Thank you all so much for responding. 

 

Petunia, I was given all those meds in December because I was having frequent panic episodes. My therapist told me it is unusual for a panic episode to last 3 days or more so we are still not entirely sure what was happening. I know it's confusing. I am still confused by the whole thing too. 

Thank you for the drug interaction info. I have the symptoms of serotonin syndrome printed out and it is on my fridge. I had my husband read it so he knows what to watch for too.  

 

Fresh, I wish I could make smaller cuts. I tried to get liquid Paxil from my pharmacy but they said it is only available in name brand and very expensive. So I'm just doing the best I can by cutting them in halves and quarters. I will not make any more cuts until I'm feeling stable for at least a week. 

 

mamaP, I had only been taking Klonopin 1 or 2 times a week. Now I'm taking it 3 or 4 times. I never take it more than once a day unless I am in an episode. I am so thankful that has not happened since March 30. I'm going to try the fish oil and magnesium. 

 

I love this site. It's like a safe haven

 

Carmen

[Altostrata]

Welcome, Carmen.

 

The tips for tapering Paxil topic explains how to make your own liquid from a tablet with water. Many people have done this and it usually works well.

 

It sounds to me like you have been getting episodic adverse (paradoxical) reactions from your pain drug, or perhaps glitches in the pump itself. The anxiety diagnosis sounds like nonsense to me.

 

What drug is in your pain pump?

 

Petunia very helpfully showed that your drugs probably are interacting in a bad way. Your doctor should know better.

 

Why were you put on mirtazapine?

[Carmen]

Thank you Altostrata. My husband is going to read about making liquid paxil because I can't understand it. My mind is pretty messed up since I started tapering.

 

My pump medications are Dilaudid, Clonopin and Bupivicaine. My therapist is still not convinced that my problem is not withdrawals from those medications. I am undecided because my episodes started becoming less frequent after I started Buspar.  It is a strange coincidence that this all started the day after I got my new pump. My pain management doctor insists it is not the pump and he won't listen to any arguments. 

 

I was put on mirtazapine because I was having trouble sleeping. It helps a lot. 

[Altostrata]

Please put ALL the drugs you take in the Drug Interactions Checker http://www.drugs.com/drug_interactions.html and post the results in this topic.

 

What is it you'd like to accomplish by participating on this site?

 

Very few doctors or therapists are aware of the adverse effects of these drugs and fewer know anything at all about withdrawal syndrome.

 

Have you never discussed the very large number of neuroactive drugs you're taking with any of your doctors?

[Carmen]

The drugs in my pump are very minute quantities. I have put them in the Drug Interaction Checker before. They all show up "Major Interactions".  They are much different than taking pills because they don't go through my system. My catheter is in my neck and goes straight into the spinal space so you don't need much. 

 

I have discussed these drugs with all my doctors and none of them seem concerned.  

 

The reason I joined this site is because my new psychiatrist is taking me off Paxil and I know how hard it can be from past experience. I want to learn easier ways and I would also like to share what I learn with others going through the same process.  

 

I might also want to eventually taper down from Gabapentin, as I'm not sure it is helping much either.

 

I just ordered a scale to make liquid.

 

I'm sorry if I'm not very good at explaining things right now. Next week should be better, fingers crossed. 

[Altostrata]

You do not need a scale to make the liquid. You would use a whole tablet and titrate with an oral syringe.

 

Doctors are irrationally sanguine about adverse reactions from psychiatric drugs.

 

Given all you're taking, if I were you, I'd want to minimize any drugs that are not absolutely necessary. I would also be concerned about the major interactions indicated above.

[Carmen]

I totally agree. I have never taken many pills before. I told my psychiatrist from the beginning that I wanted to keep it as simple as possible. 

 

I'm glad I ordered the scale. It's going to make things so much easier, especially if I don't need to make liquid . I'm such a newbie but I will be an expert like you all soon

[Altostrata]

In my opinion, it's much easier to taper with a liquid.

[Carmen]

Thank you. Sorry, I was mixed up with another answer which was "You don't need to make liquid if you have a scale".  I get mixed up easily lately, especially when I'm tired.

 

I appreciate you all so much for taking time to help me.

[Carmen]

A little update: I am feeling so much better than I was when I posted.  I took an extra week off to make sure all my symptoms were gone. My head is much clearer. I just started my 10% taper. 

 

I just wanted to thank you all again for your help and advice. I will let you know how it goes.

 

Carmen

[Iamfine]

Hang in there Carmen, it gets better. Paxil helped me too for a short time but I tapered off after it pooped out.

[Altostrata]

That's very good to hear, Carmen.

[Carmen]

Thank you both

[JanCarol]

Hey Carmen!  KC,MO!  I lived there in 1972!  (blast from the past!)  I even still remember my address on W 67th street - just a block from the Kansas border!  I remember the year we lived there, a tornado took out 6 houses on the Kansas side of 67th Street.  I remember huddling in the crawl space because the basement opened out into the back yard and wasn't safe for tornadoes.  In fact, I had my birthday party in that crawl space - maybe that was the day that the houses up the road got hit?

 

I spent more time in KC, MO in the 80's and 90's, made a best friend there, and she came to Indiana to live with me.  But enough about me.  I do remember that KC was a beautiful city, lots of fountains, and it had a thriving "alternative" community.  I still wonder about many of the friends I made there in the 80's and 90's.

 

I'm going to chime in with your therapist:  I think you are having "interdose withdrawal" from the klonopin in your pump.  Interdose withdrawal is why you never do "every other day" stuff with psych meds.  NEVER.  Your doc doesn't have a clue on that one - but - don't be alarmed, most of them don't.  

 

It is my guess that you had already built up resistance to these drugs, and when you were given anaesthetic for surgery, it stripped you of some nutrients, and when the pump came back online, you were more sensitive.  I don't know how a pump works, it's supposed to be small, constant doses of the drug, right?  But if one drug is not working - can you change the mix of drugs in the pump?  Or are you stuck with that mix until you replace the pump?

 

(growling under breath:  dear doctor, opoids are not as bad as these drugs are!)

 

You will need liquid taper.  Paxil is a very strong, sensitive drug.  That is, it will knock you for a loop if you are not careful.  You can buy liquid Paxil, you don't need to make it up yourself, if that is too intimidating.

 

Welcome to SA, KC Carmen!

[Carmen]

Well hello JanCarol from KC! It's so nice to meet you. Isn't it funny how we can remember addresses and phone numbers from that long ago? KC is a beautiful city. I love it here. Have you tried looking up some of your old friends on Facebook?

 

Thank you for your input about my meds. That makes perfect sense about my surgery. They gave me Ketamine so I was not all the way asleep but I remember having an almost euphoric experience. You are right, my pump meds are small, constant doses. I don't have Klonodine in my pump. It sounds similar but it is Klonopin. It is a strong blood pressure medication. The others are bupivicaine (a numbing agent) and Dilaudid.  This mix of has worked for me very well since I got my first pump in 2008.

 

Although my symptoms mimic withdrawal, I now believe that they were mostly severe anxiety. I am sure some of it was withdrawal though.  I had to wait 8 hours in pre-op before surgery, which was nerve wracking. I have been doing pretty well with my taper using my little scale. I had some symptoms few days after the first 10% taper but they were relatively mild and only lasted 3 or 4 days. I will definitely not be trying the "every other day" my psychiatrist recommended. I don't understand why these doctors think that could work when this is their job.  

 

Thank you so much for your warm welcome JanCarol

[Fresh]

That's excellent news Carmen. Here's to future smooth decrements

[Carmen]

Thanks Fresh

[Fresh]

Hi Carmen ,  I've been wondering how you are this week?    Happy 4th July  

[Carmen]

I'm doing fantastic this week Fresh. Thank you for asking. How have you been feeling? Happy 4th of July to you too.

[Altostrata]

Carmen, please let us know how you're doing as your taper proceeds.

[Carmen]

Hello

 

Thanks for asking about me Alto. It's been up and down. I dropped down again yesterday and I am already feeling it today. It usually takes a few days to feel the affects but every cut is different.  I'm having insomnia, feeling very dizzy and my head hurts. 

 

The last time I saw my doctor she told me it would get easier as I go down further. I did not believe that and I sure don't believe it now. 

[Altostrata]

No, it gets more difficult at lower dosages, there's less of the drug to affect the receptors.
 
You may wish to taper with smaller decrements at this point, even Micro-taper instead of 10% or 5% decreases

[Carmen]

I had not seen that. Thank you so much for the link.