snostorm: long term Paxil user - making another attempt

[snostorm]

Ok I am just about 2 weeks into an updose to 7.5mg from 5mg Paxil.  I initially experienced some relief however last night I woke in the middle of the night with panic and chest pain.  Today I have higher levels of DP and anxiety than I have had all week.  It has been a stressful week at work and I had a court date earlier in the week.  I'm seeing a Psych NP today who specializes in medication management.  Its becoming tiresome.  I really need to stabilize.  I need to function at a relatively high level at work and its becoming difficult to do.  Is it advisable to stand pat and give it more time or is another updose what I should try.  When I began my taper I held at 10mg for a few months and was stable. That is when I got really stupid and started tapering way too aggressively. My therapist suggested stabilizing at 10mg for a few months and then when my life calms down I can began a slow proper taper. I dont want to screw with my CNS too much.  Would going to 10mg be risky? 

 

Should be interesting to see what the NP has to say. 

 

I need to change my sig as I have access to my medical record through my place of employment. I was guessing to the best of my memory as to what I did.  I was on 10mg of Paxil from the beginning of june until October 2016.

[ChessieCat]

"I initially experienced some relief"

 

"It has been a stressful week"

 

It could very well be that the stress of the week has caused the increase in withdrawal symptoms.  Because these are external stressors, an updose may not lessen the increase in withdrawal symptoms.

 

Paxil is a strong drug.  I don't think making a 25% increase would be wise.  If you do decide to updose, a dose increase of 0.5mg may be enough.

[snostorm]

I would like to update my thread.  I have had a consultation with a Psych NP and I have to say it was very interesting. He says he is convinced that I am reacting to something that I am eating. He suggest an elimination diet.  This caught my interest because when he suggested this I told him that its funny that eating seems to bring about anxiety for me.  Then I came across histamine intolerance..and that led me to histamine intolerance with SSRI's.  Before I started tapering I was having this exact issue of getting all jittery and freaked out after eating. I was thinking blood sugar and suspecting reactive hypoglycemia.  So I got a glucose monitor and when I was feeling symptomatic after eating I checked my sugar and it was not low.  When presented to my doctor he was pretty dismissive of the connection of anxiety and eating.

 

When I googled symptoms of histamine intolerance I almost fell out of my chair.  Watery eyes, flushing, anxiety,,,etc,  I had a lot of these. This morning I woke with low grade anxiety.  Felt fine as I took my medication.  An hour later I had a bowl of whole grain cereal and them WHAM!!!  Anxiety.  I dont want to grasp at straws and I am well aware that when you are suffering with these types of things you tend to place yourself into a diagnosis only to find there is not relief.  However more than anything this has opened my eyes to the possibility that my anxiety problem from the get go before I ever took an SSRI might have been intolerence to histamine or gluten or sugar or something. 

 

Th NP suggested a supplement he has had success with.  Life Extension stress relief that has Lemon Balm and l-theanine I believe.  He also recommended a very high grade probiotic.  Additionally he said try eliminating gluten and dairy to see if that helps things.  

 

Oh and he said if my intention was to get off of Paxil...stay at 7.5 mg and dont updose at this point.  I am also reading of antihistamine properties of Paxil and am wondering if this might be why it was effective in the first place.  

[ChessieCat]

I would strongly suggest that before you take anything you find out exactly what is in it and research.  Here is SA's topic:  l-theanine-for-anxiety-insomnia

 

To search I used google and typed in survivingantidepressants.org l-theanine.

 

Just remember to only make 1 change at a time and to start anything at a low dose and build up.  If you do the elimination diet at the same time as starting the Life Extension, you won't know which is working/not working/causing issues.

[snostorm]

I tried one pill of the life extension stress relief. Didn't feel much other than increased focus. I'm still not stable. But I am functioning. It's hard. I really need to stabsloze now. The DP, and moods are terrible. What if I never stabilize. Should I start s taper? Or updose. Very confused as to my best route to take at this point.

[KarenB]

You updosed less than a month ago, and are also trying out a new supplement, so I would recommend holding for now - as CC says above, one change at a time. 

[snostorm]

I am approximately 4 weeks after updosing to 7.5 mg. I'm not going to updose further at this point. I have pangs of agitation and anxiety low mood but the vertigo and visual disturbances have abated. Had a bout of insomnia last week that really amped up my anxiety. Was freaking but I pushed through it. How long would it be reasonable to give it before I updose? 6 weeks? 2 months?

[ChessieCat]

 

Here is an updated graph of your taper.

 

Because you tapered so quickly at the end of last year, it may be prudent to have a long hold now in order to set yourself up for, hopefully, a better taper.

 

You might consider holding at your current dose for a total of 2-3 months, OR you could hold for 2 months and then try a 5% reduction to see how you go.

 

I had a few hiccups when I started tapering but needed to get my dose lowed quickly because of mild serotonin toxicity.  When I got to 50mg (Pristiq tablets are only available in 100mg & 50mg) I did a long hold of 3 months to give my brain a chance to catch up if it needed to.

 

It is better to hold for a bit longer than to try and reduce too quickly and then have to updose.  If you change your dose too often there may come a time that your CNS becomes sensitised and you run into trouble and end up with lots of issues.

[snostorm]

Im gonna hold at 7.5 at least 2 months and hopefully I level out some more.  Im using a pill cutter on 10mg tablets.  Im doing my best to be precise.  Im wondering how precise I really am.  SHould I adopt weighing these pills to be more precise?  I think Brassmonkey does this.  Can anyone recommend an adequate scale preferably affordable?  

 

Thank you Chess.....

[ChessieCat]

It is important to get accurate doses especially the lower your dose gets.  Paxil liquid is available OR you could to make your own liquid.  From Tips for tapering off Paxil (paroxetine)

 

"Cutting up tablets
To reduce your dosage, cut regular Paxil tablets up with a pill cutter, available at any drug store.

If you get your prescription filled with the 10mg tablets, you may be able to cut them in half or quarters to reduce by 5mg or 2.5mg at a time.

Paxil CR tablets are enteric-coated and not designed to be split. Switch to regular Paxil if you wish to cut up the tablets.

Precisely weighing tablet pieces or crushed tablets with an electronic digital scale
You may wish to precisely measure your dosage with an electronic scale that measures milligrams. These are available for under $30 US. See Using a digital scale to measure doses

Use Paxil liquid to taper
This is the easiest and most accurate way to taper Paxil.

See FDA prescribing information at http://www.drugs.com/pro/paxil.html

Paxil Oral Suspension (liquid) comes in a concentration of 10 mg/5ml.

The ordering code for brand-name Paxil orange-colored, orange-flavored, 10mg/5 ml, in 250 ml white bottles is NDC 0029-3215-48 (http://www.hipaaspac...es/0029-3215-48 )

 

Some people are sensitive to changes in the form of the drug. If you are taking tablets, you may wish to take part of your daily dosage in tablet form and part in liquid for a few days to ease the transition from tablets to liquid.

Use oral syringes to taper with the liquid, see http://survivinganti...ing-techniques/

Make your own liquid
You can make your own liquid with water. See How to make a liquid from tablets or capsules"

 

.

[brassmonkey]

Hi Snostorm-- That's the method I've used my entire taper.  I crush the tablets and weigh the powder to get the dose I desire, which I put in a gel cap.  I played with a pill cutter and scales and found that the pill cutter was very inaccurate.  It would be fine at the higher doses, but below 10mg it's just not accurate enough.  Ten mgs and below can be very touchy and you need to be as accurate as you can, and it gets more important the lower you go.  It's easy enough to do you just need the right approach and take your time to learn to do it right. Either the measuring with scales or using some form of liquid aret effective ways to go about it.

 

I use the gemini-20 scale and size "0" gel caps. Both available on line at a very reasonable price. I paid $35 years ago for the scales I think they're down to $14 now, but don't quote me on that.

 

Best of luck with your continued taper and I hope things stabilize more soon.

 

Brass

[snostorm]

Thanks Brass.  Im wondering if the variation in dosages using the pill cutter is messing with my stabilization.  I am not sure about liquid I had a bad experience and think I want to stay with the tablets. Gonna get the scale and do some calculating.  SO Im thinking about measuring a full pill finding the pill weight and multiplying by .75 to get 7.5mg  out of a 10mg pill to start.  

 

sound about right?

 

many thanks

[brassmonkey]

That should do the trick.  You may want to treat it as a dose change, because you're changing the method used and hold at that level for a few weeks to let things stabilize.  It probably won't cause any problems but it's better to wait a bit before starting to taper again.

[snostorm]

Im stilling struggling a bit.  Having cortisol spikes during the day I think. Always at work maybe its stress.  Im not near a point where I begin tapering.  Im moody and feeling blah.  Its moments like this where I want to try and updose as I become tired.  But don't want to go backwards.

 

A new development is nightmares.  Like Hellraiser type crap.  Its amazing what the mind can conjure up coming off this horrid stuff. Sleep is ok.  Never real restorative restful sleep lots of tossing and turning.  My Psych NP suggested going to 10mg and stabilizing for awhile before I taper.  Not sure im in agreement with that Im afraid more Paxil will be activating.  Ill give it another week and see how I feel.

[snostorm]

Ok im almost 5 weeks in from an updose to 7.5mg  Last night I had I think a window?  Like I felt almost normal.  relatively speaking.  Does the waves and windows pattern of stabilization apply when tapering and or updosing?  Is this just a phenomena when you are off and going through the withdrawal? If I can maintain this sense of well being at 7.5mg is that an indicator of healing?  I was in a difficult place and it was all I could do to not updose further.  Right now Im glad I did not.  But traumatized nonetheless at what I put myself through with that aggressive taper.  

 

Best regards

[ChessieCat]

It's good to hear that you have had a feeling of normal.  That seems to indicate that your updose has worked.

 

Now to be patient and allow your brain some time to catch up.  Here are some links which may be helpful:

 

Keep it Simple, Slow and Stable

Keep Notes on Paper

Rate Symptoms Daily to Check Patterns and Progress

Stabilising After a Reduction - What Does That Mean?

Withdrawal Normal Description

 

This link has some computer and printable spreadsheets:

 

Dr Joseph Glenmullen's Withdrawal Symptoms

[kateinsocal]

Ok im almost 5 weeks in from an updose to 7.5mg  Last night I had I think a window?  Like I felt almost normal.  relatively speaking.  Does the waves and windows pattern of stabilization apply when tapering and or updosing?  Is this just a phenomena when you are off and going through the withdrawal? If I can maintain this sense of well being at 7.5mg is that an indicator of healing?  I was in a difficult place and it was all I could do to not updose further.  Right now Im glad I did not.  But traumatized nonetheless at what I put myself through with that aggressive taper.  

 

Best regards

Hi!

 

I think if you found a window that is a very good sign - that's how I knew I was starting to stabilize. If you can cope with life at this dose (and continue to find windows), you should hang there and try to really stabilize. I'd hate to have you up dose again if you didn't need to! 

 

Glad to hear you've finally found (some) relief! 

[snostorm]

I have made a mistake.  I will never learn.  After feeling better I went down a hole.  I had bad insomnia and it exacerbated my symptoms and I had panic and suicidal ideations as a result.  Now Im not sure if that is the right term I didnt want to kill myself.  But I felt like this is why people do.  Kinda scary.  So my therapist said stop white knuckling it and updose.  SO for the past 2 days I went from 7.5mg to a full 10 mg tab.  I now feel completely wired.  Should I go back down to 7.5.  I know messing around with doses is bad.  But I only took 2 doses of 10mg.

 

FWIW its so hard I know the information I have gotten from this site flies in the face of what I have done.  I was listening to my therapist.  I was desperate. I just what it all to stop.

 

What is the best thing I can do right now?  Stay at 10 and ride it out or go back to 7.5?

[nz11]

snostorm recovery is not linear so you will have good days followed by bad days and then some bad days followed by hell days thats the way it goes

 

What is worse feeling completely wired or completely suicidal?

Don't feel bad about the updose imo i would sit now on the 10 and try to sit it out there for  a few months you have been wanting to updose for a while now and feeling desperate for a while now so its not a failure what you have done just a blip on the exit projectory off this drug.

You might like to expand on what you mean by 'wired'.

One can only take wdl for so long and its impossible for a person  who has not experienced this to understand the suffering involved.

I am very familiar with paxil wdl...please don't be hard on yourself many have had to updose to get stable.

Therapists doctors and pdocs even family members can be very dangerous in wdl you need to find a way as difficult as it is to not lean on these people. Else the outcome is very predictable.

Wishing you stability.

[snostorm]

Wired means anxiety.  amped.  Like there is no way im sleeping tonight. Im under the impression its the Paxil.  I know it takes a few days to get your blood level up. At just two doses at 10 i didn't think this would be the reason I feel such nervousness. but it cant be a coincidence.  Im very  down I thought i was stabalizing just last weekend then I spiraled down.  So I am sensitized to this crap I guess?  

[ChessieCat]

If updosing to 10mg is the only change you have made it would seem that 10mg is now too much for you.  You haven't been on 10mg since June 2016 (according to your signature).  A 25% updose was a big jump.  You might want to consider reducing it and start taking 8mg or 8.5mg.  Unfortunately we can't predict what might happen.  These drugs are strong.  If you are going to reduce your dose it would probably be better to do it straight away rather than leaving it for a few days.

[ChessieCat]

I updosed from 50mg because I got to the stage I couldn't type (I am a professional typist).  Within 4 hours of the updose my foggy head was clearing and I was able to type again.

[MollyN]

Oh my goodness snostorm - the drugs are definitely fast acting as far as I'm concerned - I'd always take my paxil in the morning around 7-8am. On a rare occasion I'd forget and around 3 pm, I'd start to feel very 'off' - off balance mainly, woozy and spacey like I was about to get the flu - then I'd remember and take the drug and within 10mins right as rain. 

 

It was after experiencing this incredibly fast response that I started thinking I'd invited a wild tiger home rather than a domestic cat!

[snostorm]

Ugh. I took 7.5 this morning. I took xanax to sleep which I hate to do but was desperate feel groggy and edgy today. Hate this feeling. Want to go lie in bed. Having difficult time at work. See my psych np today. If I had known the hell I was in for I would have never tapered. Now it seems I can't get back.

[ChessieCat]

Hi snostorm,

 

If the psych np suggests adding in another drug or changing to a different drug, I suggest before you take it that you post here so that we can offer our thoughts.

 

Also, please update your signature with the updose and reduction.  Thank you.

[snostorm]

Ok so first he said it's highly unusual that updosing would cause me increased anxiety. He spoke about melatonin and finding the right dose. I told him I took xanax but hate it. He prescribed me visteral said I should try that. Also klonopin prn. Told him I didn't want to get addicted he said I wouldn't if taken occasionally.

 

I'm on my phone I will update my sig when I get to my PC.

 

Thank you

[ChessieCat]

I've asked the other mods for their thoughts.

[nz11]

snostorm

if you have been taking a benzo or changing its dose can you please update your drug signature.

You need to be up front with ALL drugs you are taking.

It is known that taking a benzo can sometimes have a paradoxical reaction on you and as they wear off you get surges of anxiety.  If i were you i would not take any benzos.

[snostorm]

I took 1 mg xanax to sleep 2 times this week. I have not been taking them. Could that cause anxiety the following day? I am very against benzo. I was desperate to sleep. Should I add that to my sig?

[snostorm]

Why is there such a void in compotent professional help for this.  It just blows my mind.  All they ever say is take this take that.  I scour the internet for information its all so confusing.  And people say stay off the internet you re driving yourself nuts. Your obsessed.  Stop taking advice from people on the internet who you have no idea who they are.  I say have you ever heard of AltoStrata?  I have seen her spoken of on many other sites.

 

They are like who?  Im still searching for a professional who can competently work with me maybe holistically, naturopath, acutpuncture im so desperate im going insane.  

 

as always I am indebted to the mods here.

 

Now im wondering if the anxiety I experienced was following the xanax I took and not the updose.  I know...slow simple and praying for stable.

[Altostrata]

Yes, snostorm, very few physicians even acknowledge such difficulties in tapering and the general public does not know anything about this at all.
 
LOL, I am flattered that you invoked my name. I have worked hard to bring together what is known about psychiatric drug withdrawal. If it's any consolation, I know a few doctors who refer to this site for tapering information.
 
It seems 10mg Paxil was too much for you. Sometimes updosing does help people, but for us, a big updose would be from 7.5mg to maybe 8mg.
 
You know us -- The rule of 3KIS: Keep it simple. Keep it slow. Keep it stable.

 

Now you've had this bad reaction, though, if I were you, I'd stay at 7.5mg. You'll need to be patient and stay as calm as possible while the bad reaction fades. Think of it like the flu, you'll have to get over it. Please let us know how you're doing.

 

PS Yes, Xanax can cause rebound anxiety the next day. Since you were also groggy, it sounds like 1mg is too high a dose for you. It's best to use Xanax at the lowest possible dose and as infrequently as you can. You might also now be hypersensitive to Xanax, be very careful, the rebound anxiety can trigger worse symptoms from Paxil withdrawal.

[snostorm]

Thank you Altostrata, I have been greatly interested in your history.  Especially because of the Paxil connection.  I have seen your responses in article comment sections, as well as being referred  to as the creator of this website in various articles I have come across.  That the professionals I have seen so far know little still just boggles my mind.

 

In my continuing search for a professional who can help me I have come across a practitioner who says she works with people on SSRI's all the time.  Says she can get me off and that I can see her for a consultation. As i know there are no quick fixes my guess is that she will try and implement a bridge to prozac.  In the state im in I would be very wary about that. 

 

Im not doing anything with out consulting this site first.  I have been perscribed klonopin and visteral.  I know klonopin is a no go. Is visteral ok to take at night?

[ChessieCat]

"Is visteral ok to take at night?"

 

Have you seen the links here about sleep?  If it were me, I would be trying non-drug ways first.

 

Sleep problems - that awful withdrawal insomnia

 

Sleep Hypnosis, Guided Meditations, Calming Videos

[snostorm]

I have had some success with melatonin if I'm not too amped. I saw a new NP today. She was interesting. Told her my story. She offers genesight testing my insurance covers I think so I did it. She is suggesting Prozac like I guessed. I asked her how she would do it. She said you would stay in your low dose Paxil and introduce Prozac. When Prozac built up in my system slowly withdraw Paxil. She said she has done this successfully numerous times. Told her I would think about it. Asked her about Prozac being stimulating. Asked her about my increased anxiety when I updosed Paxil. She said very odd. Not common and wasn't convinced it was the Paxil could have been from the xanax. I'm very hesitant to ft this.

 

Any thoughts on the genrsight genetic testing?

[ChessieCat]

Here are a couple of SA topics I found by using google and typing in survivingantidepressants.org genetic

 

genetic-testing-personalized-medicine-liver-enzymes-genotypes-genesightrx-genomind-etc

 

the-importance-of-mthfr-methylation-and-b-vitamins

 

And here is the topic about the-prozac-switch-or-bridging-with-prozac

[snostorm]

I have received my Gemini-20 scale and did some investigating on my doses.  I have been splitting my 10mg tabs in half and then using a pill cutter to split halves into quarters to roughly get 7.5mg.  After weighing some of my doses It is clear that I haven't been getting anything close to what I thought was 7.5 mg.  As this is a powerful med.  Im of the thinking that my dosages have been varying by as much as .75mg. This would compromise stability no?

 

Additionally after seeing my new practitioner she kinda led me onto something I seem to have not given much credence too.  She said you look like you have thyroid disease.  Red face puffy eyes.  I have a very nodular thyroid and recently had a biopsy done.  terrified I had thyroid cancer "health anxiety" i got the path report back and said benign.  But it said something else.  Lymphocytic thyroiditis.  Now this wasnt something new.  Back when I initially started having panic and anxiety issues I had my thyroid checked.  Blood levels were in range.  But nodules back them.  Biopsy benign.  I tested thyroid antibodies positive but not to a large degree.  Was told that this wasnt the cause  that Hashimotos disease was hypothyroid and no connection to my mental health issues was made.  Was told eventually my thyroid would burn out and I would need hormone replacement therapy someday. 

 

So I was put on PAXIL.  Now I my be reaching here but I think there is a distinct possibility I fall into the catagory of people who were put on an anti depressant because of a thyroid condition.  I just was always told it wasnt my thyroid.  I believed the doctors.  Now here I am 15 years into an exposure of Paxil and suffering to get off.  But I my very well indeed be having thyroid issues in the mix.

 

Thyroid issues run in my family.  My mother and grandmother had them.  My basic thyroid panel usually comes within range.  I am now learning they paint a very basic picture and I could have been swinging in and out of hyper-hypo thyroid due to the auto immune attack on my thyroid.  Looking at symptoms list I have them all. 

 

Or I might be driving myself nuts in Paxil withdrawal.  I was always told it wasnt my thyroid.  Im starting to seriously question that.