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SkyBlue

SkyBlue: Paxil taper

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Hi everyone, 

 

So glad to have found this forum in my journey weaning off Paxil. 

 

Because of severe withdrawal symptoms during my doctor's recommended tapering schedule, I'm weaning off Paxil painstakingly slowly (liquid prescription, with a syringe). I have a question about tapering at smaller doses. 

 

I accidentally missed a dose (just 1.2 mg.) on January 17. 

 

Anyone who has taken Paxil knows that you do. not. skip. a dose. I don't know how it happened, but I forgot to take it one night (for the first time in about ten years). 

 

For the next TWO WEEKS, I was nauseous, had trouble eating, had mood swings, and worst of all, had some very scary depersonalization (feeling like I was in a dream or on LSD). Very scary. 

 

So, this can really happen from just missing a tiny 1.2 mg. dose? I called my doctor and they said this "isn't because of Paxil." Lol. Thanks so much! (This is why I'm so grateful for this forum--people actually dealing with the reality of tapering off these medicines.)

 

Wouldn't tapering get easier as I get down to lower doses? ? 

 

What am I going to do at lower doses? The 10% method sounds good in theory, but yikes -- it will take forever just to get off 1.2 mg. 

 

My eventual goal is to get off Paxil and Zoloft, but my primary goal is to stay alive.

 

I appreciate your thoughts and opinions!

 

Thanks!

 

 

 

I ran out of room in my signature for my quite-lengthy history, so I am expanding it here since this is my intro post

 

 

On Paxil since 1996--anxiety and depression. It worked for a while, but had to keep increasing it. 

20 mg --> 40 mg --> 60 mg. 

 

For years I've wanted to get off it -- it wasn't working anymore, but very difficult to come off.

 

Early 2013--Getting treated for sleep apnea (with CPAP) eliminated about 75% of my anxiety. Who knew?!?!? How long had I had sleep apnea, but treated anxiety with meds?

 

March 2013: Feeling so good with CPAP treatment that I started weaning off Paxil about 10 mg/month: 

60mg to 50 mg to 40 mg (NO negative effects whatsoever--if anything, I just felt better and better.) 

 

July 2013-- went from 40 mg to 30 mg. Some dizziness; nothing major. Starting a new job; paused taper.

 

June 2014, began Paxil taper again, going from 30 to 20 in one week. (I can't believe that a medical professional actually advised me to do this.) This was very, very bad (dizziness and suicidality--the first time in my life--very scary), so went back to 25mg. 

 

Stayed at 25 mg. for another year. Not looking forward to going back down and continuing taper!

 

In June 2015 started a cross-taper while adding Zoloft--went from 25 mg. Paxil to 20, to 10, to [this was the most difficult one] 5.) The cut from 10 to 5 mg gave me akathisia; nausea; suicidal thoughts; rage; and severe anxiety. Most of my time was consumed in dealing with Paxil tapering effects.

 

August 2015 -- obtained a prescription for liquid Paxil

 

September: 4 mg Paxil

 

October 2015: Suicidality -- doctor advised me to go up on Zoloft; I did so to save my life. Now at 100 mg Zoloft. (But it's not working -- my exercise, eating, meditation, acupuncture, and supplements are.) 

 

October to December 2015: 4 mg Paxil --> 3 mg --> 2 mg --> 1.6 mg. Symptoms are tolerable at this rate; the worst is a feeling of being intoxicated for several hours a day. But going this slow makes me feel like it will take forever to get off! ! ! 

 

Currently: 1.2 mg Paxil.  

 

Also: Vitamin D; Vitamin B complex; magnesium; plenty of protein; exercise; acupuncture; meditation/mindfulness; working with a naturopathic doctor.

Edited by scallywag
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Hello SkyBlue and welcome to s/a,

 

Thanks for writing your signature and all the details to give us a clear picture of what's been going on. 

 

It is actually true that the lower end of the taper is the one people find more difficult.  There's a graph that will explain why better than I can:  http://survivingantidepressants.org/index.php?/topic/6036-why-taper-paper-demonstrates-importance-of-gradual-change-in-plasma-concentration/

 

When did you start taking Vitamin B?  If it was after you started tapering you may want to stop taking it as it can be quite activating for your central nervous system.  Fish oil is something many people find useful in w/d, and you are already taking magnesium. 

 

I know it's hard to believe, but a person destabilised by w/d can be badly affected by a missed dose.  It doesn't happen to everyone but some of us are just more sensitive (such as me).  Each time you go up or down in dose, or switch drugs, your CNS gets affected.  It takes time for it to stabilise again.  So you may want to hold at this dose until you feel things have settled somewhat.

 

Just a thought - what was happening with your Zoloft dose around the time you missed the Paxil dose?  Were you still increasing to the 100mg?  100mg is quite a high dose. 

 

I hope that answers some of you questions.  Have a read around, and feel free to come back to this thread and discuss things further.  It's good to have you here. 

 

Karen

PS I like your 'primary goal' - such a good way to put things. 

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Dear Karen,

 

Thank you for your reply! 

 

I forgot to mention -- I am taking fish oil and believe it is very beneficial. That is interesting what you said about Vitamin B. (I did start taking it after withdrawal.)

 

Thanks also for your kind words about my primary goal! :)

 

These responses from you were so validating and affirming:

   "It is actually true that the lower end of the taper is the one people find more difficult."

        and

"I know it's hard to believe, but a person destabilised by w/d can be badly affected by a missed dose."

 

I am finding those two statements to be absolutely true!!!! It's so counter-intuitive. 

 

(At the time of my missed dose, my Zoloft had been steady at 100 mg. for a solid 3 months.)

 

I will absolutely stabilize at this point, 1.2. for a while. I have learned the hard way not to rush!!

 

 

Thank you for the link to the study about SERT occupancy. I'm not fully understanding "SERT occupancy" and

0 vs. 80% part,

but I gather, and trust, that essentially this is showing that tapering gradually is helpful, and necessary for some.

 

Thanks again!!

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Does anyone else have experience with such severe symptoms at such a low dose? I'd love to get more input since I only get one "intro" thead.  :D 

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Hi SkyBlue,

 

Welcome to SA.  I've just been having a glance over your intro.  With regards to you question about severe symptoms, are you still getting severe symptoms and what are they?  Karen has already mentioned Vitamin B being activating.  If it's a multi B it's hard to tell which if one is causing an issue.  Also, what sort of exercise are you doing, how often and how vigorous?  Also, are you drinking any alcohol or coffee, eating lots of sugar?

 

The more details you can give (and on here you will find that even what seems a silly detail can make a difference), people are better able to answer your questions.

 

MOD INPUT HERE PLEASE:  Could Zoloft be causing/adding/complicating current symptoms?  Could any current symptoms be as a result of tapering Paxil too quickly last year?

 

Regarding Zoloft, did you jump from 25 mg to 100 mg?  You say in your first post that Zoloft isn't working.  What makes you say that?

 

BTW the best way to search this site is to use Google & search of "survivingantidepressants.org" + topic you are looking for.

 

Edit:  Just a thought - was there any reason you were going off Paxil?  I mean were you getting any adverse reactions while taking it (before Zoloft was added in)?

 

CC

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Hi Skyblue

Welcome to the community.

Did the doc explain his intentions and plans regarding the so called 'cross over' i assume it was introduced to get you off paxil right ?

 

Does anyone else have experience with such severe symptoms at such a low dose?

Yes for many  the home straight of the taper can be tricky stuff and difficult.

But after looking at your taper history you have had difficulty from 25 mg down. Its not just this last leg thats problematic for you. Due to a too fast taper.

 

Slow tapering is no faster than the 10% of previous dose per month. Thats what 'slow is' Your doc has simply tried to quell the wdl symptoms. (The suicidality is part of wdl symptoms ) by throwing zoloft at it. Simply replacing a 'heroin' with a 'cocaine' .

 

Now you have to get off the paxil and then taper the zoloft. Has the doc shared with you the plan for tapering the zoloft.

 

Here's the thing, to taper off 100 mg zoloft safely you may have to take 45, 4 week intervals. (180 weeks , 3.5 years).

 

Please read info on why to taper at 10%  here

 

Also check out Tips for tapering off Paxil (paroxetine)

 

Tips for tapering off Zoloft (sertraline)

 

I'm not fully understanding "SERT occupancy" and 0 vs. 80% part,

Yeah the SERT study is a bit above me too but it can be basically summarized imo as this: The lower then the slower.

Brassmonkey is one who can articulate the implications/meaning of this study very well.

 

This study is strong recognition/evidence/confirmation that the taper process rec here is correct ie each successive drop is smaller than the prior one. It smooths the taper in a correct manner.

Note abrupt changes in serotonin can cause suicidality. As you have experienced.

 

This study should inform taper procedures and is consistent with recommendations here.   Notice how the sert curve is not a straight line, tapering by a constant amount every drop follows a straight-line trajectory, taking this approach will at some point in time trigger as you have already discovered a whole heap of trouble. 

 

But each successive drop must get smaller.

Using this method tapering at 10% of previous dose (not original dose) can take 18 months to get from 25 mg to 4 mg and another 10 months to get from 4 mg to 1.6 mg.

 

Like cc i ask why do you think the zoloft is not working. My guess is it is covering/trying to cover paxil wdl symptoms.

 

I cant help but feel very disappointed in your doctor, and gutted for you. I'm sorry you're in this difficult position no fault of your own.

100mg zoloft is equivalent to 34 mg paxil.

 

Once you stabilise it would be very wise to follow the advice of this site. Don't worry about taper timeframes it's all about having a life while tapering and remaining functional; and will ensure that your primary goal is easily accomplished "but my primary goal is to stay alive."

 

Have a read of cc's favourite link Brain remodeling

actually it's one of my favourites too but I have a lot of trouble remembering where it is hiding.

 

Well done on finding a safe place

nz11

You have given me a great idea for my drug sig comment

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Dear ChessieCat and nz11, thank you so much for your thoughtful replies. I just have a second to check in here and will respond in more depth later, but I want to express my gratitude for your prompt and thoughtful replies.  :D

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Welcome, SkyBlue.

 

In answer to Fresh's question, it is possible you are having adverse effects from Zoloft, too. Please keep notes on paper about your daily symptom pattern and when you take your drugs.

 

When you started the Zoloft, did it reduce your Paxil withdrawal symptoms? How did you increase the Zoloft? How has it "saved your life"?

 

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

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Chessie, thank you so much for your thoughtful response. 


 


I work best with lists so my response is in that form. :)  


 


1. With regards to you question about severe symptoms, are you still getting severe symptoms and what are they?  


Main symptoms are depersonalization/dissociation (feeling like I'm in a dream, sort of); nausea (the least bothersome); and suicidal ideation (no intent or plans -- still scary). Feeling like I am intoxicated / loopy. 


I have been having what I think are called "windows"!!!!!!! A day (about once every two weeks) where I have *no* symptoms and just feel alive, "normal," me, engaged in life. 


 


2. Vitamin B -- my doctor (naturopathic) has told me to hold off on the Vitamin B for now. 


 


3. Same amount of coffee as always -- one cup a day. I haven't wanted to mess with this right now with all of the other changes. No alcohol. 


 


4. Exercise / eating: You're very astute to ask about this. I've recently learned (by being in therapy for the Paxil withdrawal symptoms) that I may have an eating disorder. This involves possible over-exercise (for mood regulation; I get very, very stressed and uncomfortable if I can't exercise vigorously just about every day); and a diet where I eat really well most days (it's technically restricting because it's low carb; but I eat a lot of vegetables, healthy fat; protein) coupled with once-weekly binges of sugar and carby stuff. So there is an imbalance there I'm definitely aware of and addressing. 


 


5. Regarding Zoloft, did you jump from 25 mg to 100 mg?  You say in your first post that Zoloft isn't working.  What makes you say that?


I was on 25 mg Zoloft, 5 mg Paxil. After calling a crisis line, I met with a crisis psychiatrist who put me up to 50 mg Zoloft. A couple of weeks later, not much improvement, he said that a "therapeutic dose" would probably be 100 mg. 


I don't think it's working, because I am still feeling suicidal, though not every day.


 


(This whole Zoloft deal was only about 10 weeks after my worst tapering jump and was most likely withdrawal… which I know now!!!)


 


6. Was there any reason you were going off Paxil?  


I'd wanted to get off Paxil for years because a) it had stopped working -- still having depressive symptoms, and B) the improvements that I *did* experience were due to lifestyle things I was improving (treating sleep apnea; beginning to take fish oil).


 


No real adverse reactions while on Paxil -- although I now believe that depersonalization I experienced while on Paxil was *because* of Paxil (since I am having the same DP symptoms as I taper off).


 


And thank you for the tip about searching the site! 


 


Thank you very much, again!!!

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Dear Altostrata,

 

I plugged in all my meds (just Paxil and Zoloft, and then some supplements) and got no interactions. That

is a really cool tool. 

 

I say that I went on Zoloft to save my life, because I woke up in the middle of the night in a Paxil rage feeling

intense suicidal thoughts. I called the crisis line, went into the crisis clinic, and they put me on a higher dose

of Zoloft (50 mg, then 100 mg a couple weeks later). So my intent was to get some relief from these suicidal 

ideations. I went up on Zoloft because I wasn't willing to gamble with these suicidal thoughts.  

 

It's interesting that you say I may be having reactions to Zoloft--that is very possible, and I hadn't considered it!!!

 

 

s-adenosylmethionine
The interactions information for this drug may not be up to date. More...
Fish Oil (omega-3 polyunsaturated fatty acids) Paxil (paroxetine) Vitamin B Complex 100 (multivitamin) Vitamin D3 (cholecalciferol) Zoloft (sertraline) Interactions between your selected drugs

No results found - however, this does not necessarily mean no interactions exist. ALWAYS consult with your doctor or pharmacist.

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Dear nz,

 

Thank you again for your response; I really appreciate it. 

 

I am in the U.S. and it always amazes me that in New Zealand it's "tomorrow" already! 

What is the future like?  :) 

 

I'm going to answer in list form again. :) 

 

1) Yes, my doctor's plan was to introduce Zoloft to help get me off Paxil.  :angry: 

 

You're right; it has been pretty rough ever since the 25 mg mark. I thought I was going waaaaaaay slow!!! I'm going to stick to 10% here on out. There's no medal for "Hey, look how fast I got off Paxil." Nooooooo way.

 

2) I can see (now) that the doctor have just tried to quell the wdl symptoms. And yes, the suicidality was/is definitely withdrawal, because I never had that before, until I started tapering. And yep, it's like replacing heroin with cocaine. And I plan to stick around this SA forum for a long time after I myself am better, so that I can help others like you all are helping me. 

 

(I actually ended up changing doctors. My last doctor made me cry, after I repeatedly requested he prescribe liquid Paxil b/c of difficult tapering symptoms, and he repeatedly said that I didn't need it; that because I had Zoloft I could just "jump off" Paxil. After I finally got the Rx for liquid Paxil, I looked for a new doctor.)

 

3) "I cant help but feel very disappointed in your doctor, and gutted for you. I'm sorry you're in this difficult position no fault of your own." 

Thank you SO much for this kindness. This really means a lot and I'm printing this thread out to keep with me. :)

 

4) As for tapering Zoloft…. I'm not even thinking about that yet. Or should I? 

 

5) Thank you for the 10% info; and I am going to read about brain remodeling. 

 

Thanks, nz11! 

 

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Hi everyone, 

 

I am having a window! I'm having a window! ! ! ! ! 

 

Not sure what changed or how this window came about, but I am glad and relieved. 

 

Last night was just the worst -- I had a combination of feeling intoxicated, and having suicidal thoughts. I have had each before during Paxil withdrawal, but never together. I was so afraid that this time it really, really was the end, that I would lose control and "do something." I had a very uncomfortable--but necessary -- talk with my parents (by the way I'm a grown adult, but what are you going to do?) that if I somehow ended up in the hospital, NOT TO LET THEM PUT ME ON ANY MORE DRUGS, no matter what. 

No matter what. 

 

Well, I'm still here.  :D  I made it. I'm still alive. My life is worth it. 

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Beautiful news Skyblue :):P:D:lol:

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Thank you, Karen!  :D

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SkyBlue, are you also taking SAM-e? How much, and at what time of day?

 

What is your daily symptom pattern relative to when you take your drugs and SAM-e? Please keep notes on paper.

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Hi Alto, thanks for chiming in. 

My (naturopathic) doctor has said to stop Sam-e and Vitamin B for the time being. 

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That's great SkyBlue! :D

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Thank you Romina!  :wub:

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Hi everyone, 

 

I go to see my doctor (actually LPN or something) next Tuesday. (This is a new one I've seen for a couple of months, 

after I stopped seeing my previous doctor last August for making me cry because I demanded liquid Paxil and "shouldn't

be having these symptoms"). 

 

Not sure what to tell him about: 

 

-suicidal thoughts (I'm safe and I don't want him to send me to the hospital OR increase my dose :huh:  )

-feeling loopy / intoxicated, "depersonalized" 

 

Any thoughts? I wouldn't go -- but I need a refill. :|

 

Thanks.

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Hi SkyBlue,

 

Do you need to tell him anything about your thoughts/feelings?  You are going for a prescription.  You seem to be well aware that what you are going through is "normal" for AD WD, and you have said that you are safe.  Maybe keep the conversation simple.  Can you tell him that you have seen some improvement in a particular area?  And having a planned idea of what you will say before you go can help you have control of the conversation.  Your goal is to get the script.  Remember that you have taken control of your AD situation and only need the doctor to provide the drug.

 

From Alto:  how-do-you-talk-to-a-doctor-about-tapering-and-withdrawal/page-2#entry163089

 

"When speaking to a doctor, do not yell, scream, beg, cry, whimper, or weep. It confuses them and they start thinking of psychiatric drugs to give you.

 

Speak clearly, firmly, and insistently -- but politely. Make a specific "request" that is actually a direction. Chicken has it figured out."

 

And from Chicken (mentioned by Alto above):  how-do-you-talk-to-a-doctor-about-tapering-and-withdrawal/page-2#entry161585

 

"I don't try to convice them.

 

In my case I told my doc that I wanted to get down to the lowest dose possible. My doc agrees that one should be on the lowest effective dose and least amount of drugs as possible.

I told him that I was converting mine to liquid and using a syringe.

He said that if I was doing that I should have the liquid so he prescribed the liquid, though I haven't filled the script yet.

 

I think that trying to convince them that you would like to be on the lowest dose possible helps them to work with you on tapering."

 

Good luck.  Let us know how you go.  CC

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Hi Chessie, good to see you and thanks for your reply. :) 

 

Yes, you bring up very good points that make a lot of sense. I really only need the Rx, from him at least. 

 

I'm going to check out those useful links; thanks! 

 

"Remember that you have taken control of your AD situation and only need the doctor to provide the drug." (Yes -- with the help

from my SA friends.  :wub:

 

"When speaking to a doctor, do not yell, scream, beg, cry, whimper, or weep. It confuses them and they start thinking of psychiatric drugs to give you." (Aiiiiiiii!!!!! How ironic. )

 

Thanks again.

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"Yes -- with the help from my SA friends"

 

That's just one of the reasons why this site is so valuable. ;)

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Hi SkyBlue,

 

Just wanted to let you know I'm thinking of you.  :D

 

And I agree in the future, as long as you're using the liquid, there's no need to tell the doctor you cutting the dose.  Just keep getting it refilled on schedule and build yourself up a little extra in reserve.  The day you spill it, you'll be glad you have the extra bottle.

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Hi Skyblue! So so glad you made it through a very rough night!. Praising God you are alive and hopeful :) I am currently working through paxil taper for 2nd time and will be following your progress.

 

We CAN do this!!

-meg

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@ChessieCat, Yes! Thanks! :) 

 

@Colonial… Thanks so much. :) Yeah, I just need to get the refill and keep on with my taper. 

 

@MegB, Hi! Good to meet you and thanks for your kind words. Glad you are here and tapering off Paxil. Let's keep in touch! 

I am looking at your signature and trying to figure out your tapering percentage -- is it 10%, or even slower?

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"When speaking to a doctor, do not yell, scream, beg, cry, whimper, or weep. It confuses them and they start thinking of psychiatric drugs to give you."

 

So true!! Once when I was in withdrawal, I went to a psych hospital and I was crying telling the doctor how I felt, she looked at me like I was a puppy and said :"do you cry???? " "do you cry a lot??!?!" like it was an alien kinda stuff. She looked kinda drugged too. Lol

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Skyblue, 

I guess I don't have an exact percentage taper so that's why it may be confusing! :) I am going straight down from 20 to 18.5 for 2 months and from there will be lessening dose by .5mg until 5mg. From 5 I will taper down by .2mg. 

 

Do you have a good community around you? Family, friends? It's the biggest help for me :) 

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Romina -- YIKES! ! !  :huh:

 

Hi Meg, That sounds like a good plan. I have a very supportive family, and of course my SA friends!  :wub:  

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Would appreciate your opinions / advice: 

 

My goal is to get off of Paxil and Zoloft. 

 

I'm thinking of holding on Paxil for a while because it is giving me a lot of trouble this far down (only 1.2 mg.).

 

So I thought I would start tapering the Zoloft. Since I've been on it less than a year, wondering if it sounds reasonable to go from 100 to 75, then do 10% from there. I don't want to do 10% unless I NEED to.)

 

Thoughts? Thanks!

 

 

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Would appreciate your opinions / advice: 

 

My goal is to get off of Paxil and Zoloft. 

 

I'm thinking of holding on Paxil for a while because it is giving me a lot of trouble this far down (only 1.2 mg.).

 

So I thought I would start tapering the Zoloft. Since I've been on it less than a year, wondering if it sounds reasonable to go from 100 to 75, then do 10% from there. I don't want to do 10% unless I NEED to.)

 

Thoughts? Thanks!

 

Sky, I tend to avoid giving tapering advice because although I've been on and off meds affecting the nervous system countless times, I never knew to do a slow taper. So what I'll say is based on ten years of withdrawal group participation, not personal experience. (And lord knows, not math expertise lol.)

 

If Alto or others with a lot of knowledge about tapering advise you differently, please give more consideration to their suggestions. But given your history and sensitivity to drops in dose, I urge you to avoid making a large drop in a med (zoloft) you've been on almost a year, and consider - you won't want to hear this, but hear me out - going slower on your paxil taper by implementing the 10% (or even smaller if necessary) drops once you're sure you're stabilized from missing one dose. I wouldn't be surprised if that setback might not have been partly or largely due to your having been doing larger than 10% drops, especially at these lower doses.

 

I'm going by your signature. Please clarify if you were only summarizing your recent drops. I'm assuming you're listing each drop when you say in your sig:

 

September 2015: 4 mg Paxil (liquid)… October 2015: Suicidality -- doctor advised me to go up to 100 mg Zoloft. 

October to December 2015: 4 mg Paxil --> 3 mg --> 2 mg --> 1.6 mg.

Now: 1.2 mg Paxil. 100 mg Zoloft.

 

I had seen the question you asked in the post I'm responding to and was considering pasting it here in your thread and replying. Again, others may have better advice to you re the zoloft. And I certainly understand your wanting to speed up the w/d process. The problem is that when you speed up tapering, you usually pay for it not only with increased suffering, but ironically with suffering longer in terms of a longer as well as harder recovery period after your taper is completed.

 

I believe the goal should be to try as much as possible to find a taper rate (with revisions as needed, especially at the lower doses) that coincides as much as possible with one's rate of healing from the changes the med has caused in one's body. This minimizes withdrawal symptoms and also the occurrence or severity/duration of symptoms of post-taper.

 

I hope others with more expertise about tapering and about going off multiple meds give input here. But I'm suggesting that if you've been tapering at larger than 10% drops for some time, as it appears, stabilizing a little longer then doing 10% or even smaller drops might make these lower dose drops go much more smoothly. And I also would be concerned about doing a large drop on the zoloft even though the dose is higher. In the other thread where you asked about doing the initial large zoloft drop, the OP had only gone up in dose about a month before. These meds take at least 6-8 weeks or more to fully take effect, I believe, even though the changes start to take effect sooner. I think that is probably why the other poster may have been told she might be able to taper that increase more or faster. But if you've been on 100 on the zoloft almost a year, your body would have fully made the changes the drug is designed to make. Some people (though not all) can indeed get away with larger drops at the higher doses, but in your situation (having been through rough paxil tapering with too-high drops and severe symptoms), I'd be very wary of doing larger drops at any dose, at least for a long, long time.

 

Try not to think in terms of length of time you'll be on the meds (tapering), but rather of quality of life (reduction or elimination of w/d symptoms). Quality of life is how people who couldn't tolerate too-fast tapers are able to be patient through very long slow tapers. I've heard so many people say it made a world of difference in quality of life, and often was the only way they could get off the meds, and with only minimal instead of intolerable symptoms.

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I read that it's better to taper drugs one by one, moreover you're at a very low dose of paxil. Are you sure that this is paxil that give you trouble and not Zoloft ?

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Hi Sky ,     it sounds like a sensible way to move forward to me - hold on the paxil and start tapering zoloft.

 

I agree with Brandy though - doing a 25% cut is a huge risk.    If it's too much , you'll go through months of distress

before stabilizing again.  And that's unnecessary.

 

I'd be inclined to do a 10% cut first , and see how you respond.    If you have no symptoms over the next 3 weeks ,

you may decide on a bigger cut for the next one.

If you get hit with severe symptoms from the 10% decrease , you may choose to do smaller cuts (see the thread

on micro-tapering) in the future.

 

bw ,  Fresh

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Hello, friends, 

 

Thank you for your responses and being the voice of reason in response to my urgency in "hey, maybe I'll try 25%!" Nooooooooooo, sweetheart. No.

 

In my copy of The Antidepressant Solution, I see that Dr. Glenmullen says: "The patient's past history of withdrawal symptoms is an important variable in selecting an initial dosage reduction" (p. 118). Brandy, you are very right that I have had extreme withdrawal symptoms at each step of the way on these more aggressive reductions. 

 

What do I have to lose by going slowly? Eh, it might take a bit longer. What about by going fast? Well, how have the last 7-8 months been for me? What has been the main focus of my life and ruined so many days and weeks? If I had it to do over, would I go by 10%???? Ah, I think I would!!!!!!! 

 

Zoloft is available in liquid form. I believe that what I will do at my dr. appt this Wed. is ask that he refill my Rx for liquid Paxil, and write a Rx for liquid Zoloft. As I have seen here on SA, a liquid form will really let me be in the driver's seat as far as reducing/changing doses at the rate that I need.(Hisame, that is a good question -- I don't know if it's Paxil or Zoloft causing my current symptoms of feeling loopy/intoxicated. That is a problem of being on 2 drugs I suppose!!!)

 

After my current acute symptoms subside I will wait at least two weeks to let my poor nervous system recuperate and stabilize (this hasn't happened yet -- I still had the intoxicated and derealization feelings today--but the time duration is lessening).

 

(Brandy, I believe you are totally right… "once you're sure you're stabilized from missing one dose. I wouldn't be surprised if that setback might not have been partly or largely due to your having been doing larger than 10% drops, especially at these lower doses.") I realize now that my drops have been basically 50% (!!!!!!!), 50% (!!!!), 20%, 25%, 33% (!!!!!!), 20%, 25%. Plus two missed doses recently.

Oh, my sweet little nervous system, I'm so sorry!! Thank you for keeping me alive anyway! ! ! ! ! 

 

At that time, either go 10% down on Zoloft or 10% on Paxil. And it will be at most 10%, and maybe less if needed, like Fresh is saying!!! 

 

Thank you, wonderful people! 

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If you're not lowering a drug, I'd advise not tampering with the formulation if you're still having WD Symptoms from a different taper.  People like myself had a really tough time changing from the paxil pills to the liquid.  All you are doing is adding another risk for more symptoms.  If you look at the first page of my thread, it's why i joined here.

 

http://survivingantidepressants.org/index.php?/topic/9562-colonial-worsening-withdrawal-symptoms-changing-from-paxil-cr-to-liquid-suspension/page-1

 

 

And another member is having a rough time changing as well, see the last few days posts here as well:

 

http://survivingantidepressants.org/index.php?/topic/9574-liquid-medications-use-past-expiration/

 

 

If you want to start reducing, you need to give your body time to adjust to the new formula before lowering the dose."

 

Are you sure the "loopy" feeling isn't from the WD?  It's hard to know but if it is, it's hard to know if changing the zoloft formula is a good idea until you're sure it's still not left over from the paxil drop.  Changing the formula is a necessary step before beginning the taper, but it may cause problems by itself, so you wanna really make sure you're still not in paxil WD before you do so.

 

Also, and most importantly,  change the LEAST AMOUNT of your dose to the liquid as possible.  If your taking 100mg of zoloft in pill form, continue to take as much of it in pill form as you can.  I don't know how it comes, but say if there is a 75mg pill, take that and change only the other 25mgs over to the liquid, that will help your brain mitigate the amount of change.

 

When I had to change from the paxil cr pill to the liquid to the taper, instead of 2 pills, I dropped to 1 pill plus liquid, and even with still 50% of the paxil in the original form I still had horrible symptoms just from changing half of it to the liquid.

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Also, if your that low on the paxil, I don't think any negative side effects would be from that.  The good news is you don't have to be completely off a med to lower or eradicate the negative side effects.  But side effects are different from WD, so if you're too aggressive with lowering your dose you're just trading one issue for another.

 

And it sees zoloft comes in both 50 and 25 mg pills.   If you got those, you would only have to change 25mg into the liquid for your initial taper.  

This is a big help if you're PRONE TO TIPPING YOUR BOTTLE OF LIQUID AND SPILLING IT ALL OVER...LIKE ME... :unsure:

These liquids aren't cheap either, and if you spill the whole bottle, it's not good.  Even if you have insurance they don't like to "repay".

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Hi Colonial, those are good tips. Thanks. 

 

Unfortunately with two medicines in my system it is impossible to know whether the loopiness is Paxil withdrawal or Zoloft. 

 

Update: I met with my provider (P.A. -- physician's assistant) last week and he renewed my Rx for liquid Paxil. Thank God!!!

 

Again, I'm not touching anything until I get AT LEAST two good weeks, maybe longer, with no symptoms. I'm keeping track of them using Dr. Glenmullen's symptom checklists each day. 

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