Miranda99: switching from paroxetine to prozac

[Miranda99]

Hi all. I'm presently on 3.8 mg of paroxetine (aka as seroxat and paxil) I am tapering very slowly- can only manage 0.2 mg every 2 months. It has been suggested to me by the local tranquliser addiction and help to come off SSRI,that I should switch to a longer acting half life drug such as Prozac (fluoxetine) or mirtazepine. As I am only on a small dose of paroxetine, the plan would be to stop one, and commence the other, then to taper the latter. Is there anyone with any success of doing this? I am stuck with my present taper, and even though the racing thoughts and anxiety have gone, I am still getting physical withdrawals like vertigo and dizziness from my last minute drop 8 weeks ago, and I go into withdrawal every morning prior to my next dose, which is why I want to try this. Any advice much appreciated. Thank you

[keepinghope]

Hi Miranda

 

I'm sure one of the mods or someone more experienced will be along soon, but I just wanted to say that I did what was essentially a cold turkey from Prozac (6 week taper advised by Dr) and am now in protracted withdrawal. In my experience, prozac is no easier to come off than any other SSRI, it's just the symptoms of stopping it take a little longer to show up, because of the longer half-life.

 

I don't think these drugs are as interchangeable as doctors like to think. If you go onto Prozac and taper from there, you'll likely still suffer withdrawal symptoms from discontinuing the Paroxetine, as well as maybe start-up/side effects from starting the Prozac. It may destabilise your nervous system and cause more withdrawal symptoms in the long run.

 

I'd stick with tapering the Paroxetine very slowly - perhaps a micro taper, one of the mods may be able to advise. To prevent getting increased withdrawal symptoms prior to your next dose, maybe splitting your daily dose into two (morning and evening) might help?

[keepinghope]

Here's some info on micro-tapering: http://survivingantidepressants.org/index.php?/topic/2878-micro-taper-instead-of-10-or-5-decreases/

 

And this is some info on using a 'prozac-bridge': http://survivingantidepressants.org/index.php?/topic/1463-the-prozac-switch-or-bridging-with-prozac/ 

 

Hope it helps,

KH

[Altostrata]

Welcome, miranda.

 

KeepingHope has given you some helpful links.

 

Please look at the Prozac bridge topic carefully. Overlapping Paxil and Prozac for a short time can make the transition easier.

 

There is a risk of withdrawal syndrome in switching drugs, but many people do it successfully when tapering other drugs becomes too difficult.

 

As you're taking only 3.8mg paroxetine, I might target 2.5mg Prozac as the initial trial dose. Prozac comes in liquid form to make this easier. You might  slowly add 0,5mg Prozac every few days until 2.5mg, see how you feel, then go off Paxil by 0.5mg every few days.

[Miranda99]

Thank you for the replies. I'm really at a loss of what to do, and worried that I will make my withdrawals much worse if I switch. I found this article that suggests that the switch can work. There is not a lot of other research out there. 

 

http://ijnp.oxfordjournals.org/content/11/5/725

 

KH, what you said about splitting doses is interesting. It does sound a lot safer as at least with paroxetine tapering I know what to expect. 

I've been tapering for 2 years already, and have booked 2 weeks off work to trial something. Maybe I should try splitting the doses first before the Prozac option, as my main issue is in the mornings prior to my next dose. 

When I dropped too fast I paid for it with extreme anxiety, and fast heart rate, and racing thoughts like I had never experienced before 

[Altostrata]

You might try splitting the dose before resorting to the Prozac switch. It could be you are now taking so little Paxil, it's getting metabolized faster and causing those morning withdrawal symptoms.

 

Are your symptoms mostly in the morning?

[Miranda99]

Hi Altostrata. Yes, I feel worse in the mornings. I have to take my medicine really early some mornings and go back to sleep. 

I think I'm going to try splitting the doses first. Starting Prozac is just so alien and I wouldn't want to be taking paroxetine and Prozac at the same time. 

[Altostrata]

To split the dose, move half by 1-2 hours earlier each day.

[Altostrata]

Miranda, how are you doing?

[Miranda99]

Hi, I have been slow tapering paxil liquid for a couple of years now, ( 20 mg down to 3 mg),  but have been stuck on 3 mg for about 3 months. I am tapering 0.2 mg at a time. I don't feel like I'll ever be ready to reduce again as it's so hard!! I am taking a multivitamin, high strength omega 3 and 6 which are amazing for the head shocks, and try magnesium spray, but not sure this does anything. Can anyone suggest any other supplements that in could try or do I just have to wait it out probably for about another 2 years at this rate! I also take cocodamol 30/500 mg for peripheral neuropathy, and I'm not sure if these are making withdrawal symptoms worse. Should I stop the codeine first? 

Thank you in advance. 

 

Edited November 5, 2017 by Miranda99
Missing info

[ChessieCat]

Hi Miranda,

 

Please create a drug signature.  This way we will be able to see your drug history at a glance.  Please remember to update it whenever you make a change.  Thank you.  This is the preferred format:

 

 A request: Would you summarize your history in a signature - ALL drugs, doses, dates, and discontinuations & reinstatements, in the last 12-24 months particularly?

• Please leave out symptoms and diagnoses.
• A list is easier to understand than one or multiple paragraphs. 

• Any drugs prior to 24 months ago can just be listed with start and stop years.
• Please use actual dates or approximate dates (mid-June, Late October) rather than relative time frames (last week, 3 months ago)
• Spell out months, e.g. "October" or "Oct."; 9/1/2016 can be interpreted as Jan. 9, 2016 or Sept. 1, 2016.
• Link to Account Settings – Create or Edit a signature.

 

This is your own Introduction topic where you can ask questions and journal your progress.  Please ask questions about your own situation here in your Intro topic.

 

Withdrawal Normal Description

 

Many members find that the lower their dose gets the slower the have to go.

Why taper paper: dose-occupancy curves

 

Slowness of slow tapers

Are there some who can't taper off no matter how slow they go?

When to end the taper and jump to zero?

 

The only supplements which SA recommends are Magnesium and Omega-3 Fish Oil.  I suggest you have a look at other members' experiences and how they take/use these supplements.  If SA knew of anything which would help with getting off these drugs, then we would be shouting it from the rooftops.

 

painkillers-in-withdrawal-aspirin-ibuprofen-paracetamol-acetaminophen-naproxen-codeine

 

Non-drug techniques for dealing with physical pain

 

Non-drug techniques to cope with emotional symptoms

 

 

 

 

[Miranda99]

On 01/01/2017 at 11:13 PM, Altostrata said:

Hi Altostratus, I didn't see that you had asked this question, so sorry for not replying until now. I decided not to switch to Prozac as was too worried I'd still get withdrawal and had introduced about drug into the topic. Today ( almost a year later I am down to 3 mgs but stuck for past 3 months. 

I also decided not to split dose as didn't want to feel bad in the evening as well as the morning

 

 

12 hours ago, ChessieCat said:

Hi Miranda,

 

Please create a drug signature.  This way we will be able to see your drug history at a glance.  Please remember to update it whenever you make a change.  Thank you.  This is the preferred format:

 

 A request: Would you summarize your history in a signature - ALL drugs, doses, dates, and discontinuations & reinstatements, in the last 12-24 months particularly?

• Please leave out symptoms and diagnoses.
• A list is easier to understand than one or multiple paragraphs. 

• Any drugs prior to 24 months ago can just be listed with start and stop years.
• Please use actual dates or approximate dates (mid-June, Late October) rather than relative time frames (last week, 3 months ago)
• Spell out months, e.g. "October" or "Oct."; 9/1/2016 can be interpreted as Jan. 9, 2016 or Sept. 1, 2016.
• Link to Account Settings – Create or Edit a signature.

 

This is your own Introduction topic where you can ask questions and journal your progress.  Please ask questions about your own situation here in your Intro topic.

 

Withdrawal Normal Description

 

Many members find that the lower their dose gets the slower the have to go.

Why taper paper: dose-occupancy curves

 

Slowness of slow tapers

Are there some who can't taper off no matter how slow they go?

When to end the taper and jump to zero?

 

The only supplements which SA recommends are Magnesium and Omega-3 Fish Oil.  I suggest you have a look at other members' experiences and how they take/use these supplements.  If SA knew of anything which would help with getting off these drugs, then we would be shouting it from the rooftops.

 

painkillers-in-withdrawal-aspirin-ibuprofen-paracetamol-acetaminophen-naproxen-codeine

 

Non-drug techniques for dealing with physical pain

 

Non-drug techniques to cope with emotional symptoms

 

 

 

 

 

[Miranda99]

January 2013 commenced 10 mg paxil

*May 2014 0.5 mg every other day.

*May 2014 back to 20 mg paxil. 

*May 2015 halved dose paxil to 10 mg

*March 2016 halved dose to 5 mg

* Mid march 2016- 5 mg to 4 to 2mg

* Mid march 2016 - 5 mg

* December 2017 reduced to 4.5 mg

* February 2017- reduced to 4 mg, back up to 4.1mg

March 2017- reduced to 4.1 mg then 0.2mg drops until 3 mg Sep. 2017

[Miranda99]

At present Chrissie cat I use magnesium spray which I don't think does anything. Will have a look at other types of magnesium as tried a tablet before which gave me diarrhoea. Will have a look at the link. Thank you very much 

[Gridley]

I take magnesium glycinate and find I can take only 50mg a day without it having a laxative effect.  So you might want to start with a really low dosage and work up from there.  Another possibility is to crush the tablet, dissolve it in water, and sip it throughout the day.

[Miranda99]

How does it help you Gridley? 

[Gridley]

I honestly don't know if it does help.  But I haven't noticed any negative effects (once I reduced my dose) and if it gives me a little relief from anxiety and little help with sleep (I take my dose at bedtime) for me it's worth taking.  Sometimes I feel more relaxed after an epsom salt bath, sometimes no effect.  It's an individual thing.  Many on SA report very positive results from magnesium and epsom salt baths.

[Nada678]

Hello  Miranda99

 

Did you manage to reduce your Paxil any further?   I am also having extreme difficulty getting any lower than 5mg.   I have terrible anxiety and numerous neurological pains.  Did you switch to Prozac to help reduce?

 

Nada