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Hazel

Hazel: struggling with Paxil to Prozac bridge

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baroquep

Hi Hazel, Over the last year I've reduced to 50% of my original dose (currently at 37.5mg Effexor).  Yes, without question, tapering gets a lot harder as we get lower on the dose, and we have to be a lot more cautious during this time. Some people have to taper down to dust before jumping off and this is a testament to just how dependant our central nervous system becomes when we've taken the drugs for a number of years and how powerful these drugs really are.  I don't drink alcohol but love my coffee and unfortunately when I destabilized in February, even a couple of sips would trigger shaking and anxiety.  Fortunately once I stabilized, I have been able to start drinking coffee again but am mindful that as I get lower on my dose this could change.  Many people on these boards report that their withdrawal symptoms ramp-up after drinking alcohol, so personally I just wouldn't take the risk.    

Edited by baroquep

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Hazel

Thanks!

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miT

Best of luck, Hazel!

We're on the same boat.

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Hazel

Thanks miT!  Good luck to you as well.  It's nice to have support from others who understand what this is like.

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Hazel

I had another bad night of not being able to sleep.  Was up for good at about 4:30 with anxiety and couldn't get back to sleep.  I am wondering if since I was never really stable on the paroxetine will I be able to stabilize no matter how long I hold?  I wish I had known about all of this before going off sertaline and switching to Lexapro then paroxetine.  I know hindsight is 20/20 and all that, but I have been holding for over 2 months and still don't feel "stable", so I worry I never will.  I feel good for the most part during the day, but nights have not been good.  I am now thinking of holding till after the first of the year, which will be a total of 6 months.  I just don't know if it will help since I was never really stable on the paroxetine to begin with?  Just looking for some advice.

Thanks!

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miT

You had a lot of changes in medication. I would stay put for 6 months, then taper. I think your CNS needs a stable dose to settle on.

 

I don't feel stable and I'm still tapering. Waves are part of the process. If it's unbearable, then ok you should hold. But else, it's just part of the taper process. 

 

 

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baroquep
1 hour ago, miT said:

You had a lot of changes in medication. I would stay put for 6 months, then taper. I think your CNS needs a stable dose to settle on.

 

Hi Hazel, I will have to agree with miT.  The CNS requires stability and the only way for that to happen is to hold as long as is necessary.  I destabilized back in February and it took a few months to get back to centre.  Before I could stabilize, I had to cut out all supplements, as everything just made me feel worse.  I'd take a sip of coffee and two minutes later I'd start to shake.  You've also made a lot of changes at the Fall of 2016, so I would say a minimum hold of six months is your safest bet, even longer if necessary.  There really isn't anything else that you can do at this time, except try and incorporate a few techniques into your daily routine that will help ease the insomnia.  At one point, I didn't think I was ever going to get a good night's sleep, but it did happen.

Have you checked out any of these links:

 

Sleep problems - that awful withdrawal insomnia

Yoga for calming (very simple poses can help greatly)

Claire Weekes' Method of Recovering from a Sensitized Nervous System

   

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Hazel

Thanks miT and Baroquep for the responses.  I guess I will hold at least until after the first of the year.  This is all going to take much longer than I first thought, but I am learning that it will be worth it to have as few symptoms as possible.  I just get worried when the anxiety is high that I won't be able to stabilize.  If time is what it will take I can do that.

 Thanks again😊

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baroquep

Will have to say that I was a bit shocked to find out how long it was actually going to take to get off Effexor safely, but after destabilizing twice over the last year, it finally occurred to me that I had to get with the program or I'd never get off of them.  Personally, I'd rather go through my tapering years with as few withdrawal symptoms as possible, so I slowed down my taper to 5% with a good hold in-between decreases.  I don't care how long it's going to take anymore ... my day-to-day quality of life is far more important to me than how quickly I get off of this drug.  This has worked for me as now I have very few if any symptoms and as I get lower and lower on my dose, I have been feeling happier and more engaged in my life than I have been in a very long time.  Hoping you start feeling better soon.  

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ChessieCat
On 05/09/2017 at 2:02 AM, Hazel said:

but worry about holding too long as well

 

It is better to hold for longer than to reduce too soon and end up having to updose.  Even though I have only been experiencing very mild withdrawal symptoms I have done a couple of long holds, one of 3 months at 50mg (a convenient tablet) and I'm just finishing a 7 week hold at 20mg because I had plenty of my compounded capsules of that dose.  I decided to do these to allow my brain to do any catch up healing that it might have needed.

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Hazel

I am prepared to hold for a good long while at this point.  I know I need to give my brain time to recover from all of the changes over the past year.  Do you think there is such a thing as holding too long?  I do worry about being on these meds longer than necessary.

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miT

Don't worry about holding. You should change the focus from "drugs in your body" to  "stabilizing your CNS".

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Hazel

Thank you miT.  That is a great way to look at it.

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SkyBlue
On September 12, 2017 at 9:21 AM, Hazel said:

I am prepared to hold for a good long while at this point.  I know I need to give my brain time to recover from all of the changes over the past year.  Do you think there is such a thing as holding too long?  I do worry about being on these meds longer than necessary.

 

Hmm. Super good question. It seems like my brain and body just treasure the holding times. At the same time, of course we don't want to be on more than necessary. The best answer is to do what feels best for you, not pushing yourself through unbearable symptoms but doing small reductions that allow you to keep the (for lack of a better word) momentum. 

 

I love what miT said about stabilizing your CNS. It's not just a matter of getting the drug out of our system. Although it would be awesome if it was!

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Hazel

I am hoping my brain appreciates this hold.  It sounds like most people do well with holding longer, so I am hopeful by holding for a while I will stabilize and then be able to taper with very few symptoms.

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Hazel

I had another bad morning.  It seems like I am getting worse instead of better and I just don't understand it.  I guess I am feeling really frustrated.  I am beginning to doubt that I will be able to stabilize on the Paxil and have been thinking of going back to Zoloft since it was what I had been on for over 13 years and had been doing well on it overall.  I feel like I may have a better chance of stabilizing on the Zoloft and then tapering off slowly.  I know it would be a risk, but at this point I'm not sure holding on Paxil is a much better option.  I would appreciate any advice.

 Thanks.

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Hazel

I have been struggling more and more the past couple of days.  Last night was the worst it has been in a while.  I woke up around 2:00 with anxiety and could not fall back to sleep.  I probably made a mistake yesterday by lowering slightly to 7.9mg from 8mg.  I am just tired of not getting better after holding for so long, so I figured I may as well start tapering if I am going to feel bad anyway.  I don't understand why I am not able to stabilize.  I haven't touched alcohol in over 5 weeks and have given up caffeine as well.  I have been trying to take good care of myself by eating better, drinking more water and going for walks.  Not sure what else I can do?  I am just feeling very frustrated and am scared I won't be able to stabilize.  Please, any feedback/support would be greatly appreciated.  I am feeling so hopeless and alone right now.

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Hazel

Just wanted to add that I did take a lorazepam last week Wednesday and this past Saturday night.  I'm not sure if this current anxiety could be triggered from that?  I felt better after taking it, but started feeling worse Sunday night.

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ChessieCat

I've learnt from this site that is what happens when you take a benzo.

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Hazel

So this is some kind of rebound effect then?  I've never noticed it before.  I guess I know not to take a benzo anymore.  I only take them sparingly so didn't think it would hurt.  Obviously I was wrong.  Thanks Chessie for responding.

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bubble

yes, that is the rebound effect.

 

It seems that you have entered a wave. That's why it is so important to hold: so that those waves can even out. Healing is not linear so having such patterns like you describe is typical although horribly frustrating and discouraging. 2 months may seem long but when it comes to holding it is not at all. Last year I held for 9 months after a too fast taper and a crash (although that taper was less than 10 % per month it was too fast for me).

 

You have had lots of changes starting with a year ago and then you started tapering Paxil (aggressively so you had to updose). I can just sense your impatience while going through your drug signature.... You even introduced Prozac. And then dropped it. More changes, more trauma for your brain. There doesn't seem to be much if any holding after that and Paxil taper was resumed...

 

I'm worried about your impatience. It is our big enemy in this process and causes us to make painful mistakes that set us back. None of us is naturally patient I would say (or very few). But we all had to become as patient as can be in order to manage this process. Considering all those changes and as needed use of benzo, waves are more than expected...

 

Maybe you could check your benzo use in our benzo subsection. Your signature doesn't really say when you started using it on as needed basis and how often was that.

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Hazel

Thank you Bubble for responding.  I started taking the lorazepam as needed last December when I was trying to adjust to taking Lexapro.  I normally take it maybe one time a month, but have been getting frustrated and desperate with not being able to sleep.  Now that I know even a small amount can mess up things even more, I will stop it all together.  I suppose I should go back to 8mg and continue to hold.  You are right, my impatience is my worst enemy.  I just want to feel better so badly, but am learning the hard way that time is the best healer.  I am actually relieved to know the lorazepam is what has set me back this time.  I couldn't figure out why I had gotten so much worse.  I will continue to hold.  It is reassuring to hear that a long hold worked for you.  I pray that it ends up working for me as well.

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bubble

This sounds like a good plan and good insights. I also find it a lot easier to put up with symptoms once I have identified their cause. We just so desperately need to see some rhyme and reason in this mostly illogical and counterintuitive process.

 

You have reduced your drug load considerably and were doing well (between waves) so I believe holding will help even more.

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Hazel

Thank you Bubble.  Holding is difficult, especially when you aren't feeling like you're stabilizing.  But I am finally seeing that is the only way I am going to get better.  I appreciate your feedback and support more than you know.

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Hazel

So I guess I've screwed up again.  I had been holding at 8 mg for 4 months and wasn't feeling all that much better.  I decided to go down to 7.9 mg on Saturday.  Sleep had continued to be a problem, so Sunday night took a lorazepam for the first time in over a month to get some sleep.  Felt good Monday, but didn't sleep well Monday night and had increased anxiety on Tuesday.  Last night was even worse and am now up with the worst anxiety I have had in months!  I'm sure it is from the lorazepam and I feel so stupid for taking it.  I knew better and that's what makes this so hard right now.  I just need to vent since I really have no one to talk to that understands all of this.  I feel so alone and scared right now.  I need to get up in a little over an hour to start getting ready for work and get my kids ready for school.  It's just so hard to function when feeling this bad.  I know I did this to myself.  I was just so desperate for some relief from the sleeplessness and morning anxiety.  It feels like this suffering will never end.  Sorry for always posting when I am at my worst.  I will have to start posting more often when I am feeling good since there have been good days as well since I last posted.  It really does help to share with people who understand:)

Thanks

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grandmaD
On 11/8/2017 at 9:54 PM, Hazel said:

So I guess I've screwed up again.  I had been holding at 8 mg for 4 months and wasn't feeling all that much better.  I decided to go down to 7.9 mg on Saturday. 

I wouldn't say you screwed up!  We have all made choices we regret, not to worry!  I found same as you, after 4 months no improvement, and after 5 months no improvement and then after the 6 month mark, I saw good improvement.  This has happened every year for the last 3 years after holding for 6 months.  You just might like to keep that in mind next time and aim for 6 months, just a suggestion.

Sleep had continued to be a problem, so Sunday night took a lorazepam for the first time in over a month to get some sleep.  Felt good Monday, but didn't sleep well Monday night and had increased anxiety on Tuesday.  Last night was even worse and am now up with the worst anxiety I have had in months!  I'm sure it is from the lorazepam and I feel so stupid for taking it. 

I hope you have forgiven yourself!  This is also something many of us have done in an effort to just feel good/normal for at least a short time!  I guess it goes back to wanting that "quick fix."  My doc told me the sleeping pills he gave me were the "safest" ones!  Such liars!  Next doc I saw, she said "oh, no, they are a benzo, get off them quick."! 

 

I found that just taking 1/4 of tablet three times a week didn't work after a short time, so I upped it to 1/2 tablet and soon that wasn't enough and I began to fear getting hooked, so just took 1/2 now and then, but it began to have a paradoxical effect and not work at all, even tried taking a full tablet and things got weird.  I decided to stop it altogether and it was very hard, took a good 4 months I would say and I had to throw them out, because the temptation was so strong.  I also stopped codeine at the same time - the one I was taking was good for sleep too because it had a "muscle relaxant" in it.  The doc surprised me when she said that was "rubbish"!  She has left, only here for a few weeks, unfortunately!

 

I think the sleeping pills (which are also a mind altering drug - m.a.d for short!) confuse the brain further, which is already confused with the taper process!  that's why things go haywire.  Alll the best for the future, and see how you go!

 

 

 

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Hazel

Thank you grandmaD for responding.  I have forgiven myself and am moving forward.  I’ve been feeling better since Wednesday.  The sleep is still not great.  I fall asleep okay but wake early and can sometimes fall back to sleep, but it is usually light and I wake easily.  I then have morning anxiety, which is no fun.  I usually feel pretty good during the day, so I know it could be a lot worse.  I think I am going to continue to drop very slowly and see how I feel.  I will definitely hold if things go bad.  I know this process is going to take a long time, but I have to believe it will all work out in the end😊. Have you found a natural supplement that works for sleep?  I have tried several, but none that really seem to work.

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baroquep
On 2017-11-08 at 5:54 AM, Hazel said:

It really does help to share with people who understand:)

 

It certainly does :)  Don't be too hard on yourself, we have all done things in withdrawal hoping that it will make things a little better ... I'm certainly guilty of that as well.  Just turn the thoughts around and use this as a learning experience of what not to do during withdrawal.  I know how difficult it can be dealing with the insomnia, have been dealing with it myself over the last month and was starting to lose hope that it would ever return to normal again but fought the urge to place the focus on not sleeping and just accept that this was my new normal, at least for the time being.  Don't know why that seems to help, guess it just takes some of the pressure off to actually have a good night's sleep which we so desperately crave.  Hoping that my sleep will eventually start to regulate soon but in the meantime, I just try and be kind to myself when I can't.  Hope that you are going to hold a little longer, maybe even into the new year ... give your central nervous system a chance to settle a little more, a little more time to heal from the disruption before tapering again.    

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Hazel

I am at 7.8 right now and going to see how I feel in the next week.  I would like to taper .1mg a week as long as I am not feeling any worse.  I was holding for 4 months and not feeling any real improvement, so decided to make a tiny drop from 8 to 7.9 last Saturday.  I dropped again yesterday from 7.9 to 7.8.  I will watch things and hold if needed.  I just wanted to make some progress since I wasn’t seeing a big improvement from holding.

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baroquep

Hi Hazel,  please remember that reductions can have a cumulative effect and hope that you are not planning on continuing to taper weekly.  I can only offer suggestions based on experience and how you proceed from here is entirely up to you.  Hopefully you are seeing some improvement/benefit after reducing your dose.  Please at least keep track of your daily symptom pattern so that you can be alerted to any changes that you might otherwise miss on a day-to-day basis and be prepared to hold as necessary.  

 

Rate Symptoms Daily to Check Patterns and Progress

Keep it Simple, Slow and Stable

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ChessieCat
1 hour ago, baroquep said:

hope that you are not planning on continuing to taper weekly.

 

I've just gone back over Hazel's post and noticed that the amount is .1mg not 1mg

 

1 hour ago, Hazel said:

I am at 7.8 right now and going to see how I feel in the next week.  I would like to taper .1mg a week

 

10% of 7.8mg is .78mg.  .1mg per week for 4 weeks is .4mg so is equal to slightly more than a 5% reduction.

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baroquep
45 minutes ago, ChessieCat said:

I would like to taper .1mg a week

 

thanks ChessieCat, I guess I should have been clearer, I am hoping that Hazel doesn't continue to reduce weekly without adequate holds, when necessary, particularly at this low dose seeing as she ran into trouble not too long ago.  

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ChessieCat
34 minutes ago, baroquep said:

particularly at this low dose seeing as she ran into trouble not too long ago.

 

Okay thanks baroqueq, I was concerned that you may have misread the amount.

 

I think it's good to do a long hold during your taper even if you don't run into problems.  Doing this allows your brain a chance to catch up if it needs to.  There could be things which it needs to do which we aren't aware of.  I did a 3 month hold at 50mg and a 7 week hold at 20mg.

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Hazel

Thank you baroquep and Chessie for your feedback.  I woke up early this morning with quite a bit of anxiety, so will go back to 7.9 and hold until my symptoms improve.  It has been typical for me to have a more difficult time sleeping Sunday nights into Monday morning.  I do much better on the weekends when I don’t have to get up early.  This morning anxiety stinks!

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bubble

I must say I don't really like the idea of you tapering just as yet. If you are still symptomatic (4 months is not long when it comes to holding) and reducing is bound to increase symptoms I don't quite understand what you will achieve. It just seems that your impatience got the better of you.

 

I also don't like the idea of cutting every week (no matter how little) for people who are still symptomatic. Mostly it can take over a week for symptoms to manifest fully so by reducing every week one can quickly lose the control over the tapering process.

 

The fact that your symptoms increased to a very uncomfortable level so quickly means that your CNS is really not ready yet. Holding doesn't mean we are not doing anything. So much rewiring and recovery is happening during holding. This is also time for practicing non-drug coping skills, especially working around your impatience. This is just how I see things.

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grandmaD
23 hours ago, Hazel said:

  I fall asleep okay but wake early and can sometimes fall back to sleep, but it is usually light and I wake easily.

This is very typical.  It's good you can fall asleep as it takes me at least 1 hour, sometimes 2.  I read somewhere that if you get 6 hours, you can manage ok.

 I then have morning anxiety, which is no fun.

This too, is very common and your right, it is no fun!  It is part and parcel of w/d along with insomnia, unfortunately.  Do you have skills in place to cope with it?

 I usually feel pretty good during the day, so I know it could be a lot worse.

!!  Yes you could be a lot worse, believe me!  I guess it all comes to accepting the symptoms we have and that's easier said than done!

 I think I am going to continue to drop very slowly and see how I feel.

We feel like we are between a rock and a hard place.  I often feel trapped, leading to frustration, impatience and depression.  It is a matter of either pressing on and putting up with it, or going slower UNTIL it subsides or staying on a full dose for life!  Some people have no choice, they have to go slower because they have to work or have children.

 I will definitely hold if things go bad.

Just for my 2 cents worth, if you want o minimise symptoms, I would hold out for 6 months.  I think I already posted how I saw no improvement until after 6 months - and even then, only 8 of my 16 symptoms had improved!  I probably should have held longer, but...you know the story!

 I know this process is going to take a long time, but I have to believe it will all work out in the end😊.

Yes, the main thing is you are going in the right direction.  Would it help if you told yourself "I am going to stay on this for life" ... but continue with your holds and tapers, of course in the meantime?  Sort of "tricking the brain".

 

 

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