WackoSirJacko: Paroxetine can be messy

[WackoSirJacko]

Started 20mg Paroxetine in 1995 for anxiety, I was 18. Been fine for 20yrs with me altering mg summer and winter. Then weaned down to 12.5mg over a couple of months Sept/Oct 16. Crashed in November realising my business wasn't working out. Major insomnia and panic ensued. Then I think I made the worst mistake of my life. I went up to 20mg again, then 25 and 30 a few days later. Went to the doctor and said what I had done. He put me up to 40 without even letting the 30 take effect. 2 weeks later the 40 started to work but I think it left me with worse anxiety and insomnia as a shock to the system. I could not feel a thing.

 

I eventually stabilised and started sleeping after a few months. My anxiety subsided until I suddenly woke with depression. So since then I've had counselling and had bouts of anxiety and depression (Which I never really had prior to going up to 40). In the Summer I had a bout of depression which wouldn't shift. I went to 42.5 and then 45. This had little impact. I discovered if I had a beer it would likely send me into depression but sometimes not. Then if I took L-Tyrosine (precursor amino acid to dopa and norepiphrine) I would come out of depression and go into high anxiety which would subside after a few days. Recently I thought that the high dose of paroxetine was damaging my brain and that may be the root cause of the bouts of depression, (could be the beer though, although I only ever had a few). I also thought it was maybe worth a change after consulting with my PDoc. He gave me Seroquel but I didn't like it.

 

Anyway, I still tried to titrate as I thought I may want to go to another anti-depressant so went down from 45 to 40 and I started to feel something, my positiveness got some nice thoughts to bring feelings. 2 weeks later after a bit of anxiety and a few zaps I went down to 35. That was a week and a half ago. Over the weekend I had 2 pints on Friday and had depression Saturday which shifted Sunday with the LTyrosine. However, the anxiety which hit was way more than usual and came with a muzzy, foggy heavy brain and feeling panic. This felt like major withdrawals from coming down 10mg of paroxetine rather than the L-tyrosine stimulating me.

 

My PDoc has given me pregabalin today and told me to hold at 35 till I feel better but don't want it. I tried one today and it hardly did anything anyway.  I think I need the stability on the Parox and to slowly titrate down which will hopefully allow me to feel more and reduce my depressional bouts. I'm really anxious today still should go back up or hold? So it's 3 1/2 weeks since I was on 45mg and 1 1/2 weeks since I came down from 40 to 35. I'm fairly hardy to the anxiety so if you think the worst of dropping has already happened I will hold. Or is it best to get stable on 40 again?

Edited November 14, 2017 by baroquep

[brassmonkey]

Greetings SirJacko-- Welcome to SA, I'm so glad you found us before your doctors have had time to really cause you trouble.  It's very smart of you not to take all the other drugs they are throwing at you.  All that would have done is cause more problems.  Having only been on the one drug it will make things a lot easier to control and taper.  I know you've looked at my profile so you also know that getting off of 40mg of paxil is possible.  It just takes a long time to do it right.

 

Where you are is a good place to be.  Dropping from 40mg to 35mg is a bit over the recommended 10%, but for a first drop it's fine.  Now you have to let things settle out for a minimum of six weeks before trying another drop.  Any change in dosage takes four days to stabilize in the blood, then the symptoms start to show up.  Those can take several weeks to stabilize, as in reach a constant level not disappear.  There is a lot going on behind the scenes in the brain that we can't feel, but needs more time to settle before we make any more changes.  That's why we wait six weeks or more between drops. So stay put on this dose for a while.

 

Drinking alcohol can cause real problems while tapering.  I like my pint as much as anyone (actually more so, read my signature) but giving up drinking made things a lot easier during my taper.  It can be tough to make the social changes, but I really recommend giving it up for the duration and then some.  We've had a lot of people derail successful tapers just by having a couple over the weekend. The pain it causes just isn't worth it.

 

Again, welcome to SA.  We can get deeper into how to do a good taper later.  Have a read around and ask a lot of questions.

 

Brassmonkey

[WackoSirJacko]

Thanks Brassmonkey,

Yep, I knew that more drugs wasn't the answer. Neither is a swop. I've just got to bite the bullet and ride the waves. Weirdly looking forward to this journey.

 

I'm pretty sure going up to such a high dose was the cause of me getting major depression. It's like I can feel my brain not having anything to give, like my receptors or producers of brain chemicals were burnt out. Then an addition of L-Tyrosine pumps in some of the dopamine and norepinephrine building blocks and I'm whooshed into anxiety. Does that ring true with anyone elses experiences to your knowledge? 

[brassmonkey]

With paxil anything over 10mg is pretty much wasted as an AD and causes more trouble than it's worth. At 10mg around 85% of a persons serotonin receptors are affected and going up to 40mg only brings that up to around 93%.  So you get very little added benefit for taking a lot more drug.  But it does leave us with a lot more to untangle when it come time to taper off. 

 

To get the ball rolling here are some links that would be good to read before you start your taper:

Preparing to taper

Why taper by 10% of my dosage?

Tips for tapering off Paxil (paroxetine)

 

[WackoSirJacko]

Were there times when you'd come down and you started to feel yourself again, like how you used to on 20mg? Like you'd come down and after it settled you'd feel life was bearable again?

[WackoSirJacko]

Hi any moderator,

 

I'm really struggling today. My first post was yesterday and Brass monkey kindly got back to me but think he misread my post. I basically came down from 45mg of paroxetine to 40 three and a half weeks ago. Then a week and a half ago I came down to 35. I had minor jerks and muzzy head but since Sunday I've gone into hyper anxiety. Should I go back to 40 and stabilise? Brass thought I'd come from 40 to 35 only. Bit frantic at work at the moment.

[WackoSirJacko]

Desperate, please help

[bubble]

Hello Wacko.

 

Please post all your questions in your introductory thread so we don't have to merge them and move them around.

 

Since it seems that your withdrawal symptoms are very intense you might benefit from an updose. Also since the reduction was 2 weeks ago you might not have to go to the previous dose but 37 mg could be enough. Depending on how you feel after that you can decide to updose more or it will be more bearable and you will be able to tough it out.

 

Keep a log of your symptoms. I hope this helps.

[WackoSirJacko]

Great, thanks so much Bubble!

 

How long should I give the 37 before I decide whether I need more?

[bubble]

Your symptoms will tell you but it generally looks something like this: if an updose is the right thing to do you should experience some relief from your symptoms pretty soon. If that relief continues, 37 mg is enough.

 

If after the initial relief the symptoms return to the previous level you experienced before updosing that's usually a sign your brain could use some more.

 

This episode shows that you have to hold longer between cuts and possibly cut by less. We generally recommend holding for the minimum of 4 weeks and you cut after 2 weeks by more than 10 % while some us can only tolerate less than 10 % cutting. These initial cuts are a way of learning what our brain can put up with.

[WackoSirJacko]

Thanks Bubble

[WackoSirJacko]

Bubble/Monkey,

 

I was suffering bad and have gone back to 40. Hopefully I will stabilise quicker. My anxiety seems to be manifesting itself as akathisia? Like all through my body, needing to get up and walk around. No real palpitations. Is this common and have you any tips on when or how this can calm down?

[Cheeky]

hey 👋🏻 

i just wanted to let you know, I too suffer with paxil and am down to 36mg but it’s been hard.

The people here are great and BrassMonkey is a legend in this. Listen to his wise words as I have done . Your going to be okay we all have each other’s back

[WackoSirJacko]

On 11/22/2017 at 6:23 AM, Cheeky said:

hey 👋🏻 

i just wanted to let you know, I too suffer with paxil and am down to 36mg but it’s been hard.

The people here are great and BrassMonkey is a legend in this. Listen to his wise words as I have done . Your going to be okay we all have each other’s back

Thanks Cheeky,

 

I've come from 45 to 35 then went back to 40 and I'm leveling with more windows. I think it's important to turn your attention away from it whilst levelling out as forums and obsessing feeds the anxiety. I've read your thread and have suffered as you at times. Anxiety isn't all down to the withdrawal, it's important to know that and turning off fight or flight takes acceptance and a certain amount of ignorance to it. Like a 'so what' and a middle finger up to it, even when you can't bear it. To my surprise you find eventually it turns off. Throughout these feelings I've found they are all paradoxical in that you need to ignore them rather than pay attention. Hence I'll only be on here sparingly.

 

Keep pushing through Cheeky, we will get there with many lessons learnt along the way. x

[Cheeky]

12 hours ago, WackoSirJacko said:

Thanks Cheeky,

 

I've come from 45 to 35 then went back to 40 and I'm leveling with more windows. I think it's important to turn your attention away from it whilst levelling out as forums and obsessing feeds the anxiety. I've read your thread and have suffered as you at times. Anxiety isn't all down to the withdrawal, it's important to know that and turning off fight or flight takes acceptance and a certain amount of ignorance to it. Like a 'so what' and a middle finger up to it, even when you can't bear it. To my surprise you find eventually it turns off. Throughout these feelings I've found they are all paradoxical in that you need to ignore them rather than pay attention. Hence I'll only be on here sparingly.

 

Keep pushing through Cheeky, we will get there with many lessons learnt along the way. x

Your right about the forums , it just when  your feeling desperate, reading other people stories makes you feel

like your not the only one suffering and at least they can give you advice. 

Goid job updoseing if you weren’t feeling good, we do have to read our body for signs .

im go Ng to wait til the new year to

taper again and let my CNS stabilise.

wishing you all the best in your journey 

[Cheeky]

On 15/11/2017 at 9:33 AM, brassmonkey said:

With paxil anything over 10mg is pretty much wasted as an AD and causes more trouble than it's worth. At 10mg around 85% of a persons serotonin receptors are affected and going up to 40mg only brings that up to around 93%.  So you get very little added benefit for taking a lot more drug.  But it does leave us with a lot more to untangle when it come time to taper off. 

 

To get the ball rolling here are some links that would be good to read before you start your taper:

Preparing to taper

Why taper by 10% of my dosage?

Tips for tapering off Paxil (paroxetine)

 

Brass , why  do we still feel terrible withdrawals when getting to 10mg ?

 I can understand getting  undet 10mg  is extremely tough , does the time being on the drug count. I know you have been on it for as long as I have  and you had pretty smooth sailing at  the beginning. I’m struggling and have on gotten off 4mg in a year. I just st don’t seem to get it ?

 

[nz11]

On ‎11‎/‎23‎/‎2017 at 10:15 PM, WackoSirJacko said:

Hence I'll only be on here sparingly.

WSJ I hope you keep in touch posting regularly.

The support and encouragement and guidance from this online support is a major player in helping to get off this drug imo.... Its a 24/7 cheer group.

I would look into doing the Brassmonkey slide method for your tapering once stable. 

You are not alone and when you have very difficult days you can pop in to sa and be carried and gain strength for the journey once again. Yes this is a long journey, we are talking years of tapering, and it is good to be in the company of those who 'get it' .

 

So glad you found sa

nz11

[nz11]

On ‎11‎/‎24‎/‎2017 at 10:48 AM, Cheeky said:

 I’m struggling and have on gotten off 4mg in a year. I just st don’t seem to get it ?

 

Cheeky I'm sorry you are struggling so much ....I notice that you are tapering 2 drugs at the same time. That could be problematic if hit with wdl symptoms at any time for which drug is to be blamed? So you have actually tapered off more than 4mg in a year (it looks like about 11mg to me). What do you think about holding on the paxil and tapering off the seraquel.?

Wdl symptoms can occur from a too fast taper  at any dose it is not limited to 10mg or under.

I think  what the BM is saying there is an oversaturation of the drug above 10 mg  (or is it above 20mg?) this may be why some people can taper down to a certain point without to much trouble then bam! the fight is on.  However as BM says higher doses still have to be 'untangled' carefully and slowly else wdl can be triggered so there is no guarantee of a free ride from any dose interval.

Yes imo  dependency is deepened with every passing year on the drug. 

 

Apologies WSJ for commenting to others in your thread. 

 

[Cheeky]

1 hour ago, nz11 said:

Cheeky I'm sorry you are struggling so much ....I notice that you are tapering 2 drugs at the same time. That could be problematic if hit with wdl symptoms at any time for which drug is to be blamed? So you have actually tapered off more than 4mg in a year (it looks like about 11mg to me). What do you think about holding on the paxil and tapering off the seraquel.?

Wdl symptoms can occur from a too fast taper  at any dose it is not limited to 10mg or under.

I think  what the BM is saying there is an oversaturation of the drug above 10 mg  (or is it above 20mg?) this may be why some people can taper down to a certain point without to much trouble then bam! the fight is on.  However as BM says higher doses still have to be 'untangled' carefully and slowly else wdl can be triggered so there is no guarantee of a free ride from any dose interval.

Yes imo  dependency is deepened with every passing year on the drug. 

 

Apologies WSJ for commenting to others in your thread. 

 

Why would you do the seraquel first?

[WackoSirJacko]

4 hours ago, nz11 said:

WSJ I hope you keep in touch posting regularly.

The support and encouragement and guidance from this online support is a major player in helping to get off this drug imo.... Its a 24/7 cheer group.

I would look into doing the Brassmonkey slide method for your tapering once stable. 

You are not alone and when you have very difficult days you can pop in to sa and be carried and gain strength for the journey once again. Yes this is a long journey, we are talking years of tapering, and it is good to be in the company of those who 'get it' .

 

So glad you found sa

nz11

Thanks nz11, I'll keep you all posted for sure. A big thing for me is to not obsess about it though and to carry on as normal. My progress is falling into the windows and waves pattern for sure with windows getting bigger and waves getting shallower. Not going to drop now till after Christmas as it's tough enough. I'll keep an eye on theings though. 

 

Cheeky, hope you are doing well? I'd agree with shifting the seroquel first. Paroxetine will stabilise and even perhaps help whilst removing seroquel from your system. We've got all the time in the world to do this so no rush. 

[Cheeky]

He

13 hours ago, WackoSirJacko said:

Thanks nz11, I'll keep you all posted for sure. A big thing for me is to not obsess about it though and to carry on as normal. My progress is falling into the windows and waves pattern for sure with windows getting bigger and waves getting shallower. Not going to drop now till after Christmas as it's tough enough. I'll keep an eye on theings though. 

 

Cheeky, hope you are doing well? I'd agree with shifting the seroquel first. Paroxetine will stabilise and even perhaps help whilst removing seroquel from your system. We've got all the time in the world to do this so no rush. 

Hey WackoSirJacko,

I'm still trying to get stable from last drop, but in the new year I will go down 1mg of paxil and then give that a break and then start the Seraquel .

Sorry for taking over your thread.

 

[WackoSirJacko]

On 11/29/2017 at 2:25 AM, Cheeky said:

He

Hey WackoSirJacko,

I'm still trying to get stable from last drop, but in the new year I will go down 1mg of paxil and then give that a break and then start the Seraquel .

Sorry for taking over your thread.

 

 

Hi Cheeky,

 

Do you get depression or just high anxiety?

[Cheeky]

Mostly high aniexty which brings on me being depressed. 

[DaveB]

On ‎11‎/‎28‎/‎2017 at 5:52 AM, WackoSirJacko said:

Thanks nz11, I'll keep you all posted for sure. A big thing for me is to not obsess about it though and to carry on as normal. My progress is falling into the windows and waves pattern for sure with windows getting bigger and waves getting shallower. Not going to drop now till after Christmas as it's tough enough. I'll keep an eye on theings though. 

 

Cheeky, hope you are doing well? I'd agree with shifting the seroquel first. Paroxetine will stabilise and even perhaps help whilst removing seroquel from your system. We've got all the time in the world to do this so no rush. 

 

Sorry to lurk and comment, but when you get "windows and waves" do they last for days and/or weeks. Seems like that is the case for most, but mine are more by the hour, like many windows and waves per day. Do you or have you ever experienced this?

[WackoSirJacko]

9 hours ago, DaveB said:

 

Sorry to lurk and comment, but when you get "windows and waves" do they last for days and/or weeks. Seems like that is the case for most, but mine are more by the hour, like many windows and waves per day. Do you or have you ever experienced this?

Hi DaveB,

 

Both, but if I can ride a window I can get gradually stable for a week or so, then I get a bit of depression, which turns into anxiety for a few days and then a window. Seems to be a cycle but the cycles are getting less intense. I'm hoping they will balance out to a constant stable. Then I'll drop again.

[WackoSirJacko]

On 11/15/2017 at 3:24 PM, bubble said:

Your symptoms will tell you but it generally looks something like this: if an updose is the right thing to do you should experience some relief from your symptoms pretty soon. If that relief continues, 37 mg is enough.

 

If after the initial relief the symptoms return to the previous level you experienced before updosing that's usually a sign your brain could use some more.

 

This episode shows that you have to hold longer between cuts and possibly cut by less. We generally recommend holding for the minimum of 4 weeks and you cut after 2 weeks by more than 10 % while some us can only tolerate less than 10 % cutting. These initial cuts are a way of learning what our brain can put up with.

Bubble, would you say that you are mostly stable now? Enjoying things a lot more?

[WackoSirJacko]

On 11/15/2017 at 3:24 PM, bubble said:

Your symptoms will tell you but it generally looks something like this: if an updose is the right thing to do you should experience some relief from your symptoms pretty soon. If that relief continues, 37 mg is enough.

 

If after the initial relief the symptoms return to the previous level you experienced before updosing that's usually a sign your brain could use some more.

 

This episode shows that you have to hold longer between cuts and possibly cut by less. We generally recommend holding for the minimum of 4 weeks and you cut after 2 weeks by more than 10 % while some us can only tolerate less than 10 % cutting. These initial cuts are a way of learning what our brain can put up with.

 

Hey Brassmonkey, need a little support please,

 

After I went back to 40mg the paxil lifted a few symptoms and then with mindfulness the anxiety subsided. I had a good week or so and then got a little depression which has turned to anxiety and my brain feels weird, like it's being pickled or something. Did you get 2 waves after a disruption/drop? Hoping my head will relax and I'll be able to control the anxiety again. 

[brassmonkey]

Hi SirJacko-- sorry about the confusion with my first post.  It looks like you've gotten a lot of good advice in the meantime.  With your just making an updose it's going to be a good idea to not make any more changes for several months.  There have been a good number of dose changes in the past several months so we need to allow a good amount of time for your body to process them and get to a stable place before making  any more changes.  A stable place is not going to be where there are no symptoms but rather an evening out of the symptoms so there are not any big swings over several weeks time.  Once stability is recognized it's generally a good idea to wait several more weeks for "background healing" to catch up before making any new reductions.  It is very important to allow time for the "background healing" to take place.  As I mentioned above there have been a lot of physical changes made to your CNS that have to be sorted out and corrected.  We frequently can't feel this happening, but it is very important that we give it the time it needs.

 

There are going to be changes in emotions and symptoms that happen through out the day and over the course of a week or so.  These are normal fluctuations.  The Windows and Waves pattern of symptoms is a longer view and the symptoms are much more pronounced.  It's called a Wave because the symptoms crash over you, drag you down and try to drown you, and a Window because it's like a breath of fresh air after being suffocated. Waves are usually protracted, lasting several week to months, while Windows frequently start small, fifteen minutes or so and become stronger over time.

 

Following a decrease in dose there is frequently a day or two delay before the symptoms increase.  That increase will generally last several weeks and then fade back to baseline of just feeling bad with slight variations.  While those symptoms are ramped up there can be fluctuations of feeling really good followed quickly by feeling really bad. I actually experienced four bouts of symptoms with each 10% drop.  This is because I broke it into four smaller drops of 2.5% a week for four weeks.  I would then add on two more weeks just to let things sort them selves out before doing it all again. This spread the symptoms out over several weeks and made them much more tolerable.

 

Well done on being able to control the anxiety with mindfullness, it's a very handy skill to develop.

[WackoSirJacko]

UPdate

 

OK, went through Christmas (tough) on 40mg and evened out feeling ok, even quite good with a bit of positive thinking. Gave myself 2 weeks to settle things in the background as BrassMonkey suggested.

Jan 15th I went down to 37.5mg - took 4 days for the symptoms to come. dizzyness, what I call muzzy headedness, bit more base anxiety but not major and little depression, which weirdly isn't as bad as past depression on 45mg or 40mg. A week on from the drop today and I'm in good spirits as along with these withdrawal symptoms I'm also recognising past feelings. So getting a bit of feeling from music etc. Just a tiny bit. I can see even at this high level still that the masking was stopping me feel things.

 

I also have noticed something well worth pointing out to those particularly on Paxil/Seroxat. The lesser feeling of depression. Paxil has an histamine blocker quality which is why it feels so sedating. This can be a cause of depression. I never suffered bad depression until several months on 40mg of Paxil (up from spending 20 years on 20mg). I have a theory that for a lot of people, when the Doc upped our dose from 20mg (standard), to 30 and for some 40 or more, it upped the ability to reduce anxiety but killed feelings stone dead and also introduced a depression creating dose of histamine blocker. 

 

Anyway, staying here for a few weeks then down to 35mg

[brassmonkey]

HI Jacko-- it's good to see that you've stabilized and are off to a good start on your taper. Keep up the good work.

 

Brassmonkey

[Cheeky]

Hey Jacko.

I'm  just chiming in to say hi and its good to see your feeling better. I've been following your thread as I too am coming of this poison too. I just went down to 35mg a few days ago so I'm hoping for the best. Ive had many failed attempts coming off so I'm going extremely slow.  Good luck with everything x

[WackoSirJacko]

18 hours ago, brassmonkey said:

HI Jacko-- it's good to see that you've stabilized and are off to a good start on your taper. Keep up the good work.

 

Brassmonkey

 

Nice one, thanks Monkey

 

Bit high last night as I had slight feelings of emotion I hadn't felt in ages. Even at 37.5mg. Didn't sleep well as brain was just going crackers. I'm 1 week after taper. Did this ever happen to you?

[WackoSirJacko]

15 hours ago, Cheeky said:

Hey Jacko.

I'm  just chiming in to say hi and its good to see your feeling better. I've been following your thread as I too am coming of this poison too. I just went down to 35mg a few days ago so I'm hoping for the best. Ive had many failed attempts coming off so I'm going extremely slow.  Good luck with everything x

Thanks CHeeky, we'll get there. You started feeling glimmers of emotion yet?

[brassmonkey]

Feeling little bits or emotion is wonderful, especially after only one drop.  I was so far into poopout and had such strong anhedonia that I didn't feel much of anything until I got down under 20mgai. and only really started to notice the return of emotions right around 10mgai.  Many of the symptoms will hit during the first week of a taper, peak and then stabilize over the next several weeks, so this is sounding pretty normal. Getting the ol' brain to quiet down is a real trick.

[Cheeky]

On 1/24/2018 at 1:32 AM, WackoSirJacko said:

Thanks CHeeky, we'll get there. You started feeling glimmers of emotion yet?

hey Jacko,

I haven't had any problem with my emotions, only when I'm having waves I get intense emotions.

[DaveB]

On 1/22/2018 at 3:53 PM, Cheeky said:

Hey Jacko.

I'm  just chiming in to say hi and its good to see your feeling better. I've been following your thread as I too am coming of this poison too. I just went down to 35mg a few days ago so I'm hoping for the best. Ive had many failed attempts coming off so I'm going extremely slow.  Good luck with everything x

 

Great to see you are feeling stable enough to taper again! Hoping to join you soon!