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Tips for tapering off Paxil (paroxetine)

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grandmaD

Well that's just great!  That could explain it.  Have other people had problems when changing over brands?

Has anyone else on Aropax in Australia experienced this problem recently?

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dreamspirit

Oh yes, I switched to a different manufacturer once years ago and it put me into withdrawal it was terrible. I ended up going to my other pharmacy and got my other prescription and within a week I felt better. 

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grandmaD

How long were you on the other brand before you realised it and switched back?  It is crazy isn't it!  They tell you the ingredients are the same, but I see many people have trouble with generic brands.

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Miranda99

Some tips that I've learnt in my time tapering from paxil are: 

* Store the medicine in the fridge

* Make sure I wipe my syringe after expelling the liquid as there is always some residual. 

* On my manufactured bottle from GSK UK it states you must use an disuse an open bottle of paxil after 30 days. ( I thought they were pulling a fast one, as wanted one to use more costing them more) but I have found out by trying this that I seem to start withdrawing if use the medicine 5 days post the recommended 30 days. 

* I always ensure I get the exact same brand every month. They have tried to give my parallel imports from Russia and Greece and I've gone into withdrawal

* I get withdrawals every morning, so I take my medicine at 4 am ish daily, then go back to sleep. I've recently found that taking 2 high dose fish oil capsules at this time helps with the morning nightmares/ jerks/ sleep paralysis and more recently loud crashing noise which was coming from my brain! 

* If in get panicky at work, I do some deep breathing, and make myself a cup of chamomile tea with x 2 bags in it. It really seems to work! 

* If I have to get up for work after a few days off which tends to worry me, I spray my body with magnesium oil spray night before. 

* I have downloaded headspace which is great for sleep, and after stressful days mindfulness techniques. 

* I try to get 9 hours sleep a night

* I keep a diary on a menstrual app as some days I sweat more, and get really angry etc where hormones affect my withdrawal. I've recently started taking chaste berry so will be waiting to see what my PMT is like this month. 

* I get super dizzy in withdrawal and the only thing that works for me is a travel sickness tablet called cinnarizine. ( I could not have gone as low as 3 mgs without this med, but understand the desire to minimise meds. 

* If I'm anxious in the morning I make sure I raise my blood sugars by eating a banana and then some other breakfast. This seems to help lots too. 

These are probably not any new idea just what I've learnt over the past couple of years. The main thing I've learnt it to never go up to an insane high dose to cope with withdrawals but just go back up by a tiny amount. Ie) I dropped to 2.5mg, got bad withdrawals went back up to 20 mg when I had only been at 10 mg before. If I'd been advised to have just gone to 5 mg I would be off by now! 

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brassmonkey

" On my manufactured bottle from GSK UK it states you must use an disuse an open bottle of paxil after 30 days. ( I thought they were pulling a fast one, as wanted one to use more costing them more) but I have found out by trying this that I seem to start withdrawing if use the medicine 5 days post the recommended 30 days. "

 

Each person is going to have an individual reaction the their medication so it's quite likely that this may be happening Miranda.  I would like to point out however that there have been several studies conducted (no I can't give references)  that showed that these medications maintained 90% of their potency when they were stored for over ten years.  Any decrease in the potency of the drug over the time span of a slow taper would be taken into account by the slow change and shouldn't be factor that needs consideration.  I personally used the same bottle of paxil 40mg for the last three and a half years of my taper and didn't notice a thing.  Home made liquids are another story.  Impurities are added in the making of the liquid that will cause it to spoil in a matter of days.  Kept refrigerated the liquid is usable for about a week maybe two.

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Miranda99

Some tips that I've learnt in my time tapering from paxil are: 

* Store the medicine in the fridge

* Make sure I wipe my syringe after expelling the liquid as there is always some residual. 

* On my manufactured bottle from GSK UK it states you must use an disuse an open bottle of paxil after 30 days. ( I thought they were pulling a fast one, as wanted one to use more costing them more) but I have found out by trying this that I seem to start withdrawing if use the medicine 5 days post the recommended 30 days. 

* I get withdrawals every morning, so I take my medicine at 4 am ish daily, then go back to sleep. I've recently found that taking 2 high dose fish oil capsules at this time helps with the morning nightmares/ jerks/ sleep paralysis and more recently loud crashing noise which was coming from my brain! 

* If in get panicky at work, I do some deep breathing, and make myself a cup of chamomile tea with x 2 bags in it. It really seems to work! 

* If I have to get up for work after a few days off which tends to worry me, I spray my body with magnesium oil spray night before. 

* I have downloaded headspace which is great for sleep, and after stressful days mindfulness techniques. 

* I try to get 9 hours sleep a night

* I keep a diary on a menstrual app as some days I sweat more, and get really angry etc where hormones affect my withdrawal. I've recently started taking chaste berry so will be waiting to see what my PMT is like this month. 

* I get super dizzy in withdrawal and the only thing that works for me is a travel sickness tablet called cinnarizine. ( I could not have gone as low as 3 mgs without this med, but understand the desire to minimise meds. 

* If I'm anxious in the morning I make sure I raise my blood sugars by eating a banana and then some other breakfast. This seems to help lots too. 

These are probably not any new idea just what I've learnt over the past couple of years. The main thing I've learnt it to never go up to an insane high dose to cope with withdrawals but just go back up by a tiny amount. Ie) I dropped to 2.5mg, got bad withdrawals went back up to 20 mg when I had only been at 10 mg before. If I'd been advised to have just gone to 5 mg I would be off by now! 

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Miranda99

I think I have read the same studies, but have these studies not been on unopened packets of pills, and not on liquid that has been made up? Surely once a bottle of liquid has been opened it is not going to keep its sell by date for as long? I'm my experience different liquids have a different time span as use before once opened such as oramorph has 90 days, and insulin has 28 days etc. I understand that you could probably get a bit longer out of them, but I don't think as long as you've suggested! I used it for around an extra 2 weeks ignorantly and I definitely suffered stronger withdrawal due to it. Here is one study. 

 

https://www.drugs.com/article/drug-expiration-dates.html

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brassmonkey

The studies were on unopened, factory sealed packages of tablets. Opening a package of tablets doesn't change much as long as you keep it cool and dry.  Moisture and heat will cause trouble.  No, an open package of tablets will not keep for ten years, but they will last a lot longer than 30 days.  Like I said, liquids are another story, even the commercial ones.  If they stay sealed from the factory they will last a long time if stored correctly.  Once they are opened, yes they need to be used with in the month.  Oramorph and insulin are totally different from ssris in their structure and play by their own set of rules.

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kateinsocal
Quote

Once they are opened, yes they need to be used with in the month.

WOAH!

 

I've been on liquid Paxil for several months and I didn't know this. It could explain a lot. 

Since my dose is so low, my supply usually lasts 2-3 months (it's supplied for 30 days at 5mg/day, I take 1.6mg currently).  It costs me at least $50 per bottle though, and will be $100 next year. I don't want to have to buy a new bottle every month. Will putting it in the fridge help prolong it? Is there anything else I can do? If I had the pharmacy put it in a couple smaller bottles, that wouldn't help, right? Because it's been exposed to air when they pour it in the bottles to give out?

 

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grandmaD
5 hours ago, brassmonkey said:

 

 

 I would like to point out however that there have been several studies conducted (no I can't give references)  that showed that these medications maintained 90% of their potency when they were stored for over ten years.

Hi Brass, I recall you asked me if I was taking a "mix" of tablets - old and new ones when I crashed earlier this year and couldn't figure out why.  Yes, I was taking a mixture.

 

The chemist also told me the tablets never get "old" and last forever.  Just the same, I didn't know what was causing my downhill spiral into the pits where I stayed for months and months so I went on the "new" ones full time.

 

However, what I didn't ask YOU or the CHEMIST, was that these tablets - the old ones, that is - were what was left from when I cut and shaved previous ones from years and years before and kept in a bottle.  SO the question needs to be asked, WHAT IF THE TABLET IS NO LONGER IN THE FOIL!  How long does it keep THEN?

 

ANYWAY, what happened, was these "new" tablets I began taking, I eventually noticed they were in a slightly different box, packed slightly different and a slightly different size..... which led me to discover they were a generic.  That, I believe explains why I went downhill for so long and could not get back up.

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grandmaD

I was going to go over to liquid as it is supposed to be more accurate, but to do it accurately you would need to dissolve a 20mg tablet in 20ml of water is my understanding. I worked out I would be taking 3mg and throwing the rest out as liquid only lasts a week.

 

Oh, boy, my head.  I now look at this and realise this can't be right!  3mg a day equals 21mg a week.  Is that right!  I can't trust my brain, honestly!

My tablet weighs 53mg, so over a week I am consuming 37mg.  Is that right?  HELP!  I think I better just stay how I am going with crushing tabs.!

 

Brass, you didn't go to liquid did you, but stayed on the crushed tablet?

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Miranda99

Apologies if I've duplicated anything. Getting the hang of the site still!! 

It's a tricky one with the use by date once opened. I'm pretty sure I noticed a difference when I used it past 40 days. 

I am a registered nurse for 20 years. One of the first things that we learn is to check the dates on everything! With liquids some of these are mixed locally or even on the ward. I'm not sure about paxil liquid but I would think with all the extra ingredients it would start to erode at some point. However, I am still learning, and I've thought for years that generic brands were the same as manufacturers brands, but now I know that they're not identical and I definitely need to get the same make every time. With the Greek one ( still GSK) it made me sick, which is when I first noticed it, and then I started getting head shocks. Pharmacy have tried to give me another parallel import this month, but I have declined as I am so sensitive to even minor differences. I actually sent 2 bottles of parallel imported paxil back to GSK about a year ago for them to test, but have heard nothing back. 

I've tried to research this loads and loads, and have found a study that showed that epileptics were sensitive to medications from different manufacturers, and they brought on fits with some people. I'm thinking that SSRI's must be similar due to it working on your brain. I  pay a low fee for my prescription so I can renew the liquid every month, but I can see the dilemma with people who have high costs with new bottles

 

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brassmonkey

GrandmaD-- that's one of the problems with homemade liquid, you waste a lot which drives the cost up.  Yes, you are only taking 21mg a week.  That's way down from the 140mg a week you were taking a few years ago, well done.  I'm not sure how you're getting the numbers 53mg and 37mg?

 

If your taper is working then I would stay with how you're doing things. 

 

Yes, I stayed on the crushed pills for my entire taper.

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brassmonkey

HI Kate--  As you get lower in dose it will take longer and longer to use up a bottle.  I tapered for three and a half years on one bottle of tablets and still had some left over.  It will really help to store it in the refrigerator, and I like the idea of getting several smaller bottles from the pharmacist.  Keep those in the fridge too until you need them.  Don't Freeze them, it sounds like a good idea, but is really bad for the medication. 

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Cheeky

Needing a little advice to make sure I’m doing this correctly. I’m on 36mg paxil, I’ve been so far taking 30mg in tablet and the 10mg that was left I’ve crushed that in a jar with 10mg of water, I shake it vigorously, take out 4mg throw that out and drink the 6mg remaining in the jar.

is that a safe way of doing it.

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brassmonkey

That is a fine way of doing it. How are you getting the 10mg that you dissolve in the water?

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Cheeky

The 10mg is what halve a tablet is, they come in 20mg tablets, so i take one and a halve 30mg and the other halve i crash with 10ml of water.

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grandmaD
On 11/8/2017 at 6:05 AM, brassmonkey said:

GrandmaD-- that's one of the problems with homemade liquid, you waste a lot which drives the cost up.  Yes, you are only taking 21mg a week.  That's way down from the 140mg a week you were taking a few years ago, well done.  I'm not sure how you're getting the numbers 53mg and 37mg?

 

If your taper is working then I would stay with how you're doing things. 

 

Yes, I stayed on the crushed pills for my entire taper.

I don't know how I came up with 37mg either!  My head is so bad, so many headaches again and if not a headache having pressure heads and very difficult to think.  Also very, very sore head (to touch)

 

In fact, I am beginning to wonder if the "changes" I've done this drop are causing all this, as I am taking a mixture of tablet cut and filed and powder in capsules.  Of course, it could also be the drop, first one after 6 months hold, but usually the first drop after a hold isn't too bad.  Or it could still be the effects of the switch to the generic. 

 

Thanks for your help I will stay on how I'm doing it rather than go to liquid.

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brassmonkey

Your's sounds fine Cheeky, the numbers all add up correctly.

 

Well, I wouldn't worry about the 37mg GrandmaD.  We know that you're taking 3mg a day and that's all we need to think about.  I have the feeling that symptoms are from the latest drop and hopefully will settle out soon.

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grandmaD

Thanks brass, I will stay on the tablet form as long as I can for now.  I had been using the powder to put in capsules and I wonder if that can cause worsening symptoms too, so have gone back to just the tablet.  I will wait a few weeks and try the capsules again then and see...

Yes, of course, it could also be from doing this drop, or everything combined, I guess!

 

That brings me to the next question:  do you know how long the powder (filing remains) keeps?  I have it in a dark, airtight bottle, kept in pantry (dark/cool)

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Krasiyan

I wanted to ask something about Paxil. In my case I took 40mg for 6 years, and stopped it pretty fast. When I reinstated at 5mg it did help a little, but it was not enough.

 

Now I'm at 10mg, and was wondering, because my history has such a high dose do I have to work my way up to 20mg? Like September I was on 40, and now I'm on 10 so will my system be expecting 20 I'm not sure.

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