Robert99: trying to get off of paxil, on 20 years, at 5mgs now

[Robert99]

On 7/20/2024 at 5:28 PM, LostInCanada said:

I feel like it is becoming a cash cow for people claiming to be able to help. I appreciate that no one here is profiting, just helping based on collective experience. And Sebas is amazing with his knowledge of supplements. Just keep asking questions here before adding anything. It is easier to prevent a reaction than undoing it. 👍

So I have been entertaining a bridge to prozac (with a increased prozac dose to try to stabilize) with Dr. Can anyone give advice on this? 

Instructions I sent in a prescription for liquid fluoxetine (Prozac). It is 4 mg/Ml. I wrote to take 2.5 mg (.625 mL) daily. Prozac takes a little longer to build up in your system, so I recommend starting Prozac before stopping Paxil.

Weeks 1-2: Continue with Paxil .7 mg daily and add Prozac 1 mg daily (.25 ml)

Week 3-4: Reduce Paxil to .35 mg daily and increase Prozac to 2 mg (.5 mL)

Week 5: Stop Paxil and increase Prozac to 2.5 mg (.625 mL) daily

[LostInCanada]

22 minutes ago, Robert99 said:

So I have been entertaining a bridge to prozac (with a increased prozac dose to try to stabilize) with Dr. Can anyone give advice on this? 

This is not a good idea. Read the member Erell or the moderator Go2zero.

Go2zero said it was the worst decision. Erell took a couple years just to stabilize.

Not only will you have solid withdrawal from paxil but then new side effects from the prozac.

It is doctors go to when someone tries to get off paxil. I was sent down that road as well. It was not good - within days I developed facial tics and worsened vomiting, etc. There is also a risk of serotonin syndrome. 

I attended a seminar of Dr Mark Horowitz the strongly discouraged bridging to another drug.

 

 

[Robert99]

17 minutes ago, LostInCanada said:

This is not a good idea. Read the member Erell or the moderator Go2zero.

Go2zero said it was the worst decision. Erell took a couple years just to stabilize.

Not only will you have solid withdrawal from paxil but then new side effects from the prozac.

It is doctors go to when someone tries to get off paxil. I was sent down that road as well. It was not good - within days I developed facial tics and worsened vomiting, etc. There is also a risk of serotonin syndrome. 

I attended a seminar of Dr Mark Horowitz the strongly discouraged bridging to another drug.

 

@Go2zero would you mind weighing in? 

The only thing to mention is that I am on .7mgs. I have not seen anyone on that low of a dose who did a bridge. Have you? 

 

[LostInCanada]

7 minutes ago, Robert99 said:

I have not seen anyone on that low of a dose who did a bridge. Have you? 

No but the principles remain the same. 

You can add water to your manufactured liquid to make the drops much smaller and therefore easier to handle. You are so low so I know it is harder. 

I was just reading the leaflet that comes with paxil. It states not to take tryptophan.

What are your symptoms at present. Do you feel stabilized? 

[Ariel]

Hi @Robert99

 

For what it's worth, I strongly agree with LostInCanada. I would NOT pursue the Prozac bridge at any cost. There is significant risk and relatively little potential reward; it's simply not worth it. We've seen it go very, very wrong all too many times. 

 

It looks like you are very low in your Paxil taper, at 0.7mg now. If you're feeling overwhelmed by withdrawal symptoms, you might consider doing an extended hold at your current dose until you stabilize.

 

In your drug signature you write that in May and June you were trying to stabilize at 0.8mg. Since you're now at 0.7mg, does that mean you felt stable enough to do that recent cut and drop the 0.1mg from 0.8->0.7mg? Or had you not yet fully stabilized prior to the last cut? 

 

To be clear, when we talk about doing an extended hold, we don't usually mean 1-2 months (which is an average-length hold), but rather 3-6+ months or longer (depending on how it goes -- impossible to predict ahead of time) until true stability is attained. 

 

Sorry if I missed this, I can't seem to find the answer in previous posts. What is your rationale for wanting to bridge to Prozac at this point, so far into your Paxil taper?

 

[Robert99]

5 minutes ago, Ariel said:

Hi @Robert99

 

For what it's worth, I strongly agree with LostInCanada. I would NOT pursue the bridge at any cost, there is significant risk and it's simply not worth it. We've seen it go very, very wrong all too many times. 

 

It looks like you are very low in your Paxil taper, at 0.7mg now. If you're feeling overwhelmed by withdrawal symptoms, you might consider doing an extended hold at your current dose until you stabilize. In your drug signature you write that in May and June you were trying to stabilize at 0.8mg. Since you're now at 0.7mg, does that mean you felt stable enough to do that recent cut and drop the 0.1mg from 0.8->0.7mg? 

 

To be clear, when we talk about doing an extended hold, we don't usually mean 1-2 months (which is an average-length hold), but rather 3-6+ months or longer (depending on how it goes -- impossible to predict ahead of time) until true stability is attained. 

 

Yeah I had a laspe of judgement and dropped to .7mgs after feeling good a few days. That was stupid. 

[Ariel]

22 minutes ago, Robert99 said:

Yeah I had a laspe of judgement and dropped to .7mgs after feeling good a few days. That was stupid. 

 

Don't beat yourself up about it, we all make errors in judgment. Tapering is an art as much as it is a science, and we do our best as we go along. You're already doing great by tapering in the first place -- take it from someone who has CTed multiple times!

 

What is the exact date that you dropped to 0.7mg?

 

Furthermore, it looks like in June you started TRT. And at some point recently you also experimented with L-Tryptophan supplements, correct?

 

These sorts of chemical experiments can be further destabilizing to an already destabilized and hypersensitive system. 

That's why we advise extreme caution when introducing any sort of supplements or auxiliary drugs. 

 

Please also carefully read this topic, esp. the intro post, about The Rule of 3KIS, a.k.a. KISSS.

We recommend only ever making one change at a time, and then holding for a while before any subsequent changes. 

If you change multiple things at once, it's impossible to tell what is affecting you, regardless of whether the effects are positive or negative. 

For now I'd suggest staying away from any new or additional supplements and just sticking with what your body is already used to. 

Focus on stabilizing properly where you're at.

 

What is the exact date that you dropped to 0.7mg?

 

[LostInCanada]

@Robert99 I also just want to mention, .8 mg to .7 mg is more than 10% so no wonder you feel a mess. 

I think once you stabilize, going the brass monkey slide method is a better option down this low. Also consider a total of a 5% drop to see if that makes it easier. 

I do wish I was at your dosage. The max I seem to be able to drop is 0.5% at a time. Slow as slow but at least still moving forward.

You are doing great really. Just a nice long hold and then slow the percentage a bit. You got this. 

@Ariel thanks ❤️ great advice as always.

[Robert99]

1 hour ago, Ariel said:

 

Don't beat yourself up about it, we all make errors in judgment. Tapering is an art as much as it is a science, and we do our best as we go along. You're already doing great by tapering in the first place -- take it from someone who has CTed multiple times!

 

What is the exact date that you dropped to 0.7mg?

 

Furthermore, it looks like in June you started TRT. And at some point recently you also experimented with L-Tryptophan supplements, correct?

 

These sorts of chemical experiments can be further destabilizing to an already destabilized and hypersensitive system. 

That's why we advise extreme caution when introducing any sort of supplements or auxiliary drugs. 

 

Please also carefully read this topic, esp. the intro post, about The Rule of 3KIS, a.k.a. KISSS.

We recommend only ever making one change at a time, and then holding for a while before any subsequent changes. 

If you change multiple things at once, it's impossible to tell what is affecting you, regardless of whether the effects are positive or negative. 

For now I'd suggest staying away from any new or additional supplements and just sticking with what your body is already used to. 

Focus on stabilizing properly where you're at.

 

What is the exact date that you dropped to 0.7mg?

 

Dropped 6/25 from .8mgs to .7mgs
Started TRT 6/24 (on week seven right now)
The L-tryptophan caused major issues. I was following advice from someone who helps people taper and owns a practice. 
July 10th I took tryptophan before bed, woke up with vertigo, spent day at the hospital. Very bad day. Haven't touched since. 
 

[ProofofLife]

@Robert99 Hey Robert, I noticed you started TRT recently - how’s it working out for you? What were your levels before starting? Considering doing so myself for low free T/low e2.

[Ariel]

15 hours ago, Robert99 said:

Dropped 6/25 from .8mgs to .7mgs
Started TRT 6/24 (on week seven right now)
The L-tryptophan caused major issues. I was following advice from someone who helps people taper and owns a practice. 
July 10th I took tryptophan before bed, woke up with vertigo, spent day at the hospital. Very bad day. Haven't touched since. 

 

Hi @Robert99

Could you please update your drug signature to reflect the above ^^^^

 

I'm not a moderator, this is just my peer support perspective. 

Since you've already been on your current dose of 0.7mg for over a month, I'd suggest you HOLD at this dose. Put your taper on pause indefinitely while you do an extended hold, for however long it takes, and wait for your system to stabilize. This may take a while, and it will be well worth it. 

 

I'd also suggest not making any further changes to auxiliary drugs or supplements. Whatever you're taking right now, as long as it's not actively causing problems or adverse effects, just stick with the regimen you've got and don't rock the boat. 

 

Hang in there <3 

Give things time and you will start to see improvement. Eventually your system will regain stability. 

In the meantime, take good care of yourself and practice non-drug coping techniques to help you through. 

You got this! 

 

Love,

Ariel

[LostInCanada]

@Robert99 I was reading about a member who started diluting their liquid and they were very happy with the result and how it was more accurate as well. If you are interested I could try to find the info. 

[Robert99]

2 hours ago, LostInCanada said:

@Robert99 I was reading about a member who started diluting their liquid and they were very happy with the result and how it was more accurate as well. If you are interested I could try to find the info. 

Why would you dilute your liquid? 

[Robert99]

7 hours ago, Ariel said:

 

Hi @Robert99

Could you please update your drug signature to reflect the above ^^^^

 

I'm not a moderator, this is just my peer support perspective. 

Since you've already been on your current dose of 0.7mg for over a month, I'd suggest you HOLD at this dose. Put your taper on pause indefinitely while you do an extended hold, for however long it takes, and wait for your system to stabilize. This may take a while, and it will be well worth it. 

 

I'd also suggest not making any further changes to auxiliary drugs or supplements. Whatever you're taking right now, as long as it's not actively causing problems or adverse effects, just stick with the regimen you've got and don't rock the boat. 

 

Hang in there <3 

Give things time and you will start to see improvement. Eventually your system will regain stability. 

In the meantime, take good care of yourself and practice non-drug coping techniques to help you through. 

You got this! 

 

Love,

Ariel

Everything is on hold here. Except my gut is totally screwed, sibo, intestinal permeability, parasites, toxins. Not sure how it is possible honestly because I am the cleanest eating person that I know! So I am adding supps to heal my gut. Adding them in slowly to make sure no effects. Its only been good so far except pretty bad intestinal discomfort the first few days. As things die of it is pretty normal to feel off.

It all clicked this week. 90% of serotonin and other neurotransmitters are made in the gut! I've done two neurotransmitter tests now and both times my serotonin, gaba, glutamate, norepinephrine, epinephrine were extremely low. I've been shown this is the key to solving a lot of what is going on. 

Wondering if anyone else on here has healed their gut? 

Its proven that SSRI's cause dysbiosis!

The gut microbiota can be subjected to profound changes after the administration of antidepressants as previously demonstrated in preclinical and clinical investigations.

[Robert99]

13 hours ago, ProofofLife said:

@Robert99 Hey Robert, I noticed you started TRT recently - how’s it working out for you? What were your levels before starting? Considering doing so myself for low free T/low e2.

I was 220 / 240 / 320 taking three tests. The 320 day I was the least anxious. 

So, its kind of a chicken egg scenario (which comes first?). The anxiety drives the hormone levels down which in turn effect your neurotransmitter's and as they lower they in turn drive up more anxiety and lower your hormones even more. So seems like a cyclical problem and until the anxiety is turned around you will experience lower hormones. 

This is week seven for me and honestly as my body adjusts it seems like there have been times when it could have heightened some anxiety (and hasn't reduced anxiety yet). 

Now finally I feel like things are leveling off and my body is getting used to it. It was effecting my sleep too, but that is getting better. 
I had some lower weeks and everyone that had been through it told me to hang in there and let my body adjust. The effects so far have not been profound even though my test levels are much higher. Gym and strength is noticeable but I was hoping to experience more anxiety lowering effects.

I'm going to get levels measured again next week. I did measure at week 5 for the heck of it and they were 900. But I think that is too early and they tell you not to test for 12 weeks. Initially your body is still making some test too so would make sense it is high like that in the beginning. 

I think my target is in the 700s. 

 

[LostInCanada]

32 minutes ago, Robert99 said:

Why would you dilute your liquid? 

Diluting it lets you make smaller drops. For example if your ratio is 1:1 and you draw up 0.7 ml, by adding water to make a 4:1 ratio, you can now draw up 2.8 ml and then when tapering you can do a much smaller drop and lessen WD symptoms.

[Robert99]

3 hours ago, LostInCanada said:

Diluting it lets you make smaller drops. For example if your ratio is 1:1 and you draw up 0.7 ml, by adding water to make a 4:1 ratio, you can now draw up 2.8 ml and then when tapering you can do a much smaller drop and lessen WD symptoms.

Oh I see. Well my three year taper from 5mgs to .18mgs at the beginning of may seemed to be ok for the most part. So once I get back on track I will be fine. Thanks for the idea though! 

[Robert99]

Well thank God for patience and allowing me to heal where I am at. There have been a lot of improvements over the last several weeks. There are still good days and bad days but things have become way more manageable and stopped having panic. Now its like relearning to be comfortable in all the different situations that I need to be in. There is still a lot of fear and nervousness around situations I have been in 100s of times which is annoying. Going to start working on more exposure therapy to start getting more comfortable in these situations. Still going to hold at the .7mgs until I feel more back to normal in my own skin. I have simplified and streamlined my responsibilities and life which I am sure is also helping. Seeing a therapist which I never did before, so that is good too. Otherwise as always exercise at least an hour a day and eat very good. I am certainly wondering if the gut health supplements and reset I am doing is helping as the reduced symptoms seem to coincide with this process. Still lots of questions. Trying to figure it all out...

[LostInCanada]

23 minutes ago, Robert99 said:

Still going to hold at the .7mgs

Good plan...it is definitely a long distance marathon.

24 minutes ago, Robert99 said:

I am certainly wondering if the gut health supplements and reset I am doing is helping as the reduced symptoms seem to coincide with this process. Still lots of questions. Trying to figure it all out...

The guy is super important. If it works- great. I take a probiotic for that reason.

What bike salts are you using?

Happy for you. Really nice update. 💯🙏

[Robert99]

1 hour ago, LostInCanada said:

Good plan...it is definitely a long distance marathon.

The guy is super important. If it works- great. I take a probiotic for that reason.

What bike salts are you using?

Happy for you. Really nice update. 💯🙏

Ancestral bile salt/liver/gallbladder