Need advice on paxil issue

[Bilo76]

Sorry for the long text but i need some decent advice and i can only get that if you guys know my situation completely. Sorry also for my bad English

I have taken paxil for 15 years. Most of the time 20 mg. Last year 15 mg. It helped me with my anxiety and panic attacks. Had some side effects i didn't like. So i started to cut down. Very slowly. In 6 months i was at 15 mg. Then i got lots of anxiety and panic attacks. I felt horrible for several weeks.
An idiotic psychiatrist said that lexapro is a better ssri with less side effects and overall more success. So he said a stopt-start would be best since both are SSRI. So oct 16th 2011 i stopped with 15 mg seroxat and oct 17th i was on 10 mg lexapro. He said that since it were both ssris; i would be fine. Well off course not. Had 2 weeks in which i felt like i had the flu. After that the panic attacks increased. And also i felt a bit more like a robot. I had a bit derealization and depersonalization. Also this psychiatrist adviced me to start with 10 mg oxazepam

The psychiatrist told me to increase the dose of lexapro so i went to 15 mg lexapro on 12 nov 2011. It didn't get better. I had a lot of anxiety and depersonalization. Even so bad that i had to go to the closed section of the psychiatry department of the hospital. I had a different psychiatrist and doctor there. They told me to increase to 20 mg lexapro 29 nov 2011. However this didnt go well. Everything was so intense. Light, sound and i got more dizzy and depersonalization got even more. After 3 weeks i realized i have been f$#ked 3 times by a doctor and i decided to leave the hospital and take matters in my own hand.

Dec 18th 2011 i figured that the anxiety and panic attacks were less but that i didn't know if that was due to the oxazepam i was still taking with 20 mg each day. But the big problem was that i felt very depressed and sad. And also had more and more derealization and depersonalization. I felt like i was lying on my bed and saw life through my robot. Also the intensity of light and sound and the feeling my brain was being fried;...it was also a problem.
So i decided the following:
1.) first get back from 20 mg lexapro to 10 mg lexapro. I functioned all this years decently on a small dose of paxil,...why this high of a dose of lexapro? (20 mg is the max dose)
2.) when on 10 mg lexapro, wait a week and then start slowly cutting down the oxazepam. Cause i wanna know what the actual status is. I had so many problems, i didnt know which was caused by the sudden stop of paxil, the lexapro, the oxazepam, the anxiety etc etc.

I am now on 10 mg lexapro and since a week on no oxazepam. Some things are better. Anxiety is slightly better, i don't have the intensity problem anymore. BUT the depression and the depersonalization has gotten way worse. Two things i never had before and are not my original problem why i used paxil or lexapro.
I dont know what to do now. I haven't left my house much last 3 months since the change. And i feel so bad i sometimes think of taking my life. I feel so much darkness in me,...and i feel like i and the world are not real.
So something has gotta change soon.

Anyways my questions:

I wanna know what you guys would advice me to do. I dont think anyone knows if my current problems are caused by the fact that lexapro is ****ty for me ,..or by the sudden stop in paxil. So the next step is very difficult for me. Its a bit of a gamble. There are lots of factors:

- I have been through a lot. Both medication wise with all the changes in doses in lexapro and oxazepam,..as mentally (hospitalized). So perhaps its better to just stay on the 10 mg lexapro and create a stable situation (although like i said; its bad with me, i cant take it very much longer)
- A lot of people (both experienced users and doctors) say that lexapro is a milder and better AD then paxil and if i can stay of the paxil it would be better. In my research and all the people i spoke;..lots of them hate anti depressant,..but paxil the most. Nobody had one good word about paxil. No doctor or neurologist
- When i get back to paxil there is a big change that the anxiety will increase (maybe because paxil pooped out on me). Cause there was a reason i switched to lexapro. Cause i had anxiety. BUT at least the incredible depression and depersonalization will go away. I would trade this feeling i have now immediately with my original problem. I so hate it that i wonder who i am, who my family is and that every thing passes me by and seems fake

What would you guys recommend?
a.) Since i am already 3 months of paxil and 3 months on lexapro; should i just wait and create a stable situation and hope the depression and depersonalization will go away in time.
b.) Start cutting down the lexapro very slowly and take no AD at all. This is a risk cause if the paxil is still causing me problems of my cold turkey stop;..this wont help much. Then i will have 2 problems; WD of paxil AND of lexapro.
c.) Get back to paxil now after 3 months. Hope that the depression and all will go away. Especially the feeling like i am watching a movie of myself..i hateee that. it scares me. Although getting back to paxil will give my brain another shock? or perhaps it is happy it gets some paxil again.
I can always cut down slowly from paxil once i am back on it and things have stablized in later year.


Please help me. All 3 options have a risk to it. But in the mean time i feel like cutting my wrist and all these 5 months of utter hell has made me so sad. Also please advice with whats in my best interest. Off course i do wanna stop with all AD's. But it has to be realistic at this point in my life.

[Bilo76]

nobody has a hint of insight :'(?

[rangerNY]

Go all the way back to the beginning. You're working your strategy around trying to find a way to have no anxiety, but it sounds like the only tool you've been using is medication.

Start RIGHT NOW working on other ways to deal with the anxiety and panic. Check the anxiety section here. There are a few good threads stickied at the top that are good starting points.

Start moving toward a place where you can eliminate the meds slowly without caring that you need something to treat anxiety.

[babs]

I agree with Ranger, but you are also in Paxil withdrawal (switching meds does not treat withdrawal from the original med). Lexapro is not milder than Paxil, though it seems like a lot of doctors tell their patients that. I think you should go back on 15mg Paxil and do a very slow taper from there.

[Bilo76]

Originally Posted by rangerNY

Go all the way back to the beginning. You're working your strategy around trying to find a way to have no anxiety, but it sounds like the only tool you've been using is medication.
.

Thanks for your time and effort to reply. But i dont understand where you got this from?? I mentioned in the post i have loads of problems except the original anxiety and panic attacks. Furthermore i have done a LOT (massage, cognitive therapy, counseling, diet) about my anxiety and i can face it head on and therefor its less an issue. And i DO wanna be AD free however at this certain point in my life i have DP/DR/dizzyness/depression and all symptoms i never had before. Can be from WD of paxil,..can also be from the lexapro (although the first one makes more sense). At this point it's not realistic to just start tempering with the lexapro.
Thats why i wasn't sure whether to sing it out a few weeks and hope the WD of paxil will get less,..then wait a few more months and slowlyyy quit the lexapro. Or if its better to get back to paxil and wait a few months and then slowly quit that.

Originally Posted by babs

I agree with Ranger, but you are also in Paxil withdrawal (switching meds does not treat withdrawal from the original med). Lexapro is not milder than Paxil, though it seems like a lot of doctors tell their patients that. I think you should go back on 15mg Paxil and do a very slow taper from there.

thanks for the reply Babs,..appreciated!!
I believe lexapro is milder. I am not saying that it is a great medicin!!! But i think it's better then paxil. And i have some studies to proof that. Here in holland they studied 100.000 AD users and compared all the AD's on a scale. On one end "how much do you benefit from this AD" and on other end "how much side effects do you have from this AD". Lexapro was by far rated as best and paxil rated by far as lowest by the people that use it.
However this is not important for me. I wanna quit AD all together. But in a smart way.
Babs; do you think when going back to paxil after 3 months of hell with lexapro, my brain will get another shock? Thats what i am worried about. I dont want more dp/dr!!
But maybe my brain is glad to have paxil back. Or i will get big time confusion and also some wd from the lexapro :'(

I think the major question is: is it realistic to think that within 1 or 2 months (so total 5 months of paxil after 15 years of use) the WD will get better. If thats the case i can better stick with lexapro and quit from there. If not;..back to paxil,..but i am scared. I dont wanna end up in the hospital again.
You read a lot of posts here babs, what do you think?

[scotty]

Originally Posted by Bilo76

I think the major question is: is it realistic to think that within 1 or 2 months (so total 5 months of paxil after 15 years of use) the WD will get better. If thats the case i can better stick with lexapro and quit from there. If not;..back to paxil,..but i am scared. I dont wanna end up in the hospital again.
You read a lot of posts here babs, what do you think?

You're looking for definitive answers, when there is no such thing with ssri's. This applies two fold when more than one drug is in the mix. If you were on Paxil for 15 years, withdrawal is going to last a lot longer than a few months, regardless of other drugs that you add, and stabilizing after a drug switch isn't guaranteed.

The waters are muddied now with lexapro on board, so you're going to have to just make the decision, stick with it and play it by ear. We always recommend to wean from the drug that you are on, but that isn't clear cut in your case.

Sorry, this isn't much in the advice department, but it's the best that I can offer. Just an FYI...Lexapro's withdrawal is just as common as Paxils, and becoming more and more evident. There is no "mild" ssri. They all act on neurotransmitters and alter brain chemistry.

[Bilo76]

Originally Posted by scotty

You're looking for definitive answers, when there is no such thing with ssri's.

I agree!! Scotty i have been to the best neurologist in my country, i been to experienced users, to many psychiatrists, to doctors and so on and so on. But nobody has answers to simple questions like "why do i have these withdrawal symptoms?" ..or.. "is it possible that its not WD but that after 15 years of paxil my mind likes lexapro better and all the stress comes out?".
however i am not looking for definitive answers..just gimme your best guess pls. Sticking with lexapro or getting back to paxil?

Originally Posted by scotty

If you were on Paxil for 15 years, withdrawal is going to last a lot longer than a few months, regardless of other drugs that you add, and stabilizing after a drug switch isn't guaranteed.

It's not guaranteed that lexapro will stabilize my problem. However can i conclude from this that you also think my best chances are going back to paxil? Have you seen this before on this forum? people using paxil for long time, then off it for another drug and back on to paxil? Can their brain handle that?

Originally Posted by scotty

The waters are muddied now with lexapro on board, so you're going to have to just make the decision, stick with it and play it by ear.

I agree,..i am gonna make a decision and stick with it. however its a hard one as you can imagine. And since i am already at a point in life where i often think its not worth it anymore;..i have to consider carefully.

[rangerNY]

Originally Posted by Bilo76

Thanks for your time and effort to reply. But i dont understand where you got this from??

Sorry I misinterpreted your meaning. I just noticed that you kept going back to anxiety and a measure of how things are going, and that you started Paxil because of anxiety and panic.

Originally Posted by Bilo

I have taken paxil for 15 years. Most of the time 20 mg. Last year 15 mg. It helped me with my anxiety and panic attacks.

Originally Posted by Bilo

Had 2 weeks in which i felt like i had the flu. After that the panic attacks increased.

Originally Posted by Bilo

I am now on 10 mg lexapro and since a week on no oxazepam. Some things are better. Anxiety is slightly better ...

Originally Posted by Bilo

When i get back to paxil there is a big change that the anxiety will increase (maybe because paxil pooped out on me).

I do see where you want the depersonalization and depression to go away primarily, but it just sort of seems like you're doing that within the context of how the meds impact your anxiety. My only point is that if you know the meds are causing the DP and depression issues, then the object would be to get away from the meds, which would mean dealing with your anxiety issues without Paxil, Lexapro, etc. You have to be willing to do that, or else you're stuck on the horrible medication merry go round.

Does that make sense?

[Bilo76]

Originally Posted by rangerNY

I do see where you want the depersonalization and depression to go away primarily, but it just sort of seems like you're doing that within the context of how the meds impact your anxiety. My only point is that if you know the meds are causing the DP and depression issues, then the object would be to get away from the meds, which would mean dealing with your anxiety issues without Paxil, Lexapro, etc. You have to be willing to do that, or else you're stuck on the horrible medication merry go round.

Does that make sense?

if i could go back in time;..i would never have started with any AD. However i have to deal with the cards given. And at the moment that is slight anxiety but more so depression and DP.
There is one big uncertainty in your reply and that is "if you know the meds are causing the DP". I am not certain of that. That i feel so ****ty like i do now can be because:
- I am still in paxil withdrawal.
- During the change i was on oxazepam for 2 months (now 3 weeks of) perhaps because of WD from that.
- Perhaps the paxil is no issue anymore but the lexapro is giving me a hard time.
- Perhaps the lexapro is doing its job and paxil was such a ****ty AD that my mind and body is de-stressing from it. And that it's to much.
- My neurologist thinks i have a disease called chronic hyperventilation and my blood is to alkalisch (less co2 in the blood) and therefore i have DP. the switch paxil to lexapro gave the breathing centrum in my brain the last knock down.

All possibilities have a different solution. I have made up my mind that i wanna get off any AD. but now what road to take. My mind is telling me "you cant take it anymore. that cold turkey stop of paxil will give you withdrawals for another year. Stop with the lexapro and get back to paxil. After 5 months on it start weaning of it very slowly. Most of this **** started with switch paxil-lexapro".
But my intuition is saying "I know life is hell. but be a bit more patient. You didnt switch from paxil to lexapro for fun. You had anxiety again back then. the paxil withdrawal will go away in a few weeks. Lexapro is easier to stop with then paxil and perhaps easier to life with for the time being"
My feeling is saying "i am scared of my choice. I am so scared that if i get back to the paxil my brain will get another kick and it wont survive that. And i am scared that if i stay on lexapro it will only get worse. And i will feel more depressed"

Thats why its so difficult ;-)
I wish someone on this forum was on 1 ad for a long time. Changed to another one and after a few months switched back to the first one. I wish i could learn from that experience.

[babs]

Originally Posted by Bilo76

My mind is telling me "you cant take it anymore. that cold turkey stop of paxil will give you withdrawals for another year. Stop with the lexapro and get back to paxil. After 5 months on it start weaning of it very slowly. Most of this **** started with switch paxil-lexapro".

My mind agrees with this. Cold turkey is a shock to the brain and makes withdrawal longer and more difficult.

But my intuition is saying "I know life is hell. but be a bit more patient. You didnt switch from paxil to lexapro for fun. You had anxiety again back then. the paxil withdrawal will go away in a few weeks. Lexapro is easier to stop with then paxil and perhaps easier to live with for the time being".

We have had members here who had a horrible time getting off of Lexapro. Just because it was everyone's favorite in a survey does not mean it is any easier to get off of (and was that even a question in the survey?)

I wish someone on this forum was on 1 ad for a long time. Changed to another one and after a few months switched back to the first one. I wish i could learn from that experience

I'm sure we have had many who have done that ... but their experience would not necessary be your experience. The one thing we know about ADs, both in use and in withdrawal, is that everyone is different and it is not one size fits all. I still think your best bet is to stop the Lexapro and go back on Paxil to do a proper wean. The longer you wait, the greater the chance of it not working.

Getting back to what Ranger said, you need to know that whichever road you take, you are going to have to accept that you will have some discomfort and symptoms at least initially and perhaps throughout. But it's important to make a decision and stick to it. So many people panic when they start to feel some anxiety and start making changes again, which makes it all worse.

[Bilo76]

.

Thanks for your reply Babs (is my mothers name so i automatically feel some kind of respect ;-)).

Originally Posted by babs

My mind agrees with this. Cold turkey is a shock to the brain and makes withdrawal longer and more difficult.

Is this true? I can imagine it makes it harder. But also longer??

Originally Posted by babs

Just because it was everyone's favorite in a survey does not mean it is any easier to get off of (and was that even a question in the survey?)

I agree!!

Originally Posted by babs

I'm sure we have had many who have done that ... but their experience would not necessary be your experience.

Well isnt that the reason this forum exists? learning from other experiences?

Originally Posted by babs

I still think your best bet is to stop the Lexapro and go back on Paxil to do a proper wean.

Thank you. This is exactly the straight forward answer i was looking for. Perhaps not to my liking ..but clear.

Originally Posted by babs

The longer you wait, the greater the chance of it not working.

Why do you think this? Please tell me

Originally Posted by babs

Getting back to what Ranger said, you need to know that whichever road you take, you are going to have to accept that you will have some discomfort and symptoms at least initially and perhaps throughout. But it's important to make a decision and stick to it. So many people panic when they start to feel some anxiety and start making changes again, which makes it all worse.

I agree 100%. Whatever road i choose now. I will stick with it

[Kay2020]

In my personal opinion, the big drop you did 5mg is what caused all the problems now. I did big drops like that before (10mg) and I had all that you are going through now. It took me months to straighten out and then (not knowing about paxilprogress.org) I did another big drop and has more months like that.

I thought the months of WD was normal and hellish until I read about slow tapers such as the 10 percent, ever since doing the 10 percent I never had that happen again.

what I did was reinstate to a dose that made feel somewhat stable (I didn't feel perfect) and then started to taper 10 percent ever 3 - 4 weeks.

I wonder if doctors think that if you switch to another AD and then taper that it will not be as bead because you have not been on it for years like the paxil? I have read others trying this and so far I have not read about anyone having success with this, they still had to withdraw from the original AD.

I have been on ADs now for 16 years and I wonder if the doctor just wrote me off? or if they really believed I would have to live the rest of life on an antidepressant?

I hope you feel better!

[Bilo76]

Kay020,

Thanks for your reply.
I read that you were 9 years on zoloft and then went to lexapro for 6 years.
How did you do that change? Crosstapering for a long time or how? And how much trouble did you have changing meds like that?

I am curious to that. Thanks for the help

bilo

[babs]

Originally Posted by Bilo76

Is this true? I can imagine it makes it harder. But also longer??

Yes, it actually takes longer for the brain to recover because the trauma is greater. Think of it like this: If you are in a car going 60 miles an hour, which is better, to slow down gradually by tapping the brakes or to throw it into reverse? Both will stop the car but one is a lot easier on the vehicle! Your brain appreciates a slow, gentle stop rather than a sudden, abrupt one. It is not about getting the drug out of the bloodstream; that happens fairly quickly. It's about reversing the changes that the drug has made to your brain, and that takes time.

The reason I say the sooner you reinstate, the better is because of what I have seen here in my 7 years on the board. People who reinstate sooner have better luck than those who wait too long. I don't know why, but that seems to be the case in a majority of instances.

[Bilo76]

Originally Posted by babs

Yes, it actually takes longer for the brain to recover because the trauma is greater. Think of it like this: If you are in a car going 60 miles an hour, which is better, to slow down gradually by tapping the brakes or to throw it into reverse? Both will stop the car but one is a lot easier on the vehicle! Your brain appreciates a slow, gentle stop rather than a sudden, abrupt one. It is not about getting the drug out of the bloodstream; that happens fairly quickly. It's about reversing the changes that the drug has made to your brain, and that takes time.

The reason I say the sooner you reinstate, the better is because of what I have seen here in my 7 years on the board. People who reinstate sooner have better luck than those who wait too long. I don't know why, but that seems to be the case in a majority of instances.

Ok thank you

[Junior]

Originally Posted by Bilo76

I wish someone on this forum was on 1 ad for a long time. Changed to another one and after a few months switched back to the first one. I wish i could learn from that experience.

I did that. And I went from Paxil to Lexapro. But before I tell you my experience I must remind you that everyone's experience is different. We are all wired differently thus different drugs affect us differently and bring out different withdrawal. I am also less sensitive to drugs in general, and drug changes, than many people here so I ask you to keep that in mind.

Ok.. I was initially put on Paxil in July 1997 for major (clinical depression) together with clinical anxiety. It helped enormously and I was pretty much back to my normal self after just 2 weeks. I stayed on it for 6 months then stopped after a quick wean. Apart from a little dizziness I had no problems.

A few months later, following a traumatic outcome to an IVF attempt I was spiralling into depression again and was put back on Paxil. After therapy and several months on medication I decided to stay on it because it helped with my GAD enormously. I also had, at that time, an 8 yo with autism, intel disability and ADHD so i found that I had a LOT more patience with him while I was on it.

Fast forward to Nov / Dec 2009. I was taking ages to fall asleep and waking early. I had learned over the years that I could vary the dose of Paxil to suit my needs at the time but I was on the maximum dose of 40mg that I'd needed at any time. I tried upping it to 50mg but it had no effect. Did some research and realised it was beginning to poop out on me.Went to my GP and we agreed that I should switch to Lexapro. I tapered from 40 to 20mg in just 2 weeks, with no apparent issues, then did a direct switch from Paxil to 10mg of Lexapro.

We moved house around that time and since the sleep was becoming an issue again I arrogantly thought I could do with Lexapro what I'd done with Paxil. So I doubled the dose. Sure it helped me to sleep but over the next few months I endured akathisia, a feeling of being electrically charged, poor short term memory, difficulty planning and organising (normally a strength), lowered mood, disrupted sleep and at the end, suicidal ideation. I had this increasingly powerful urge to slit my wrists. Thankfully I was aware that anti depressants can have that effect so I knew to come off it.

I tried Cymbalta between this point and going back onto Paxil and it was a big mistake. My journal has the story if you are interested. Finally my neurochemistry was so messed up that sleep just wasn't happening. At best, with a low dose of melatonin, I could get a few hours broken sleep each night. I was desperate. I opted to go back onto Paxil after 6 months off. It helped the sleep a little but not as much as I wanted or needed. I waited 3 weeks then doubled the dose from 20mg to 40mg. In hindsight that was wayyyyyyyyyyyy too quick and brought on severe anxiety and feelings of depression. I waited it out and it settled after a week. I then spent 3 months stabilising before I started tapering. I had no emotions at first and it took a LONG time for my sleep to improve but thankfully going back onto Paxil worked. For me. I'm still tapering ...

I had no trouble getting off Lexapro after 4 1/2 months so I think you could try switching back to Paxil. It is likely that Paxil w/d is your main culprit but if it works, and that it a big if, then you will need time to stabilise once the switch has been made. There is no quick fix.

Good luck.

[GrandmaD]

Originally Posted by Bilo76

Have you seen this before on this forum? people using paxil for long time, then off it for another drug and back on to paxil? Can their brain handle that?

I had been on paxil for 14 years when I switched to another SSRI (Endep) and and then to Lexapro. IMO the problems I faced were the sudden w/d from paxil, but at the time, thought it was the different drug.

I was so fed up I CT and after 3 months was in severe depression and went back onto paxil and decided to do a slow taper.

The only reason I went back to paxil was an old saying I remembered, that said "better the devil you know than the devil you don't know"! Not very scientific, I know, but here I am!

[Bilo76]

Thanks junior and grandmad for your stories. Much appreciated.

@grandmad. After 3 months of
the paxil. Did you have problems getting back on it? Did..:
- the anxiety or other reasons why you moved from paxil to lexapro in the first place, came right back?
- did your mind or body had problems getting back to the paxil?
- did you started to feel "better" soon when back on the paxil? Did the WD depression go away?