I'm new and off paxil!

[KW2004]

Hey Everyone,
I visited this site last August when I was still taking paxil. However, my doc decided to take me off after I started suffering severe cognitive effects. I was taking paxil 80mg for 6 years for panic disorder. To wean me off the paxil, she prescribed prozac to mask the withdrawal effects. Big mistake. Turns out that I got this rare serotonin syndrome that landed me in the hospital for 7 days. What a nightmare. Anywayz, off the paxil and prozac for good now. Feeling alright, completely drained with some terrible zaps (like every other second). Also, some terrible stomach upset. But I am trying to stay positive. I am open to any advice out there to get me through this rough time. Thanks a bunch.
Kelly

[Delynbetter]

I'm so glad to hear you are off of it! Hopefully with your complications the doctors learned something!

I'll let the others give you advice. There is a wealth of information in the members here!

Best of luck to you!

De Lyn

[Homerbcool]

KW

80 mg..is quite a large dosage and I have heard that anything above 30mg is not affective anyhow..but I sell machinery for a living not medicine...

Tell us more about your journey...did you taper off of the meds or go cold turkey..

there are others on this site who have had severve reactions as the one that landed you in hospital...they may need your help as well...that is the beuaty of this site, even though we come here to help ourselves we end up helping others...a real community...not to say we do not have our moments though

[scotty]

Kelly, YIKES Serotonin syndrome is one scary deal!! We warn people alot about this possible interaction if they're doing the switch to Prozac, but I have to say you're the first one here to actually experience it. You are one strong women!

[KW2004]

homerbcool,
I was told, probably naively, that larger doses are more effective for panic disorder while lower doses (around 20mg or so) are more effective for depression.
So, I attempted to taper off, hence adding the prozac to hold off the withdrawal symptoms. I was to taper my paxil, while keeping 20mg constant prozac. However, before I could even do that I ended up in the ER with 106 fever, seizures, tremors, disorientation.....nearly fatal. I am just thankful that the doctors in the hospital were smart enough to realize what it was. Serotonin syndrome (there is a great article in the new england journal of medicine on it) happens when the system is overloaded with two much SSRI or a combo of SSRI and diet drugs, pseudophredrine, MAOI, etc. It is worth reading about for anyone taking these drugs. I am just glad to finally be off them, even if I have the major inconvenience of the side effects, at least I know my system is attempting to return to normal.

[feelin'_wiggy]

Hi Kelly,
You've come to the right place. There is a wealth of information and support here. Don't forget to read the FAQ and other info here and in linked sites.

Eighty mgs for six years, no wonder you were having cognitive effects. You say you're off both paxil and prozac now. Did you taper or cold turkey? How long has it been?
I'm pretty new here myself. Have been tapering for 16 days now. My doc prescribed prozac, too. It seems to be helping, but I say that very cautiously. Zaps are the worst! Ugh! But so are the upset stomach, wild dreams, tremors, etc. etc.

There are a lot of people here with more experience at this than me, so I'll let them advise you. Someone will be along soon. Best of luck to you.

[Homerbcool]

Originally Posted by scotty

Kelly, YIKES Serotonin syndrome is one scary deal!! We warn people alot about this possible interaction if they're doing the switch to Prozac, but I have to say you're the first one here to actually experience it. You are one strong women!

Lauire, is this not what happened to Dottie?

[scotty]

No, I believe that Dottie experienced paxil poop out, it just stopped working. Seratonin syndrome is a physical reaction to to much serotonin. It basically puts the body into an out of control multi body system response.Think of it as every body system(brain,kidneys,nervous etc..) in massive overdrive! High temps, seizures etc.. are the symptoms. VERY often fatal!!

This is my big concern about switching over to prozac! While some handle it OK, it can have serious ramifications if it triggers a serotonin syndrome.

[Dottie]

Kelly,

I got thrown into withdrawal out of the blue after being on paxil 40 mgs for seven years. I was put in the hospital and pumped full of seratonin medications, I was lucky that I didn't go into seratonin syndrome, I got myself out of the hospital afetr four days because I felt I was going from bad to worse. After coming out of the hospital I still had to taper off the paxil even though it wasn't working anymore.

What kind of cognitive problems are you having and how long have you been off the paxil?? What other problems are you having besides the cognitive ones?? The more information we have the more answers folks can give you. Please feel free to let it all out as this is what this site is for and this is where you will find much support.

If you don't want to post your details here you can pm me and I will see what advise I can offer to you.

Hugs Dottie

[Caroline49]

Welcome Back Kelly,

I was going to ask what Dottie did. How long have you been off Paxil and what were your cognitive effects??

I was going to go to prozac the next time I started weaning, however, now I'm thinking that I'd be better off simply weaning off Paxil and NOT going another SSRI. I was not depressed anyway and did not have panic disorders of any kind, just headaches.

Laurie, this has been a good thread for me. Thanks for clearning up some matters.

Kelly, keep us informed on your recovery, please, we all care so much.

[Homerbcool]

thanks dottie

luv ya tons

[KW2004]

I want to thank everyone for the overwhelming replies. It means a lot to see that there are people out there experiencing the same things that I am.
As far as the cognitive effects, they were terrible. I am a graduate student and need my brain...all of it! Plus, I do surgeries on animals and the tremors from the meds made it so difficult (like caffeine tremor times 100). I couldn't remember anything. I would read journal articles over and over and absorb nothing. It got to the point that I would have to right down everything little thing people said...like what my boss said I should work on next to where my keys were! Pretty scary. I went from being fairly smart to feeling like I was losing my mind. I knew it was the last straw when people would stay stuff and I would give a blank stare and they would be like "it's like you weren't even there when we were talking about it." Plus, all my memories since paxil are pretty much wiped out. I can remember everything beforehand, but since the drug, I can't remember any details about my prom, graduation, etc. And those are memorable experiences. Plus, the memory issues were getting progressively worse over time. And to make matters worse, I couldn't really think anything in my head....I had confused thoughts, very scrambled....couldn't even add numbers in my mind anymore. Not a good drug for me.
Since being off the paxil (for a whole 7 days woohoo!) i can already think a lot more clearer. And call me crazy (which i may be) but everything seems clearer...from making decisions to actual visual acuity.
Hopefully, I keep making improvements.
Thanks for the support everyone. I am so glad I found this site!

[elisa]

Here are the facts of Serotonin Syndrome, copied from www.antidepressantsfacts.com :

Serotonin Syndrome
The Serotonin Syndrome is a hyperserotonergic state which is a very dangerous and a potentially fatal side effect of serotonergic enhancing drugs which can have multiple psychiatric and non-psychiatric symptoms. This is a toxic condition which requires heightened clinical awareness in order to prevent, recognize, and treat the condition promptly. Promptness is vital because, as we just mentioned, the serotonin syndrome can be fatal and death from this side effect can come very rapidly. This syndrome is a toxic hyperserotonergic state whose rate of incidence is unknown, but is on the rise. This disorder, brought on by excessive levels of serotonin, is difficult to distinguish from the neuroleptic malignant syndrome because the symptoms are so similar. The neuroleptic malignant syndrome is a serious condition brought on by the use of the neuroleptic drugs.
Source: Prozac: Panacea or Pandora? by Dr Ann Blake Tracy http://members.aol.com/atracyphd/syndrome.htm

The Serotonin Syndrome is a potentially lethal condition caused by excessive serotonergic activity and is diagnosed by the presence of at least 3 of 10 symptoms: mental status changes (confusion, hypomania), agitation, myoclonus, hyperreflexia, diaphoresis, shivering, tremor, diarrhea, incoordination, and fever.
Source: Journal of Clinical Psychiatry

Symptoms: euphoria, drowsiness, sustained rapid eye movement, overreaction of the reflexes, rapid muscle contraction and relaxation in the ankle causing abnormal movements of the foot, clumsiness, restlessness, feeling drunk and dizzy, muscle contraction and relaxation in the jaw, sweating, intoxication, muscle twitching, rigidity, high body temperature, mental status changes were frequent (including confusion and hypomania - a "happy drunk" state), shivering, diarrhea, loss of consciousness and death.
Source: American Journal of Psychiatry, June 1991 "The Serotonin Syndrome"

A recent study (25 sept, 2004) shows us clearly that serotonin toxicity (such as the Serotonin Syndrome) can even appear rapidly in a few hours after taking a single therapeutic dose of SSRI medication. In Bio-Psychiatry it is a common thought that SSRI's are believed to have their effect by inhibiting the re-uptake of serotonin (downregulation of transporters) and thereby gradually increasing serotonin outside the tissue cell wall (extracellular) in the synaptic gap between brain cells (neurons) in the brain. In this important study, Zoloft (Lustral, sertraline) was given to monkeys for 4 weeks to establish how long it would take before Zoloft would have it's effect on serotonergic neurons and thus elevation of serotonin. In contrast with the commonly accepted SSRI theory, it was observed that serotonin levels raised NOT gradually, but rapidly and dramatically and kept on raising during these 4 weeks, an effect that can NOT be ascribed solely to a "re-uptake inhibition" of serotonin.

[elisa]

Kw2004,

I'm so sorry that you had serotonin syndrome!! In my mind it is downright malpractise. You were on such a dangerously high dose of Paxil already!! The doc should have known!! They're playing with fire, a ticking timebomb waiting to go off!!

Glad to hear that you're off the meds now.

[KW2004]

Thanks Elisa,
I mentioned before a very informative article in a previous post.

The New England Journal of Medicine; Serotonin Syndrome. I think it was this past March issue.

It provides very detailed description of symptoms and also differential diagnoses. It helped me understand my condition a lot. Apparently, my doctors categorized me into the highly moderate to severe category of the syndrome.

[Scott]

check out the ssri link in my signature

i can see why you had problems on that high a dose

[Dottie]

Kelly,

Thanks for the additional information. I recommend staying close to this site in case you need more support and you will certainly find it here. It amazing to me that in all this mental chaos that I can still do the crosswords. I keep doing them because I am afraid ( Use It or Lose It ). Did you do a slow taper or just quit the paxil??

Hope things continue to go well for you.

Hugs Dottie

hi Kelly and welcome !

Great to hear you are doing good .
I had serotonin syndrome myself , i was on 60 mg of paxil , but i didnt know it was serotonin syndrome at the time . Very scary thing.

[elisa]

Originally Posted by KW2004

Thanks Elisa,
I mentioned before a very informative article in a previous post.

The New England Journal of Medicine; Serotonin Syndrome. I think it was this past March issue.

It provides very detailed description of symptoms and also differential diagnoses. It helped me understand my condition a lot. Apparently, my doctors categorized me into the highly moderate to severe category of the syndrome.

KW2004, is that article accesible through a website?

Since you were in the hospital for the serotonin syndrome it must have been severe....

I'm so glad to be here and talking with you, this syndrome can be deadly.

[KW2004]

Elisa,
I have a subscription to the journal through my school. However, here is the info if you wanted to purchase the article online:

Current Concepts: The Serotonin Syndrome
Boyer E. W., Shannon M.
Extract | Full Text | PDF | CME Exam
N Engl J Med 2005; 352:1112-1120, Mar 17, 2005. Review Articles

I'm not sure I am allowed to copy/paste it on here. Probably not. But lemme know.

[elisa]

Originally Posted by KW2004

Elisa,
I have a subscription to the journal through my school. However, here is the info if you wanted to purchase the article online:

Current Concepts: The Serotonin Syndrome
Boyer E. W., Shannon M.
Extract | Full Text | PDF | CME Exam
N Engl J Med 2005; 352:1112-1120, Mar 17, 2005. Review Articles

I'm not sure I am allowed to copy/paste it on here. Probably not. But lemme know.

Thank you for the info KW!!

Yes, you can copy and paste on paxilprogress. You might want to copy and paste it in our NEWS Section and/or through the "Link Manager".

[KW2004]

Ok Elisa,
I'll give it a try. Thanks
Kel

[KW2004]

Here is the link to the journal...may not work since it is subscription based....

http://content.nejm.org.proxy.hsclib...urnalcode=nejm

[Delynbetter]

I had to take out the "pictures" and such, but you can find the rest of it in the News section.

[Caroline49]

Kelly,

Please stay close to this site while you are going through withdrawal. You say you've been off 80 mgs of Paxil for 7 days and that you've taken it for 6 years? That is a long time at a very high dose. I'm not saying your withdrawal symptoms are going to get worse, however, mine didn't really hit hard until about two weeks into withdrawal.

Someone is always here night and day.

I can also relate to the brain problems you've been having. My husband has been so worried about my memory loss. I have always had a fast mind when it comes to recall. Not on Paxil. I get completely dumb about things and it is embarassing.

I wish you smooth sailing from here on out Kelly!!