Difficulty Breathing??

[nomorepaxil]

I know that the feeling of breathlessness is one of the withdrawl symptoms. I have been off Paxil (after a very gradual titrataion) for about 2 weeks now, and am starting to get the sensation that I can't breath, like my lungs are constricted (no history of asthma or other lung difficulties).

It's not like the "lump in throat" feeling of a panic attack, just a very uncomfortable breathlessness. Anyone else experience this, or can offer ideas on what to do to help relieve this feeling? I feel this during waking hours, but also get sleep disrupted with the gasping-for-air feeling.

Please offer any advice!!

Thanks!

[scotty]

Welcome NoMore!! Paxil has an antihistamine quality that most people don't know about. When you start weaning you lose that antihistamine that you've become use to, which can cause shortness of breath and congestion.

[kristoferjon]

wow! i never knew that! that makes sense because i was having similar symptoms with my chest, the breathing difficulty and weirdness there! no history of asthma or anything like that!

[nomorepaxil]

Wow, thanks for that info, Laurie! It makes sense now why people are talking about Benadryl as an aid.

I just wish I knew how to lessen the symptom! I had a pretty bad spell of it today at work when I first posted this thread. I felt like a fish out of water and I tried to sit and relax, but the feeling didn't subside for about 20 minutes. It's such a huge discomfort for me; although I'm working hard on making sure it doesn't lead to a panic attack, my heartrate does go up and I just feel SO uncomfortable! I wish there was some sort of exercise that could be done to help quell the discomfort.

[feelin'_wiggy]

Thank you, Laurie! Your answer came at the perfect time. I didn't know about the anti-histamine factor. For the past two days, I've had bronchitis-like symptoms, full chest, coughing, phlegm. It's different from the tightness in my chest that I've had all along, so I didn't know if it was an actual infection or part of withdrawal. You've saved me a dreaded trip to the doctor. Of course, if I develop fever or severe symptoms I'll be forced to go. Yuck!

[Buxy`s Back]

scotty,i thought that was the case about the histamine,thanks for confirming you have made my day again,i have bad bouts of the breathing stuff.and explains the allergy symptoms too........go scotty

[zappelina]

Welcome nomorepaxil! Breathlessness is one of most common WD symptoms, I´ve have now lived with it constantly since February 2004 and it is awful but it is now getting very, very slowly better but it can take a very long time. Not entirely sure about the histamines though becuase antihistamine medication is not helping me at all.

[Buxy`s Back]

zapp just a thought i had bad reactions to antihistimines b4 seroxat,are you sure this is nt making you feel worse too,soz not suggesting it is but i know i was real bad on them in younger years for hayfever cant touch them now

[darcyb]

nomorepaxil, does it feel like you're inhaling, but get the feeling that there's no oxygen in the air? As if breathing is wasting your time and you keep craving the next breath?

[zappelina]

Joanne, I did try to take an antihistamine to try to get better breathing but since it did nothing for me, I stopped taking it a long time ago. I am not taking any drugs or supplements, they have all made me feel worse so no more guinea pig experiments for me. Will keep going on the track I am on now which is minimal amount of fat and protein since both of these make it worse. Tried eating more meat for a couple of weeks and the muscle pulling, twitching and flu symptoms immediately got worse. Mnimal amount of sugar, trying to stick to vegetables, some fruit and dark bread and only eat some lean ham now and then, lots of water and the amount of coffee I can drink without getting too stimulated. This diet is so far the only thing that has had positive effect.

[nomorepaxil]

Darcy, YES! EXACTLY!

I know I'm taking a huge breath, but I still feel like I'm not getting enough oxygen and I start almost panting. This isn't from any strenous activities or anything (not quite ready to get back into aerobic exercises yet)...

[Buxy`s Back]

id describe it like that too im taking a breath but not enough air to satisfy,bloody awful like all the rest

[zappelina]

Good description, Darcy. This is exactly what it´s like and on top of that I actually lacked the IMPULSE to breathe for a long time but it has now returned. For the first six or seven months I had to hyperventilate constantly to be able to get enough oxygen and I also did it automatically during sleep.

Bloody awful is an understatement, Jo!

[darcyb]

Originally Posted by zappelina

Good description, Darcy. This is exactly what it´s like and on top of that I actually lacked the IMPULSE to breathe for a long time but it has now returned. For the first six or seven months I had to hyperventilate constantly to be able to get enough oxygen and I also did it automatically during sleep.

Yes! Lack of impulse! That's EXACTLY what I went through too:

1-Felt like I wasn't getting any oxygen despite noticing my lungs breathing;
2-Felt like I had to remind myself to breathe, because I kept stopping. As if the instinct itself to gasp was gone while awake. I was fine once asleep.

I could sit there with all my air exhaled for several minutes until my head hurt, vision getting dark, and feel no panic, no urge to breathe, no pressure to do something as important as breathing. It was so freakin' weird! And intimidating. I would then have to learn to guess when it was a good time to breathe based on what activity I was doing. I could even sprint (run) for 5-10 seconds and feel nearly no urge to breathe harder. I would just feel sick, clammy, and sensation from limbs would decrease momentarily.

This was one of the MOST annoying parts of having experienced Paxil withdrawawal. Months after I was free of the stuff, that breathing crap got worse and worse. It took YEARS for it to almost disappear. I'm near 5 years Paxil free, and it still gets me once and a while, but there are so many months apart between incidents, I don't notice it as much. It's become old hat.

When it does show up, it happens most often when I'm sitting idle waiting for something, an appointment, show to start or whatever. It's as if it's tied into a thought of anticipation, then it kicks in and is difficult to get rid of for several minutes, and sometimes hours.

Next time it happens, gauge the pressure in your diaphragm, and upper part of your stomach. Does yours feel weird? Does your face get a bit numb and clammy? My skin would get oily after several minutes of lost urges to breathe.

I've accepted it as part of normal post-Paxil life and it's really no bother. Just a mosquito'ish experience. But it saddens me that I'm not the only one to have had the experience. How awful!

[elisa]

Look what I found! Could the fact that up to 10% of people lacking CYP2D6 be a factor in difficulties in breathing due to diminished ability to metabolize Paxil? That is, Paxil still remaining in the body for a long long time? What do you think?
http://ajp.psychiatryonline.org/cgi/...l/162/6/1225-a

Letter to the Editor
Positional Asphyxiation From Paroxetine
ASIF MALIK, M.D., and SAJID RAVASIA, M.D.
Fargo, N.D.

To the Editor: Paroxetine is a selective serotonin reuptake inhibitor with a unique structure and metabolic characteristics that is used in a variety of psychiatric conditions. Here we report a case of mechanical asphyxiation, suspected secondary to increased blood levels of paroxetine, in a patient taking a low dose of the medication.

Mr. A was a 19-year-old white man with a diagnosis of social phobia and major depression. He was given paroxetine, 10 mg/day, after a suicidal gesture led to a brief hospitalization. Blood work showed a bilirubin level of 1.9 mg/dl, with an upper normal level of 1.2 mg/dl; the rest of the results were within normal limits. His paroxetine dose was later increased to 20 mg/day; this was his only medication. Mr. A showed considerable improvement in his depressive symptoms and some improvement of his anxiety over the next few weeks. After forgetting to take his medication one night, he took it the next morning and took his scheduled dose later in the evening. His mother found him unresponsive on the couch the next morning.

Mr. A was pronounced dead at the scene. An autopsy reported the cause of death to be mechanical/positional asphyxiation probably secondary to paroxetine. A postmortem blood analysis showed paroxetine levels of 400 ng/ml, with caffeine and theobromine as incidental findings. No other drugs of abuse were found. A pill count did not reveal missing medication. His parents reported him to be fairly stable psychiatrically with no suicidal thoughts or intents before his death. In fact, they had noticed that he was doing better than they had seen him for some time. He had seen his psychologist 2 days before and was doing well at that appointment.

Paroxetine is generally dosed at 20–50 mg/day in single doses. Blood levels corresponding to a dose of 20 mg/day are 23–75 ng/ml. A 50-mg dose can produce blood levels as high as 207 ng/ml. The blood levels of our patient were about 10 times higher than the expected mean at that dose. Paroxetine is metabolized by the cytochrome P450 2D6 system, and the drug itself is an inhibitor of the enzyme. This results in a nonlinear metabolism, with higher doses causing a noncorresponding increase in the blood levels of the drug. Also, almost 7%–10% (1) of the white population has diminished 2D6 activity and consequently relies on unknown mechanisms for the metabolization of the drug. Dosing is guided by the clinical response; most patients improve in this dose range, and drug levels are rarely drawn.

Since toxic concentrations fail to produce reliable clinical signs, drug monitoring may be indicated. More research is needed to elucidate the relevance of slow metabolism and its adverse effects.

[elisa]

Yes, I'm having the very same problems in breathing as well and that's on Effexor XR. Seems I never get enough oxygen and have to take deep breaths on purpose very often. It started to develop after tapering below the 37.50 mg Effexor= 5 mg Paxil.

[feelin'_wiggy]

Elisa,
This article is one of the most frightening I've read. I've suffered that lost impulse to breathe off and on over the past several years and never would have associated it with the poison. It's not severe, just pesky like Darcy said. I've been doing yoga breathing exercises since I've been in w/l. It's too soon to tell, but I wonder if it will help long term. Just one more PaxHell gift to add to the list.

[Delynbetter]

Losing the impulse to sleep is something I'm dealing with right now. I don't want to breathe and exhale every last bit I can get out, then make the effort to breathe really deep and slow. Caught myself doing this on the trip this last weekend and was wondering what my breathing rate was. Couldn't have been more than 6 per minute.

The "desperation" breaths, as they felt to me, happened during my anxiety-ridden times and tapering down from Paxil. These happened mostly during the day and I'm wondering if I only noticed the slow breathing mostly during the night because I didn't have anything else capturing my attention.

The need for deep breaths, like I wasn't getting enough oxygen, was happening before Paxil as well as after - so I don't know what to make of it.

[elisa]

Originally Posted by feelin'_wiggy

Elisa,
This article is one of the most frightening I've read. I've suffered that lost impulse to breathe off and on over the past several years and never would have associated it with the poison. It's not severe, just pesky like Darcy said. I've been doing yoga breathing exercises since I've been in w/l. It's too soon to tell, but I wonder if it will help long term. Just one more PaxHell gift to add to the list.

Wiggy, so sorry, I didn't mean to scare you!! The article must have been an isolated case.

The reason for my posting the article was to show that there might a connection with the antidepressant still in our body after a long time and some of us still having some breathing problems. The patient in the article seemed to have lacked the crucial enzyme in the liver to metabolize the med and was therefore severly toxic. The toxicity could have contributed to the positional asphixciation. It happened to him within a few weeks time while on the drug.

Since we are/were on these drugs for longer than that, I wouldn't worry that something similar might happen to us.

[zappelina]

This is an interesting and scary article Elisa but for most of us the breathing problems come when we reduce the dose or quit, not while on it so in the case of withdrawal breathing problems remaining traces of it can´t be the reason. If that was the case, we would have had these problems while on the drug.

[feelin'_wiggy]

No worries, Elisa. It didn't scare me, per se. I'm just furious that the drug has the potential to cause sudden death, albeit in rare instances, and yet it is still handed out like candy.

My son and his girlfriend (21 yrs-old) visited me yesterday. I knew that she had taken Effexor in the past, but I didn't know that at one point between the ages of 17-20, she was simultaneously taking seven different psych meds, all prescribed by the same doctor! Thank God she is drug free and healthy now. It's bad enough parents worry about kids becoming addicted to street drugs, but it's unforgivable when prescription medication is killing them!

[elisa]

Originally Posted by feelin'_wiggy

No worries, Elisa. It didn't scare me, per se. I'm just furious that the drug has the potential to cause sudden death, albeit in rare instances, and yet it is still handed out like candy.

My son and his girlfriend (21 yrs-old) visited me yesterday. I knew that she had taken Effexor in the past, but I didn't know that at one point between the ages of 17-20, she was simultaneously taking seven different psych meds, all prescribed by the same doctor! Thank God she is drug free and healthy now. It's bad enough parents worry about kids becoming addicted to street drugs, but it's unforgivable when prescription medication is killing them!

Well, I'm so glad that the article didn't scare you.

Yes, it is very infuriating seeing all kind of info on the web on these drugs!! I've got tons of websites dedicated to negative info on these psychotropic drugs. Info supplied by docs, researchers, media etc.

Since there is a test available, (for abt 1 yr now) all potential antidepressant users SHOULD be mandatory tested for any lacking specific enzymes in their liver that interfere with metabolizing these drugs!!

[special k]

I am freaking out so badly right now. Unable to take deep breaths... feel like I'm going to pass out. I thought maybe I was developing asthma or something! I called the doc... but I guess maybe it's just another late symptom of paxil withdrawal. I've been off for 4 months after a very slow taper. I can't take anymore, I really can't.

[scotty]

Get a paper bag and breath into it.. if this is panic that will force you to slow the breathing down and make it easier to breath.. go do it now!!!

[nomorepaxil]

Hi special k,

Don't freak out! That makes things worse, at least when I experienced the breathlessness. I felt (and looked) like a fish out of water – the way I had to gasp for air through my mouth. When I started to freak out, it just made the feeling of suffocating that much worse.

This horrible symptom started for me about 4 months after I started tapering, and at about 3 weeks completely off Paxil. But if it makes you feel any better, the symptoms subsided after a couple of months. I still get a tinge of the sensation occasionally, but not to the severe extent of last July (when I originally posted).

Someone suggested Vicks Vaporub, and that does help make you feel like your breaths were more productive. I would also sit near really cool air, like near an A/C vent, which made it seem easier to breathe.

Hang in there!!