27th day without Seroxat, symptoms still bad, what do I do?

[Miona]

Hi everyone,

I've been off Seroxat for 27 days after taking 10mg for a little over a year and tapering by taking 5mg for two weeks. After reading some of the posts here, I see that this was too fast. My question is - should I go back to taking it and taper more slowly or, since I have been off it for almost a month, can I hope that I will start to get better? And if I go back, should it be to the full dose or the 5mg?

I was put on Seroxat for panic attacks and I have been kicking myself for having ever taken it at all and for not learning more about it beforehand.
The psychiatrist who prescribed it, though generally compassionate, was dismissive when I mentioned withdrawal, said if it existed it would go away in a few days. It was on his recommendation that I stopped taking the medication the way I did, he said such "low doses" could be discontinued immediately. It was actually my idea to halve the dose before stopping.

I felt euphoric for the first few days, followed by a day of pretty bad anxiety attacks. After a couple of okay days, there came a deep depression. I seem to be cycling ever since, from anxiety to okay to feelings of depression, all in a few days, sometimes in the same day. The thing is, I wasn't even depressed when I started taking the drug. I'm having depressive thoughts right now (like how meaningless life is) that I haven't had since puberty. I have begun to burst into tears for practically no reason. I'm starting to cry now while I type this. I'm beginning to get scared. Will it ever stop? Will it get better? Will it get better before I go crazy? Right now I feel like the symptoms are actually getting worse, that the state of my mind is getting worse.

Thanks for your help
Miona

[Rachelina]

Welcome Miona! Everything you are feeling is withdrawal and could get worse before it gets better. I would go back on 10 mg right away. The longer you wait the more likely it is not to work again, but it's not too late if you go back on it now. It might take a few weeks to feel better. We all know exactly what you are going through and are here for any questions and support that you need.

[Miona]

Rachel, thank you for your advice and support.

I think you're right, I'll have to go back to the drug, I can barely function. It's just that I feel like all the misery of this month will have been wasted.

I've been looking over the threads and see that a reduction of 10% of the current dose is recommended. Thing is, I don't think liquid paroxetine is available in my country and I was already taking only half the tablet. Any advice on how to get around this?

Miona

[anjopom]

Miona,

You need to reinstate seroxat, i would start at 5mg if you were pretty stable on that dose, if yuou werent then you will have to go back to 10mg.

The medical profession are completely ignorent about tapering these drugs and even more so about withdrawal as you have learned.

Reinstate and stabilise yourself first, then worry about tapering the last bit.
When you do taper again, do it very slowly, symptoms should be minimal and short lasting by using this method. Any problems, always someone here to help you out.

By the way, welcome to pp.
Anjopom

[anjopom]

Miona, remember also, low doses they may be, but what an impact they can have on you and your life when tapered in the wrong way.

The symptoms you have are withdrawal, and will likely get worse before they get better, all of this just confirms that the meds know little about the way we suffer from the drugs they prescribe!!!

Anjopom

[Rachelina]

If you can't get liquid Paxil, you can still do the 10% taper by cutting and weighing pills, which is what I do. You need to get a jeweler's scale - you can probably find a decent one on eBay. It has to weigh down to .001 g. Here is a thread with more info on this method and a spreadsheet that will do all the math for you:
http://www.paxilprogress.org/forums/...ad.php?t=41850
The spreadsheet is in the second post, from Songbird. Another option is to get your doses compounded at a pharmacy, if you can find one that does this. But then you will need a new prescription from your doctor for each dose.

I know it feels bad to be going back on when you thought you were done, I felt the same way. But believe me, the misery of this month will not have been wasted; you are probably saving yourself many months or even years of that misery. Not that that would necessarily happen to you, but we do have members still suffering two or more years out from a taper like yours, and it is just not worth that risk.

Good luck to you!

[Miona]

Thank you for your responses. When I first read them, I burst into tears.

You know how you said it'd get worse before it gets better? I think I'm at that worse now. The first few weeks were slightly easier than these last few days.

Anjopom, I'm not sure how stable I was on 5mg since I only took that dose for two weeks before quitting, but I'd really like not to have to go back to the 10. I took 5mg today and will take the same amount tomorrow.

Rachel, thanks a lot for the info about cutting and weighing the tablets. I was relieved to hear there's a way to do that. I'm not sure what compounding is, is it when a pharmacist makes you a tablet with the dose you need?

And you're right, I can use this experience to help me in the future, sort of like a reference. No use torturing myself if I don't have to, especially if it can increase the risk of this lasting for months.

A lot of people, especially medical professionals but others too, seem disinclined to believe me when I say what I'm experiencing is withdrawal. It really means a lot just to know that there are people I can ask for help and support who have been through this, who know what it's like.

Miona

[Songbird]

So many medical professionals are unaware of the w/d problems these drugs cause! I would recommend going back on 10mg, wait until you stabilise then taper down much more slowly. If you can't get liquid you can cut the pills and weigh the pieces on a digital jewellers scale.

[Miona]

Took 10mg today. I don't like the idea of having to stay on it for about a year more to taper it safely enough, but I'm not going to risk this hell again if there's any way I can help it. I am lucky in that I don't feel Seroxat numbed me and when I decided to quit I was in a really good place emotionally, optimistic and joyful. Hopefully, I can get back there when I stabilize.

I just feel so stupid for ever getting on it at all because I didn't really need to. My diagnosis is panic disorder with agoraphobia. I know that talk therapy and a short stint on benzos to manage the most acute phase of the bout of attacks would have been enough, but the doctor assured me that Seroxat was very well tolerated and easy to get off of. Yeah, right.

I'm curious about one thing - has anyone tried crushing the tablets and then measuring the needed dose? Does this even make sense?

Miona

[Miona]

Took 10mg today. I don't like the idea of having to stay on it for about a year more to taper it safely enough, but I'm not going to risk this hell again if there's any way I can help it. I am lucky in that I don't feel Seroxat numbed me and when I decided to quit I was in a really good place emotionally, optimistic and joyful. Hopefully, I can get back there when I stabilize.

I just feel so stupid for ever getting on it at all because I didn't really need to. My diagnosis is panic disorder with agoraphobia. I know that talk therapy and a short stint on benzos to manage the most acute phase of the bout of attacks would have been enough, but the doctor assured me that Seroxat was very well tolerated and easy to get off of. Yeah, right.

I'm curious about one thing - has anyone tried crushing the tablets and then measuring the needed dose? Does this even make sense?

Miona

[carolyn]

Hi Miona -- I have panic disorder as well (no agoraphobia though, thankfully, except in occasional bursts). I found Cognitive Behavioral Therapy to work a lot better than talk therapy; if your panic problems crop up again in the future, that could be another thing to try.

I don't know about crushing the tablets; I don't see why you couldn't crush and weigh, but I'll let someone else chime in.

[Rachelina]

I think there are some people who crush the tablets and then weigh out the dose; you could certainly do it that way although it might be messy.

I have panic disorder and agoraphobia too, but they were made much, much worse by Paxil withdrawal (I mean worse then they were before I ever took Paxil). The good news is, they are totally treatable without drugs. Check out Claire Weekes - she has a great technique for overcoming panic. I would recommend both her book and her recordings, which you can download for free at www.controllinganxiety.com. The recordings are especially good on agoraphobia and are very soothing and reassuring to listen to. Also, The Anxiety and Phobia Workbook covers many different approaches to dealing with anxiety, panic and agoraphobia. It also covers the basics of CBT, which Carolyn mentioned and is also extremely useful for anxiety and panic.

So, if I were you, I would begin to learn these coping techniques now and continue to practice them as you taper. They will help you deal with the increased anxiety that often comes with tapering, and then by the time you are off, you will be in great shape for coping effectively with any anxiety or panic that may return.

[Si in Wales]

Hi Miona

I just wanted to say I think you may have made a sensible decision in going back on.

I've been off for 8-9 months now after tapering faster than is suggested on here and if, like you, I was encountering problems whilst still measuring the time off in days not months, I'd definitely have re-instated.

Hope things work out for you.


Si

[Miona]

Carolyn, hi, thanks for your advice. I actually did go to see a CBT psychiatrist once, about the time when I was started on Seroxat (so in the midst of pretty bad attacks), but her manner was so off-putting, at least to me, that I did not pursue it further. I already had a therapist I was and am very happy with (she's a psychologist, does Gestalt) and at the time I didn't have the energy or money to keep looking for a CBT specialist. However, I'd be very interested to know what CBT looks like exactly. I researched it at the time, but if you don't mind sharing, could you describe what a session may look like and the homework I heard they give you?

Rachel, I already have some coping strategies in place, but thanks for the link, it sounds interesting and I look forward to exploring. My agoraphobia is mild and consequently has been a little neglected, but I like the sound of that workbook and feel excited now about doing some exercises, about finding new ways to help myself. The anxiety and panic attacks I have grudgingly come to accept, value even, as signals (very scary ones) that there is something wrong in my life that I have been ignoring for too long and it needs immediate attention.

I guess you can tell that I'm having a good day so far today. Is it possible for the Seroxat to kick back in after only three days?

As to crushing the tablets, if I can't get my hands on the liquid, I'll just play around with cutting and crushing them when the time comes and see what works best for me.

Si, thanks for the support and good wishes. Since my symptoms were getting worse as time went by instead of better, I'm becoming more and more convinced that I did the right thing.

Miona

[Miona]

Carolyn, hi, thanks for your advice. I actually did go to see a CBT psychiatrist once, about the time when I was started on Seroxat (so in the midst of pretty bad attacks), but her manner was so off-putting, at least to me, that I did not pursue it further. I already had a therapist I was and am very happy with (she's a psychologist, does Gestalt) and at the time I didn't have the energy or money to keep looking for a CBT specialist. However, I'd be very interested to know what CBT looks like exactly. I researched it at the time, but if you don't mind sharing, could you describe what a session may look like and the homework I heard they give you?

Rachel, I already have some coping strategies in place, but thanks for the link, it sounds interesting and I look forward to exploring. My agoraphobia is mild and consequently has been a little neglected, but I like the sound of that workbook and feel excited now about doing some exercises, about finding new ways to help myself. The anxiety and panic attacks I have grudgingly come to accept, value even, as signals (very scary ones) that there is something wrong in my life that I have been ignoring for too long and it needs immediate attention.

I guess you can tell that I'm having a good day so far today. Is it possible for the Seroxat to kick back in after only three days?

As to crushing the tablets, if I can't get my hands on the liquid, I'll just play around with cutting and crushing them when the time comes and see what works best for me.

Si, thanks for the support and good wishes. Since my symptoms were getting worse as time went by instead of better, I'm becoming more and more convinced that I did the right thing.

Miona

[carolyn]

Sure! Here's a post I wrote last year about my CBT experience:

http://www.paxilprogress.org/forums/...ad.php?t=37531

[Rachelina]

Also, if you can't find a CBT therapist that you like, you can do it on your own. The Anxiety and Phobia Workbook covers it in one chapter, and if you want to go more in-depth then check out David Burns. His book Feeling Good is the classic CBT manual, and focuses on depression. He has another one specifically for anxiety and panic, I think it's called When Panic Attacks? It's a pretty simple concept really, and you sound motivated enough that you could learn it quickly, and if you are persistent with it, it can make a huge difference.

[Miona]

Sorry about the double posting, I was having trouble with my internet connection and must have clicked on something twice. I hope it'll work okay this time.

Rachel, thank you SO much for recommending using books, I don't think it ever would have occurred to me and I think it's just the thing for me . I looked at the preview of When Panic Attacks on Amazon and it looks really good so I'm probably going to order it. Of course, I'm open to other suggestions too. I can't seem to find the Anxiety and Phobia Workbook at the link you gave me, unless its audio, I haven't listened to the mp3s.

Carolyn, I read your story about your CBT experience and it helped me understand better what it was about. Like you said, more like taking a class than the usual talk therapy. You are so brave.

By the way, this is my fourth day back on Seroxat and I can already feel the symptoms almost literally fading away. So if I needed more proof that I was going through withdrawal, that would be it.

Thank you everyone who replied and gave me information, ideas, advice and support. I feel optimistic now that I will get off this vile drug while still living my life.

Mio