Very lost; urgent advice/information needed!

[Anonymous_User]

Hello everyone,

I have been on 20 mg of Paxil since February of 2003 for the treatment of vertigo/dizziness/loss of balance. In February of 2008 I decided to start a taper from 20 mg to 15. I stayed on 15 mg until August of 2009 where I reduced the dosage to 12.5 mg. In January or February of 2010 I went down to 10 mg and all was fine until one day in April of 2010 I was overtaken by my very first panic attack whilst driving--which has now given me major anxiety and some phobia. Doctor recommended to up the dose to 20 mg. I tried this but felt very sick so then I tried 15 mg and still felt sick. I am currently on 12.5 mg along with 1 mg of Ativan once per day or 0.5 mg of Klonopin once per day. I may ditch the Ativan and stay on the Klonopin for a little while as it doesn't make me as sleepy/tired as the Ativan.

My doctor is now recommending I switch from Paxil to 25 mg of Zoloft however I'm absolutely not comfortable with the fact that Zoloft in Canada is manufactured as a capsule as tapering will become very difficult? Is Celexa a better alternative?

I will also be seeking Cognitive Behavioural Therapy but I feel very lost and have no idea as to what to do.

Any advice or information would be greatly appreciated.

[Rachelina]

Welcome! First of all you should understand that the panic attack you had was withdrawal caused by tapering the Paxil too fast. Since you never had panic attacks before Paxil and the attack happened a couple of months after dropping dose, it's safe to say it was withdrawal. Delayed withdrawal like this is actually very common.

Secondly, switching to another SSRI usually doesn't work. You will still get severe Paxil withdrawal along with possible start-up effects of the other drug. Sometimes switching does work, but it also frequently lands people in the hospital, so to me it would not be worth the risk.

Is your goal to get off Paxil? The only way to do so is to taper it very slowly, by no more than 10% of your current dose every 3 - 6 weeks, although many of us find we have to go even slower than that. If you are in Canada I don't think you can get liquid Paxil and you will have to taper either by getting doses compounded (need a cooperative doctor for this) or by cutting pills and weighing them with a jeweler's scale.

It's great that you will be doing CBT as we highly recommend that for anxiety. With a slow taper plus CBT, I bet you will do great!

[Rachelina]

Forgot to ask, how long have you been on Ativan and Klonopin? Benzos (like Paxil) may give short term relief but in the long run can cause more problems than they solve.

[Anonymous_User]

Hi Rachelina and thank you VERY MUCH for the reply!!! In this rough time, which I never imagined would ever happen, I appreciate your words of advice.

My doctor had prescribed Buspar but it wasn't working fast enough for me so I stopped it after taking it roughly three times. He then prescribed Klonopin on May 13th 2010 (he did warn me that it would only work for 2 months but I was in dire need of relief) however I haven't been taking it religiously as I felt when I first started taking it that it was throwing my balance off. Since then I have been taking 1 mg of Ativan (I had some left over from December of 2009 when I was travelling) and find that although it makes me very sleepy and tired, it does give me the strength to get through the day, and most of all, to drive--more like getting rid of the phobia I have associated with driving ever since the panic attack!! I have been taking Ativan for about two weeks. I do not want to be on this either but it allows me to work and like I stated above, to drive.

I must also say that while I was on the full 20 mg dose of Paxil I didn't experience panic attacks however while in university, about once per semester, I would experience severe dizzy spells during my sleep. When I tapered down to 15 mg. these went away.

My question to you is, do I now updose to the original 20 mg. or 15 mg.? and approximately how long will it take to kick in? I'm also scared that if I updose, it won't work but then again I haven't taken 20 mg since 2008 and 15 mg since 2009.

[Anonymous_User]

I have one more question!!

Is there a difference between generic and brand name Paxil?

[Songbird]

I would recommend you stay on the 15mg until you stabilise, which could take several weeks. Re generics, some people are sensitive to the differences between formulations, so it can be a good idea to stick with one formulation that you know works okay for you. When you feel ready to try tapering again, see if you can get the liquid form as it is the easiest way to get the small dose drops needed for slow tapering.

Re the anxiety, I highly recommend the book 'Hope and Help For Your Nerves' by Dr. Claire Weekes.

[Anonymous_User]

Thank you Songbird!

I was also thinking upping to 15 mg as that was the dose that kept me stable. I was also thinking of 17.5 but I will wait and see what happens with the 15.

My other concern now are the Benzos--I've only been on them for about two weeks and I'm not sure if I should continue, stop completely or taper off

[scotty]

I wouldn't change anything with the benzos right now. Get stable...and then wean one drug at a time.

[Anonymous_User]

Hello again,

I'm on day two of 15 mg and had a huge spike of energy (adrenaline) all throughout the day today. It calmed down by 6 pm this evening. Also, my mood seems to go in waves of positive and negative thinking--hopefully this is normal and just a side-effect of the Paxil adjusting?

Furthermore, my doctor has prescribed a low dose (10 mg) of Inderal (beta blocker). Does anyone know if this reacts with Paxil or if it's one of those medications where one becomes "dependent" on it? I have read and researched for such information but the only thing I have found is that this medication should be gradually decreased according to the doctor's instructions.

[Songbird]

SSRIs work slowly, you may need a week or two to feel any better, and it can take at least several weeks to stabilise. I know it is hard to be patient when you're feeling rotten.

Re the beta blockers, I'm no expert, but I believe that with long-term use there can be dependence issues and they need to be tapered. What did your doc prescribe the beta blocker for?

[Anonymous_User]

Yeah, the adrenaline rush I experienced today was in one word, WOW! I'm keeping optimistic though and telling myself that this too shall pass.

He prescribed the beta blocker for the anxiety I'm experiencing.

[Songbird]

Have you tried valerian, passionflower or skullcap for the anxiety? I find them very helpful and they are non-addicting.

[Anonymous_User]

Songbird, you're a wealth of knowledge!!! Thank you!

Actually, I was at the health store today before visiting my doctor and was looking at Magnesium as well as Bach's Rescue Remedy. I mentioned Magnesium to the doctor but he said the beta blocker would work better.

The associate at the health store gave me a pamphlet with various natural anti-anxiety remedies and Valerian was one of them. Relora was another. I will look further into these and if they don't cause any adverse effects to individuals with underlying heart conditions, then I'll give them a try.

[Anonymous_User]

I'm getting the urge to go back to 12.5 mg (or even 13.75 mg) after being on 15 mg for four days. My reason for this is because I'm finding a huge build-up of anxiety. Would it be wise to taper down a tiny bit at this point?

[NoRx4me]

Amazing. You experienced a Panic attack due to Paxil withdrawal and instead of your doctor recognizing it, you've been prescribed; Buspar, Klonopin, Ativan and Inderall for anxiety. All in a very short period of time. They really don't have much to offer do they?

I wouldn't take Inderall for anxiety. It lowers blood pressure. Which, if you don't have high blood pressure, isn't a good thing to do.

My son was prescribed Inderall for anxiety also. I can't remember what exactly it did to him but he only took it for about 4 days.

Hopefully, knowing it was Paxil withdrawal will help with the fear while driving, once you get stable.

[Anonymous_User]

NoRx4me,

It's strange because my days seem to have ups and downs. Mornings are usually my downs characterized by high anxiety and fear which diminish as the day progresses.

I truly hope it's just the Paxil re-stabilizing itself. I can't believe I was going into withdrawal and didn't even think it was because of tapering too fast off the Paxil.

BTW, can someone give me more information about scales? Or perhaps refer me to a topic on this site that discusses scales?

Thanks

[Anonymous_User]

I forgot to mention that the Buspar and Klonopin have been taken back to the pharmacy for recycling and I'm looking to replace Inderal with Magnesium. Hopefully it works!

[Songbird]

Originally Posted by Anonymous_User

I'm getting the urge to go back to 12.5 mg (or even 13.75 mg) after being on 15 mg for four days. My reason for this is because I'm finding a huge build-up of anxiety. Would it be wise to taper down a tiny bit at this point?

Go to whatever dose you were stable on before. If that was 12.5mg then go to 12.5mg. Once you've picked your dose, make sure to stick with it for at least 3 to 4 weeks because changing doses around confuses your system, you want to stick with the same dose for a good while so that your system can adjust and stabilise.

Interesting to hear about Relora, that's one I haven't heard of before. Some people here have reported good results with Bach's Rescue Remedy.

There is some scale information here:

http://www.paxilprogress.org/forums/...ad.php?t=41850