Really need advice

[Crossroads]

I could really use some help here. I recently started feeling the effects of withdrawl without lowering my dose. About a month ago I went through a particularly stressful period. 2 weeks ago I started waking up with extreme muscle tension. In the last week I noticed that I'm very angry and feeling out of touch with reality. Yesterday I could barely function. HAs nayone else ever experienced a sudden change like this?
I went to the doctor (GP) last week thinking that I needed to lower my dose (I know I don't want to raise it). He agreed. I've started to lower my dose. I'm alternating between 15mg and 20mg every other day. I started this about three days ago. I now know that some of what I'm feeling could be connected to lowering my dose but it doesn't account for the fact that I was feeling this way before I lowered it. I don't know what to do as I was already feeling this way before i lowered my dose. Everyday seems to get worse.
How long should I expect to feel withdrawl from lowering my dose? I'm prepared to push through if need be but I'd like to know how long to expect these symptoms so I can devise a plan B if they don't seem to be going away.

[TryingtoGetWell]

Welcome, Crossroads.

Judging by the symptoms you describe, you're beginning to experience withdrawal.

I strongly urge you NOT to alternate doses, and also to do a slower taper (this group recommends maximum 10% drops in dose every 3-6 weeks or longer) taking the same dose each day consistently until stabilized after sufficient time to drop further.

Even with bad side effects from the med, your brain and nervous system have adapted physically to the drug and need to heal in drops small enough for it to handle, and allowing sufficient time for the healing process.

I suggest you go back to your original dose, stabilize on that while either having your doctor prescribe liquid paxil (oral suspension) or getting scales if liquid is not an option. (It's not available in all countries.)

The scales need to be jeweler's scales that measure extremely minute cuts in pills accurately. They are readily available online, but first see if you can get the liquid, which is easier and more accurate.

There are many resources on this site we can guide you to that tell you how to use either method, and also a spreadsheet for calculating drops in dose.

But first step is to go back to taking the same dose each day. Alternating dosing "confuses" the brain and leads to problems for almost everyone.

[Crossroads]

Thank you for the advice. I am afraid that I won't stabalise if I go back to my original dose as I was already experiencing these symptoms before I lowered it. My intention when i lowered my dose was a test to see why all of the sudden i was having these symptoms even though i hadn't changed my dose. I've been taking 20mg regular for 5 years and then all of a sudden two weeks ago, without changing a thing, i started to have these symptoms. I'm just trying to get back to feeling normal. One day I'd like to get off Paxil but for the moment it's been working fine up until recently.

[scotty]

As you're learning Paxil isn't a "forever" drug. At some point in time most will experience what we call poop out. This is when the brain can't maintain the imbalance that Paxil has caused. This usually happens after 5-10 years of use for many.

The options are increase your dose, which will buy some time, or start reducing. Increasing dose once poop out has been reached usually doesn't result in long term stabilization.

If you're going to start weaning consistent daily dosing is key. Do no alternate doses. This only creates chaos in the brain with the constant dose changing.

We recommend weaning by 10% of your current dose every 3-6 weeks.

[TryingtoGetWell]

I just remembered I forgot to ask you how long you've been taking the clonazepam, and whether you're taking it regularly.

[Crossroads]

been taking the clonazepam for the same time as Paxil. every night with my Paxil.

[Crossroads]

Originally Posted by scotty

As you're learning Paxil isn't a "forever" drug. At some point in time most will experience what we call poop out. This is when the brain can't maintain the imbalance that Paxil has caused. This usually happens after 5-10 years of use for many.

The options are increase your dose, which will buy some time, or start reducing. Increasing dose once poop out has been reached usually doesn't result in long term stabilization.

If you're going to start weaning consistent daily dosing is key. Do no alternate doses. This only creates chaos in the brain with the constant dose changing.

We recommend weaning by 10% of your current dose every 3-6 weeks.

I know I haven't been through this before but I'm just not certain that what I am experiencing is a poop out. I thought a poop out was a return of the symptoms I had before taking Paxil? should I be experiencing symptoms of withdrawal even though I was taking my regular dose, (that is before I started alternating)?

[TryingtoGetWell]

I'm not scotty, but she seems to be offline at the moment.

As far as I know, tolerance withdrawal aka poop out causes one to feel withdrawal while still on the med - even the same dose as always.

Anger/irritability and derealization are common withdrawal symptoms.

[Crossroads]

Originally Posted by TryingtoGetWell

I'm not scotty, but she seems to be offline at the moment.

As far as I know, tolerance withdrawal aka poop out causes one to feel withdrawal while still on the med - even the same dose as always.

Anger/irritability and derealization are common withdrawal symptoms.

I just don't know if I'm ready to face this challenge but I know I don't want to up my dose. the idea of continual ups and downs while tapering over a matter of years is overwhelming. how can I work and raise two kids like this? I can't put it all on my wife. how does anyone do it?

[scotty]

Originally Posted by Crossroads

should I be experiencing symptoms of withdrawal even though I was taking my regular dose, (that is before I started alternating)?

This is exactly what poop out is.

Originally Posted by Crossroads

I just don't know if I'm ready to face this challenge but I know I don't want to up my dose. the idea of continual ups and downs while tapering over a matter of years is overwhelming. how can I work and raise two kids like this? I can't put it all on my wife. how does anyone do it?

You can have a life while weaning. You do it VERY slow and leave plenty of time in between each wean. Everyone here understands the fear of doing this, but the reality is that not "being ready" doesn't change the fact that Paxil has stopped working for you and something to going to have to change.

[Crossroads]

Thanks for the honesty. One more question, if Paxil has 'pooped out' for me then shouldn't i be expecting to feel severe withdrawal symptoms not just the kind I would feel from tapering off or is it still working on some level. It just feels like every day was getting a little worse even before I dropped to 15mg.

[scotty]

It's not usually a drastic change. Just enough that the drug isn't doing what it use to do.

[fishy]

Alternating doses probably did more harm than good. The idea is to stabilize and changing doses or medications will cause changes in serotonin levels that may take weeks or months to stabilize (I know this first-hand...look at my siggy). My recommendation would be to go back up to 20 mg for a few weeks to a few months and see if things stabilize. Then start a slow taper.

[texgirl]

It does sound like you're in Paxil poopout, but you absolutely can't ignore the role that Klonopin is playing here. After 6 years of daily use, it would be unusual if you weren't having tolerance to it, the symptoms of which can be similar to those of Paxil poopout.

[Crossroads]

Originally Posted by texgirl

It does sound like you're in Paxil poopout, but you absolutely can't ignore the role that Klonopin is playing here. After 6 years of daily use, it would be unusual if you weren't having tolerance to it, the symptoms of which can be similar to those of Paxil poopout.

Klonopin? That's Clonazepam, right? Hadn't thought of that. Ach. So do I up my dose of that? I have a doc appointment on monday but since he thought dropping from 20 to 15 was not a problem I'm not sure how much use he'll be. I might try and get in touch with the P doc who originally put me on Paxil but I get the feeling he's the type to say the only option is to up the dose.
I'll get back on my 20mg and see if things stabilize but I'm not sure they will since they started to destabilize before i even dropped my dose.

[texgirl]

Originally Posted by Crossroads

Klonopin? That's Clonazepam, right?

Yes.

Originally Posted by Crossroads

So do I up my dose of that?

No! As with Paxil, upping the dose might only bring short-term relief, and you'll end up on a higher dose to taper off of. Benzos (that's clonazepam) are very addictive and can really get their fangs in you, so they should always be prescribed, taken, and tapered very carefully.

It can be challenging to figure out how to get off multiple meds, and there's a lot of controversy about whether to taper the SSRI or the benzo first. Generally we say to taper first the one that's giving you the worst symtpoms, but with multiple meds it can be impossible to say. You might have to experiment a little. Just don't try to do both meds at the same time, take it very slowly, give yourself time to stabilize in between drops and in between drugs, and be very skeptical of how much help you're going to get from your doctor with this (which it sounds as if you already are).

Dr. Ashton's manual on benzos and how to taper is very useful and can be found online at http://www.benzo.org.uk/manual/.

[Crossroads]

So when you poop out and you start to feel the effects of w/d without changing your dose, do you eventually stabilize? For instance if I keep my dose at 20mg does anyone think i will stabilize or because i am pooping out i will just continue to destabilize and it will get worse and worse? It seems like the advice I'm getting is that i should go back to 20mg and wait to stabilize, then start my tapering off, which sounds like a good idea but if i am pooping out will that even happen? Oh how very complicated this Paxil stuff is!

Ari

[Brassmonkey]

Your discribing pretty much what I was going through three months ago. I am feeling so much better and more grounded now that I am on my taper. I was scared to start taking less because I thought it would cause more symptoms, but it turned out the opposite. For me the activity and schedule of having a job really helps take my mind off of the symptoms I do have. It is a tough first step but you won't trip and fall because of it.

We're all pulling for ya.

[Crossroads]

Originally Posted by Brassmonkey

We're all pulling for ya.

Thanks Tom. I will talk to my doc on Monday about getting some liquid after a few weeks of going back to 20mg. Fingers crossed.

[fishy]

Sometimes you get "breakthrough" symptoms. This happens when you are close to tolerance and extra stress in your life can "tip you over the edge". Once the stress is gone, you may start to feel better. I think that was my issue with paxil. I thought I was in poop out, but had 3 poeple die who were very close to me (including my mother) in a 2 year period.

Even in tolerance, the paxil is doing SOMETHING. If not, you could just cold turkey and you would see no difference. That is never the case. So again, get as stable as you can and see if you can get some relief. Texgirl is the Benzo Queen. Listen to her wrt all things Benzo.

Many of us are on SSRI and Benzos. Which to taper is not an easy decision. First try to get stable...you can worry about which to taper later.

[Crossroads]

Update:
Saw my P doc. Not helpfull. Suggested adding another anti-dep to my cocktail. Thinks that the current stress in my life is too much for what I am taking. When I asked him if he thought I could get through this crisis without it he said "I don't know". My GP suggested taking more Klono. I have panic/anxiety all day that usually lets up around 4p. then i do it all over again the next day. I've set up an appointment wit ha psychologist for Monday. I'm sick of the drug pushers.

[babs]

Good for you! You are much better off seeing a therapist than a doctor. Panic and anxiety can be managed without drugs, as many members here can attest.

Re poop-out ... I was on Paxil 11 years and feel that it stopped doing anything for me, but I didn't experience any withdrawal symptoms while I was still on the med (not that I was aware of, anyway). I started tapering and didn't ever stabilize between drops ... my symptoms were random and with no predictable pattern. I think the routine of doing a drop, waiting to stabilize and then dropping again works best with people who are not in poop-out yet. Once you've pooped-out you kind of have to just keep going despite symptoms, which should be manageable if you go slowly enough. Some people actually feel better the lower they go in dose.

[IMISSME]

Originally Posted by babs

Good for you! You are much better off seeing a therapist than a doctor. Panic and anxiety can be managed without drugs, as many members here can attest.

Re poop-out ... I was on Paxil 11 years and feel that it stopped doing anything for me, but I didn't experience any withdrawal symptoms while I was still on the med (not that I was aware of, anyway). I started tapering and didn't ever stabilize between drops ... my symptoms were random and with no predictable pattern. I think the routine of doing a drop, waiting to stabilize and then dropping again works best with people who are not in poop-out yet. Once you've pooped-out you kind of have to just keep going despite symptoms, which should be manageable if you go slowly enough. Some people actually feel better the lower they go in dose.

Looking back at my experience, I believe poop out started in year 11 for me as well. That was late 2008. I started to have an underlying nervousness as I was beginning to process events in my life (primarily my divorce from a year prior). I also started to suffer from insomnia. Never had that before. Insomnia is a classic poop-out/withdrawal symtom, right?

[IMISSME]

Originally Posted by IMISSME

Looking back at my experience, I believe poop out started in year 11 for me as well. That was late 2008. I started to have an underlying nervousness as I was beginning to process events in my life (primarily my divorce from a year prior). I also started to suffer from insomnia. Never had that before. Insomnia is a classic poop-out/withdrawal symtom, right?

By the way, Paxil stopped really helping me for the reason I started it (night terrors, waking up startled and anxious in the middle of the night) after about 5 years, that was my first attempt to get off it. But when I would discuss with my doctor (always during a time when I had stopped for about 4 or 5 days and was very "jumpy") she always convinced me that I needed to stay on it because of how I acted when I missed several doses. Boy, looking back at it, that's about as ignorant as a doctor can get. Of course I was jumpy after quitting for several days. It does have effects and when your body ain't getting it then trouble follows. Do all these doctors really think that there is no withdrawal period on these meds. Geez, she had me convinced both times I tried to quit that my nervous anxiety after 4 days off was evidence that I needed to be on them, WOW!!!!