Paxil withdrawal

[jakecat]

I have been on 30mg Paxil for over 27 years.  Don't let anyone tell you it isn't addictive.  Unfortunately I didn't know how addictive it is until 2 years ago.  Within the last 3 weeks I have begun the withdrawal process - which, by the way, mimics withdrawal from Heroin.  I am doing o.k. other than the uncontrollable anger, dizziness and debilitating sweats.  

Anyone know of anything natural that I can take to alleviate the withdrawal symptoms?  I am determined to rid myself of this most horrible medication.  And, apparently, as long as you do not express your concerns about Paxil to your doctor the prescriptions will continue.

[Paxiled]

They say fish oil helps.  Otherwise, it depends on why you were on it.  Relaxants if for anxiety, perhaps something like St. John's Wort if depression.  And I disagree it mimics heroin withdrawal, though I've gone through heroin withdrawal.  Heroin in far worse physiologically, and Paxil far worse emotionally to withdraw from.  And Paxil withdrawal can last a whole lot longer.  But the reason it's not addictive is, to be technically considered addictive, you have to need to continually increase the dose to get the same effect.  That's not true of ssris.  But addiction is actually a medical term that has found it's way into our common lexicon in all kinds of erroneous ways.  And it doesn't matter what you call it, Paxil withdrawal can be murder.  It sounds like yours is actually not that bad comparatively speaking, so far.  Good luck.

[Paxiled]

Oop., meant to say I've never gone through heroin withdrawal.  Never used it.  And I meant to say the natural remedy depends not on what you were on Paxil to treat, but what you're suffering during withdrawal.  As you can see, I never got over my Paxil withdrawal!

[jakecat]

Thank you for your response and your kind encouragement.  And what I meant to say is that it mimics heroin withdrawal SYMPTOMS.  I appreciate your suggestion of fish oil.  Seems like fish oil does all kinds of good for the old body.  Thanks again.

[RCA759I]

27 years?  It was FDA approved on December 29th of 1992, and wasn't in widespread use until the spring of 1993. Never-the-less, you've been on it long enough - long enough to forget how long you've been on it. Long enough that it has likely lost most or all of its effectiveness over the last 16 years or so.

Honestly, there IS an easy way to get off of Paxil. The trick is to do it correctly, or else it can leave behind residual effects. It should to be discontinued VERY gradually. Unbeknownst to many, there is an oral suspension available, which comes in one size only - 10 mg/ 5mL base. That's 2 milligrams per milliliter of suspension, which is about the rate you want to taper off of this drug initially.

Taper Schedule (Weeks 1-5):

Required: 20 mg Paxil Tablets and 10 mg/5 mL Paxil Suspension

Week 1: Take a 20 mg Paxil tablet, and 4 mL of suspension.
Week 2: Take a 20 mg Paxil tablet, and 3 mL of suspension.
Week 3: Take a 20 mg Paxil tablet, and 2 mL of suspension.
Week 4: Take a 20 mg Paxil tablet, and 1 mL of suspension.
Week 5: Take a 20 mg Paxil tablet. Your dosage has been reduced to 20 mg.

Taper Schedule (Weeks 6-10):

Required: 10 mg Paxil tablets and 10 mg/5 mL Paxil Suspension

Week 6: Take a 10 mg Paxil tablet, and 4 mL of suspension.
Week 7: Take a 10 mg Paxil tablet, and 3 mL of suspension.
Week 8: Take a 10 mg Paxil tablet, and 2 mL of suspension.
Week 9: Take a 10 mg Paxil tablet, and 1 mL of suspension.
Week 10: Tale a 10 mg Paxil tablet. Your dosage has been reduced to 10 mg.

Taper Schedule, Final Phase (Weeks 11-20):

Required: 10 mg/5 mL Paxil Suspension

Week 11: Take 4.5 mL of suspension.
Week 12: Take 4.0 mL of suspension.
Week 13: Take 3.5 mL of suspension.
Week 14: Take 3.0 mL of suspension.
Week 15: Take 2.5 mL of suspension.
Week 16: Take 2.0 mL of suspension.
Week 17: Take 1.5 mL of suspension.
Week 18: Take 1.0 mL of suspension.
Week 19: Take 0.5 mL of suspension.

Week 20: Paxil has been gradually discontinued.

If you are experiencing issues, try the above recommendation. Paxil has a very short elimination half-life, and abrupt alterations of the dosage can manifest with sudden and severe withdrawal symptoms. A gradual dosage reduction will minimize or prevent severe withdrawal symptoms.

Ryan

[jakecat]

Your first paragraph is offensive.  I am not senile, mentally deficient or even mildly disturbed.  Paxil became generic around 1992.  And no, it did not become ineffective.  I simply made the decision to get off an addictive (by whatever definition you choose) medication.

GFY.

[Paxiled]

Don't mind Ryan -- he generalizes a lot, and sometimes is a bit arrogant sounding.  But he does know his stuff -- if I had him around instead of my stupid psychiatrist, I would never have suffered the horrible and never-ending consequences of my own Paxil withdrawal.  So ignore some of his generalizations, but do listen to the technical stuff.  When I first came on here, he basically told me I couldn't possibly be suffering what several psychiatrists and my therapist confirmed I was suffering, and I got pretty mad, too, but I've come to appreciate the detailed information he has learned and freely shares.  Let's just say he doesn't always have the best bedside manner, but his advice is excellent on slowly withdrawing and the availability of liquid Paxil.  It doesn't actually work for everyone and it isn't "easy" for many no matter how they do it, but most get through it and you will, too, from what you say.  

[amish1979]

Physical dependance due to a medical condition and addiction are two very different things.  You are not "addicted" to Paxil, it is not "addictive."

[Paxiled]

Amish, addiction is addiction, no matter whether it's for a medical condition or not.  Paxil is not technically addictive, because you don't have to take more to get the same result, so you're right on about that, but benzos are addictive no matter how you get them, and so are many painkillers.

[amish1979]

Paxiled,

Yes I could have phrased that better.  Benzos can absolutely be addictive as well as opiates.  I didn't mean that just because something serves a legitimate medical purpose it can't be addictive.

[amish1979]

There is quite a difference between an addiction to a painkiller and the withdrawals we suffer when coming off of an SSRI.  I don't see many back-alley Lexapro dealers.

[Paxiled]

Actually, they exist.  I know it's weird, but they do!  Look at these celebrities with antidepressants and no prescription.  I can't even see why anyone would take benzos to get high, it isn't much of a high, but people do.  Don't ever underestimate the nut factor of humanity.

[RCA759I]

Addiction implies craving, abuse, escalation of dosage, and so on. No drug is addictive when used to treat a legitimate illness - be it anxiety, hypertension, rheumatoid arthritis, blah, and when used as prescribed for the duration of said illness.

Any drug that significantly alters biochemistry during the course of treatment for an illness will result in physical dependency of some degree, and this is of no consequence. It is NOT addiction. I have an autoimmune condition, and frequently take prolonged courses of Prednisone. If I were to abruptly stop taking the Prednisone, my body would not instantaneously produce the correct amount of Cortisol, which in turn would lead to adrenal crisis. Therefore, it must be tapered VERY gradually, given the dependence. Likewise, I suffer from cardiovascular disease, and take the beta-blocker Atenolol. Atenolol blocks the effects of adrenaline at specific receptor sites on the heart, leading to a reduction in pulse and blood pressure. If I were to abruptly stop taking Atenolol, I would suffer from severe rebound angina, tachycardia, hypertension and a potentially fatal cardiac event from catecholamine surge. I have attempted to discontinue Atenolol five times, and from my experience, it is more difficult to withdrawal from than Klonopin. Am I addicted to Atenolol as a result? Do I wait impatiently for my next "fix"? Of course not. But, if I miss even one dose, the result is hellish.

There are a plethora of drugs used to treat various medical conditions that can induce a state of physical dependency. Severe anxiety is no less benign than a cardiac condition - particularly when they co-exist, such as in my case. It does seem that "mental" diagnoses are still heavily stigmatized, however, which no doubt contributes greatly to this "addiction" debate. If this discussion were focused on heart disease and beta-blockers, the term "addiction" would never enter the picture. Ditto for any other disease. Mental illness is not imaginary, it is not particularly easy to treat in severe cases, it has a substantial impact on quality of life, and it is no less benign than any other illness. Suggesting, for example, to the depressed, suicidal patient that he should not take Paxil because it is "addictive" is just as reckless as telling a diabetic that he doesn't need to take his insulin. In either instance, the subject could end up DEAD as a result of such nonsense. Dramatic, perhaps. But true.

Ryan

[Paxiled]

This is getting off the point, but just two amendments to what you said.  The first is that, yes, even medications used for the duration of an illness can be addictive.  Ask the many soldiers who return with devastating injuries; once they recover, they still must detox from the opiates they were on just like any junkie, and many never are able to kick.  Your medications aren't addictive, but they are hard to withdraw from, but that's medically a different condition.  It's a small point, and doesn't matter much to the person who's suffering, but as a writer, I kind of focus on the fact that words do have meaning, and that sometimes people's confusion is the result of their misunderstanding of words.  The second point is, yes, Paxil might be necessary, but any knowledgeable psychiatrist isn't going to prescribe it as the drug of first resort anymore.  It will only be if less troublesome meds haven't worked.  This is often the case in medicine, where the least problematic meds are tried first and the most problematic tried only if necessary.  But I completely agree that the question of addiction isn't the question for someone who needs medication.  If you need a benzo, the fact it's addictive shouldn't stop you, and the same with painkillers, because pain and anxiety and depression are terrible for some people.  I've never solved my problem with therapy, and so I turned to meds, but it would have been nice if I had been forewarned what the consequences might be.  I never was.  You are very informed, but I would venture to guess you got that way by necessity because your physicians weren't giving you the best info.  Peace.

[theotterone]

Ok, so I get coming off Paxil is hard.  I have been on it for almost 10 years now.  And I understand that the effects of coming off can be devistating, but aren't there withdrawal symptoms to ANY antidepressant?  Is insulin addicting because one's body can not produce it and they need to to process glucose?  I'm not trying to stir up trouble, just asking for clarification.

[ChinaMike]

TO JAKECAT AND THEOTTERONE:

I've been on Paxil for the past three months; at first at a 20mg dose, then after a month it was upped to a 30 mg dose. The results were mixed at first but it has stabilized and I now function better and my overall, concentration, mood, irritablity and anger have stabilized for the better. Although it is not a perfect solution, I do feel more normal in character and just feel better about myself. My family can see an improvement in my behavior and temperment as well.

Now,  I don't have the uncontrollable urge to lash out if things don't seem to turn out right and I don't get angry at myself and withdraw from life like I have been doing for the past five years. At this particular time in my life it has been the right desion and the best thing to do because there really was no other immediate relief or better solution made known or offered to me by either friends, family or most important, the health professional community. It is, at best, a stop-gap solution until I get my life back together and find the real cause and the best solution to repair my mental health problems.

After having said all that, my personal observation is that the withdrawal symptoms to Paxil mentioned by others in response to jakecat's post may just be amplified side effects from the Paxil. I say this because many of the withdrawal syptoms (symptoms) mentioned here, I have experienced  as minor side effects to my Paxil use.

I once missed two days of my meds (at 20mg) and at exactly 48 hours off my dose,I experienced "hot flush-like sweats" and I became quite irritable. The slightest negative thing or comment to me would set me off like a stick of dynamite. I did realize what was wrong and told my coworkers what was happening and they were glad just to know that it was the Paxil and nothing personal boiling up inside of me. I finished the workday without any other blowups or incidences as I consciously made the effort to control my feelings with my friend's help. I went back onto the Paxil the next day and aside from the minor side affects I have improved. Things have really slowed down for me and I now can concentrate better and my mood has mellowed considerably.

However I find I catch myself trying to concentrate on noticing for the side effects but this is the wrong thing to do. The analogy that comes to mind is: that noticing for the side effects is kind of like paying 300 dollars for a good quality pair of jeans and then checking for imperfections and pulled threads everytime you put them on. You shouldn't have to worry about things like that and it won't help with lessening your anxiety!!!

I do concur that doctors tend to push these drugs onto patients as it is the easiest thing to do and it dispenses with the expensive testing to find out the real causes of our anxieties. As for how long I will be on Paxil meds?; Well I had a very traumatic experience that lasted about a year and this is what caused my anxieties (which was  5 years ago) and I have yet to come to terms with it. Since taking Paxil I feel I have finally started down my road towards recovery and can now forget about and start putting that ugly experience behind me.

I guess the point I'm trying to make is: Just give the Paxil a chance to see if it can help and take note of the group's advice. Consider the Paxil as a stepping stone towards feeling normal again and do not rely solely on the drug to cure whatever ails you. Instead, while on Paxil use the time to find other more healthy alternatives to feeling better.

China Mike

[theotterone]

I get what your saying.  Here is the thing for me.  I am on 75 mg Paxil CR a day.  You read that right, 75 mg a day!  I am working with my doctor and since I am being treated for ADD, my anxiety has gone down, so I am looking to have my dose lowered.  This is why I am so interested in this discussion...

[nursegirl6572]

This subject is one of my pet peeves...and by official definition, Ryan is 100% correct.  By definition, "addiction" is characterized by WAY more than just your body "needing" a drug/medication.  It includes maladaptive behaviors and taking very out of character risks for that person in order to obtain said substance.  It includes seeking out the drug, and more of the drug to obtain a certain sensation.  THREE terms are used interchangeably all the time...erroneously.  Addiction, physical dependence, and tolerance.

A person does NOT become a Paxil addict, or a Prednisone addict.  They become physically dependant on the drug after they start it...with many different meds having a withdrawal phenomena if discontinued.  "Tolerance" is the need for a frequently higher dose of a medication in order to acheive the same effect.

So, to say that Paxil is "addicting", is actually not correct...it is another example of misuse of very sinmilar terminology.  

Don't get me wrong, Paxilled...I'm not meaning to pick on you or anyone else...but like I said...this subject is a pet peeve of mine because so many people use those terms interchangeably and it just isn't accurate.

You were never "addicted" to Paxil...you became dependant on it.  The difference between the two may not be vast for you....and in the end you still found yourself in a rotten place.

I also want to mention yet again that I think we all have an obligation to carefully choose our words and indicate when something was OUR experience and OUR opinion.  It isn't fair to scare someone away from an option that may be the "miracle cure" for them because of statements like, "No sane doctor would prescribe Medication X"....or "Don't ever take Medication Y, it will have you living a nightmare".

For example, Paxilled (again not picking on you here...just feel this is SO important on a forum like this)......the following statement you made I take great issue with:

"The second point is, yes, Paxil might be necessary, but any knowledgeable psychiatrist isn't going to prescribe it as the drug of first resort anymore.  It will only be if less troublesome meds haven't worked. "

You are making a very strong statement that any p-doc who Rx'es Paxil isn't knowledgeable.  You also go on to state, as though it is a known fact that Paxil isn't or shouldn't be a first choice medication for ANYONE.  You feel that way b/c of your history with the med.  For many many people...it would be the ONLY first choice med that makes sense.  For some people....they have experienced similar horror stories with Lexapro...so then would it be accurate, or fair even to make the above statement about Lexapro?  The FACTS are...Paxil has helped a LOT of people and still does.  

I am just asking you to PLEASE remember that the people on the other end of your words often come here desperate for help...scared...and totally clueless...totally new to the world of anxiety.  Sure, share your experiences...but in a much less biased way...allow people to have their own experiences...and remember to be cautious not to state info about your history as fact.  For every one of you that have had a nightmarish experience on Paxil (and you can really apply this statement to ANY of these types of meds)..there is someone it helped.

I feel very strongly about this and truly want people coming here to get great info and support without all of the preaching to stay away from a certain medication...medications in general...or ANY form of treatment. It just isn't fair.

Thanks!  :0)

[greenlydia]

This is a GREAT thread people.............much needed, highly informative and long overdue.
I ask only that it be kept as an intelligent, considerate debate. The alternative is that the MH Mods will delete it and much knowledge will be lost.

Thank you
Greenlydia  

[nursegirl6572]

Thanks lydia.  Hugs!

[amish1979]

Thanks for more eloquently making my point.

[Paxiled]

I think you've got me half confused with someone else -- I said Paxil was not addictive, not that it is.  My information about Paxil no longer being a drug of first choice was told to me by several psychiatrists, and researching Paxil on the web.  This has been true for years.  It was the sixth or seventh choice for me, so I'm not claiming it was the first choice for me, either, and that was several years ago.  My health plan at that time was owned by one of the top medical schools in my area, and that's how they approached it, and again, that was several years ago.  My last two psychiatrists don't use Paxil much at all.  But I agree, there are people with Lexapro horror stories, just a whole lot fewer of them, and the manufacturer of Lexapro didn't oversell it as did GlaxoSmithKline and didn't lie about it, as did GlaxoSmithKline.  They spent a lot of money on lawsuits because of this, and left psychiatrists unprepared for what followed.  And you misunderstand my Paxil experience.  The medication did help me, and I've always said so -- more than any medication I've ever taken.  My problem wasn't necessarily with Paxil, it was with a quack psychiatrist who never told me about withdrawal even when I entered, and I was unlucky enough to suffer an extraordinarily bad reaction that is still ruining my life three years later.  Had I a better psychiatrist, I would have been counseled about what was happening to me and put back on Paxil, leaving me the choice to taper more slowly or just stay oneit.  Now I'm in a never never land where nobody knows what to do to get me back to those good old days where all I had was anxiety attacks.  But my warnings go beyond that.  Paxil does have a lot of side effects -- that's what drove me to try stopping it -- and it does seem to be more difficult to quit than any of the other antidepressants other than Effexor.  So if you know that, why wouldn't you start with a different medication first in the hopes you wouldn't have to use the one that psychiatrists have the most difficulty getting patients off of?  You keep it on your list of possibilities, but you don't start with it.  Because it has nothing special other ssris or tricyclics don't also potentially offer; it's not a situation where there are no alternatives.  If you go on the mental health forum, Dr. Gould always recommends Prozac first, because he finds it to be the easiest on patients.  If it doesn't work, yes, you move on.  I don't want to ban it, I might in fact end up back on it and I certainly don't want that option taken away from me.  I always say, try therapy first, then natural remedies, then medication as the last resort, and the more difficult medications last.  What's controversial about that?  

[Paxiled]

If Paxil works for you, stay on it.  I wish I hadn't quit, but I couldn't sleep anymore on it and I couldn't write on it, but I can't do any of those things now, anyway.  But no, not all ssris cause bad withdrawals, and most people will get off Paxil without a terrible withdrawal.  You might have a very easy time of it.  There's no predicting for any individual, just probabilities that the ones with the most reported problems will potentially be more likely to cause a problem than the least.  The most important thing is to have an understanding and educated and curious psychiatrist.  And it's different than insulin -- the Type 1 diabetic can't live without it.  You can live without Paxil, and there are alternatives, while there are no alternatives for a Type 1 diabetic.  Ryan has a heart condition that could kill him; anxiety is really unpleasant, but we won't die of it, though I kinda wish I would.  But the most important thing is, you won't necessarily have a bad withdrawal, so if it comes time you wish to quit, don't expect it to be hard.  Just prepare so you know what to do if it is.  Anxiety is a horrible disease, and if the medication helps, then that's the best we can do at this moment in history, assuming therapy hasn't worked, and it doesn't work in the large percentage of cases from the few studies that have been done.  

[theotterone]

Ok, I get that (though I was gestational diabetic and even getting down to ideal weight I will probably be type 2 in a few years).  Since I went on Adderall (adderrall), I have noticed that I have calmed down quite a bit.  That being said, the last two days I have been very "edgy" and feel like I have been on the cusp of having an attack, but haven't quite gone over that edge.  I don't think the anxiety will ever "go away" or be "cured", but to drop my dosage would be nice.

I am very lucky to have a great doctor who listens and really makes me a partner in my treatment.  He doesn't hand me a prescription and say "take this" and expect me not to ask things.  It helps he is the first psychiatrist I have had who is personable, laughs at my jokes instead of analyzing them, and truly listens to me.  The Family Therapy has really helped my husband understand my different issues too.

I appreciate the information and you kind words!

[Paxiled]

Just wanted to add that you weren't suffering side effects, china, you were suffering withdrawal.  When you skipped your dose you went into withdrawal; when you resumed the med, it stopped.  A side effect would be something you suffer while on the med, such as headaches or weight gain.  

[jakecat]

It has now been approximately 6 weeks since I started tapering off Paxil by reducing dosage froom 30 to 15 mg per day.  It has been 9 days since I have taken any Paxil at all.

This post is intended to offer a bit of encouragement to all who are tapering off.

I am free of all symptoms of withdrawal (by whatever definition you choose to attach to the use of the word withdrawal), no more lightheadiness, no more unrealistic anger.  I am calm, happy and feel terrific.

The long term effects of taking Paxil are just now coming to light.  When coming off Paxil I noticed I was no longer throwing up (which I had been doing at night, 3 to 4 nights a week) for years.  I have had every medical test known to man to diagnose the problem - no answers.

I have had sleep disturbances for years.  Couldn't sleep through the night, dreams so vivid I can remember them for years.  So I did a sleep study.  Nothing definitive there.

Left hand shaking, feet felt like ice, a myriad of small, odd things.

Without Paxil every one of my "oddities" have disappeared.  What I began to have, post-paxil, is terrible edema of the feet and ankles and unexplained weight gain.  Because of all the previous throwing up I found I could never eat more than 1.5 cups of food at a time, and still don't.  So no reason for weight gain there.

There is legitimate medical literature with findings that longterm use of Paxil does cause edema and unexplained weight gain.

To those of you just embarking on this journey - you can have optimism because you will make it.  It sometimes isn't a pretty sight but there is a light of the long and sometimes very dark tunnel.

Because the long term effects of taking Paxil are only recently being reported my wish would be that although Paxil can be a blessing unfortunately there is a price to pay and that you carefully consider long term use.

My very deepest and sincerest Best Wishes to all of you.  May God bless and keep you during this journey.

Good Luck to all.  

[Julie359]

Well i was on Paxil or Paroxatine for 12 yrs in total and in so many ways it was a God send, it gave me back my life, i did have Symptoms while on it but i could live with them.  I did have a lot of trouble coming off as well, a lot of withdrawl which was terrible and lasted for the longest time.  I can say that even though i miss the confidence it gave me to live my life normally i am glad i am free of Paxil now cause now i can actually learn how to control the anxiety, which is sending me on a great personal journey of self discovery which i am enjoying and learning heaps from.  For the first time i am actually learning alot about me.

Also one question, isn't addiction and dependancy the same???  Different word same meaning....?  N please no one bite my head off for asking that....LOL

[Paxiled]

No, they are different.  But it's probably best to research it in authoritative texts rather than here, for obvious reasons.