Withdrawals while taking an SSRI (Please chime in Ryan)?

[Slappy3243]

I have been having issues with anxiety and depression as most of you know. I have a question in regards to SSRI medications though. The first SSRI medication I took was Paxil and it worked great. A few years ago I was on Paxil CR 25 mg per day and it relieved pretty much all of my symptoms. I had normal levels of anxiety (no more panic attacks) and my mood was much better. I did have some side effects but they were better than feeling how I did.

However, after being off of the Paxil CR for a while I started it up again after trying Zoloft (which made my anxiety so unbearable; I thought I was insane) and the results were not great. I gradually worked my dose up to 37.5 mg as per my doctor's instructions and while it did seem to help with the anxiety and depression, I was having the eye zaps and severe depersonalization that I only experienced during withdrawals. The doctor thought I may not have enough Paxil in my system so he put me on 25mg Paxil CR twice daily and it made me feel even worse. I felt like I had the flu and very achy. Very bad withdrawal effects. I was then put on regular paxil 40 mg daily and I constantly had the eye zaps and strong depersonalization feelings like I was in a constant withdrawal.

I was then switched to Lexapro 20 mg. It seemed better than the Paxil but I was still getting the eye zaps and depersonalization but to a lesser extent. I was dropped down to 10 mg of Lexapro a day and the withdrawal symptoms pretty much subsided except for some depersonalization.

So what happened? Why was I once able to tolerate the SSRIs just fine but after the Zoloft incident, the Paxil and Lexapro would give me withdrawal symptoms while I would take them? Is my body metabolizing the medicine too quickly? Am I on too high a dose? Do I need to try a long half-life drug like Prozac? My doctor is not sure why but says that everybody is different. That is great but I once tolerated the SSRIs just fine and now all of the sudden my body seems to be in a constant withdrawal when taking Paxil or Lexapro (20 mg).

Any ideas? Since being off of the Lexapro I am feeling very depressed. It has been just about two weeks of being off and I definitely felt better while being on the medication. Perhaps I didn't realize I am depressed and well as anxious. I feel really sad and depressed now that I am off the Lexapro. Did the Zoloft somehow damage me?

-Adam

[xanweaner]

Ryan did a quick overview of mirtazapine in the post that you were involved in with David. Be sure to check that out - may help...

I totally know what you mean about wanting to feel "normal" again....I miss the old me so, so much - I miss having normal feelings - happy, sad, etc. All I can do is hope that once I'm off xanax, they'll come back. I also have to tackle Ambien withdrawal next, but it normally hasn't been that difficult in the past.

I want to live drug-free...

[Slappy3243]

Thanks for the response. I will speak to my doctor Monday about what is going on since I didn't really start to feel sad, anxious, and depressed until Friday. I want to make sure that this is not just part of the Lexapro withdrawal effects. The only SSRI to truly agitate me is Zoloft as I have mentioned. I sort of feel the way I did on Zoloft as I do now. So I am assuming I also have underlying depression issues as well as anxiety. When I speak with my doctor, I will certainly bring up Remeron. I have nothing to lose at this point I feel so bad. I am so sad and anxious that I feel like I could cry. I never cry. The last time I cried was during the Zoloft "treatment". I am not trying to be macho or anything like that, but it just goes to show how debilitating mental illness can be. I look at all of those people around me and wish I could be like them. Thanks for your input.

-Adam

[xanweaner]

I could not tolerate any of the SSRI's except for Remeron - mirtazapine....it's different from the SSRI group, but unfortunately, I can't tell you how. (I hope someone else will post why - like Ryan). I became unbelievably agitated on all of the SSRI's..  Once I got past the sedating effects of Remeron as you slowly titrate upwards - I take 30 mg. - it's the only AD that doesn't agitate me. As you know, I had to combine xanax with it but have been slowly withdrawing my dosage over months, and so far, so good.

I asked Dr.'s during my drug trials if these drugs could damage me, also, as I felt like I was losing it when I would try the different AD's. (My doc always started me on the very lowest dosages as I'm unbelievably sensitive.) My docs claim that the SSRI's wouldn't do any damage to my brain, too.

So, Adam, has your doc ever offered mirtazapine as an alternative?

And, hopefully, Ryan will chime in - what do you think of mirtazapine, overall, as an AD?