Insomnia from reduced dosage of Paxil

I have been tapering off of liquid Paxil for more than a year now, from 10mg, to 8mg, to 6mg, to 4mg, and then finally to 2mg. Between the time of 4mg to 2mg period, I suffered from extreme insomnia.  I would take the dosage at about 10:00pm, and then go to bed at about 11:30pm, but could not fall asleep under any circumstances (no matter what) until about 6am, or possibly not at all.  I suffered through this period of insomnia for more than six months, until April 2003, when my psychiatrist learned that I had been keeping the liquid Paxil at room temperature.  At that point, he instructed me to keep the liquid Paxil in the refrigerater to prevent the medication from clumping up and possibly destroying the concentration.  Keeping the liquid Paxil in the refrigerator worked.  Now, after increasing the dose to 5mg, I fell asleep almost immediately, slept ten hours to about 10:45am, but then, however, an hour later, I felt incredibly tired, and I literally had to fight myself to stay awake the rest of the day.  Therefore, I reduced the dosage to 4.5mg, but, again, I felt extremely sleepy during the day.  Even taking 2 cups of coffee and 2 cups of tea could not overcome the sleepiness.  So I reduced the dosage further to 4.25mg, and then to 4.0mg, and then finally to 3.85mg.  However, at 3.85mg of liquid Paxil, I could not fall asleep at all under any circumstances; and, again, went through insomnia until I increased the dosage back to 4.0mg.  Now, I believe I have two options here:  (1) Take reduced dosage of liquid Paxil below 4.0mg to prevent extreme sleepiness during the day, but, in addition, take a little bit of Ambien (such as 2.5mg) to try and cure insomnia from reduced dosage.  Or (2) take reduced dosage of Paxil below 4.0mg, but, in addition, take 5mg or 10mg of Prozac to end the sleepiness during the day, but prevent insomnia.  I must take the Paxil since it cures my anxiety, but I cannot take feeling sleepy during the day any longer.  Thus, I am looking for advice on this grave problem.  Thank you>

[Roger Gould, M.D.]

It sounds like your psychiatrist knows a lot about this and is the best one to advise you, but if it were me, I would try the first option you suggested.

[keeknap]

hi, i bought in an herb store -but its not an herb, its called melatonin and it works great for me. its a natural substancs. ive also heard that valarian root works really great too.melatonin is what you need to sleep. you can read about it on the internet.