Paxil Withdrawal Insomnia Chest Tightening

[SleeplessDonna]

I was on Paxil for 11 years. I tried 9 years ago to get off it but had extreme side affects. At the time, my doctors told me I was crazy and making up symptoms (electric zaps). Of course now these symptoms are fully documented. I have been off Paxil completely for 4 weeks. I was originally on 40 mg and have dropped 10 mg every 3 weeks. The withdrawal has been horrendous (especially the drop to 0 mg of Paxil) and haven’t worked (& have now lost my job). Most of the symptoms have gone away except for the electric zaps and insomnia. (The electric zaps seem to occur when I don’t sleep enough). The insomnia is a strange one. It started when I dropped to 10 mg of Paxil In the beginning I was actually sleeping from 11:00pm to 6:00am with the help of melatonin & calcium. But at 6:00 am my chest, neck and upper back would tighten, I would feel crawling worms across my chest & would often wake up gasping for air.  It was so uncomfortable that I would force myself to get up even though I wanted to sleep longer. If I tried to take a nap during the day the same chest constriction would occur and I couldn’t fall asleep. The last 2 weeks it has gotten to the point where I sleep for ½ hour then up all night and then manage another ½ hour of miserable sleep. I’m now at a point where I’m afraid to go to sleep. Last night not only did I have the chest constriction but also when I was awake I was totally anxious (racing thoughts). As soon as I fall asleep the constriction & crawling starts. Has anyone heard of this? Is there a cure? Will it eventually go away? If so, how long will it take? I do not want to go back on Paxil or any other antidepressant. My doctor recommends valium and trazadone (antidepressant) for 2 weeks, then cut it in half for 1 week, then try sleeping without it the last week. I am extremely nervous about taking any more drugs. I am even nervous about taking melatonin for the rest of my life. But I am desperate for sleep. I also have pain in my neck/shoulder which is getting worse due to the lack of sleep. 3 days ago I met with an herbalist and have started drinking an herb mixture twice per day. I’ve tried valerian root (which I don’t think helped) and acupuncture as well. The acupuncture has helped me relax but has not changed the insomnia.

[Roger Gould, M.D.]

Something like what your doctor recommended sounds right to me. It will give you the sleep you need, and it is not addicting in the same way. Alternatively you can ask your doctor about a straightforward sleeping pill like ambien.

[shade]

I took the trazadone a few years back when I was in a similar situation.  It worked.  If you want to keep off meds long term, a short term small dose of Trazodone might help because if you continue to not sleep for too long, you might get really run down and have no choice but to stay on meds.

[SleeplessDonna]

To Too Big:

Thanks for your response. Did you have the same chest tightening? I'm really starting to lose my mind. I stopped the herbs because you're not supposed to mix the herbs with Western medicine. Did you have to go back on meds? If so, what? I don't want to go back on Paxil. Maybe Cymbalta because I heard it also deals with pain. Do you know anything about 5-HTP (hydroxylating Tryptophan) or SAMe as a replacement for meds?

[SleeplessDonna]

Thanks for your response. Did you have the same chest tightening? I'm really starting to lose my mind. I stopped the herbs because you're not supposed to mix the herbs with Western medicine. Did you have to go back on meds? If so, what? I don't want to go back on Paxil. Maybe Cymbalta because I heard it also deals with pain. Do you know anything about 5-HTP (hydroxylating Tryptophan) or SAMe as a replacement for meds?

[andie3330]

I have an idea of what you are going through. I've been on Paxil for about 10 years. Had been on 60 mg/day but have recently started to wean off of it and I'm now down to 40 mg/day. I've read that the last 10 mg drop is the most difficult and that often people have to reduce the dose by only about 2.5 mg per couple weeks or so to get from 10mg to zero.  I know you said that you don't want to take Paxil again, but it may be worth it to take a very small dose - maybe 5mg per day for a couple more weeks and then 2.5 for a few weeks. It might make a big difference in how you are able to sleep and function and really, what's another month or so on Paxil anyway?  I read an excellent new book recently about SSRI withdrawal called "The Antideppressant Solution". It talked about a lot of different withdrawal symptoms - maybe yours would be mentioned. Personally, I haven't had the skin crawling thing - my most distessing symptom has been these very intense and confusing de ja vue episodes - it is like my brain looses track of the current day and time - and these episodes happen as I am trying to wake up from sleep. If you want to start another SSRI (instead of continuing the Paxil), maybe it would help to start it sooner rather than later - I know that my dr suggested that I take a low dose of Prozac when I get down to a very low dose of Paxil because it can ease the withdrawal symptom from Paxil - and because of Prozac's long half-life - it doesn't cause many withdrawal problems itself.

Your brain has been adapted to living with Paxil for a long time and it sounds to me that you discontinued it a little too abruptly.  I don't think you are doing yourself any favors by trying to tough it out cold turkey - be gentle with yourself and give your brain more time to adjust to living with less  Paxil -I think you'd feel much better if you start taking 5 or 10mg of Paxil a day and then take it down even more gradually than you did. Take care, Andrea

[SleeplessDonna]

Last night I actually slept straight through from 11:00pm-6:30am with the help of 5 mg valium & 50 mg trazadone but when I woke up I still had the chest tightening. I can't tell you how terrifying it is. The last 5 days have been horrible. Terrible anxiety, can't stop racing thoughts and have been contemplating suicide. I promised my fmaily & therapist I wouldn't do it until I saw a psychiatrist. At this point I'm waiting for an appointment. Things are so bad that I can't be alone. But I'm afraid to miss the phone call from the psych. I think I have no choice but to go back on meds. Yesterday I started Cymbalta. Cymbalta is supposed to help with pain. All of this (the last 5 months of depression) started with neck pain. Of course the chest tightening is creating more pain. By the way I have the book "Antidepressant Solution" and there is no mention of chest tightening. But I think what is happening is that I'm having anxiety attacks when I'm asleep. In terms of coming off Paxil too quickly...the chest tightening started when I dropped to 10 mg. I have a feeling it wouldn't have made a difference dropping slower only because it didn't go away at all during the 10 mg drop. If you have any more advice it would be greatly appreciated. Thanks for you info and concern. Donna
P.S. I'm so angry about all of this. I was never told about how addictive this stuff is and all of the side effects being on it and getting off it. I'm so afraid that this chest thing is a permenant condition. Have you heard of any side effects that are permanent?

[shade]

Hi There,

What an awful time you've had.  Since Paxil, I've been on:  serzone, prozac, Celexa, Effexor, Lithium.  After the horror of getting off Paxil, I had to realize that I was a "lifer" on meds.  I'm also a librarian by trade and have done a ton of research, though I'm obviously no doctor.

I'm currently on Effexor/Lithium.  Effexor is a great drug because it's not just an SSRI, it also works on a whole other part of the brain too.

Personally, I hate lithium.  I want to get off it and replace it with Wellbutrin.  Wellbutrin also works on dopamine.

[andie3330]

My psychiatrist, along with my sister (who is a pharmacist)reassured me that NONE of the withdrawal side effects are permanent - they may take weeks to fully resolve - but you will get better and back to normal. Your theory about your chest tightening being related to panic attacks while asleep makes a lot of sense to me - I also have had many years of dealing with panic and anxiety attacks and I know they can definitely happen while asleep and they can absolutly cause severe chest tightening and pain. I've experienced the chest tightening first hand with panic attacks - I just hadn't linked it to Paxil withdrawal. I think Paxil must somehow effect the way the brain wakes from sleep - it was in that twilight time between sleep and waking that I have my most distressing symptoms.  I'm glad you stared on Cymbalta. My sister said that Cymbalta helps with anxiety, depression, and pain. You're going to feel much, much better soon - but I know it is sometimes nearly impossible to see a light at the end of the tunnel when you are suffering so much.  Please don't hesitate to call 911 if you are at risk of hurting yourself. It sounds like you have some family or friends to support you through this very difficult time. Please trust them and the positive things that they tell you, even if you can't really see for yourself right now how things will get better soon.  Take care, Andie

[shade]

It's been a long time since Paxil, but I do think I had chest tightening.  Do you have emoltions along with the chest tightening?  If so, it's part of the anxiety/depresiion.  If not, it could be a medical condition.

[shade]

As awful as it was coming off Paxil, I don't think there azre any lingering problems now, 3+ years later.

[shade]

If you're able, do some research on low levels of dopamine.  I posted a comment about it under real talk about antidepressant weight gain.

[SleeplessDonna]

Yesterday I was able to see a psychiatrist (the best according to my therapist). She's the first doctor that actually cared about me. I have Blue Cross HMO and it's been an absolute nightmare. The psych said the chest tightening is most likely panic attacks in my sleep. During the day I constantly pace and worry about everything. The fear of being alone is overwhelming. And since I haven't worked since Jan. and am in no condition to work or even volunteer the anxiety is worse. Last night I slept even better straight from 11:30-7:30. But again I woke up with the chest thing. But this time it was less severe. I'll be taking 2.5 mg of valium 3 times per day and 7.5 at night with 50 mg of trazadone. Seems to work. Also, I'm back on 10 mg of Paxil with the plan to wean off eventually. I'll be continuing the Cymbalta to see if it has any effect. Unfortunately, in the past the Wellbutrin made my stomach really sick. Have any of you tried Lexapro? If the cymbalta doesn't work that's the next one I'll be trying. My psych said since I've had a long history of depression (earliest memory age 5) I probably need to be on meds the rest of my life. This is so depressing but I  guess if it works it's certainly better than living the way I am. In terms of suicide...didn't mean it as a threat to anyone who is reading this. I made promises to my husband, family, therapist, and the very few friends I have that I wouldn't do it. I keep my promises. I can't tell you how grateful I am at your responses. I'm so isolated and alone. I just watch the clock tick by. I can't read or watch TV it makes me too nauseous. I hope and pray this chest thing goes away and this fear of being alone. I feel like a prisoner in my own home. The chest tightening makes me feel totally anxious, scared and lonely. Hope to hear from you guys soon.

[shade]

Cymbalta is one I've actually never tried.

Celexa and Effexor both worked very well for me.  Celexa stopped working for me when I lowered my dose because of weight gain.

Effexor works in more different ways, so it's sometimes given for worse depression that doesn't respond to SSRIs.  I know you feel awful now, just awful, but it will end.  Constantly remind yourself of this.  you've gottn through bad depressions before.  You'll get out of this.

I was sad to have to accept being a "lifer" too.  But now I think of it as being a diabetic.  A diabetic would never try to "get off" their insulin.  For a lifer like me, it's just as ridiculous for me to think I can function well without my meds.  Without my meds, I have a life threatening brain disease called depression.  It's not a personal weakness.  Yes, my meds need an adjustment sometimes, but I'll always be on something unless a cure is found.  Medication makes the symptoms go away, but not the disease.

[andie3330]

I'm so glad you were able to see the psychiatrist.  I hope that after a couple more decent nights of sleep, and once you get a little Paxil built back up in your system you'll have more relief from you distressing symptoms. Being alone has also been one of my biggest fears - with therapy and Paxil I'm pretty much ok with that issue now, but I still avoid being alone in my house overnight.  Were your symptoms tolerable the first time you got down to 10mg Paxil? Were you OK at 20mg? I've read, and through personal experience (I've weaned off of Paxil twice over the last ten years, I was off of it for a period of months and then started taking it again for incapacitating anxiety) that the best thing to do is reduce the dose by a small increment, stay at that dosage until you feel perfectly fine again and then do the next dose reduction. In other words, you shouldn't move on to a lower dose until your withdrawal symptoms have totally resolved from the previous dose reduction.  Typically, I stayed at each new dose level for at least a couple weeks, and I only reduced the dose by 5mg increments. I definitely still had withdrawal symptoms, but I was able to function at work, etc. My point being - you may need to go a little higher than 10mg of Paxil, get to the point were you feel ok, and then do the reductions very, very gradually. Best wishes, Andie.

[SleeplessDonna]

The chest thing started when I dropped to 10 mg. I'll check with my psych to see if I should be at 20 mg. This fear of being alone I never have had. I've always been a loner and accepted it. But since I don't have a job and I truly am constantly alone until my husband comes home it's really tough. The last two days I've been taking small doses 2.5 mg of valium for anxiety. My psych switched me to Xanax. The first dose did nothing. So two hours later I took another pill and it knocked me out. I just woke up with the chest thing from a 2.5 hour nap. I hope I'll be able to sleep at night. She's also given me a sample of geodon which is supposed to help with fear of being alone. The irony is this weekend is Memorial Day and I'll will be around people. So the true test of whether it works on the fear will be next Tue. I'm inclined to just go back to the valium then start the geodon next Tue. I can't tell you how grateful I am for your writings. Again I'm so isolated and alone. I just don't know what to do with myself. Hope to hear from you soon. Donna

[andie3330]

For short term intense anxiety episodes, I've found Xanax to be very helpful. I think I usually take about .50mg every 6 hours or as needed - but don't quote me on that - I haven't needed it for a while. Do you only have the chest tightening as you wake up from sleep? Do you think the chest tightening is what wakes you up? Do you feel emotionally panicky at the same time? Hopefully by Tuesday you'll be feeling better. Also, have you tried progressive muscle relaxation. I usually am able to do that even when I can't focus well enough to meditate or do other relaxation techniques. Take care, Andie

[shade]

Hang in there.  You can get through this.

[SleeplessDonna]

Tried the Xanax didn't work at all. Decided to take second dose and it knocked me out for 3 hours (& I woke up with the chest thing.So I'm going back to Valium. Unfortunately it's really affecting my coordination especially in my legs. I just keep hanging on day after day hoping the Cymbalta kicks in. Do you know how long it takes? The two things I want to go away are the chest tightening(which has lessened & the fear of being alone. My psych upped the geodon in hopes of controlling the fear. Thanks for all your support.

[shade]

Even when you don't notice it, things will be getting better in subtle ways.  I think I usually end up thinking that it's all of a sudden, but of course it isn't.  I don't know about you or Cymbalta,  The last time I switched meds, I think I felt about 30% better each week until I was finally 100% better.

Klonipin might be a good option for helping you feel more calm.  It might be less habit forming than Valium.  I like it, but it's definitely something I take close to bed time, for it makes me sleepy.  Best of luck.

[RaquelBear]

I just read your posting and I’m so glad I did. I am weaning myself off of Paxil, and I had no idea what was happening to me until I read the message board you are on. I don’t even think I needed Paxil to begin with I was just going through a transition from college to the working world and felt super anxious. The doctor put me on a reasonable dose of Paxil. After taking it for a few months I received nothing but positive feedback from everyone in my life even the people who love me the most. People were saying “I was a whole new person, a more fun, easy going, and less reserved person. Of course I loved the feedback, and I loved my new carefree life. It was also making me have NO appetite which made my cute little frame even cuter without any extra curves. I went out of town for a about 3 days and forgot my pills, and felt like “if I was going to stop these I might as well do it now”  Now I’m going on a week with no pills, I feel super dizzy, my head feels so heavy, completely out of it (to the point where people at work think I’m a total lunatic and something is wrong with me.)  I am so tired in the morning I can barley wake up, and the fatigue continues throughout the day where I just drag. I also feel super nauseous once in awhile. My appetite is HUGE. Every kind of food sounds super delicious to me. I think I am getting my original appetite back that I haven’t had for so long. Sorry to write you a lengthy email, but your posting really made me think you could help me. I am thinking about starting it back up just because I feel SO out of it, and very afraid of turning back into the reserved, anxious, kind of anti social person I was before. What do you think? When do you think these withdrawals will go away?  I don’t constantly tap my foot or anything, but I get hot flashes and feel like I want to stare into space all day. I thought something was wrong with me, because the doctor told me I would have no withdrawals and little to no side effects so on that note I am really glad I read your posting!

[SleeplessDonna]

I personally don't trust doctors. They just lie to you because they get their info from drug reps. You must find a really good psychiatrist. I finally have and I never thought I would. My withdrawal symptoms never went away so now I'm on the following meds: Lexapro, Valium, Trazadone, Lamictal, Geodon. I don't know how long you've been on Paxil. If I knew what I was going to go through I NEVER would have taken it. Again, I've always been a loner and it never really bothered me but now I can't be alone. Now I know I'll be a "lifer" and truly believe this is a result of being on antidepressants in the first place. If I had a chance to go back in time I would not have taken it. I've lived with depression all my life but have ALWAYS been functional. Now I've completely lost 6 months of my life and who knows how long it will be til I'm functional enough to work. Getting off the Paxil alone is not a good idea. I thought I could do it but it just didn't work. Again, find a really good psychiatrist. Most of them are simply crazy but keep searching til you find one. My chest tightness has gone away, but I still wake up with a "sad heart". It's hard to describe. I have to rub my chest for a while until I calm down. It's amazing how so many of the drugs I'm taking create side effects that I'm taking the drugs for. Hope to hear from you again. All the best. I know what it's like. What is the dosage you're on & how long have you been taking it?

[AnnieQ]

You listed your medicines & left of Cymbalta.  Does that mean you no longer take it?  I have Fibromyalgia & other arthritic ailments.  A new doctor put me on Cymbalta (20 mg twice daily) & had me drop the amount of Celebrex I take daily & also worked me off Elavil at bedtime (40 mg).  I've been on Cymbalta about 4 months & after being off Elavil about 6 weeks, I could no longer stand the nervousness at night.  I started taking 1 Elavil (10 mg.) at bed time & this feeling has stopped.

Did you get any help from the Cymbalta?  Thanks.  I am enjoying reading all the posts.  I stumbled into this by accident & glad to see I'm not the only one who experienced the nervousness.

[SleeplessDonna]

Yes I'm off the Cymbalta. Apparently, the whole "works on pain" is a marketing thing. I too suffer from arthritis in the neck and generalized pain in my neck & upper back. Haven't worked since Jan. If it's working for you that's great. Let me know if it's helping with the pain. My doctor's are tossing about the diagnosis of fibromyalgia but my psych (& I agree with her) thinks it's myofascial syndrome. There is a difference. Is Elavil a sleeping aid? Anti-anxiety? Right now I'm on Geodon (which I'll be weaned off of) & Lamictal.

[mal1102]

I'm hoping that someone out there has some information for me...

A very good friend of mine recently informed me that she abruptly stopped taking her prescibed 60 mg/day of Paxil. She has been on it for 8-9 years at varying dosages. She claims that she isn't experiencing any side effects although she did say that she felt as if she were on Ecstasy for the first 24-48 hours after stopping.

I am worried about her because she seems to me to be presenting signs of a manic episode and I am curious if this is linked to her abrupt cessation of Paxil. I've known her 17 years and she has suffered from Major Depression this whole time. She is the only person I know who I believe is truly ill. (I firmly believe that antidepressants are very over-prescribed and that most people can manage their diseases/problems through non-medicinal means - I include myself in this group as I suffer from diagnosed depression and general anxiety.) Also, she is a drug addict and an alcoholic and has experieced other manifestations of the underlying disease of Addiction.

When I spoke to her on the phone, she was extremely talkative and spoke very quickly. She told me she needs only 3 hours of sleep a night. She recently (5 weeks ago) met a guy on a trip for her Master's program (during which she stopped the Paxil) and already has plans to marry him. She is talking about doing a PhD when she has said, for years and years, that she wants a job where she is required to do only a minimal amount of work. She also told me that alcohol and marijuana are not as interesting to her as they were before this trip. She feels energetic and extremely happy.

Can anyone provide any insight to her situation? I know the fall from these manic episodes can be hard and fast and she has tried in the past to commit suicide. As I've never seen her like this, I don't know what to do to help her.

Thanks...

[turtle76]

I just got off of Prozac 10 mg.  I was taking 150 mg Wellbutrin as well.  I am now on 300mg Wellbutrin.  I am having severe racing heart, tightening of chest, etc.  I took a Xanax to calm down.  Has not worked yet.  Is there anyone out there that can tell me how long this will last?  I used to also do a lot of cocaine, and now I am worried that my heart is going to stop.

[Debbie in Maine]

I have been having tightening in the chest too.  I'm so glad to hear someone else is having this withdrawal symptom.  I was afraid I was going to have a heart attack.  I have been slowly cutting down on paxil after being on it for 10 years or so (when it first came out).  I get the zaps too - have a dull headache off and on.  I'm on Trazadone at bedtime.  Getting a good night's sleep really helps coping with the withdrawals.  I started at 40 mg and now I'm down to 10.  Next week I'm totally going off - I'm so excited to be off Paxil.

DebbieinMaine