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Mental Health (Expert Forum)
paxil withdrawl
Answered by
Roger Gould, M.D. - Mental Health, Wellness
Questions posted in the Mental Health forum are being answered by Dr. Roger L. Gould, author of the Mastering Stress and Depression program and affiliated with the UCLA. Department of Psychiatry. Topics covered include anger, attention deficit disorder (ADD) , bipolar disorder , dementia , electroconvulsive therapy (ECT) , learning disabilities, memory, obsessive compulsive disorder (OCD) , panic , personality disorders, phobias , post-traumatic stress disorder (PTSD) , schizophrenia , stress , transitions, and work problems.
paxil withdrawl
by mome43, May 30, 2004 12:00AM
I have been on Paxil for 2 years due to anxiety attacks. I have gained a great deal of weight. I feel that there is no hope of loosing weight while on it. I did try weening myself off, but the side effects were too much to take. The side effects included headaches, dizziness and just being tired. My MD is of no help other than he says to just get thru it. Can you offer any advice as to how to get myself off Paxil and perhaps recommend an antidepressant that doesnt cause weight gain?
Doctor's Answer
by Roger Gould, M.D., Jun 01, 2004 12:00AM
, Jun 01, 2004 12:00AM
Most people switch to wellbutrin under these circumstances. YOu can start that ( ask your doctor) and while taking that, taper off the Paxil over a three week period.
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Boy, do I know what you mean by withdrawl's! Paxil withdrawl's are not fun at all. From what I have read and been told, it is common to have these withdrawls with Paxil.
What my Psychiatrist advised me to do was over a period of time, wean myself off of it little by little. For instance, I was on 45mg of Paxil a day. I was taking 1 30mg and cutting another in half to equal to 45mg. This is what seemed to work best for me. I bought one of those pill cutters in walmart for about $4.00 and every day I would lessen the dose 5mg. For me, I did not start feeling the side effects until I got to 15mg. When I went from 15mg to 10mg, I had vertigo and was extremely dizzy about every 30 seconds. It was very anoying and I felt nausous as well. So, my doctor suggested when I started feeling the side effects to take the 5mg to bring me to 15 mg so I would feel better again (which I would the next day after waking up). Then, the next day, instead of going from 15mg to 10mg, I cut one of the pills and made it so I went from 15mg to like 14mg.... if I was ok the next day, then I cut it down 1mg. I did this each day and there were a few days I had to cut the pill smaller than what 1mg would be. It took a couple of weeks to work, but it really did get me through all of the withdrawls and wean me off of it. That was my experience, I don't know if it would work for everyone. Also, I was not on Paxil CR, so that would not work if you are on that.
I am not sure how your medical insurance is, but you might want to look into seeing how much it would be for you to go to a phychiatrist. They are usually much more knowlegable in this area and could offer some good feedback. I was lucky, my MD had a big interest in mental health, but when when we started to identify other issues I had (ADHD, OCD), he suggested I see a Phychiatrist.
I too gained weight on Paxil (about 15 lbs in two years). After trying other A/D's I reverted back to Paxil. It was the best one for me. I went off of it due to having sexual side effects. The weight gain was not as big of an issue for me, I was pretty thin and the 15lbs did not look THAT bad on me, but I still try and lose it without success! =(
For me personally, when I was on my 45mg of paxil before weaning off of it, it made me feel just where I needed to be. The others I tried (Effexor, Wellbutrin, Buspar, Lexapro) made me feel better but never as good as Paxil. I choose to go back to taking Paxil, but only taking 30mg and it is working well for me. For the sexual side effects, I take Viagra which works for me as well. I take Adderall (adderrall) for ADHD which makes me feel like I fit in this society for once in my life! Between both of those, for me I am a new person.
Hope some of this helps, but try and be patient and if I were you , I would look for another doctor regarding your mental health and medicine you take for it since family Doctors don't always specialize in this area.
Good Luck and have a Safe and Enjoyable Holiday!
-Paul =)
I quit Paxil 4 days ago [cold turkey]. A personal decision. I was prescribed Paxil for anxiety but after 2 years on the medication I started experiencing anxiety once again.
The first 2 days, and nights, were hell. I was constantly over heated, shaky and angry. I had horribly vivid dreams the first night and woke up every half hour the second night. The dreams [nightmares] have stopped now [day 4] and I am sleeping through the night, but I am still continually suffering from "brain zaps", numb tongue, hot flashes and fatigue. I also am having a difficult time adjusting to changes in light [indoors vs. outdoors]. Other entries suggest it can take up to 4 weeks, sometimes more for the symptoms to subside. How long am I going to feel this way?
"A Forum-M.D.-RG(10-Mar-04) innakap Paxil is out of your system completely in 6 days or less. Stopping should be down slowly over a two week period. Many doctors add Lexapro while you are doing this, but you should not simply stop cold one day and start another the next day."
Any advice, suggestions, HELP anyone can offer.
Regards
When I was in fourth grade, my parents decided that there was something wrong with me because I did not eat that much, and they took me to many psychologists and psychiatrists. None of these people were able to diagnose me, probably because there was nothing wrong with me in the first place. However, I was forced to take Prozac for about a year, and it made me overly hyper, so I was switched to Paxil. I took Paxil for about two years. I quit taking it almost cold turkey during winter break in eighth grade because I did not like the effects it had on me. I was completely unaware of the dangers of this action, because my doctors had told me that Paxil is safe, has no side effects, is not addictive, and has no withdrawal complications. I experienced relatively mild symptoms for a couple of weeks, such as headaches, chills, teeth chattering, and muscle spasms. I later experienced profuse sweating when I was at rest. These symptoms went away, but, about a 6 months later, I discovered that I had shortness of breath and fatigue during exercise, which prevented me from doing activities such as running and playing tennis for my school. I had a very low temperature, close to 93 degrees F. My hands were always ice cold and my fingernails were purple. I had a stiff neck and went from being tan to being as pale as a ghost. I felt faint and fell several times for no apparent reason. I was also slightly anxious in social situations, but shortness of breath was the biggest concern for me. I am 15 and want be on my school tennis team! I shouldn't have to worry about these things. I have been to my doctor, and he had blood tests and heart tests done on me, which were normal. He prescribed asthma medicine and Lexapro for depression. I have not taken them, because I don't have symptoms of asthma such as weezing and coughing, and I don't feel depressed at all. I don't trust my doctor. He says that these symptoms are not related to Paxil withdrawal, but I wonder if they are. It is a year after I stopped taking Paxil, and I still have these problems. Does anyone know if they are related to Paxil withdrawal? If so, how long will they last and what can I do to get better? If not, does anyone know what could be causing them?
Thank you for your time,
Carla
Trac
Finally my boyfriend talked to his doctor and told him he needed to be on paxil. The doctor wrote him out a Rx for it. My boyfriend has good insurance with his job so he got the meds written for him but I would be the one taking them. it may have been wrong but I couldn't be without the pills. All this time I wasn't seeing my doctor or a therapist to be monitored or anything.
Well, about 2 months ago and started to feel the withdrawal symptoms just like I had stopped taking it. The zaps in my head, freaking out, panic attacks, etc. I figured that my body must have adjusted to the 30mg a day so I started taking two 30mg pills a day. Then I was still feeling sick and all screwed up so I increased again to three 30mg pills a day. I increased from 30 to 90mg a day on my own without asking my doctor. Well, because I was doing that I ran out of the 30 day supply too fast and the insurance wouldn't cover a refill too soon so basically I was screwed. I went for 2 days without it and I was starting to get so sick. All of the regular paxil withdrawal symptoms but also I was having such bad panic attacks that I was starting to hurt myself. I was thinking crazy thoughts. Thinking of ways to try and kill myself and I was cutting myself. It is really messed up. I have never in my life been that way. I called a crisis number in my town and they had me go to the emergency room because I didn't feel safe by myself. The ER doctor just gave me another script for the meds and sent me on my way. I honestly didn't want to leave. I cried and said someone has to help me cause I am afraid to be alone. afraid that the next day would be worse and I'd really try something bad.
Anyway, it has been 2 weeks since that hospital episode and I got Temporary medicaid from the state to pay for my meds. So, I am taking my pills again and I have been trying not to take 90mg a day. I have been doing 60mg a day but I still am getting the zaps in my head. I still want to hurt myself. It's weird but cutting myselgf actually feels good....like a release. It scares me so much that I am getting so crazy. The people in crisis want me to get in for an appointment as soon as I can and I want to so bad, but I can't afford it and I don't have insurance. I feel like I am losing my mind. Panic attacks still. I am afraid to go out anywhere, I am afraid of everything. My brother committed suicide in Febuary and ever since then I just can't get myself feeling right anymore. I don't have a job anymore because of me being scared all the time. I was having panic attacks at work and I'd have to leave or I would be so depressed and afraid to go out that I'd call in. I feel like my life is SOOO much worse now then before I started taking paxil. I am afraid to stop it cause I don't want to have those suicidal thoughts again, I don't want to be physically sick and just plain out of my mind. I wish that I never started taking it. I don't want to be on any replacement meds. I don't want anymore pills going into my body. I want to get to the therapists and just dump all my feelings out. I feel like that is what I really need.
I have a big family and it's like no one believes me when I tell them what I am going through. They think I am just lazy and don't want to work. I told them that I am so afraid of what I could do to myself. But I didn't tell them that I was cutting myself. They would really think I am nuts.
How is someone supposed to wean off the paxil and get the right help if they have no insurance and no money????
I feel like I am trapped. Soon I will be out of the meds I have now and then I will withdraw again and start losing my mind again. It scares me so much. So what do I do??? Doctors won't see you if you don't have money or insurance. I feel so helpless. Anyone have advice???
I wanted to post a main thread on here but I see that I'd have to pay 5 dollars to do that, which I can't afford to do right now....so I am posting this way.
Thanks
Diana
I started taking 20 mg of Paxil 3 years ago. It has been a wonder drug for me. It shuts down my mental 'complaints department' and 'golden oldies jukebox'. When both were putting out noise, I would do anything to shut them up and relax. Generally, this meant breaking off all social entanglements and commitments, then retreating to my dark and quiet home office. 3 years ago, I was unemployed and couldn't imagine surviving in an office environment. Today, I've got a great job, 2 years of steady raises and lots of opportunity.
My new career has required a two less-than-desirable life style modifications. First, it is harder to get my brain going. I've become fairly dependent on caffeine and sugar to kick-start things in the morning. Over the last 3 years, I've gained 10 pounds per year. I don't want to gain another 10 pounds this year. Second, I've needed Adderal (5 mg per day as needed) to write memos of more than 2 pages.
My doctor told me Paxil would be a 1 year treatment which would produce a lasting change in how my brain functioned. I've never really believed this, fully expecting to take Paxil for the rest of my life. On the other hand, getting control of my weight seems to require getting off Paxil, so I've decided to experiment with 'life after Paxil'.
When I got back from a vacation with an additional 5 pounds of weight, and decided my eating habits needed to change, I used up my last tablets and 'forgot' to get more. After about a week without Paxil, and no side effects, I told a key friend about my weight loss efforts and asked him to help me through the expected weight loss dieting crisis (he doesn't take Paxil and can't understand getting off it, but can empathize with weight loss issues). I've got the pills, so I can go back if I don't like what happens.
I've experimented with 'stopping' my Paxil intake twice. Both times, the 'undesired noise level' in my head rose significantly. For example, my 'mental jukebox' would start cranking up a 5 second segment of a 'song on the radio' and refuse to stop. In some cases this would go on for several days. Another version of this was my 'mental complaints department', which seemed to go into high activity. Together, they would increase my tension/anxiety level. I would start up the Paxil.
As I write, I'm 16 days into the phase out process. There were no withdrawal issues for the first 5 or 6 days. After that, I started feeling an unpleasant tension across my back. Additionally, I've noticed an increased sense of paranoia about the intentions of co-workers. Yesterday, I had a memo out for approval in our legal department. When the memo wasn't approved in 2 or 3 hours (the normal delay), I was flooded with paranoid thoughts. The company's lawyers were out to get me. I ought to quit my job. No one listens to me. It was the 'mental complaint department' getting into full gear. I 'know' all this has zero reality, so I try to be very quiet and conceal my anxiety. Then, I started worrying if anyone noticed me concealing my anxiety. This sort of anxiety about anxiety can get out of hand quickly.
At the end of the day, the approval came through and I rushed the memo out for publication. I was very tense and cursing at anything that crossed my path, but also 'knew' I was making a mountain out of a mole-hill.
My schedule then called for going out to a baseball game with an old friend. The game had no interest for me, but was part of the schedule so I forced myself to go (cursing at all the drivers that got in my way while driving to the game). When I got there, I decided to see if a shot of tequila would sooth my nerves. It and the follow up beer did wonders and I had a relaxing time at the game.
I've made losing 30 pounds a high priority, so I'm going to stay off the Paxil. I've asked my wife to let me know if my paranoia gets out of hand and living with me becomes a problem. The edginess is somewhat reminiscent of the feeling I had the first 3 weeks of taking Paxil, so I'm hopeful it will go away. If I can get control of the 'mental jukebox' and 'mental complaint department' without Paxil now, I'll be much better off than I was 3 years ago when I started the Paxil.
Reading this thread has been a comfort. I hope my comments are of some use to other Paxil users.