Tapering SSRI

[Amangi06]

I suffer from panic disorder and generalized anxiety. I have had it my whole life, meaning since I was a child. I was on Paxil for 12 years and it was amazing. I was on 10mg most of the time and during stressful life situations I went up to 20mg until I felt too drugged from it, which seemed to be after I had processed and coped with what had cause me to go up, then I would go back to my 10 mg. this was working great with no panic attacks or anxiety for 12 years. Then I had a stressful situation so I went up to 20mg and it didn't help so my doctor suggested going up to 25mg and that didn't work either so I went up to 30 and became a "zombie" all I do was sleep. Each time I went up on dosage I did give it 6 weeks before coming to the conclusion it wasn't working. The doctor decided I should try another SSRI. Which makes sense cause I have read a lot of blogs where people have had their SSRI "poop out" on them over time. I started the Zoloft on 25 mg for the first week and went down to 10 mg of the Paxil the same week, then 50 mg Zoloft the next week and 5mg Paxil, the following week I stayed at the same 50 mg Zoloft and went to 2.5 paxil. During all of this time I had the horrible side effects from starting and withdrawing from SSRI meds. The doctor gave me Xanax to help, I am taking .26 mg of it 2-3 times a day. The doctor said I could take .50 up to three times a day, but I am completely scared of Xanax. I tried to do the every other day of 2.5 mg Paxil and had a full blown withdrawal episode from it, shivering so bad my teeth were chattering, hot and cold, nauseous, chest tightening sensation and panic of course. I am still taking the 2.5 mg Paxil daily cause I'm petrified to have that happen again. I plan on going down to 1.25 Paxil this week, but is it possible I could have adverse reactions to being on both ssri's at the same time this long? Obviously I have a med fear and I am still having anxiety, headaches, shakiness, lightheaded feelings and stomach issues, at times. They are becoming less often, but I can't handle any steps backwards. How do I get off this Paxil fully? Am I just gonna have to accept that I will have the withdrawal symptoms temporarily? Also my doctor wants to switch my benzo from Xanax to klonopin, now I'm freaking out that this switch will cause more symptoms. Any encouraging experiences would be greatly appreciated. I have a daughter that I home school and a household to keep up with. This has been a hellish 6 months and far from the other side of it.

[Amangi06]

I made an appt with my doctor for Monday. So before I take the drug away completely. I'm just at a state of sadness, not depression yet. The Paxil made my panic disorder, along with therapy go away completely for so long and I want that back. I understand you not wanting to plant seeds of additional fear from your experience and I do thank you for that. I've read other people claiming that name brand Paxil and Paxil cr made a difference when the generic one failed. I'm not sure if that's a route I should have tried first. Hindsight is a real, you know what, lol. I started on name brand and when generic came out I switched and didn't seem to have issues so I doubt that would make a difference, but I've never tried the CR version. I know everyone is different and these meds and conditions vary so much that its frustrating, but as sad it sounds, it's comforting to know we aren't alone in all this trial and error treatment.

[Paxiled]

My history is just too weird for words.  That's why I don't want to talk to you about it -- you don't have to worry about it.  While I do take meds, nothing has worked much since the Paxil withdrawal.  I hope this works for you.  What I would suggest is, if you find yourself with emotional problems you never had before after completely stopping the Paxil, I'd consider going back on it.  But you've made your choice, and I know many docs believe it's fine to taper down on one drug while you taper up on another.  I don't believe that's safe or wise, but you've already done it, so let's hope you just go through the "Paxil flu" and come out the other side quickly.

[Amangi06]

Your so right, all around. I tried CBT too and I failed. I still see a therapist but it's more for support and encouragement now. It is helpful, but I think people with these conditions are almost too strong for their own good. Lol. We can't be weak enough to let go of the fighting instinct against the panic. At least that's my problem. I realized I am a "lifer" with meds and I have accepted that because the alternative is worst. Do you currently take anything or are you attempting to be free of drugs? I have started to think, I'm just postponing the inevitable with my tapering and am debating just stopping it at the 2.5 mg and see if I can make it through. I'm not saying Zoloft will work, but I think still being on Paxil is complicating the ability to know if it is working or not. I think this weekend while my husband is off, for support and comfort, I will just attempt the withdrawal. Hopefully the lowering dosing will help at least a little, but I'm not counting on it.

[Paxiled]

What happened to me with stopping Paxil isn't something you want to hear about, as it's rare and won't affect you.  It did, however, force me to do a lot of research on withdrawal, as my psychiatrist was such a quack he never told me of the possibility or that I was going through it.  Here's what I see as the flaw in your thinking, which is the flaw in all of us how have this ridiculous disorder -- in fact, you can do whatever you need to do without drugs, you just don't believe it.  That's what therapy, especially CBT, is supposed to teach us.  But I confess, it didn't work for me.  But you didn't die before you went on Paxil and you survived and you won't die if you're temporarily off medication now.  We're all stronger than our distorted thinking tells us, which is more interesting than comforting for those of us who therapy didn't work for but true nonetheless.  You still have to do medication safely and healthfully as you would any other medical intervention, but you do get to decide.  

[Amangi06]

The only problem I have with that is that my panic is definitely not something I can function with and having a daughter to care for and household, I can't be off meds all together or I won't be able to do what I have to. I would have loved to get off the Paxil first but then I would have to be a zombie on benzos for who knows how long before I would be able to start another SSRI. I'm guessing you have experience with Paxil. Do you take it now or have you weaned off?

[Paxiled]

This isn't the way I would do it.  Paxil is the hardest of these meds to stop taking, and taking another ssri won't do anything about withdrawal since they don't work the same.  Paxil also tends to have a stronger affinity for both serotonin receptors and choline receptors, and can take a long, slow time to stop taking successfully.  If you withdraw from one drug while starting another, you can't tell which symptoms are side effects of the new drug and which are withdrawal effects of the old.  So in my opinion, the best way to do it is to stop the first drug completely and successfully before starting another med.  After all, there's no guarantee another med will work, we all react differently, and this is particularly true after taking Paxil.  When you've been on this med for a long time it usually takes a long time to get off it.  Now, you may very well come out of this fine, but that's how I would do it.  I'd taper off the Paxil as slowly as you need to and see if you're able to get off it without lingering effects, and then I'd try a new med.  Good luck.