Psycho-Babble Medication Thread 14468

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Dropping Paxil, Help Please.... ASAP

Posted by Aylse on November 3, 1999, at 0:26:01

In September I began decreasing 30 Mgs of Paxil to see if it is causing my itching, pain in fingers & toes, frequent bathroom trips at night, etc. I was taking it with Trazadone and thought Trazadone was the culprit. I have been off Trazadone for a month now, and see it caused some side effects, but I can now see that Paxil is also causing lots of side effects. My question, do I have to quit Paxil completely before I begin something else? I am afraid to do that. I will surely get into deep doo doo if I am on nothing, and then have to wait for something else to kick in. How do I do this???? ASAP, If you Please Thanks, Aylse

 

Re: Dropping Paxil, Help Please.... ASAP

Posted by saint james on November 3, 1999, at 1:19:47

In reply to Dropping Paxil, Help Please.... ASAP, posted by Aylse on November 3, 1999, at 0:26:01

My question, do I have to quit Paxil completely before I begin something else? I am afraid to do that. I will surely get into deep doo doo if I am on nothing, and then have to wait for something else to kick in. How do I do this???? ASAP, If you Please Thanks, Aylse

James here....

You can go from Paxil (a ssri) to another ssri, TCA or some of the odd ball AD's like Effexor w/o a washout. You cannot go to or from a MAOI w/o washout. That would cause deep do do ! Changing from AD to AD does cause a day or to of feeling funny in me, and I take atavin for a day or so so I don't snap at a roommate or innocent bystander for no special reason other than I am crabby. Your milage may vary.

j

 

Re: Dropping Paxil, Help Please.... ASAP

Posted by JohnL on November 3, 1999, at 3:04:20

In reply to Dropping Paxil, Help Please.... ASAP, posted by Aylse on November 3, 1999, at 0:26:01

> In September I began decreasing 30 Mgs of Paxil to see if it is causing my itching, pain in fingers & toes, frequent bathroom trips at night, etc. I was taking it with Trazadone and thought Trazadone was the culprit. I have been off Trazadone for a month now, and see it caused some side effects, but I can now see that Paxil is also causing lots of side effects. My question, do I have to quit Paxil completely before I begin something else? I am afraid to do that. I will surely get into deep doo doo if I am on nothing, and then have to wait for something else to kick in. How do I do this???? ASAP, If you Please Thanks, Aylse

Those side effects are characteristic of Paxil in some people, especially women. Don't know why. James said it all. You don't have to wash out unless switching to an MAOI. Sometimes a dangerouse serotonin syndrome has happened when people take two similar ADs at the same time. So small dosing would be wise when starting the switch. When you get the Paxil down to the 10mg range, start adding in the new AD at perhaps half the minimum dose. Keep adjusting each as needed. If the switch is to a TCA or Wellbutrin, no need to do this at all, because they are commonly added to full doses of other ADs for increased response.

The overlap switch might still feel kind of weird, as your body withdraws from the Paxil and gets used to a new drug's side effects simulataneously. But it should be a whole lot more comfortable than a washout period with a lot less risk of mood deterioration.

Just curious, what drug are you thinking of switching to?

 

Re: Dropping Paxil, Help Please.... ASAP

Posted by Aylse on November 3, 1999, at 11:52:57

In reply to Re: Dropping Paxil, Help Please.... ASAP, posted by JohnL on November 3, 1999, at 3:04:20

Ah, you guys are so good! You didn't let me down. Thanks so much. As to what drug I am thinking of switching to, I still don't know. I have nothing to base an opinion on, except I think it would be easiest if it were a breakable pill and not a capsule. It is easier to juggle a breakable pill, until it "feels right." I would definitely appreciate hearing about everybody's favorite, with the understanding that we are all different. I was on Prozac briefly, a few years ago. It was a short trial as my Doctor switched me to Paxil because Prozac was keeping me awake. (It did not itch, though, which was super!) Anyway, a psychiatrist added the trazadone and I began sleeping like a baby. But these side effects of itching, etc. have either gotten worse recently or I can no longer tolerate it as well. I really don't know what the difference is. But I sure want to get OFF this itchy Paxil ASAP! Thanks so much. I will be watching your suggestions. Much appreciation, Aylse

 

Re: Dropping Paxil, Help Please.... ASAP

Posted by JohnL on November 3, 1999, at 15:15:37

In reply to Re: Dropping Paxil, Help Please.... ASAP, posted by Aylse on November 3, 1999, at 11:52:57

> As to what drug I am thinking of switching to, I still don't know. I have nothing to base an opinion on, except I think it would be easiest if it were a breakable pill and not a capsule. It is easier to juggle a breakable pill, until it "feels right." I would definitely appreciate hearing about everybody's favorite, with the understanding that we are all different.

Since you asked..:) You'll get 10 different answers from 10 different people. If you are staying in the SSRI class, which is probably what most doctors would do with you at this point, my vote would be to go back to the Prozac. Of the whole group, it's my personal favorite. But that doesn't mean anything. As for sleep, 7.5mg of Remeron will do it. I find it much smoother than Trazodone was. Remeron mixes well with Prozac. To save money, you could get the 30mg pills, break them in half, then with a knife cut the halves in half. Prozac comes in a capsule but you can easily customize your dose by emptying it into juice or water. Drink the desired dose, put the leftover in the fridge for later. No taste. My pdoc taught me that trick. If your doc was fine with Paxil and Trazodone, then Prozac and Remeron should be perfectly fine too. Nothing any more exotic or different than what you were doing. That's what I take.

Several things I like about Prozac over other choices. You already mentioned we're all different. True. But generally speaking, Prozac is the more activating one. Least likely to cause weight gain. And for some, like me, it is the only one that doesn't cause sexual dysfunction (I've tried them all). But the unique thing about Prozac I like is its long half life. About a week. It can be dosed daily, every other day, every three days, whatever works for you. This long halflife would provide a smooth transition from the Paxil. For example, to start, you could take 10mg Prozac every other day or so while still tapering down the Paxil. Taper it in slow and smooth.

Someone else might prefer Effexor. Or Zoloft. Or whatever. For you my vote is on Prozac+Remeron. :)

 

Re: Dropping Paxil, Help Please.... ASAP

Posted by Bob on November 3, 1999, at 16:19:43

In reply to Re: Dropping Paxil, Help Please.... ASAP, posted by JohnL on November 3, 1999, at 15:15:37

Dropping Paxil was a withdrawal nightmare for me. Wellbutrin ended the nightmare quite effectively and immediately. Even after tapering off the paxil, while it was still in my system, forgetting my welbbutrin in the AM would spell disaster from about 10 AM till 15 minutes or so after I got my belated daily dose down. The day I knew I was clean of the paxil was the day I forgot my meds and made it through the day without crumbling.

OTOH, Wellbutrin alone was a disaster for me as well. My pdoc believes that was because I started out on too high a dose (300mg/day from day one, soon up to 450). A year and a half later, I'm finally giving SSRIs the boot completely having had no good response to them even with augmentation. In five or six weeks, I might be able to tell you how a TCA+low dose of Wellbutrin (50-100mg) works for me, but that's hardly ASAP.

Whatever you do try, I hope it goes well for you!

Bob

 

Re: Dropping Paxil, Help Please.... ASAP

Posted by Phil on November 3, 1999, at 17:25:56

In reply to Re: Dropping Paxil, Help Please.... ASAP, posted by Bob on November 3, 1999, at 16:19:43

>
> Aylse,

Sounds like Zoloft may be worth a shot. Effexor was the one that gave me the itchies...HIDEOUS! But it's a great drug for many. I took Paxil for about 3 years.
Right now, I'm on 50mg Zoloft and augmenting with amitriptyline, 10 to 20mg at night for sleep.
Also, 1 to 1.5mg Klonopin.
Good luck or good hunting.

Phil

 

Re: Dropping Paxil, Help Please.... ASAP

Posted by disturbed on May 16, 2002, at 11:40:06

In reply to Re: Dropping Paxil, Help Please.... ASAP, posted by Phil on November 3, 1999, at 17:25:56

> >
> > Aylse,
>
> Sounds like Zoloft may be worth a shot. Effexor was the one that gave me the itchies...HIDEOUS! But it's a great drug for many. I took Paxil for about 3 years.
> Right now, I'm on 50mg Zoloft and augmenting with amitriptyline, 10 to 20mg at night for sleep.
> Also, 1 to 1.5mg Klonopin.
> Good luck or good hunting.
>
> Phil

I started on Zoloft, it seemed to calm me down quite a bit at 50 mg, but I was not sleeping well and still felt depressed. The doc raised it to 100mg and I hated it. I felt like a zombie. My head/mind was going 100 miles per hour but my body felt like it wasn't moving. I slowly weaned myself off by going to 50 mg and then went to the doc and he gave me 25mg for 7 days and took me off. After I was on 25mg for a week I felt alive again. My psych wanted me on Paxil instead and I had 1 day with nothing, I felt wonderful. I started Paxil 25mg and I felt great for 5 days, on the sixth day I felt nauseas and missed some work. I have been trying to maintain my work and home but I have almost fell asleep at the wheel and have fallen asleep at my desk. I called the docs yesterday and told them I want off this crap. I have only been on Paxil for 8 days and they told me I wouldn't have severe withdraws to just quit taking them. So this morning I haven't had any and I was fine til I just finished lunch, now my stomach hurts, I am shaky and I got dizzy and light headed. Hopefully by the time I wake up tomorrow I will be okay.


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