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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 25 of 27. This is the beginning of the thread.
Posted by tcv on April 20, 2010, at 22:19:39
Hello,
I've been on Paxil for over 12 years. I am doing very well and am toying with the idea of getting off of it. I haven't pushed hard on this, but I don't believe I need the meds any longer. I've been doing quite well for years.
I haven't been in the care of a psychiatrist for a long time, perhaps for ten years. In all this time I've gotten prescriptions from general practitioners.
This year I thought I might try to get off the meds. I've read that it's quite difficult to stop taking Paxil, so I wanted to get with a psychiatrist for help.
Well, I've been having trouble finding one. I've called three in the last couple of weeks. In each message I've mentioned my desire to stop taking Paxil.
I've not gotten any return calls.
Is it possible some psychiatrists are avoiding this? If I can't go to a psychiatrist for help, is there anyone else I can call? My GP has stated she will not help with this.
thanks!
Posted by evenintherain on April 20, 2010, at 23:06:08
In reply to Are Psychs avoiding helping with Paxil withdrawal?, posted by tcv on April 20, 2010, at 22:19:39
Wow, that is really weird.
Why won't your GP help? That seems sort of unethical to me...
I think you are being smart about this, it would be helpful to have someone monitoring you while you go off a drug you've been on for so long. Sorry you are not getting any responses from the doctors. Hopefully you will get some advice from someone on here who has done the taper.
Posted by Phillipa on April 21, 2010, at 0:53:06
In reply to Re: Are Psychs avoiding helping with Paxil withdrawal?, posted by evenintherain on April 20, 2010, at 23:06:08
Agree with above poster they prescribed now should help I weaned off paxil after two years by taking tiny bites out of the pill each day avoided the zaps. Was on l0mg. Remember if it's still working maybe just cut down a bit and stay for awhile as it is possible it might not work again in the future. Phillipa
Posted by tcv on April 21, 2010, at 6:38:22
In reply to Re: Are Psychs avoiding helping with Paxil withdrawal?, posted by Phillipa on April 21, 2010, at 0:53:06
What do you mean by "it might not work again in the future?"
Posted by SLS on April 21, 2010, at 7:14:46
In reply to Re: Are Psychs avoiding helping with Paxil withdrawal?, posted by tcv on April 21, 2010, at 6:38:22
> What do you mean by "it might not work again in the future?"
It sometimes happens that someone who has discontinued an antidepressant will not respond to that antidepressant when it is restarted.
Can you describe your history of depression before you began taking Paxil?
- Scott
Posted by tcv on April 21, 2010, at 8:30:52
In reply to Re: Are Psychs avoiding helping with Paxil withdrawal?, posted by SLS on April 21, 2010, at 7:14:46
>Can you describe your history of depression before you began taking Paxil?
How long do you have? :-)
I've been on medications a good part of my life. I'm 40 now and started with Pamelor back in 1985. I was diagnosed at the time with depression and an anxiety disorder.
I believe I went off of Pamelor in 1988. I didn't start anything again until about 1998/9 with Prozac. About a year later I switched to Paxil due to its "anti-anxiety component" as it was described to me.
Since then I've been at 40mg Paxil daily. I've been in and out of therapy most of my life.
Last year I discovered meditation and it's been helping me significantly. When I consider this and that I've not needed continuous therapy at times, along with the mistaken belief that feeling down or sad or blue isn't a normal part of the human condition, I have begun to wonder whether I really need any medication any longer.
Is that what you want to know?
Posted by SLS on April 21, 2010, at 8:51:18
In reply to Are Psychs avoiding helping with Paxil withdrawal?, posted by tcv on April 20, 2010, at 22:19:39
> Is it possible some psychiatrists are avoiding this?
Probably. I don't think there is any schooling on how to go about discontinuing these drugs. It is a neglected aspect of psychiatric care.
I hope someone here will offer you suggestions on how to go about discontinuing Paxil. Personally, I don't use a fixed schedule of dosage tapering. I usually manage to get off of these drugs in two to three weeks. However, I have not been on any one antidepressant for as long as you have.
- Scott
Posted by tcv on April 21, 2010, at 9:41:02
In reply to Re: Are Psychs avoiding helping with Paxil withdrawal? » tcv, posted by SLS on April 21, 2010, at 8:51:18
Thanks! It's beginning to look like I may have to do it myself, although I don't honestly want to do it alone.
There was an ebook I found not terribly long ago that explained what to do...
Posted by Laney on April 21, 2010, at 12:22:16
In reply to Re: Are Psychs avoiding helping with Paxil withdrawal?, posted by tcv on April 21, 2010, at 9:41:02
Well I've had some experience with trying to discontinue paxil. It's damn hard. I'm still on it. 10mg. after 13 plus years. I say try to get down to 20. I can take my 20 and pretty quickly go down to 10. But going down below ten is much harder and below 5 for me seems impossible. So far it has been. If you feel fine at 20, I'd re-evaluate the need to go off. I basically should have stayed on paxil as it was working fine. Katgirl has had horrible problems after getting off paxil. Then her problems really began. I hope I'm stating this correctly.
Some people seem to have no problems and others, it's pure hell. I'm of the latter. I think it's the amount of time we've been on it.
There's a site called "Paxil Progress" that says to go down 10 percent every 2-4 weeks which would take absolutely forever to do it from 40. They're a little too anti-med for me.
Doctors don't know what the hell to do about those of us that have such severe w/d. At least that's been my experience.
I wish you the best. Maybe you'll be one of the lucky ones.
Laney
Posted by tcv on April 21, 2010, at 13:32:51
In reply to Re: Are Psychs avoiding helping with Paxil withdrawal?, posted by Laney on April 21, 2010, at 12:22:16
If it's okay, could you explain to me what happens when you go to 5 or less?
Posted by ed_uk2010 on April 21, 2010, at 13:55:01
In reply to Are Psychs avoiding helping with Paxil withdrawal?, posted by tcv on April 20, 2010, at 22:19:39
>I've read that it's quite difficult to stop taking Paxil....
It can be, although not for everyone. I didn't have much trouble myself.
Posted by Laney on April 21, 2010, at 13:58:55
In reply to Re: Are Psychs avoiding helping with Paxil withdra » Laney, posted by tcv on April 21, 2010, at 13:32:51
Well here it goes. I'm angry, negative about everything, find fault in everything, feel absolutely stressed to the max, have crying spells, argumentative, etc. I would describe it as mental tortue. My husband can attest to this. He's witnessed it a few times now. Last time I got to 3.5 and threw in the towel.
What's even worse is that going back on it maybe took the worst of the symptoms away but left me in this bleak, dark depression. That's what I've been trying to dig myself out of since. I tried to get help naturally and wasted several months and just got worse. About 3 months ago I saw my Pdoc again and we started checking out meds. I still have to take paxil though.
I hope that helps. Let me know if I can answer anything else.
Laney
Posted by tcv on April 21, 2010, at 18:38:21
In reply to Re: Are Psychs avoiding helping with Paxil withdra » Laney, posted by tcv on April 21, 2010, at 13:32:51
Sure!
Posted by tcv on April 21, 2010, at 18:41:13
In reply to Re: Are Psychs avoiding helping with Paxil withdra, posted by Laney on April 21, 2010, at 13:58:55
Yes, it helps and I feel sad about your experience.
I am hoping that I really understand what I could be undertaking. In the end, I realize (I think) that I may need to stay on Paxil. I suppose I can also hope that I don't turn the medicine into the enemy. In the end, there may not be much I can do that won't cause myself more suffering. If that's the case, then I would do well to offer myself compassion.
Posted by linkadge on April 21, 2010, at 19:05:45
In reply to Re: Are Psychs avoiding helping with Paxil withdrawal?, posted by Laney on April 21, 2010, at 12:22:16
You need to be careful. I am not going to say whether you still need paxil or not *but* its common (when well) to feel that the medication is not necessary. Often when I started to get better with meds I would feel that religion was what healed me and that all I needed was god. To make a long story short the meds were doing more than I thought they were.
At the end of the day, you can't really say whether you need a med or not untill you come off of it. Good luck. A switch to prozac (which has a longer half life) may ease withdrawl.
Linkadge
Posted by linkadge on April 21, 2010, at 19:11:27
In reply to Re: Are Psychs avoiding helping with Paxil withdra, posted by tcv on April 21, 2010, at 18:41:13
During celexa withdrawl I went from calm, enlightened, easy going and stable to an irritable, unstable, narcissitic, jealous anxious insomniac. All the therapy (which worked) all of a sudden was completely meaningless and ineffective. Oh, and I was borderline psychotic for a while.
I felt like a woman going through menapause who lost all the "fruits of the spirit" in one go.
Linkadge
Posted by tcv on April 21, 2010, at 19:36:27
In reply to Re: Are Psychs avoiding helping with Paxil withdrawal?, posted by linkadge on April 21, 2010, at 19:05:45
You've got a very good point and I appreciate it. What you say is very possible and I hope to have the grace and humility to accept that if it's true. I'd like to know what happens, though. :-)
Posted by 49er on April 23, 2010, at 6:02:03
In reply to Are Psychs avoiding helping with Paxil withdrawal?, posted by tcv on April 20, 2010, at 22:19:39
> Hello,
>
> I've been on Paxil for over 12 years. I am doing very well and am toying with the idea of getting off of it. I haven't pushed hard on this, but I don't believe I need the meds any longer. I've been doing quite well for years.
>
> I haven't been in the care of a psychiatrist for a long time, perhaps for ten years. In all this time I've gotten prescriptions from general practitioners.
>
> This year I thought I might try to get off the meds. I've read that it's quite difficult to stop taking Paxil, so I wanted to get with a psychiatrist for help.
>
> Well, I've been having trouble finding one. I've called three in the last couple of weeks. In each message I've mentioned my desire to stop taking Paxil.
>
> I've not gotten any return calls.
>
> Is it possible some psychiatrists are avoiding this? If I can't go to a psychiatrist for help, is there anyone else I can call? My GP has stated she will not help with this.
>
> thanks!TCV,
Go to http://www.paxilprogress.org. It is run by an RN whose son had a horrific time getting off of Paxil. Fortunately, he is now fine and has been off the drug for about 5 years.
The recommendation is to taper at 10% of current dose every 3 to 6 weeks and use the liquid form of Paxil. But if your doctor will not prescribe the liquid, there are other ways to do this.
Solves your psychiatrist problem:)
49er
Posted by 49er on April 23, 2010, at 6:14:06
In reply to Re: Are Psychs avoiding helping with Paxil withdrawal?, posted by Laney on April 21, 2010, at 12:22:16
> Well I've had some experience with trying to discontinue paxil. It's damn hard. I'm still on it. 10mg. after 13 plus years. I say try to get down to 20. I can take my 20 and pretty quickly go down to 10. But going down below ten is much harder and below 5 for me seems impossible. So far it has been. If you feel fine at 20, I'd re-evaluate the need to go off. I basically should have stayed on paxil as it was working fine. Katgirl has had horrible problems after getting off paxil. Then her problems really began. I hope I'm stating this correctly.
>
> Some people seem to have no problems and others, it's pure hell. I'm of the latter. I think it's the amount of time we've been on it.
>
> There's a site called "Paxil Progress" that says to go down 10 percent every 2-4 weeks which would take absolutely forever to do it from 40. They're a little too anti-med for me.
>
> Doctors don't know what the hell to do about those of us that have such severe w/d. At least that's been my experience.
>
> I wish you the best. Maybe you'll be one of the lucky ones.
>
> LaneyHi Laney,
As one who has used the Paxil Progress Method, I can understand why you think it might take forever.
But if you read the various posts, you'll notice that the folks who cold turkeyed or tapered too quickly seem to have alot more problems than the folks who tapered slowly. So really, how long it takes really is irrelevant when you think of it that way.
As far as the site being anti drug, that is true, that is not their first recommendation:) But no one is condemned who chooses meds as the common response is that your qualify of life is what is important..
Also, please don't equate them with extreme radical anti psychiatry sites as people who post information that blames Paxil for things like a hangnail are taken to task. I am not saying you did by the way but many people will infer from your words that this is their philosophy.
Anyway, there is no way I would have had the success I did in tapering off of meds without the support of that site. I don't see any other like it.
49er
Posted by Laney on April 26, 2010, at 12:33:32
In reply to Re: Are Psychs avoiding helping with Paxil withdrawal?, posted by 49er on April 23, 2010, at 6:14:06
49er,
I'm glad that Paxil Progress helped you. But if you really think about it, if you take 20mg. of paxil and drop 10% off the remaining dose, you will be at it for years honestly. It's not like you take 10% less of the original dose, you take 10% less of the remaining dose. So think about it when you get down to 4mg. You then take 3.6mg., and this is every 4-6 weeks. I'm gonna go check but it's literally years.
Laney
Posted by Katgirl on April 26, 2010, at 19:25:33
In reply to Re: Are Psychs avoiding helping with Paxil withdrawal?, posted by Laney on April 26, 2010, at 12:33:32
Hey TCV, I am the woman that Laney made reference to in an earlier post. (Laney, I will babble you back when I'm feeling better. Turns out I have swine flu and am on week 7 of feeling like I'm on death's door).
I went through withdrawal to paxil and it so changed my biochemistry that I now can't take ANY of the SSRIS (and I need to be on a med!!) They either don't work anymore or I am no longer able to tolerate them.
I had very severe withdrawal symptoms when I would try to drop down off the last 2.5mg. I would throw up, shake like I was having a seizure, be unable to stand up from vertigo, stop sleeping entirely and have bone shaking, crawling out of my skin anxiety. The way I finally got off of it was by getting the liquid and diluting it with water to drop very very slowly over many many months. But all hell still broke loose after the drug cleared my system. Within a few months I relapsed into clinical/agitated depression and then the unsuccessful drug trials began. Just a nightmare.
Why did I go off the drug? Pressure from an ex-husband. And, like you I also got involved in meditation and energy work, and thought that I didn't need the drug anymore (although there were a LOT of people I was hanging around at the time who were really putting the "if you were more spiritual/healing you wouldn't need to take these drugs" rap on me.
But in the end, I am responsible for the choice I made. It is a choice I regret, because I still have not gotten my life back.
If you are doing well on the drug, I would reccomend staying on it, but that is because of my own very harsh experience with my discontinuation of the drug.
I personally know two other people who went through either no or very mild withdrawal symptoms and have been fine since.
Unfortunately, there is no way to know which camp you are going to fall in.
I wish you all the best,
Kathleen
Posted by tcv on April 26, 2010, at 22:00:42
In reply to Re: Are Psychs avoiding helping with Paxil withdrawal?, posted by Laney on April 26, 2010, at 12:33:32
I've read a lot of the Paxil Progress site, though I've not read it all and I don't quite recall the eBook I read so many moons ago. I don't really know if PP is suggesting 10% of the ORIGINAL dose or 10% of every reduced dose.
Technically, if you had to go down 10% of every reduced dose, you'd never reach zero. Each time you'd be slicing off ever smaller, smaller amounts.
I don't think they're suggesting to NEVER reach zero. ;-)
Posted by tcv on April 26, 2010, at 22:11:23
In reply to Re: Are Psychs avoiding helping with Paxil withdrawal?, posted by Katgirl on April 26, 2010, at 19:25:33
Hi Kathleen,
Thanks for your story. Admittedly, I am of two minds. Part of me wants to know that I can survive without, but then part of me thinks, "Who cares?" I am fortunate enough to live in a position where I can continue to take the medication and, well, if it were something I literally needed to live, I wouldn't be thinking about trying to get off of it unless it were really making my life tough.
And, who knows, maybe it _is_ something I need to live.
My inclination at the moment is to not rock the boat. Maybe something will happen in the future that will come out to help people off SSRIs. I don't know.
In any case, I'm sorry you've had to endure this experience.
Posted by 49er on April 28, 2010, at 7:54:32
In reply to Re: Are Psychs avoiding helping with Paxil withdrawal?, posted by Laney on April 26, 2010, at 12:33:32
> 49er,
>
> I'm glad that Paxil Progress helped you. But if you really think about it, if you take 20mg. of paxil and drop 10% off the remaining dose, you will be at it for years honestly. It's not like you take 10% less of the original dose, you take 10% less of the remaining dose. So think about it when you get down to 4mg. You then take 3.6mg., and this is every 4-6 weeks. I'm gonna go check but it's literally years.
>
> LaneyHi Laney,
Yeah, it does sound like a long time. But the goal is to be off the drug permanently and living a good quality of life or at least one that is better than if you had tapered too quickly.
If you decided to taper every 3 weeks, it would go alot more quickly. The co-moderator did it that way from 20mg and it took her 13 months.
She seems to be doing very well. As an FYI, she did take Label Me Sane Products and still does as far as I know.
I wanted to disclose that upfront but I don't think you can imply a direct correlation because many people don't find the products helpful.
There is a spreadsheet from the site you can download to figure out how long it would take you with various doses and the rate of tapering. You have to register though..
Anyway, you might want to do the calculations as it might not take you as long as you think.
49er
Posted by 49er on April 28, 2010, at 7:59:47
In reply to Re: Are Psychs avoiding helping with Paxil withdrawal?, posted by tcv on April 26, 2010, at 22:00:42
> I've read a lot of the Paxil Progress site, though I've not read it all and I don't quite recall the eBook I read so many moons ago. I don't really know if PP is suggesting 10% of the ORIGINAL dose or 10% of every reduced dose.
>
> Technically, if you had to go down 10% of every reduced dose, you'd never reach zero. Each time you'd be slicing off ever smaller, smaller amounts.
>
> I don't think they're suggesting to NEVER reach zero. ;-)You're right, they aren't:) Sorry for not being clear about that.
According to Laurie Yorke, the RN, who runs the site, 2.5mg is when you can consider jumping off safely. Many people stop at 1mg.
I don't remember where she got that information as an FYI.
I will probably consider stopping when I get below 3mg with my Doxepin as I think it is going to be a royal pain in the neck to reduce that low.
49er
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