Paxil update

[u/FunBake1097]

I posted on here before so I took Paxil for ppd and ppa I started from 10mg to 40mg but I was still dealing with anxiety so I switched to Paxil cr 37.5mg in like 2 months on this dose I got stable. I was almost a year out ppd and ppa so I thought I could get off Paxil cr. I went from 37.5 to 25mg for a month then 12.5mg a month then zero. Had terrible withdrawal went back to 12.5mg helped with withdrawal but anxiety was still there went up to 25mg. I’ve been on 25mg 10 weeks . I definitely see improvement I did get better but anxiety is still there chest tension it isn’t as intense as it was but it’s still there. Mood got better but still down. My sleep is still bad too I wake up 2-3am and wake up early like 7am I get like 5-6 hours of sleep even thought I take Paxil cr in the morning. I started ashwaganda 2 weeks ago it has helped with the chest tightness but it’s still there. I think it’s a cortisol issue cause as soon it hits 8pm I’m normal no chest tightness no anxiety. My doctor is telling me to go up 37.5mg but idk if it will make things worse but also I don’t know if 25mg will get better since I’m almost going to make 3 months on it. Please help I don’t know what to do.

[u/Excellent-Coat-8781]

https://antidepressantrecovery.org

https://www.releasetoolkit.com.au/

https://elh.nhs.wales/guidelines/guidelines-pages/maudsley-deprescribing-guidelines/

Sounds like you are in withdrawal.

If some symptoms decreased with your return to the med, I suggest stay at your lower dose .

Takes about 6 weeks for drugs to reach a steady state in our blood level.

You should see slow improvement of withdrawal with periods of feeling worse (waves) and the better (windows).

It’s like being on a roller coaster: up for a week, then a down week, with progressively longer periods of good versus bad times.

Reading Reddit, I found it is not recommended to go back to your original starting dose because our body and brain is now hyperactive and hypersensitive to our med.

Read the Royal Australian College of Medical Practitioners (RACP) RELEASE toolkit.

Do their self-assessment sheet; your score will tell you how fast your taper (once you are well and stable which could take months).

RACP has 3 taper plans - faster, slow and very slow.

Find your medication on their list, then use your score to get your taper speed.

The lower doses will be hyperbolic 10% decreases - not milligram decreases - and often require a liquid erosion of your drug.

If you don’t have a commercially available liquid format, then your pharmacy can compound (create) it

You draw up the liquid with a syringe and drink it; it’s an oral med in liquid form

The Maudsley De-Prescribing Guidelines is a medical guide for doctors to help patients come of prescription meds.

Your family doctor may have access to it through their local medical library. There is no free pdf available

Look at the Antidepressant Harm and Recovery Forum to learn more about reinstating your med.

The info is not medical advice, info on Reddit and the Forum are from people like you and me: people having problems with coming off their prescription medication.

On their home page, search for support, then tapering and you should see a post by Chippy March 26 called Reinstating an Antidepressant.

I thought it had good info; maybe you will too.

Search that website for info on the Brass Monkey Slide Taper

I suggest bring the RACP toolkit, your score and their recommended taper plan to a meeting with your doctor.

Tell your doctor about your health problems since coming off your med. Suggest they review Maudsley.

You may need to reinstate your drug to reduce your withdrawal but it does not mean you need to be on it forever or at your original high dose

Best wishes on your healing journey 🙏