I eventually decided to wean by alternating 20mg with 15mg for a week or so, level off at 15mg for another week, then begin alternating between 15mg and 10mg and so on.

The weaning process began during the first week of September. I took my last dose of Paxil around the first or second week of November. The actual weaning process took about two months (which is fast compared to most of the people I know), but the severity of the withdrawal didn’t let up until near the middle of January 2001.

In my previous posts I mentioned that I’ve been back on Paxil for about a week or so after the hell of going cold turkey, and that, although I’m feeling better than I was during the withdrawal, I was feeling depressed occasionally in a I-don’t-want-to-live sort of way. I’ve been doing my best to walk it off, so to speak, but last night I made an effort to go to bed early and not stay up late as is my tendency.

It made a difference. I slept all night and woke up feeling more myself. I’m not feeling depressed; I can usually tell the second I wake up whether I’m feeling depressed or not and whether I’m going to feel depressed or not. And right now I feel good.

I read that during deep sleep, serotonin production increases. So I didn’t have to take a pill; I just had to get some good, natural, unmedicated sleep. It did the trick. I’m not going to begin weaning myself of the Paxil just yet, but I wanted to mention that a good night’s sleep can make a big difference (for those of you who stay up late and wonder why you’re feeling depressed). I’m going to do more research on this.

That withdrawal experience was more traumatic than I realized. It’s left a mark on me. It was like the final straw. I’m feeling better now, but I’m not feeling nearly as good as I was before it happened. I’m struggling through my days in a way that I haven’t for a long time. It took away a lot of my strength. I’m having a hard time really caring about anything anymore.

I’m tired of caring about people, about everything.

I’m pretty damn close to checking myself into a hospital. If anything else happens, I won’t be able to handle it. I need something to go my way soon. This whole year has been too much. I can’t take much more.

There is no way I will be silent about what’s happened to me. But right now I’m back on the Paxil only because the brain zaps were killing me. Today is my 7th day back on Paxil (previous to that I was experiencing withdrawal syndrome), and only in the past day or two have I been feeling like myself again.

My plan is to wean myself off the Paxil eventually. If you’ve only been off four days cold turkey, it’s going to worse before it gets better. Some people bear it out; I couldn’t, and you may want to go back on it too — knowing that you can wean yourself off it. And weaning is definitely less traumatic than cold turkey.

I didn’t have dilated pupils when I went on Paxil. The main thing I felt was a bit of numbness is my hands and a slight lethargy, kinda dragging myself around a little. Which at the time was exactly what I needed because I was going through too much stuff at once and my nervous system was on overload. Feeling the numbing effects of the Paxil gave me something to fight against. Seeing how everything else in my life was out of control and I was beginning to lose my determination, fighting against a little pill was a synch.

I felt that I fought off the numbness of the Paxil, and getting through it, it gave me a sense of being in control. For those first few days I also felt a little punchy, if you know what I mean by that word. It’s like being pleasantly light-headed so that your overall attitude is, “Ah, what the hell,” and you find yourself with the guts to do things and say things you normally wouldn’t do. It allowed me to get through some social anxiety I was feeling, and to say and do things in social situations I normally wouldn’t have. A friendliness that I’d always known was in me was able to let loose a little, and that had nothing but a positive impact on my life.

So Paxil did work for me, and it didn’t leave me feeling sedated in any way. There were certain sexual side effects, but I was able to deal with it (it just took a bit more work). Otherwise, until the horror of my attempt at going cold turkey, Paxil seems to have been exactly what I needed at the time. Had I known of any natural remedies such as St. John’s wort, and had I known more about proper nutrition (such as the importance of Vitamins A, B-complex, C, and E, etc.), I would have taken those routes first.

Paxil would have been a last resort.

Most natural remedies (if not all of them) have no withdrawal effects (so that’s a big, big plus). It may not be as easy as taking a little pink pill every day, but it’s a hell of a lot better for you in the long run. As soon as I get off the Paxil, I will do everything I can never to go on an SSRI again.

The main benefit of proper nutrition and natural remedies is that YOU ARE IN CONTROL. Taking the Paxil, you’re handing the control of your life over to that little pill (and you know exactly what I’m talking about if you’ve experienced “withdrawal syndrome”).

Never had them dilated pupils though.

Postscript – February 4th, 2001: Eventually when I got off the Paxil, I began taking Ginko Biloba with Ginseng for about a month. It’s the only herb I tried that made a noticeable difference in my recovery, most notably in my cognitive abilities.

P.S. (Sept. 2006): I said I wouldn’t take another SSRI again, and I haven’t. There are still days even now when I think I’d love to have that little pink pill to help me along, to bring out the easy-going friendliness I wish I had on the go more often. But I’d rather live with whatever anxiety I was born with and find a way to make it work. I may not like it, but it is a part of who I am after all. I’ll never be a relaxed as I was when I was taking Paxil, and hopefully I’ll never be as stupid either. (With all due respect to those who really do need anti-depressants to live a normal life.) Oh, and I’m not sure how affective herbals are for anything. Many of the herbals I tried are now off the market (like Kava). I find mint tea relaxing, but I’m not sure any of it makes a significant difference to anyone who is severely depressed. Still, it never hurts to eat healthy.

I’ve been reading a lot about weaning recently, and everything I’ve read seems to show that decreasing one’s dosage by 5mg can have an immediate effect on how someone feels and the withdrawal they experience — and it’s usually not good.

Lowering the dose by 5mg every other day for at least a week seems to be the least painful way of going about it. It’s like giving your body and your brain a taste of what it’s like every other day. So you get a taste of the lower dose one day, then the next day you (and your body and your brain) can rest on the regular dose. So that gives you a week (or more) to get used to the lower dose. Then lower it again and keep alternating for another week or so — or whenever you feel ready to lower it again.

Doctors right now are learning about weaning as we are; they don’t necessarily know any better. They’re saying lower it by 5mg one week, and then another 5 the next week, but it doesn’t necessarily have to go that way. Your body doesn’t necessarily work on a weekly schedule. You may have to gradually lower it by alternating with the lower dosage, and you may have to take longer than a nicely rounded 7-day week before you begin lowering it further. Everybody is different, so this can’t be an exact science.

If you don’t like how you’re feeling, you can probably make adjustments to how you’re weaning yourself off the Paxil. You may want to talk to your doctor. And don’t let him or her push you around.

If it doesn’t feel right to you, then it probably isn’t. You can dictate your own treatment.

Postscript – February 4th, 2001: When I began weaning myself off the Paxil, I followed the alternating method as described in this post. I didn’t have a bad reaction to this method, but there are people who do. The thing to always remember is that everyone is different. You have to find out what works best for you.

P.S. (Sept. 2006): I’m not sure if this information is out-of-date, if new less-painful withdrawal methods have been discovered. But if anyone wants to leave a comment with more info (if there has been a change in the past 6 years), I’d be more than willing to post it.

Okay, today is my 6th day back on Paxil after my attempt going cold turkey. I still plan to wean myself off it, but not yet.

After going back on the Paxil, all the withdrawal effects disappeared — to be replaced by sleepiness. And then on the 4th day, I felt a tiny bit depressed and still sleepy. On the 5th day, I didn’t feel sleepy, but I felt definitely depressed. And today, the 6th day back on the Paxil, I just woke up and I’m not feeling the depression I felt yesterday (at least not yet; I just woke up 30 minutes ago).

So judging from the first day I went off the Paxil cold turkey (as my doctor ordered), up until today, about two weeks of my life were pretty much a write-off. That’s how much of my time this crap wasted.

But I’m trying not to dwell on that, because that’s depressing. I’m certainly not happy any of this happened.

I have noticed, though, that I feel considerably better after I’ve eaten a good meal. And I’m learning what better food to put into my body to give me more energy, which usually translates into more positive mental energy.

Postscript – February 26th, 2001: Here I am grieving over two weeks of my life which were stolen from me because of my initial withdrawal experience. Considering that the worst of the withdrawal would stay with me for about another seven months, it’s no wonder that my perception of time became distorted.

Today is my 5th day back on Paxil after going through cold turkey withdrawal.

I felt tired yesterday and a little depressed, and then around 10:00pm I seemed to get a second wind (after eating a large supper). But it also left me wide awake and I couldn’t go to sleep, not until about 1:30 in the morning.

I woke up this morning feeling depressed. My dreams seem to have a strong effect on my moods. I’ve never been a morning person, but I hate waking up feeling like I don’t want to get out of bed.

I’m tried to have a good breakfast and put good things into my body (I’m learning more about proper nutrition). Before my going cold turkey, I was feeling really good. No depression at all, positive spirits, no “social anxiety,” no fear underlining my actions. Now, having gone through the hell of withdrawal and then going back on the Paxil at my regular dose, all of those things have been affected. — And I’m am dying for a coffee and a cigarette (but saying no to both).

This is still my 5th day back on the Paxil after trying to cold turkey. I’m taking 20mg, my regular dose, but if you can believe it, I’m considering increasing it.

Before I went off the Paxil cold turkey as my doctor ordered, I was feeling fine. Happy, functional, smiling joe. Now my 5th day back on Paxil after my terrible cold turkey withdrawal experience, all of my withdrawal symptoms have long gone, and the headaches and the sleepiness I experienced when I first got back on the Paxil have also disappeared.

All I’m left with now is feeling depressed. My body feels fine, but emotionally I’m feeling depressed and easily saddened.

I plan to wean myself off the Paxil, but I need to feel not depressed before I do that. Right now — or at least today — I don’t have the guts to do anything. And I’m not used to feeling like this. It’s not overwhelming yet, but it is interfering with my ability to do what I want to do; that irrational, underlying fear is there. I’m fine when I do talk to people, but I’m not feeling as brave and easy-going as I was before.

I don’t want to increase my dosage. I’m trying to eat well, trying to get outside, trying to be positive, but I don’t feel like any of it. I’m hoping this will pass. I’m hoping I don’t have to increase the Paxil.

I’ll be making a doctor’s appointment today, but does anyone whose been through this having any suggestions? (I hate this shit!)

P.S. (Sept. 2006): That’s the vicious cycle of Paxil. You take it because you feel depressed or you’re axious in social situations. But once you stop taking it, whatever depression or social anxiety you experienced before doesn’t just come back — it comes back with a vengence. Some call this relapse, but how do you relapse into a condition that is worse than what you started with? This is one of the many ways paroxetine messes with your nervous system. Paroxetine may not be considered officially an addictive drug, but I’ve heard from heroin addicts who had an easier time going clean. (See also the Wikipedia entry for SSRI discontinuation syndrome and paxilprogress.org’s Published Withdrawal Studies.)

It’s true that some doctors are now becoming aware of Paxil withdrawal. I sent an email to my doctor after I experienced the living hell of cold turkey withdrawal, and yesterday he got back to me. I’ve included his reply in this message just so some of you (at least in Canada) can get an idea where general practitioners are in their understanding of Paxil. It seems that those of us who experience extreme withdrawal are learning about it as our doctors are learning, if not faster.

I’ve edited my doctor’s email message here, removing any remarks that could identify him:

I am sorry that you had such a bad experience on stopping the Paxil. You are right when you state that I was ill-informed when I advised you that withdrawal symptoms would likely be mild and transient. I gave you that information based on the year 2000 edition of the Compendium of Pharmaceuticals and Specialties [C.P.S.] which is the information source most widely used by physicians in Canada. You should be pleased to know that physicians are becoming aware of distressing adverse effects of withdrawal from SSRIs such as Paxil… I recently attended a continuing medical education session on the management of depression where the speaker who is a psychiatrist spoke at some length on ‘withdrawal syndrome’ and the need to taper SSRIs rather than stopping ‘cold turkey.’ I plan to report your experience (without identifying you) to the Canadian Adverse Drug Reaction Monitoring Program at Health Canada in Ottawa. Hopefully they will include a warning to Canadian physicians in the next issue of their Adverse Drug Reaction Newsletter.

P.S. (Sept. 2006): I wonder if doctors are any more aware today of the effects of paxroxetine withdrawal. Is the CPS still “the information source most widely used by physicians in Canada”? Is the CPS still heavily financed by the pharmaceutical industry? I wonder how much has changed in 6 years.