Peter wrote:

Well, it’s day 9 on 10mg from 15mg and it’s like the 4th of July in my head. The zaps appear when I move my eyes. They still squeak too. Everyday when this crap begins, oh, and it’s funny how it doesn’t start until around 3-4 p.m. I’m so tempted to just take another 5mg and this will all be over, but I keep telling myself, “I’ve made it this far, let’s try another day.”

Here’s hoping for “zapless” days once again.

My response:

As someone who has been there (and back), let me tell you that it will get better, but it’ll never get better as fast as you want it to.

But if the zaps don’t kick in until around supper time, that’s a good sign. As you go on you may experience some days of extraordinary clarity of mind and other things related to “The Paxil Window.” That might last for awhile and then as the window closes you might get hit with the zaps again. It’s a roller coaster at times.

I took Xanax (Alprazolam) on the days I didn’t think I could take it, but I just wanted you to know that if the zaps aren’t kicking in until later on in the day, that means that the end is getting nearer.

Speaking as someone who’s been there.

First response:

Just hearing from you, that if the zaps only come later in the day that it will be better soon, well, I nearly cried with joy. I was so happy to hear that.

Thanks you.

If you’re down to 5mg and feeling really good, you may be experiencing the mysterious “Paxil window” where one’s vitality and overall sense of well-being feels about as good as it gets. It seems that for some people the window never closer; they get off the Paxil completely and things only get better. But for others it really is a window and it eventually closes.

That’s what happened to me. When I was at the dose you’ve got yourself down to (around 5mg), I was feeling really good. Specifically, I experienced a sexual rejuvenation that made me feel like I was in my teens again. No complaints there. But eventually the window closed (it was open for about two weeks) and I became completely impotent. I got worried about that, but luckily it didn’t last too long. It’s been about two weeks since things became… limp? (Whatever adjective suits you.) But within the past three or four days things have returned to normal. I don’t think they’ll ever reach the peak I experienced during my “Paxil window,” but I can at least step up to the plate again. While I was at the stage you are right now, though, I was hitting a home-run every single time. Nice.

Perhaps your window will stay open forever. Perhaps it’ll gradually close and then return to normal, as it did with me, as you continue to wean yourself off the Paxil. Whichever way the wind blows, if you got it good right now, I’d say make the most of it.

You might want to stay at 5mg until you’re ready to continue with the weaning. If you’re feeling really good right now, maybe hold on to that until after the holidays.

When I decided to go down to zero, I think I took 5mg every other day for awhile. Then I stopped altogether. Things got a little rough again at this point. On really bad days I took another 5mg, maybe once or twice. Then, still more or less at zero, I took an occasional sliver of a Paxil pill to ease my sensitivity to light and the electrical heaviness in my eyes, but I only did that once or twice over a period of a few weeks. I can’t remember how long I’ve been Paxil-free, but it’s been at least three or four weeks now, and although things still aren’t the way I’d like them, things have been getting slowly but progressively better.

I think when you decide to go down to zero, you just have to wing it. See what works for you.

From Jane:

For the last 10 days I have been alternating between 20mg and 15mg. Wednesday night I came home from work and after dinner got very dizzy. I absolutely panicked and took 20mg instead of the 15mg I should have taken. Felt better shortly thereafter. Now, I am really worried about being able to get off this damn drug. I went on it due to anxiety and dizziness. How will I ever get off it if this is a withdrawal symptom? I took 15mg last night and feel fine now.

My response:

I don’t mean to belittle what you’re going through, because I think I know what you’re going through, but so what? So you took 20mg instead of 15mg. Big whoop. When I began weaning by alternating, the same thing happened to me a few times — I had to take the higher dose instead of the lower one. Then I felt better and was ready to move on.

The best way to get through this crap is to play it by ear. Don’t lower the dosage until you’re ready to lower it — and you’re not going to feel ready precisely every 7 days. None of this crap runs on clockwork. I don’t think you should feel discouraged because you had to take a 20 instead of a 15. It’s not a setback. You may have to take the lower dose every 3rd day — who knows? You work it out as you go a long. I was winging it the whole time I was weaning, and now I’m off it completely and I’m never going back. It can be done.

As far as I can tell, there is nothing consistent about this process. Throughout my weaning, I had days where I felt great. They were rare, but they were there. Most of the time I felt like crap. Then I had my window of heightened vitality about a month ago where, at least sexually, I felt like I was a teenager again. That lasted for about 10 days or so. Then I was completely impotent. Oh joy oh bliss. About four days ago, I didn’t have a single brain zap; my eyes weren’t heavy, nothing — and my spirits immediately got better, despite still being impotent. Then two days ago I got hit with the brain zaps like I’d never had them before. It was as if my body was letting it all go with one final surge. (Just a theory.) But at the same time, the impotence disappeared. I don’t feel like a teenager again, but I’m back to normal, or at least getting there.

There’s no predicting how things are going to progress. It’s a roller coaster to say the least — and that’s one of the hardest things about it, that it’s such an up and down experience. But it does get better. Sometimes it’s such a slow process that it’s hard to tell if anything is happening. But in the long run at least, there’s progress. You might not notice it yet, but as you continue with the alternating, you’ll eventually see that you’re getting somewhere. Don’t let the inconsistencies and the slowness of the process discourage you.

I’ve been Paxil-free for a few weeks now, but certain symptoms have not completely gone away, namely the short-circuiting electrical disturbances connected to my eyes. Last week I was went through a dull stage where my emotions were almost non-existent. A week or so before that, for about two weeks, I went through the Paxil window, or a peak period of increased all-around vitality. This included sexual vitality as well. I’m 30 years old, but it was like I was in my teens again. No complaints there. That peak period passed, then I had my dull week, and now I’m having a week where things seem to be normalising. At least my emotions seem to be normalizing. The paresthesia and the brain zaps, although still lingering in my eyes a bit, are subsiding. Or at least I hope so. As a result, emotionally I seem to be more stable. I’m still not ready to jump up and take on the world full force, but I’m better (this is an extremely slow process).

So I guess I’m getting better. But what I don’t like is the sexual condition I’m in right now. When I was on Paxil, like many people who take Paxil, I experienced some sexual dysfunction. I had difficulty getting it up and keeping it up, and it took a lot of work to have an orgasm (the female equivalent seems to be exactly the same). Eventually I managed to work around this to where it wasn’t a major problem. Then, like I said, I hit that peak period for about two weeks when I was close to being completely off the Paxil. And now, going through this period where I feel like my emotions are beginning to normalize themselves (e.g., none of the weepiness that I experienced earlier in the withdrawal), my sexual function has disappeared again. Oh joy oh bliss.

I seem to be having the same sexual side effects (the dysfunction) that I had when I first took the Paxil, but what I’m experiencing now seems to be even worse. I’m not in an intimate relationship with anyone now, so it’s not a major problem, but still, it does kind of worry me.

So I’m wondering if anyone has experienced this while going through withdrawal (or post-withdrawal), and if you have, do things get better, or will I have to take Viagra for the rest of my life?

This is one thing I could definitely do without.

First response:

Speaking from a female perspective, the sexual thing did not get better with time for me. I’ve tried everything — it ain’t working. It’s as though the part of my brain that is involved in this process was damaged… and I think that’s just what happened.

Second response:

I have been off Paxil for about two months now and I feel very good, just an occasional brain creep here and there. The sex stuff I was embarrassed to talk about at first and I normally don’t post about it. Someone who visits paxilprogress.org once said that when his libido came back, it came back with a vengeance, and that is what happened to me. As I was reducing, it would come back like that for a week and then subside. When I was off completely it was bad for a couple of weeks. I could not even think straight half the time. Then it subsided way back. But now I am normal again, just right. So I think maybe you will be normal again it just may take you a little longer.

Postscript – February 7th, 2001: There were peaks and valleys (I preferred the peaks), but my sexual vitality eventually returned to normal. It took about a month or so. Right now I wouldn’t say I’m flying off the charts, but for a 30-year-old male, I’m probably right where I should be. (Sure enjoyed those peaks though.)

I just got back from my seeing my doctor. Today is my 82nd day of weaning off the Paxil. I don’t know how long I’ve been down to zero; two or three weeks, I suppose. I’ve been seeing this psychiatrist because I needed someone who supposedly knew what they were doing to supervise my weaning off of the Paxil. So far he’s done a good enough job. But as far as therapy is concerned, my sessions with him have never been a catharsis of healing. Occasionally, though, I manage to have a conversation with him, like I did today, that does provides some insight, or maybe it’s hope. In the midst of all this, hope can go a long way. So anyhoo…

I mentioned to him today how my libido went through the roof a few weeks ago and stayed that way for about two weeks, but how that peak period of vitality has since come and gone. This was around the period in the weaning when I was almost off the Paxil completely. It might have kicked in during the last few days I was on 5mg. That peak period lasted about two weeks after that and now it’s gone.

This is when my doctor mentioned that there seems to be a “window” for people coming off Paxil, a window of time in which the blood level of Paxil is just right and everything clicks. Observing this window of peak effectiveness, doctors have attempted to “freeze” the patient’s medication at whatever the dose is during the window. But… it is a window. Which means it eventually closes regardless of what actions are taken to keep it open. (This reminds me of Oliver Sacks’s Awakenings.) Doctors have yet to find a way to keep the window open.

He told me that patients coming off Paxil often report this “window” of peak effectiveness. During the past 82 days, I think I experienced minor peaks that eventually came together in this full peak a few weeks ago. Things have since levelled off. To be honest with you, I’m feeling kind of dull. Not much interest in sex, etc. (There’s more to it than that, but that’s all I care to say at the moment.) He said eventually, if I don’t experience any major traumas any time soon, I should return to a more realistic state of well being, a middle ground between that peak period and where I am now.

My eyes still often feel like they’re soaking in electrified saline, but as soon as that goes away (I am so sick of it), things should begin to return to normal. I look forward to that middle ground.

Anyhow, I just wanted to inform everyone that there is a window of vitality in the midst of the Paxil withdrawal. Eventually it levels off, but until then, for those of you who haven’t had it yet, it’s something to look forward to.

Response:

I experienced this “window” that you are talking about. It was the strangest thing and happened about three weeks after taking my last 2.5mg dose. I had one whole glorious week of normalcy. I felt better physically and mentally than since I was 15 years old (I’m 39 now). No anxiety, no depression at all! I was normal.

Now that I have seen what it can be like I want it all the more for myself.

Something interesting about this… I visited Dr. Shipko’s PDI site and he said this “window” is pretty common and that he has patients who use SSRIs PRN to try to achieve this state.

I am going to discuss this with my “new” doctor on Thursday during my first appointment with him and get his take on it.

I just wanted to affirm this phenomenon to any other withdrawing people. Also, you guys and gals hang tough.