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[reener06]

So, I was on Paxil for about 3 or 4 years beginning in 2000. I was on it through the pregnancy & birth of my daughter. After a few years it was not as effective, and I switched to Welbutrin. Flash forward to last year, when I was still on Welbutrin (it worked better than Paxil) and had a miscarriage, my third. The fertility specialist I was going to (who was fully aware I was on Paxil) told me after diagnosing the miscarriage that I shouldn't have been on Welbutrin, it was dangerous for fetuses, and hinted this may have caused the miscarriage. I was angry and of course devastated. He insisted I switch to Paxil, although at the time I could find little evidence that Welbutrin wasn't safe.

In the past year, on the Paxil, I've gained almost 30 pounds, despite exercising, and depression has gotten worse. I was going to remain on it just a few more months while we kept trying. I got pregnant again. I go to a new OB--my old OB had also missed the Paxil problem, amid other problems. The new OB is aghast I am on Paxil, and says it is very dangerous for the baby. Apparently, newer studies have come out. They switch me back to Welbutrin.

Aside from a lot of anger at doctors over this, and feeling like my body is some kind of experimental lab, I am suffering from Paxil withdrawal. At first they wanted me to go cold turkey, but I couldn't take it. I have decreased from 20 mg of Paxil/day to 5 mg every 3 days over about a 2 week period. But still, every 2nd or 3rd day, the withdrawal symptoms come back (hot flashes, chills, "popping" sound in my head, dislocation feeling).

Any pointers out there? How much longer do I have to suffer through this? I am taking the Welbutrin daily and that is building up, so I'm hoping I just get to a point where I don't have withdrawal symptoms anymore. Trying to teach with these symptoms is not fun. Thanks for any help.

[littlefred]

I don't have any advice, although I would expect you are nearing the end of the withdrawal symptoms if its been two weeks.

But, I popped into this thread to see what others have had as experiences.

I was prescribed SSRI's twice, (Paxil the first time) and each time became suicidal while on them. The second was about 18 months before this info actually came out that it DID in fact cause this. No one believed me, and when I think about those dark moments, I really wonder what kept me from not doing it.

Each time, it dawned on me that these feelings were new, and unusual starting after I began taking the SSRI's, and I immediately stopped. I had withdrawal the first time, but the suicidal thoughts went away, so I remember being relieved, not upset at the symptoms. I was in school still at the time, and a recent grad the second.

when the study's about the connection to suicide came out I shouted from the rooftops!  "I knew it!!!"

[msparticularity]

Reener, I had horrible withdrawal when I tried to go off of Zoloft--so much so that my psychiatrist called her father (who was some kind of bigshot researcher) to find out what to do. She ended up putting me on Prozac to get me off of the SSRIs; it has a much, much longer half-life so it's self-tapering. And Littlefred, I had some bizarre experiences with pretty much everything but Prozac--which pushed me over the edge into massive anxiety. I ended up reading up on the European research literature and going on St. John's wort. American doctors truly are unaware of it because the pharma companies so completely control the American market.

[dellaroux]

I don't recall the exact sequence of meds now, but a friend had (and is continuing to have, I think, from what they've said) a horrible time with this sort of thing.

If I recall correctly at all, she (with her MD/psych caregivers' knowledge and guidance) was trying to wean herself down to a lower dose of one med (I think it was Zoloft), had a serious episode requiring hospitalization over a weekend or a bit longer, and ended up on Paxil afterwards, but she has still not stabilized and is still unhappy with the whole scary scenario. That was over a year ago; we had dinner a few weeks back and she indicated that while she's better, she's still not as stable as she'd like, and sees the whole thing as a disheartening trap.

(There may have been one other brief admission a few months ago; I was traveling and didn't get all the details, but I think another friend was concerned about trying to reach her, and has concluded that that might have been the issue again.)

I don't think working towards pregnancy was involved, because she's also unsure about the relationship she's in at the moment, and often talks about breaking up with the fellow she's involved with; either the wish to just have fewer meds on board or perhaps a problem with some other side effect (heavy sleep needs, I think, was possibly an issue) started the weaning efforts, then the rebound that followed catapulted her into a more serious situation.

All good thoughts to all those dealing with these situations; I once worked at a hospital and used to get mightily angry at the pharma reps who ply the (tired, truly overworked, probably on weekend call) residents with pizza on Fridays without fail (the reps take turns buying the pizzas, this is standard in all the hospitals across town, apparently) which I saw as a terribly blatant attempt to aim at the below-the-radar level of Maslow's needs in conditioning the residents to see the reps as their "good, nurturing" suppliers of food and drugs on a regular basis as well.

Once they start their own practices, the reps are right there, of course, too.

I'll mention the St. John's wort to my friend, thanks for that suggestion, as well.

[lilac53]

Dellaroux, one thing about St John's Wort if you are recommending it to a friend (or for your own info) - as far as I know, it has a negative interaction with birth control pills, making them less effective, so that's something to think about.

[marigolds]

I did a Paxil cold-turkey once.  The weird dizzy spells/lightheadedness lasted for about a month (decreasing frequency)--I think it has a pretty long half-life in the blood.

And I'm so sorry for the nightmare you're going through between depression, pregnancy, miscarriage, bad/changing meds, and unsympathetic doctors.  It sounds like a hormonal perfect storm.

FWIW, my psych had me on Zoloft when nursing for post-partum depression, and said that it had the most real-world testing with fewest effects on baby.  I'm not sure if this is true for the actual fetus, but it might be something to look into if you're not comfortable with either Welbutrin or Paxil (which, I think, have VERY different modalities of operation; isn't Welbutrin primarily a dopamine reuptake inhibitor, while Paxil is a serotonin reuptake inhibitor?  I'd think if one of those works well for you, the other one wouldn't.  IE, if Welbutrin helped, Paxil might not, since they work on different neurotransmitters.  But I'm just a humanist and this is a totally lay understanding, so...grain of salt.)

Again, so sorry for your troubles with this.  It sounds awful. 

[reener06]

Thanks everyone, for the info/experiences. It at least makes me feel less lonely, and maybe my withdrawal is standard/ok. It's just getting to me. I see my new OB today, and I'm hoping they can help. When I withdrew from Paxil the first time, and switched to Welbutrin, I didn't go through this b/c I was living in another city at the time, and had a doctor who knew how to make the switch. I don't recall any withdrawal symptoms. The OB seems unfamiliar with how to make the switch, and just suggested I steadily decrease the dosage. I want to stop taking the stuff, but these symptoms just keep coming back. Then I think if I shoulder through another day, they'll get better. I can make it to three days before I break down and take another 5 mg. For example, I took one Saturday morning, felt much better, and then the popping sounds came back last night and are getting worse today. Ugh!

[dellaroux]

Dellaroux, one thing about St John's Wort if you are recommending it to a friend (or for your own info) - as far as I know, it has a negative interaction with birth control pills, making them less effective, so that's something to think about.

Thanks, I'll let friend know (and no, it's not I in disguise). I know she doesn't want to get pregnant right now, so that would be a major issue!

[tauren]

I don't have much to contribute but I have the same reactions withdrawal reactions with zoloft, lexapro and celexa. I have been wanting get off of my celexa but dread the withdrawal effects (dizziness, feeling like my brain is hitting my skull when I turn my head, and just being out of it, inability to think or function). I may talk to my psychiatrist this summer after classes are done. Best of luck to you Reener!

[_touchedbyanoodle_]

I don't have advice, because that needs to come from your doctor. But, I will send my empathy. It took me two months to wean off Celexa, and I was only on 20mg to begin with. The entire process was terrible, just terrible. I had the electric brain zaps constantly for about four weeks. If I were to do it again, I would ask for prozac to help with the side effects. I was just so angry about the side effects that I was afraid to go on anything else that might come with its own side effects.

I'm so, so glad to be done with all that. I thought it would never end.

[onetimecomment]

I'm not sure how Paxil compares to Celexa, but perhaps my experience will be helpful.

Because of the half life of meds like Celexa, weaning off of them is a challenge. It can be done without feeling like a train wreck, but it does take time and patience.  I came off from a very low dose (20 MG, once a day) and it took almost 3 months, but I did it without using any other medications. 

I had taken that dosage for 18 months (with good results for my depression) when I accidentally missed a dose.   I took the next pill the following morning, but it was already too late - the withdrawal hit hard, and the resulting headache and eye pain sent me to my knees in a store.  I had to call for a ride because I was unable to drive.  That day I spent in bed, or vomiting, and several days passed before I felt OK. 

I immediately decided to quit, since my insurance company had recently refused to fill the prescription in multiples when I had to travel abroad for periods longer than a month.  It could have been a very dangerous situation if I ran out!

I'm rambling, sorry.  My two points are:  1) There *is* a significant reaction to coming off these drugs.  Pharma and docs hate the word "addictive" but that is beside the point.  If your current doctor argues with you about what you're experiencing, find another, because you need some one who will taper you off properly.  With Celexa, skipping pills or stopping suddenly will NOT work. 

2)  I researched many fora and discovered that to taper with no symptoms from 20 MG, I needed to remove 5 grains (particles) of medicine from the capsule each day, and stay on that dose for 3-5 days.  I then removed 10 grains (for 3-5 days), increasing by 5 grains each time period This process took about 3 months, but I did *not* get sick, and I did not go on any other medications.  Perhaps a similar technique will work with Paxil.

I'm still battling depression, and there are days that I really miss the wonders of chemicals - but I'm no longer worried about being laid out flat by a missed pill.

You are not alone in this, and there is a lot of helpful information in the various depression forums.  All the best to you : )

[littlefred]

I had no idea it would take that long to wean off it, so thanks forumites have educated me here. I stand corrected, and I'm thinking of you reener!

[reener06]

Yes, thanks to everyone for sharing experiences. I went to the OB yesterday and brought it up. She was quite sympathetic, and thinks I have done a great job getting down from 20 mg/day to 5 mg/every 3-4 days. She is going to call a high-risk OB colleague and see what they suggest and get back to me.

Part of the problem is spouse, who is prone to some anxiety, freaked out when he realized I didn't quit cold turkey. He was quite upset that the baby would have major health problems (despite reenerette, at 10, being fine). The doc calmed him down yesterday, and he is more on board with helping me.

As for right now, I haven't taken one since Saturday and have hit my limit again. I think it also affects my motivation as well, which is not good, combined with being 9 weeks pregnant. I just keep thinking "this too will pass"--the withdrawal, the first trimester exhaustion, and the semester. Just a few more weeks.

[dellaroux]

All good thoughts.

Bon courage.

[marigolds]

I wonder if you could cut the one you're taking up, so that you don't have to take the full pill every 3 days?  That might be something you run by your doctor as another tapering mechanism now that you're not taking it every day (like the poster above who took grains out of the Celexa.)