:smack:
Perhaps that’s one of the side effects they aren’t aware of?
Ahh, Side-Effexor. It and it’s cousin Cymbalta are notorious for their withdrawal syndrome, nowadays (and in truth, I was taught about slowly tapering Effexor way back in my pharmacy school days), and yet I still run into patients who haven’t been told about this phenomenon. I usually make it a point to correct that when I can, and both are drugs where I’m more inclined (as allowed under Ohio law, at least) to loan a small supply if out of refills or in need of a prior authorization. Despite the internet horror stories, however, they really are (Cymbalta in particular) very useful drugs in a number of conditions.
It’s not really possible to know. My own anecdotal experience suggests that you’re probably going to be dealing with a similar intensity in experience if you go cold turkey, but other than how uncomfortable/unpleasant it can be, it shouldn’t be harmful to you if you were to choose to stop cold turkey. I don’t recommend that course, and would instead suggest a taper. The taper your GP mentioned in your OP isn’t an unreasonable one. If you aren’t in any rush to stop therapy as quickly as possible, you could even reduce dose by 5mg every week or two if you wanted, assuming you are using a tablet splitter and the quarter-tablet chunks (if we’re talking 20mg tablets) are roughly even in size, or you could switch to the liquid formulation, though the liquid form tends to be more expensive in my experience, and SSRI’s aren’t therapeutically dependent on blood levels like some other drugs can be, so being extremely precise shouldn’t be necessary. Your pharmacist may also be able to substitute 10mg tablets if you prefer to not have to quarter a tablet, though this again might cost at least a little bit more than you are used to paying.
When I quit cold-turkey, I didn’t get “zaps” per se, but I did get weird moments of feeling very disoriented. Maybe that was my version of the brain zaps.
When I tapered properly and had no side effects, I did something like JayRx mentioned with splitting up pills and reducing by a very small amount each week. I had a couple of those pill containers with a compartment for each day, and that made it easy to set up.
When I ran out for a couple of days, it wasn’t zaps exactly, but like being superaware of my body moving around, and a sort of lag when I would turn my head. Almost like a virus I had once where I would get a weird feeling when I turned my head, or my field of vision moved/turned. Hard to explain, obviously!
I got that too. Turn your head, and your brain sloshes around afterward like a dashboard compass.
Not so hard to explain after all 
Thx VT.
For me the “zaps” were almost like static electricity, like when you touch something, and it kind of shocks you a bit? Only I’d get that in my head randomly.
You need to wean yourself off, don’t quit cold turkey.
Thanks everyone for the feedback. Sorry I haven’t replied. Been busy at work. I haven’t started weaning off it yet. I am actually a little scared–not of the withdrawal, but what it will be like without the meds. Part of me thinks, don’t upset the apple cart and tempt fate. But then I think, these meds weren’t meant to be taken forever. God only knows what they do to someone long term. It’s a really tough decision. My regular doc thinks I should get off since I am “fine” now, for what that’s worth.
Why aren’t they meant to be taken forever? If they are medical maintenance, what is the issue?
Well, let’s take a stab at possible reasons:
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if the reason for taking the drug no longer exists/is no longer a problem, why continue the drug? For example, one use of Paxil is treating certain symptoms of menopause. Once menopause is past such symptoms typically disappear, thus, such a person might want to discontinue Paxil after the symptoms are no longer likely.
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Paxil is associated with weight gain. If someone is having weight problems, or wants to seriously solve a weight problem, getting off Paxil can be a significant factor in achieving that goal.
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Paxil is associated with diminished sex drive. If someone has zero libido while on it but wants to have a sex life again then getting off Paxil might be important to that person.
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Paxil is associated with a slightly higher risk of birth defects, so a woman who is on Paxil but wants to have biological children has a reason to get off the drug for at least a couple years.
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If someone develops a medical condition that requires medication that may interact badly with Paxil that is yet another reason to get off Paxil.
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Quite a few people don’t like to be dependent on any form of pharmaceutical, and such a person might, after a number of years, attempt to wean off Paxil to determine if it is still/truly necessary for them.
I do not know why the OP wants to get of Paxil, that’s his/her business. All the OP asked was advice about tapering off.
I’m curious why you feel it is so important to get off the medication? Do you suffer from side effects that have grown to become unacceptable? If your life is improved being on the medication, it very well might be a permanent part of your life. 100 mg of zoloft has been a part of my daily life for nearly 15 years. And I’ve experienced life without it (and i stopped correctly and incorrectly) and I know it will always need to be a part of my life forever.
ETA: This question is posed to the OP, not Broomstick. Thanks.
The standard recommendation for antidepressant therapy is a trial of an antidepressant for sufficient period of time to lead to partial or full remission of the depressive symptoms expressed in the given patient, usually taking 4-8 weeks to assess the effect of any given dose change. Once you are on a dose achieving full remission (or multiple agents, if the initial agent only led to a partial remission), therapy should be continued for 6-12 months. After that point, a doctor and patient can consider discontinuing therapy to see if remission is maintained. If remission is not maintained (not counting any withdrawal effects), then antidepressant therapy may need to be restarted and maintained for life, or at least for long periods of time.
While most of our antidepressants appear to be safe with long term use, like with most drugs, we don’t really have any strong data (so far as I’ve read), other than observational data, on long term impacts, so it isn’t unreasonable to try to stop the therapy in question if a patient has achieved a stable remission in order to minimize any potential unknown harms of long-term use (or at the least, harms to the pocketbook if it turns out the maintenance is unnecessary).
Living Well, it is important once you quit that you keep an eye out for a return of one or more of the symptoms that initially led to your use of the Paxil and let your doctor know of how you are doing periodically without the medication. Otherwise, when you do start, I wish you a problem-free taper.
Sorry, I didn’t mean it as a judgment, just a question. I was asking because I’ve been on it for many years, and if we’re meant to treat it like treatment for any medical condition (like my taking Synthroid forever), it wasn’t clear why one would need to get off it. I know I’ve been anxious and depressed until taking it so I would think if it’s not situational, I would continue to want it to take the edge off indefinitely.
I guess it comes down to the source of the depression. People prescribed antidepressants due to situational depression only need them until that situation gets better, so they get better (very generally speaking). However, a person prescribed an antidepressant for chronic depression, the “situation” causing the depression is internal, not external and does not improve due to external situations. In many cases, chronic depression is incurable, only manageable.
Ambivalid, I think this is a very good point. Honestly, I don’t know the answer. It seems people in my family are prone to depression and anxiety. And there were definite situations that caused me to get on Paxil in the first place back in 2002.
I briefly saw a psychiatrist when I was decided to go back on Paxil the second time. He made the point that some of you have made, which is this is a life-long condition for me and I should expect to stay on it for life. But then six months later I went back for a follow up visit and was doing much better. This time he said in another six months we could consider taking me off the medicine. So who knows what is right?
And like JayRx1981 said, there is no data about long term use of these kinds of medicines. Are we causing ourselves harm we don’t know even know about it? That’s one of my concerns.
Another reason I think I want to get off Paxil is that I don’t even know if it works anymore. I still get depressed/anxious/OCD from time to time. It’s no where near as severe as before. Is that the Paxil working? Did I just grow out of some this? Have I dealt with it in other ways?
Also, someone asked if the side effects from the medicine are why I want to get off. That’s not the case at all. Honestly, I like the side effects. I sleep better, I get a sexual side effect I like (TMI I know), and I get no weight gain from it. The only problem I have is if I drink I get horrible hangovers. I guess this can be seen as a good thing since it often prevents me from drinking.
Anyway, thanks to everyone for the tips and feedback, especially Jay. I think Ive learned more about antidepressants from him than my own doctor.
On-or-off is a decision that a lot of people on antidepressants go through repeatedly, I think because we don’t know if we’re doing better solely because of the drug (as you mention) and also because most of us don’t want to use a crutch forever.
I’ve tried going off antidepressants several times and always ended up back on them. Now that I take them for pain management as well as depression, I’ve decided not to mess with something that’s working. BUT, that’s just me.
I agree. I resisted meds for a long time thinking they were a crutch and I should just be able to deal with it on my own. But it is a struggle and it’s exhausting. Meds don’t make me happy, they just take the edge off debilitating anxiety or panic and let me live with less fear. It seems worth it to me, but of course I respect whatever someone wants to do for themselves.
I was on Paxil previously and quite cold turkey. That was really not pleasant. Later, I went back on then when I decided to quit, I tapered off, which did help.
I found that Zoloft helps me better. My depression can get serious enough to cause significant and disturbing changes in my outlook on life, so any possible side affect has to be balanced against that.
Fortunately, I only have a minimal copayment so getting advice is well worth visiting the psychiatrist.
I’m finding that you really need to ask many more questions concerning possible side effects of drugs to both the doctor and the pharmacist. I took Antabuse when I stopped drinking alcohol, which I was using to cope with PTSD. I was also seeing a therapist and none of them warned me that the PTSD would get worse after stopping my self-medication before it would get better.