Posted by Scott L. Schofield on January 27, 2000, at 23:48:35
In reply to Re: advice on titrating off Paxil, posted by cg on January 22, 2000, at 21:09:13
> > Hi,
> > I've been taking 20 mg of Paxil for approximately 6 years to treat dysthmia. I've changed doctors over the years due to moves and insurance changes. My meds are currently prescribed by a primary care physician who is essentially clueless in regard to these things. I'm a mental health professional myself and basically manage my own mental health care with therapy and adjusting my dosages. Here's the problem- I want to try life without Paxil but am frightened of becoming emotionally unstable again (as I was 6 years ago). I cut my dose to 10 mg approximately one month ago and have noticed that I've been extremely moody, sensitive, and tearful over the past week. Is this common? A short-term effect of my body adjusting to lower doses? Or is it a sign that I need 20 mg and my always? Any advice on how to titrate off the medication at least for a short experimental period would be greatly appreciated.
> Maybe you cannot see that you NEED that Paxil. If you completely stop, it may not work again. Don't mess with a good thing. In my experience, you may be very sorry. Controlling dysthymia is much more valuable that testing to see if you can do without medication. Do without the dysthymia instead, it will be much more acceptable.
I would not want to speak as to the wisdom of discontinuing treatment with Paxil. I know dysthymia is difficult to treat and that the SSRIs are a good place to start. Certainly, if one particular SSRI does not yield a substantial improvement, one of the others may. One trick to help prevent or mitigate withdrawal effects is to use Prozac as a sort of descending bridge to the bottom. Of course, this is only feasible if you suffer no ill effects from the Prozac itself.
This works because the Prozac is being used as a substitute for Paxil. Whereas the body eliminates about half of the Paxil every day, it takes a week or more for Prozac. I don't know how often it is done now, but when I last read anything about it, doctors were giving their patients one 10 or 20 mg dose, and allowing it to clear without further dosing. Sometimes this would have to be repeated i.e. 20 mg for week 1 and 10 mg for week two. I believe this method was also used for Effexor, another pain-in-the-ass drug to get off of.
Good luck.
- Scott
poster:Scott L. Schofield
thread:19412
URL: http://www.dr-bob.org/babble/20000112/msgs/19850.html