Changing medications?

[10x10]

Hi everyone,

I am after a bit of advice, and I was wondering if anyone could help me? Over the next few weeks, I am going to be changing medication (from Paxil to Prozac) and I was wondering if anyone has done the same before.

So my back story: After being on the drug Paxil for 2.5 years, I want to try and get off the drug altogether. I have already been to my psychiatrist to work out a plan for tapering off Paxil. However, when I tried to do this before, I tried dropping 2.5mgs every 3-4 weeks, starting at 20mgs. Everything went fine until I hit about 7.5-5mgs, then it all just went haywire. I was horribly depressed, very disoriented, having the 'zaps', felt very dissociated and unable to concentrate and my vision was blurry. So I quickly went back up to 12.5mgs and have stayed there ever since. However, I feel as if Paxil isn't really working for me anymore. I feel anxious quite a lot and experience a lot of 'brain fogginess'.

Since I was so terrified of experiencing the withdrawals I had experienced before, my psychiatrist has prescribed me Prozac to start taking, to get me off Paxil, and then we will work at getting me off Prozac. But... I am terrified of doing this. And I know a lot of it is my anxiety speaking, but I would really like to get some advice (if anyone has done this before), what they did to change drugs.

My psychiatrist has advised me to just start taking 20mgs of Prozac and ween myself off Paxil 2.5mgs every couple of days. But I'm concerned. What will this interaction of 20mgs Prozac + 12.5mgs of Paxil do? How long does it take Prozac to kick in if you are already on an SSRI? Should I take 20mgs of Prozac + 12.5mgs of Paxil for a week and then start weening off Paxil?

I know at the end of the day I should just follow the advice of my psychiatrist, but I guess my concern is my psychiatrist has never weened themselves off Paxil before, and I would like to hear the thoughts of someone who has.

I went onto another forum that specialises in Paxil for this advice, but no one really helped me, and I actually felt as if I was getting attacked since I was changing drugs and not attempting to be "SSRI" free. I do feel like it is my choice to be on medication, so I hope that whoever is reading this will respect that. The switching of medications is majorly to help mask the horrible Paxil withdrawal effects, which I really don't want to experience again.

I would really appreciate any advice, and would love to hear from you :)

[Beautiful Disaster]

Hi! I actually went through the EXACT same thing you're talking about. I wanted to try to be med-free, after being on Paxil (and trying various other SNRI's, SSRI's) for almost 10 years. I was only on 10mg of Paxil (baby dose!) so my doc said I could just cut that in half for 2-3 weeks, then go off completely. WRONG. A few days after I was off of the Paxil completely the withdrawal effects came on strong - anxiety, shaking, depression, crying, etc. I called my doc and he gave me 3 choices: 1) try to ride it out 2) go back on a low dose of Paxil and wean off slower or 3) go on Prozac (because of the longer half life it helps people wean off other SSRI's). I went with the Prozac. Then, once I felt better again, I was afraid to go off of it! I was only on 10mg and that seemed to keep me stable.

So I went to a different psych and started SLOWLY weaning off the Prozac after a couple months. I seemed to be okay a couple weeks after being off of it.... but then the panic attacks started. I wanted so badly to be off meds (thinking of starting a family in the near future) but I turned into a basketcase. I was constantly anxious and I would have debilitating panic attacks every week or two that would cut off my appetite completely. I lost 20lbs in 3 months purely from the anxiety. After 7 weeks being off prozac, I finally decided my quality of life was more important than not wanting to be on a medication. Started back on 10mg, which had worked for me before... 2 weeks later moved up to 20mg. Then had another panic attack, lost my appetite, AND had a misscarriage all in the same week. Went up to 40mg. Then a few weeks after that, even though I was feeling a lot better, they moved me up to 60mg since I still had a lot of anticipatory anxiety. I have been taking ativan pretty much every day (sometimes a couple times a day) since the middle of March. I'm starting to feel a lot better but for some reason I still have trouble at night. Been taking .5mg of Ativan at night so I can sleep. Right before bed or in the middle of the night are when my panic attacks have occured so I think I'm just afraid.

So anyway... to get back to your situation. I would say you can follow your doc's advice. I think when I was trying something else back in the day (maybe from Paxil to Lexapro?) I took small doses of both for a few days while I was weaning off one/starting the other. In my recent situation, once I went off Paxil, I started Prozac about a week later (and didn't restart the Paxil). I started feeling better within a few days. Maybe most of that was placebo effect, since I know meds take a while to get into your system... but oh well. Give it a shot.

And P.S. for most people, being on medication can get them to a state of mind where they're able to work on coping skills so they could potentially be med-free in the future. I was absolutely miserable and scared to death when I was off medication or the medication hadn't kicked in yet. I wasn't in a place mentally where I could really focus on doing things to relax myself (CBT, deep breathing, meditation, etc). Now, because medicine has helped me calm down, I have more confidence and hope that I WILL get back to normal and I CAN do things to help myself. I listen to relaxation podcasts, practice deep breathing, and am trying to get into meditation. I'm also reading a lot about anxiety/panic so I can understand what it is, why I'm prone to it, etc.

Good luck to you! :)

[10x10]

Hi Beautiful Disaster,

Thank you so much for your reply! Just having someone validate my situation can be really therapeutic.

Firstly, your doctor was CRAZY! I can't believe they would advice to cut the dose so quickly. I did my ween slowly (10% every 2-3 weeks) and I still had a horrible time of it. Zaps, dissociation, depression, it was just awful. So I can't imagine what you would have felt. What irritates me more is that we follow the advice of these people because we think that they know best... Drives me crazy.

I actually have started my first dose of Prozac today. Feeling pretty good actually! I think I will star on 20mgs of Prozac and 12.5mgs of Paxil for a week, then start to cut down Paxil. I'm a bit unsure whether I should follow the doctors orders and do 2.5mgs every few days, or do my own way and go 2.5mgs every week. I think maybe I should follow his orders and do it quickly, before my body adjusts to both drugs. I've prepared everyone around me for the withdrawal again, since last time I went absolutely batty. I just hope the Prozac covers those effects this time...

[Beautiful Disaster]

Hi 10x10 - how are you feeling now?

[10x10]

Well I have started on the prozac, so I am currently on 20mgs of Prozac and 12.5mgs of Paxil and I must say, I'm feeling frigging terrific. Been on it for 3 days now. Only interesting thing that has happened is last night I had a coke and vodka and my brain went crazy, think I will stay away from alcohol for a while.

I will start cutting down Paxil on Monday coming. Still a bit scared...