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Withdrawal

I was going to respond to a rather long and tedious comment on this morning's post, and I was going to do it here, rather than in the comments, because it really needs responding to. However, something more important and serious has come up. Perhaps this something might explain my behavior over the past few days. Trust me, I have not been myself. I know this. My family knows it. And anyone who has read this blog for any amount of time knows it. More importantly, I have not liked being this way.

I did a very stupid thing.

I've been taking Paxil CR (38.5 mg) for almost two years. About six months ago, my doctor put me on Wellbutrin (XL - 300mg) for various reasons, in addition to the Paxil. He said he would start weaning me off the Paxil as soon as I got adjusted to the Wellbutrin.

Well, that took a while, because I had an allergic reaction to the Wellbutrin at first. Once that disappeared, I felt great. In fact, I felt better than I had in years. So we mad a joint decision that I would stay on both meds for a while.

Last week, I decided that I was being overmedicated. Part of this decision was a vain one; I had gained an incredible amount of weight since starting Paxil (a common side effect) and I was feeling physically horrible because of it. So, when it came time to get a refill of Paxil, I didn't.

That was six days ago.

I really thought that being on such a high dose of Wellbutrin would offset any effects of going off Paxil cold turkey, which I knew could be a Bad Thing.

It started slowly and really came to a head yesterday. I became agitated, high strung and anxious. I attributed all this to covering the war non-stop on Command Post and writing so often about that and terrorism in general on ASV. Job hazard, I guess.

Then I started getting belligerent. I was very short tempered with my kids and the rest of my family. I got in my father's face the other night in such a mean way that the rest of my family, gathered for my brother in laws Passover dinner, had their jaws hanging open. In 41 years, I have never disrespected my father like that.

It wasn't just anger and irritation. I was having wild mood swings. And I do mean wild. And severe. I was crying, I was screaming, I was totally unpredictable. I noted that this was probably the worst PMS I've ever experienced. Well, I had to blame it on something.

Then today. I started getting dizzy. But it was a weird kind of dizzy. It was as if someone was shooting off a taser gun inside my head. Electroshocks. They would throw me off balance sometimes.

Some time in the past four hours or so, the shock-like feelings became so severe that they were happening at the rate of at least 15 a minute. (There goes one right now - it's almost as if your head goes numb for a second).

Finally I accepted the fact that this had to have something to do with the lack of Paxil in my system. When in doubt, hit the internet.

Within seconds I discovered that the little shocks are referred to as zaps and they are a common symptom of Paxil withdrawal. Imagine that - not only was I not going crazy (or dying from a brain tumor as I had imagined at one point), but there was actually a name to this crazy feeling.

I started Googling Paxil withdrawal. Some of the symptoms:

nausea, dizziness, electric shock sensations sometimes known as "the zaps," headache, flu-like symptoms, balance problems, anxiety, sleep problems, gastro-intestinal problems, sweats, vivid dreaming, sensitivity to light and/or sound, etc.

Well. I've been nauseas all day. Dizzines, yes. Zaps. yes. Oh my god, the sensitivity to light! I was complaining not less than an hour ago that someone must have turned up the brightnes on the laptop screen because it was blinding me. The vivid dreaming, I always have. But this week's dreams have been more than bizarre (on that note, I dreamed about Sheila last night and she dreamed about me - and we were doing the same things - but that's another story).

Check out some of these common symptoms of Paxil withdrawal:

bq. Agitation, Irritability - Aggression, Severe Mood Swings - Extreme Irritability and Anger - Outbursts of Tears For No Apparent Reason

And there we go. My last few days in a nutshell.

That's not to say that I never had those emotions before going off the Paxil. God knows I've covered them all in the past month alone. The difference here is the extreme. There were times this week that I could not even stop myself from saying/doing/writing things I knew would just end up causing trouble; either for me or someone else. Poor DJ and Nat. They felt the brunt of this, I'm sure. And my husband, who kept saying all along that I should be taking my Paxil, but I completely ignored his pleas.

My moods and behaviors this week have indeed been extreme. I sincerely and without reservation apologize to any of my friends that I have slighted, hurt or caused distress to this week.

Oh, I meant most of what I wrote - that stuff was nothing new. I just am really sorry for the way in which I approached some subjects.

So what am I going to do? I am not going to call my doctor, I'll tell you that. He'll want me to go back on Paxil immediately. I don't want to. I can make it through these withdrawals now that I know what they are and I no longer thing I'm dying or going crazy. I think there is no scarier feeling than thinking you are really, honestly losing your mind.

So for the next few days, I'll get the zaps and maybe slur my speech a little and feel a little confused at times - that sounds like a typical night from my high school era anyhow Without the groovy hallucinations. I'll temper my emotions now that I know where they are coming from and I would be so frightened at my anger when it pops up. I'll just take a few Excedrin Migraine, put on the headphones, turn up some Portishead and mellow out.

In fact, I think I'll do that right now.

P.S. This is not an excuse for being an asshole. It's an excuse for being more of an asshole than usual.

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Comments

I hope you feel better soon, Michele. Best of luck with the next few weeks; here's hoping they pass sooner rather than later.

Hope you feel better, as well.

I totally feel you, Michelle, When I went to Germany for a month a couple of years ago, thanks to my effed-up insurance company, I wasn't able to fill my Effexor scrip. I had to go four days without before I discovered that you can get fluoexetine without a scrip at any druggist in Germany. I thought I was going to die, I swear -- like the worst flu ever crossed with the worst migraine ever, and extra depression and dizziness on the side. Get better soon!

Yowza!

Go slow off the Paxil because Welbutrin makes seizures more likely (if that's what the zaps are).

My experience with Welbutrin was that it made me very irritable unless I took something else with it. I got angry easily and more angry than I should have.

My worst withdrawl from antidepressants was from norpramine. I was having siezures for a few months. I should have seen a doctor about it, but I was too confused and despondent to do anything.

My siezures, by the way were peti-mal ones that made me completely lost track of where I was and what I was doing. It became impossible to cook because I'd forget the pot on the stove most times.

Anyway your writing has been good.

Just don't do this to yourself just to make a good post.

I'm finally on 5mg a day. I've been on Paxil or Zoloft for nearly 5 years.

From my experience, I can only wean slowly. In another week or so, I'll try to go to 5mg every 2 days. The last time I tried to go from 10 to 0 I was fine for 6 days. Then the Head Zaps started again. Bad. So bad they caused nausea which was unbearable. I won't even mention the first panic attack I'd had in nearly 2 years. Oops, I guess I did.

I've heard it said that it is easier to break a heroin habit than getting off Paxil. My doctor wanted me to take Prozac while I weaned and I told him to take a hike. I don't need to substitute one habit for another.

Anyway, for me, the Paxil is simply for a chemical imbalance in my head. I've never been overly manic or overly depressive and no one ever believes me when I tell them I'm on the stuff "But, you're one of those happy go lucky types of people!"

My doc gets a kick when I show up because I don't have anything I ever want to talk about. My life, outside of the panic attacks, is pretty much happy.

I wish you the best of luck. What seems to be working for me is the slow, methodical weaning. I went from 30mg to 20mg for a month, then 15, 10, and now 5.

Oh yeah, the first 6 months I was on it I gained 60 lbs. However, my skinny ass needed it.

Poor Michele. When I changed doctors, I had to go without my Zoloft for a week. Very bad.

Phil- Last year I quit taking Effexor cold turkey after deciding I didn't like the side effects, and WOW- what a miserable experience. I didn't get the flu symptoms, but for almost a month I had major dizziness, nausea, wild mood swings and crying fits (I couldn't listen to music at all without crying)...I don't wish that on anybody.

If there's anyone else out there on depression meds wanting to get off, I hope you'll read all of these posts and proceed very cautiously.

Maybe there's a hint of solution to our political problems here.

We just need to put the Islamic world on Paxil.

I don't know if the American left needs more drugs or less, though.

Robb, I'm taking it for the same reason - horrible panic attacks. I'm scared to death of them coming back. I'd rather get root canal without novacaine that suffer another panic attack, ever.

You know what's funny? I kept checking yesterday on some posts to see if you'd recruited a guest blogger. It's not that the style was drastically different; it just seemed like the volume had been turned too far up or something (God, I'm bad with similes)--like you with distortion, I guess.

But you know something, it's not like I didn't enjoy your work any less for all that. In fact, it was kind of a plus: Great, Michele gets angry and now I don't have to! But that's a real selfish viewpoint for me to have because at that point I'm not thinking about how you're also the one who has to put up with all the consequences, all the potentially negative feedback from it.

I hope you're not beating yourself up over it, anyhow. And I hope the Paxil withdrawal eases up.

God, this explains so much. I've just been coming down of Paxil!

...for 31 years.

Heh.

Hang in there. My wife had similar symptoms switching from Zoloft to Wellbutrin. I am not a huge fan of Wellbutrin, but neither am I a doc.

Honestly I don't know if it was zoloft withdrawal or getting on wellbutrin...it just wasn't fun around here.

She went back to the Z and feels much better.

Did I mention hang in there?

While I don't have a solution for anxiety, my psychiatrist cured me of severe panic attacks (nose bleeds etc.) by pointing out that I was reacting to my own reactions. He told me that no one ever died of a panic attack. No need to be afraid of your own fear reactions.

Oddly enough, that was enough to stop the panic attacks. Years later I had a problem with anxiety, but that's not quite the same thing.

I know exactly what you're going through because it's happened to me a couple of times. Paxil withdrawl is extremely scary. As the days go by without Paxil, you start to feel as if some evil demon is taking control of your body, and you're just left to watch helplessly. It was so bad, at one point, that I jumped out of a moving car and took a bus to the hospital. The ER doctor gave me a prescription for Paxil and I took myself off of it the right way--in slowly decreasing doses. I experienced no withdrawl symptoms whatsoever. It was so easy.

I strongly suggest you do the same, because it makes a huge difference.

I took Paxil for anxiety and panic disorders, and it was actually pretty good. I like Lexapro much more, though; it doesn't make me sleepy and the withdrawl is mild (I had to quit cold turkey for insurance-loss reasons).

Michele, Sorry about your withdrawal issues. However, I was really enjoying your posts. They had a little more zing than usual, but with the rising tension in Iraq, they seemed quite reasonable. You have some really good advice from others already. I just wish you the best.

Michele, can't you call your doc for a weaning prescription? Tell him point blank that you want off of the Paxil and need a weaning dose. Otherwise you'll either get through the withdrawal using alternate methods or find a doctor who will give you the scrip.

Paxil. Never had that one, and will dump my doctor if he ever tries to prescribe it.
Watch the backlash if you have to stop Welbutrin as well. Not as bad as Paxil, but each of the meds have their issues.
"The Zaps" LOL.. I never heard it termed like that. though I never caught it in the head. It was always a very strong current originating at the base of my skull and traveling down my right arm to my wrist. quite painful.
Having been on: Ritalin, Imipramine(Toffrenel), Asendin, Zoloft, Lithium, Neurontin, Welbutrin, Resperidol, Lamictal and Gabatril (damn.. has it really been that many?), I have experienced the least amount of side effects with Lamictal and Gabatril. Neurontin will load you up like a cow weight-wise (like Paxil) I stopped taking Neurontin and dropped 40lbs in a month.

Michele, I know you may not like some of the things I've said on your blog, but I think maybe now you understand why I act the way I do sometimes.
Do you, or anyone else reading, experience the "spring-effect"? You know, you get all messed up for about a month starting in March?

The Zaps. I get very mild ones if I miss more than 24 hours of my 20mg/day Paxil. Slight vertigo, too.

Hang tough, Michele...and based on what I've learned about Paxil withdrawals, flu-like symptoms are not uncommon, either -- but most, if not all, of the coming-down-effects should be gone within 10-14 days.

Best wishes.

Ouch. Hang in there, indeed.

You should REALLY consider tapering rather than jumping off that cliff, though. Even a fast taper, to 30 for a week, then 20 for a week, then 10 for a week, then 5 for a week.

Some people can do the cold turkey with minor symptoms; you don't sound like one. Have your hubby and nearby friends keep a close watch on you, please, in case it gets worse.

All,

Why do you think Prozac was such a miracle drug, none of the withdrawal symptoms and very little side effects. Unfortunately, it doesn't work for many of us (or like me, side effects aren't acceptable: micro-shakes).

Michele's story is a good reminder that antidepressants shouldn't be treated like painkillers, it's dangerous for us and others to decide to self-medicate!

Michele, Don't forget to call your Dad and explain (apologize?).

Raydog

Yet another Paxil user here. Just the thought of going off it is scary to me. Not so much because of fear of withdrawl (but I have definately heard that it can be bad) but because I really don't want to go back to the person I was before.

Hang in there. It'll get better.

Yep, another member of Paxil Unanimous.:)

Michelle, I know what you mean about panic attacks. Folks, you never bother somebody having a panic attack. You could end up in itty-bitty pieces while your killer looks down on you wondering what the hell happened.

BTW, start taking evening walks, with the family. Just grab everybody and the family dog and go out. Even if you have to beat 'em to death. It'll do everybody (include the drama queen) a world of good. And if it don't they should be too pooped to make an effective protest.

Good luck.

Just a note from an observer of one who has gone through the antidepressant gambit (my wife is currently on Wellbutrin [formerly on numerous others] - so to understand this I had to study). Michele, you need to contact your doctor. Even if you refuse his advice to get back on Paxil, he needs to be aware that you're off it.

I think that doctors just don't communicate to their patients how unbelievably powerful these medications are. So patients become complacent, thinking that going on/off them is no big deal. You may be right that it's just a matter of time before you get over the withdrawal, but that all assumes there's nothing else physiologically wrong with you, and that you fit inside the bell curve of response to Paxil withdrawal. If this is your first time "shock" withdrawing then you don't know what else is happening inside you. Nor do you know what your response will be over the next few days.

You've already noted that this process has the power to take your rationality from you. Do you think you know this medicine well enough to assume the reaction won't peak worse than it is now?

So, talk to your doctor. And you may want to avoid encountering stressful situations for a while (like doing the war correspondent bit, listening to the news, posting on your blog... in other words: give yourself some time to heal and rest).

Either way, Paxil (and similar meds) is not a do-it-yourself drug. At a minimum your doctor should know what you're up to. Blow his advice off if you must, but at least keep him aware.

Switching meds is tough. Good luck.

Panic attacks suck. Period.

I'm one of those people that everyone looks for in a crisis. I keep my cool, control my stress, and can think very well under extreme pressure. It has always been one of my better qualities.

Then, one day, for no reason BAMMO! Panic attacks. I don't quite buy into the "no one died from panic attacks" statement. Maybe the physical effects don't kill you, but the mental anguish you go through can.

Although the Paxil withdrawl is hard, there is a major benefit to taking it. No Panic Attacks (or at least the ability to control them and not let them affect my life). So, 5mg a day isn't making me groggy like the 30 was and if when I wean, the PA's come back, I have no problem taking it again.

Since I didn't suffer from depression and actually had a good time with the mania (;p) the only difference between being on Paxil and not was the PA's. I WANT to go back to the old me, but if need be, I can settle for the 'almost the same, just with meds' me.

My heart goes out to all who share my plight.

Michele - One of the side effects of Wellbutrin is rage. Your rage might not be a side effect of going off the Paxil, but going on the Wellbutrin. After bein gon Wellbutrin for a while I Googled for side effects and sure Enough. RAGE. That explained my horribel moods. I dropped it without asking my doctor and I was fine. I've now begun self medicating half doses of Wellbutrin taken before bed to avoid the fatigue I experienced before. That was a week ago. Things seems ok for now.

Maybe, Michele, you should talk to the doc about the Wellbutrin side effects.
By the way, there is often one VERY good side effect of Wellbutrin that is the exact opposite of one of the worst side effects of Paxil.

I hope you figure this out. Figuring out all this medication crap is frustrating.

Patrick - Got it.

It's why my husband let out a WHOO! when I said I was going off the Paxil.

(

I went off of paxil after a year, transitioned to Paxil CR, transitioned to Effexor XR, and finally got off of everything around January.

It's going to be a tough two weeks, Michelle. After 6 days you should be over the worst of it. After 14 days you should be completely off.

SAM-e is an over the counter antidepressant with no side effects (except mania in the case of manic-depressives).

I mention it because I found that it takes some of the edge off of Welbutrin.

The cheapest non-crap brand is Pharmaton, available at Safeway. I take 1600mg per day.

There are crap brands available on the internet. I tried one and had a terrible allergic reaction. I gave it to a friend who usually doesn't have allergic reactions - and he had a terrible allergic reaction.

I recommend Pharmaton.

Michele, did some talking with my wife tonight about your post. She first said "bless her heart" (with a tear in her eye), and then said to tell you she believes the Wellbutrin kicked off her rage symptoms.

Anyway, now we both say, hang in there.

and God bless all of you who talked about struggling with this chemical imbalances in your bodies and doctors and medicine. Today is the last day I will ever bitch about missing Marlboros.

Good luck, and feel better.

Ooh, another ex-Paxil user here. It made me CRAZY. That stuff is just pure evil in the wrong brain; mine was the wrong brain. I was more depressed and anxious than I'd ever been off of it, and - get this - it made me start lactating, two years after weaning my son. Yeah, you heard right. Eww! Went off it, became sane again, dried up, etc. I've been SRI-free for over a year now!

I got the spins and the dizzies going off of it, too, but you can tough it out if you put your mind to it. A month oughta do it; just be careful driving!

Good luck.

I've just gone on Cipramil for my panic attacks and anxiety (I was a anti-dep-med virgin before this). I've been dealing with it for way too long now, so I sympathise michele when you say you never want to have another attack. Makes it scary to think about going off them though when one of the major symptoms is anxiety sigh.

Good luck! I'm discovering more and more bloggers every day who are on meds. Depression (and anxiety) is the black plague of the modern world ;).

Withdrawal complaints have been the number one complaint for my patients taking Paxil. Too bad, really, as it seems to work fairly well in patients with panic attacks or a strong anxiety component to their depression. The CR formulation was supposed to alleviate some of the withdrawal problems...doesn't look like it worked. Recently, I've been prescribing more Lexapro, which I haven't had as many problems with. Still, consider yourself lucky. The SSRI's are head and shoulders above the previous drugs in terms of efficacy and side effects.

I know nothing about any of the medications in question.
The only help I can offer is that based on the experiences my sister had, over a long period of time, over-medication is a very serious concern. I'm sorry you have to take any of this stuff, Michele - I know it's not any fun. Hope you feel better soon...

I referred to them as "pings" and "invisible electric jellyfish".

Wellbutrin (added later to the mix) made me feel perky but I couldn't concentrate for long. On 25 mg Paxil CR and current doc wants to re-add Wellbutrin.

Getting off my blogging tush and exercising may help, too.

Are you sure you weren't just cranky because the Yanks split two series with the lowly Devil Rays?

By the way I just heard Rice's testimony.

Your anger at Bob Kerry wasn't Paxil or Wellbutrin talking!

Bob seemed really peaved that Dr. Rice tried to answer his questions which were apparently all rhetorical grandstanding.

Hint to Mr. Kerry, if you're trying to mock someone who's smarter than you are, you'll be more successful if you do it behind her back.

Please, Michele, contact your doctor. As others have said, you can refuse any treatment he prescribes, but please let him know what you're doing. And do NOT add SAM-e or St. John's Wort or any other OTC supplement without telling him what you're doing. Anti-depressants are too complex to just toy with.

Wellbutrin was by far the worst drug I've ever taken in my life. The effect was so bad I ended up in an intensive 6 week psychiatric program. It was totally contraindicated for my symptoms and diagnosis, as I learned after I fired the doctor who gave it to me and found a much better one.

Please call your doctor Michele. Just to let him know what you're doing.

Wow. Given the bizarre vivid dreams and all, this might not be the best time to ask, but is the little dead girl meme from the movie The Ring? (...which I saw for the first time last night...)

The only firsthand knowledge I have with medicines like that is watching my wife taking the ones she's been prescribed for her ADD. Even with side effects she's better when she takes them. <accepts smack upside the head for stating the obvious>

Of course, now she's also being treated for sleep apnea, which has affected how much good-quality sleep she gets each night (not to mention poor oxygenation of her blood and the effect on her brain over time), and I've gotten to wondering if, in her case, that might have been a contributing factor in the diagnoses that led to all the prescriptions.

I'm going to have to lean on her to use the anti-apnea contraption more consistently though. When she uses it, I sleep better too.

Thanks for sharing, Boopsie, it truly takes courage, and health, to write the above.

P.S. The family has hidden the banana clips for the AK-47, right? Ha-ha, just kidding, M-, put That DOWN!

This whole entry is a big Deja Vu to me. Last year I took myself off of 40mg of Paxil, experienced those same symptons, with the biggest being irritability, I was snapping at everybody for no reason. I didn't tell my doctor until about 2-3 months after I stopped, I knew he would put me back on and I didn't want to do that.

The first 2-3 weeks is the roughest to get through, but after that it should be down hill from the peak, that's how it was for me.

I found a yahoogroup for support, I can't remember the name though, :/

Again, the withdrawl will pass and you'll be back to normal.

I can sympathize. I'm on 12.5mg Paxil and 450mg Wellbutrin and that finally seems to be a good combination. I've been through all of them over the last 9 years. The worst was Effexor. I ended up trying to go off that on my own and be unmedicated. That was about 7 years ago. The results were disasterous. I'm surprised that somebody else didn't kill me back then, I became such a belligerent jerk. Good luck, I wish you only the best.

Yeah i take 10 mg of Paxil a day. 20 makes me feel like i'm choking and i tense my jaw and gnash my teeth. Wellbutrin just made me want to kill people. But it's nice to be able to draw and write and paint again after 5 years of "kill me please" depression, week-long anxiety attacks and sudden nebulous fears that everything was going to be taken away from me for some small slight.

From my own welbutrin/paxil experience, i'm more inclined to think your side effects are from the wellbutrin and not weaning from paxil. But i'm no doctor or anything. I just know the wellbutrin gave me all the problems you say you are experiencing and i havent had any major side effects from the Paxil dosage i'm on.

doesnt it seem a weeee bit weird that you would have to take a second antidepressant to keep the edge off the first?

anyway, best of luck to you with all of this, and definitely let your doctor know what you're up to. As you can see, you're not the only one. heh. whoa!

Shelby, one of the reasons that SAM-e is less dangerous than other antidepressants is that your liver makes a couple grams a day - unless you have liver problems.

I've taken it with Wellbutrin and had no side effects.

Oh, my GOD! The ZAPS?! It has a name? Here I was thinking this only happened to me when I went off my meds.

Jesus, are all bloggers medicated?

M, I can only echo what the others have said here. Your doctor should know. You REALLY REALLY REALLY aren't supposed to stop taking these kinds of medicine cold turkey. People kill themselves. You should taper off, blah, blah, blah.

Just e-mail me when you get a chance, okay? I want to talk to you about this in detail. I have tried to white-knuckle it through no meds before and it was a bad, bad idea.

Take care.

Feel better.

D

It is too bad pot isn't legal.

It might solve your anxiety problem and the side effects are relatively mild. (increased desire for food and sex - hey it's not a bug it's a feature)

BTW like all medicines pot isn't a universal cure. It helps some and hurts others.

It is just unfortunate that a drug that is safer than aspirin is not one of the allowed choices.

You don't suppose it has anything to do with the $$$ that anti-anxiety nedicines provide the drug companies do you? You don't suppose the support the drug companies give drug prohibition has anything to do with protecting their profits do you? They are only interested in helping.

And lest you get the wrong idea I'm a die hard capitalist. I just resent companies that protect their markets with government guns.

It sounds really unpleasant. I hope you feel better soon. Also, I'm sorry if this week's complicatons served to make the withdrawal worse.

I have been off of Paxil for three weeks now, transitioning to Wellbutrin CR. I am getting the zaps, but the worse is muscle spasms in every part of my body. Reminds me of the science fiction movies where something is bursting out of a persons skin. ;o) I had no idea this could be this bad. I am experiencing self righteous rage on Wellbutrin. My Dr. told me to
begin going off of it today. I hope you feel better soon. Keep educating yourself and getting support from us other "Withdrawers" I wish you well.