beastie080 Posted November 25, 2005 Share Posted November 25, 2005 Hi, I've heard that the discontinuation syndrome for Paxil is supposed to be one of the worst of all SSRI's. But I thought when this phenomenon was stated it mainly refered to the IMMEDIATE release version. Now there's a controlled release (CR) version of Paxil, and I'm wondering if the discontinuation syndrome for the CR version is still comparable to the discontinuation for the immediate release version. Can the intensity of the discontinuation syndrome associated with Paxil CR now be comparable to say Celexa or Zoloft or is it still the same as Paxil immeidate relase? Link to comment Share on other sites More sharing options...
Fiona Posted November 25, 2005 Share Posted November 25, 2005 A big part of the reason Paxil is often so unpleasant to stop too quickly is that it has a relatively short hald-life and cycles out of your body quite rapidly. While I can't speak from experience, it seems likely that the CR version will only be a little better. The controlled release is how rapidly it dissolves into your system, it would still be removed from your systems at approximately the same rate as the immediate release. The only advantage might be an easier time while tapering the dose down. Of course, I might be completely wrong -- I went from Paxil CR directly to Cymbalta without any ill effects. Fiona Link to comment Share on other sites More sharing options...
whitenoise Posted November 26, 2005 Share Posted November 26, 2005 The reason Paxil discontinuation is particularly bad probably isn't entirely due to it's short half life. Paxil is the least selective SSRI. It is as anti-cholinergic as a TCA (desipramine), so discontinuation might cause "cholinergic rebound", and it's a weak NARI as well. Link to comment Share on other sites More sharing options...
Loon-A-TiK Posted November 26, 2005 Share Posted November 26, 2005 I've taken Paxil in either regular or CR form for 5 years. In each of the 3 times I carefully, under pdoc supervision, titrated down to try to quit, as soon as I stopped (went down to 5mg and then took it away after a long time on 5), I had a major mixed episode and in 2 occasions, ended up in the psych ward, back on Paxil. Word of caution!!! Some people may have an easier time, but for my mother and I, it was HELL to get off of Paxil. I STILL take it, even though it does not help my BP (I started taking it before the dumbasses figured out I had BP, even though I had mania every other month). Take it as slow as you want, and stay on whatever dose for as long as you want. For me, CR @ 12.5 is about my minimum before I wig out. I think I'll need to go down by .5 like a month at a time or something!!! Take it slow, and good luck! Loon Link to comment Share on other sites More sharing options...
firedancer Posted December 2, 2005 Share Posted December 2, 2005 When I was trying to quit Paxil the first time I was on it (was on it for 2 years at 40mg) I had horrible withdrawal symptoms with regular Paxil. After about 3 months I was about to give up. My doc gave me samples of Paxil CR and I tried with those. I was still a hard process, but after about a month or so, I was off completely. I believe that the Paxil CR made it easier for me. Link to comment Share on other sites More sharing options...
Loon-A-TiK Posted December 6, 2005 Share Posted December 6, 2005 it is ever-so-slightly less terrible. the only non-terrible way is with the liquid form in 1mg at a time, like you drop 1mg every other week or something!! I'm still on it, despite it totally whacking out my bipolar disorder, because i CANNOT quit. It has put me in the hospital before, no shit. Link to comment Share on other sites More sharing options...
echonchaos2u Posted December 28, 2005 Share Posted December 28, 2005 Hi, I've heard that the discontinuation syndrome for Paxil is supposed to be one of the worst of all SSRI's. Link to comment Share on other sites More sharing options...
chimpmaster Posted December 28, 2005 Share Posted December 28, 2005 Advice for discontinuing: - if you are changing to another core ssri (eg lexapro, zoloft, luvox etc) then a smooth change over is often best. There is a 0 day change over period between those drugs, but from my experience, its important to be on the same equivalent dosage asap. So for example, if you were on 40mg paxil you would want to be on 200mg zoloft pretty fast to avoid discontinuation syndrome. When I changed from luvox to paxil my symptoms were worst when I was on the lower doses of paxil and luvox, but immediately disappeared when I jumped up to 60mg paxil (i was on 200mg luvox). - If you are discontinuing and not changing over, talk to your dr about using prozac and benzos to manage the discontinuation period. Both can be very helpful tools for this purpose. Also a fairly slow discontinuation program would be advisable - dropping perhaps 5mg every couple of days. Work out a plan with your dr. Link to comment Share on other sites More sharing options...
krojoy24 Posted December 28, 2005 Share Posted December 28, 2005 Could someone please tell me what could happen after taking Paxil Cr for 7 month, then doc dropping it cold turkey? How long will withdrawal last. Also is there any chance of rebound such as a depressive state ect? Please let me know what could happen. What do you think of doc that just drops someone from Paxil Cr because they are getting hyper mania? Shouldn't they still be decreased off of the med? Thanks for any info Link to comment Share on other sites More sharing options...
Velvet Elvis Posted December 28, 2005 Share Posted December 28, 2005 krojoy: Dropping cold turkey is usually the best way to go when mania pops up since it can sometimes escalate. It's not somthing you want to fuck around with. Discontinuation syndrome and rebound depression can suck, but not as bad as psychosis. Are you on any other medications? With regular paxil the worst of the discontinuation symptom started 3-4 days after I stopped taking it and lasted a couple of weeks. With the CR I guess it would start a bit later and last a bit longer but not be as severe. Link to comment Share on other sites More sharing options...
chimpmaster Posted January 1, 2006 Share Posted January 1, 2006 Link to comment Share on other sites More sharing options...
echonchaos2u Posted January 2, 2006 Share Posted January 2, 2006 krojoy: Dropping cold turkey is usually the best way to go when mania pops up since it can sometimes escalate. Link to comment Share on other sites More sharing options...
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