Remeron tapering and Paxil withdrawal

[IMISSME]

I have asked this question on the other forums but wanted to get some opinions on this site. I managed to get stuck on Remeron back in July 2011 after being off Paxil for 2.5 months. I am currently at 4.2mg. I am concerned that the Remeron is impeding my paxil recovery. What do you all think about this? I also want to get off the Remeron but can't seem to drop very quickly without grave consequences. I was dropping 10% or so every 3 weeks but have now stayed at 4.2mg for 5 weeks. I just don't want to "rock the boat."

I am still an emotional mess from paxil. All the usual psych symptoms. I am also wondering now if the axiety may be akathesia. Akathesia seems to be very hard to define as it is different for everyone. I do have the burning skin sensation back but more mild I think.

I am 18 months off paxil and really have had a tough time of it. I had some pretty big life events happen during my time on Paxil and now I am dealing with it emotionally and it brutal. I do have the horrible mornings but better evenings experience.

[Luc]

Well, on the one hand, to allow your CNS to heal entirely, one needs to be free of drugs. On the other, considering you have been through this Paxil ordeal already, you may need to take it easy. Hm... "On the the third hand", getting off of the drugs must eventually happen to let your system heal. These are really tough choices, IMISSME. Perhaps, going down with the dose still more slowly would be an option. You could simply check how the land lies with a smaller dose, and if your body tolerates smaller drops, you could go this path.

[IMISSME]

I don't really know why I keep asking the question. I know what to do and how to do it. My problem is the chronic depression. I just can't settle events in my life that took place while on paxil (divorce). It is tragic at this point in my life. I can't believe it happened the way it did. Funny thing though, no one else sees it the way I see it. Why is that? Will this negative, guilt ridden feeling go away?

[Luc]

It will be absolutely getting better. In case you didn't know this thread yet, it's really worth looking into; http://antidepressantwithdrawal.info...-Neuro-emotion. All those hellish emotions are *not* real you, and they will be improving. Also, even it's still is a very rough ride, the very realization that the way you feel is not your fault, and that it's simply physiologically-induced phenomenon helps to take an edge off of the suffering.

[IMISSME]

It will be absolutely getting better. In case you didn't know this thread yet, it's really worth looking into; http://antidepressantwithdrawal.info...-Neuro-emotion. All those hellish emotions are *not* real you, and they will be improving. Also, even it's still is a very rough ride, the very realization that the way you feel is not your fault, and that it's simply physiologically-induced phenomenon helps to take an edge off of the suffering.

Hey Luc, thanks. Yes, I did read this thread about neuro-emotions. I read it several months ago over at SA as well. I have some questions for you but at the moment my mind is elsewhere and I can't think of what I was going to ask you.

I also read this thread to my therapist and he agress completely about what is going on. But it is very hard to not react to these feelings. For me it is all about guilt, remorse and a sense of loss. I can't stop thinking how I might have handled things differently if I had not been on Paxil. I don't know which is the more "real me" the paxil me or the w/d me, LOL. I tend to think that although paxil may have blunted my emotions and I may have handled things in a less caring way I was not a raging lunatic. Aside from elevating my more obsessive nature and doing things to excess in some instances I think the person I am in withdrawal is definitely NOT me. It affects all my emotions and memories.

When I can figure out specifically how to phrase my question I will post.

Thanks...

[Sheila]

Luc presents the dilemma well. I don’t think it’s obvious what you should do. You’re still going through Paxil w/d and you’re having a strong reaction to every drop of the Remeron. It is reasonable to take a break from tapering. I know Rhi is noted for this method, and I think it’s a very wise option.

OTOH, if you do decide to continue tapering, it would probably be a good idea to try a 5% drop. We have people who need to do 2.5 % drops. The goal is to trigger as little destabilization as possible. I think that helps you heal faster ultimately.

May I ask what it means to you to discriminate between anxiety and akathisia? What’s important to you about drawing that distinction?

A divorce takes a *long* time to get over for most people. Being in the midst of w/d will, of course, make the real emotions more intense, perseverative, and somewhat distorted.

Does it work at all for you to think that the divorce and the Paxil use and the Paxil w/d all happened when they did and the way they did for a reason? And that reason is in the process of being revealed as you move through the healing?

[IMISSME]

Luc presents the dilemma well. I don’t think it’s obvious what you should do. You’re still going through Paxil w/d and you’re having a strong reaction to every drop of the Remeron. It is reasonable to take a break from tapering. I know Rhi is noted for this method, and I think it’s a very wise option.

OTOH, if you do decide to continue tapering, it would probably be a good idea to try a 5% drop. We have people who need to do 2.5 % drops. The goal is to trigger as little destabilization as possible. I think that helps you heal faster ultimately.

May I ask what it means to you to discriminate between anxiety and akathisia? What’s important to you about drawing that distinction?

A divorce takes a *long* time to get over for most people. Being in the midst of w/d will, of course, make the real emotions more intense, perseverative, and somewhat distorted.

Does it work at all for you to think that the divorce and the Paxil use and the Paxil w/d all happened when they did and the way they did for a reason? And that reason is in the process of being revealed as you move through the healing?

Sheila, Based on the things I've been reading that you have wrote I think I know where you are going with this. You certainly have a great way of seeing things. I think my girlfriend would be very interested in the way you try to look at things. Unfortunately I have fallen into the trap of questioning my entire existance while on paxil. I have chosen to believe that my behavior on paxil was more "me" then the "me" I am during withdrawal. It can be difficult. Yes, what you say makes sense and does help, thank you. I just hate how distorted everything seems. I cruzed through my divorce (or so it seems in retrospect) but am second quessing everything now. That was 6 years ago. You commented that a divorce takes a long time to process. Well for me it did not thanks to Paxil. I had a very dysfunctional marriage and by all accounts it was better for everyone including my kids that we split. They have never held this against me. But still, I just wonder if I would have done it if not for Paxil. It drives me nuts. Even my 20 year old daughter gets it. She told me today "dad, you deserve to be happy. you needed to think about yourself."

I was on 20mg Paxil from 1998 to 2010. I had two unsuccessful attempts to get off in the mid 2000s. I dropped to 10mg in the middle of 2010. I was emotionally "off" for the next year and had no idea what was going on other then the fact that my divorce started to haunt me in a very suttle way. Then two months after dropping the final 10mg all hell broke loose. I should probably start a journal to give all the details. I worry that my whole life on Paxil was not right. I had 4 kids and lived quite a life those 13 years.

Right now my head is not processing what I am thinking so I can't seem to find the right words so I will move on to the other issue, LOL.

Tapering Remeron. I would have never thought dumping the final 4mg could be so hard. What was the technique that Rhi had for tapering?

The distinction between anxiety and akathesia may not really matter for us but when I try to explain my condition to family members anxiety has a certain meaning for those who have experienced it. If I can come up with another term that they have never heard of and attempt to explain it there might be a bit more credibility if I just don't refer to it as anxiety. But I guess in the end we all know how hard this is to explain to folks. My brother said today if I felt this was going to go on for many years why wouldn't I just go back on something. He even said try Paxil again. They just don't understand this whole thing. I have tried other things like Celexa (only 2 days) and got stuck on Remeron. Most people just don't understand why a person wouldn't just go back on something. I know this is my only shot to get clear of all this. Paxil will just make it worse, much worse.

Anyway, thanks for you advice. It's a different perspective for sure. I will be getting my head together so I can express my issues a bit better to be interested to hear what you all advise. Coming up with other ways to see things is huge in trying to move forward, thanks for that.

[stan]

hi Imissme,

i divorced after 26 years with my exwife, being on paxil 12 years and tapering alone during one year, it was hell; many people divorce, lose their job; how much paxil played in my divorce(i was not the real me), i will never know it; with time, i do no more think often about, thinking to try to built a new life ;
the tapering of remeron will give you depression(they increase what they normally mask), but this depression is not a natural depression, it is a chemical and i think it will not last many months;
what do in your case? what you will do, you will suffer(after 12 years paxil), so for me better to taper slowly the remeron, and after, try to held whithout, and after time, you will improve as many
i think we cannot be free from 12 years paxil and remeron and be well; for my case, with all my knowledge and experience, if i had to decide again what do for me, i would only taper on 2 years and not one as i do, but know i would suffer, no miracle when poisoned during years; i could not speed my healing or not suffer

[Junior]

Stan, even for those of us doing a slow taper - it can still be very hard. I didnt have too many problems (aside from the on-going sleep issue, which has been around for nearly 4 years now) until I got below 20mg. Now, at 13mg, I'm finding it harder and harder. My latest 1mg drop, back in September, has been quite brutal compared to some of my earlier ones - a bit of akathisia, some anhedonia, early morning waking and not being able to get back to sleep, blah blah blah ..... Most recently I've noticed that I just cannot push my CNS too much or sleep becomes almost non-existant. If I take things slower, and stay away from places like noisy shopping centres, it is easier.

IMISSME - I wonder if you are actually processing your divorce now - at least partly - where you couldn't before. Seems a possibility to me. ALthough, your mind will ruminate now where it might not have before. Have you thought about keeping a journal - a private one - just on the feelings you have about it? It might be useful in terms of getting the thoughts out of your head and also helping you to see whether you are just ruminating, or whether there is a grief process going on. Just a thought.

[Sheila]

Hi I.M.M – Rhi had the great idea of taking holidays from tapering. Listening to your body and discerning when it might be a good idea to stop dropping further and just sit where you are. Some people can’t do this, but if you do have the option, it allows your body to adjust without further challenges, improves your quality of life, gives you a chance to rest, and might just help you heal faster.

Oh, I see now why you were interested in the term akathisia. It is, indeed, terribly hurtful and frustrating not to be able to get through to our families how serious our condition is and how getting back on a med is not an option.

As you know, you’re definitely having neuro-emotions about your divorce. It may not be possible right now to parse what was you and what was not you or how you might have done things differently. And it may not be possible to stop *trying* to do this all anyway. I had perseverative, obsessive fears in w/d (for years, getting better now). You’re having more of the perseverative, obsessive self-doubt, second-guessing, self-criticism. I had that too, come to think of it, it’s just that the fear overrode everything else.

Sometimes, I used the tack of looking at it as all meant to be and serving a purpose. But, a lot of the time I just had to practice self-compassion and self-reassurance to the best of my ability while I waited for the intensity to subside. You *will* be getting better and then you will have more internal freedom and space to do more things with your thoughts and feelings.