Adventures with Benzodiazepines and SSRIs

[David Baxter PhD]

His approach, it seems so far, is to focus just on the future and give me what feels like life coaching, like 'join this club' etc... But I still have an extremely lot of feelings and emotions that haven't come out, and that are every day, but just to the front of my own mind and staying there. In the session, every time I tried to talk about these, he said not to think about the negative things and focus just on the positives, let the medication work and get more proactive than I was before. In an ideal world, this is how I would do things also, but especially in my case where the suppressed thoughts were that far back and some still are, I think it would be good to process all of these and for him to help me how to change the way I think - I can't even understand it and control it, so I'd like the help in therapy to do so. He'd even said to me at the end of the last session "So we'll meet next Thursday and you can update me on progress of making friends and finding connections" - That is not what I want to do every week.

Ah, I see. That's a little bit different from what I was suggesting in my previous post.

It does sound rather like telling a depressed person, "Go out in the sun and do stuff... you'll feel better". It's not that it isn't true. It's that when you're in a major depression, you're not able to follow that advice. It's missing the point.

 

[AmZ]

To play "devil's advocate," have you been working on that homework assignment?

Haha, thanks for slipping that one in there Daniel!
My homework (which I have personally been working on for hmm, about a year now) was given only last Thursday. Since then, I went to work on Thursday and spoke with many people lol - I have no problem with social interaction but part of the problem I know is that I am quite shy with 'new' people and my self-esteem could be improved on quite a bit. Friday and Saturday I felt at my worst, so can't say I was doing too much. And here we are, Sunday! In saying this, I have been making an effort more in the last few weeks, regardless of being in the midst of all of this going on. I started going to come classes, which I've only been to 3 times so far, but in 3 weeks time, the new semester starts again and it'll be twice a week. On the times I went before, I was speaking to the women and girls like everyone else, you know, bit of small talk here and there... Just takes time. Hopefully the classes will be good opportunity for me to meet some people.

Ah, I see. That's a little bit different from what I was suggesting in my previous post.

It does sound rather like telling a depressed person, "Go out in the sun and do stuff... you'll feel better". It's not that it isn't true. It's that when you're in a major depression, you're not able to follow that advice. It's missing the point.

PRECISELY!!! I think for once, I actually managed to get my point across clear enough amidst all of my rambling.
I still have so much pent up emotions and feelings and thoughts in my head, that when he gave me this life advice in the last session, it literally turned my stomach. Hence, why your example works in comparison to what I'm talking about.

Seriously, I have people telling me to eat a certain amount of grams of dark chocolate every day and it'll help me... Yesssss, OOOOOOKKKK, that would be a 'great' start if I could physically make myself eat right now! That's why that doesn't work for starters.

 

[David Baxter PhD]

Given that, perhaps you'd have better success wuth anither psychologist?

 

[AmZ]

Given that, perhaps you'd have better success wuth anither psychologist?

Well, I know that I have been a bit renowned in the past 4 weeks for having done things a bit compulsively, so I'm trying not to make the same 'mistakes' or 'moves'. I think maybe to try him once more, or maybe not. I am leaning more on the maybe not. But on the other hand, I must admit, it's exhausting to now go on to the 4th psychologist and even then, in not wanting to think negatively, but could happen, what if even then they aren't suited to what I think I need? It doesn't mean that I need to stick with this one of course, but just deciding what is best to do.

I have only gone privately so far. If I go through my health care provider, I first of all need to set up an extra monthly payment with them to get this 'extra' stuff. Then they will give me a list of 30 or so psychologists, literally names and numbers, and then I can call and ask what I want and 'choose one' - Sounds like a task and a half to me and I don't really know the 'right' questions to ask etc. First reason why I went privately is so that I could know that they were mother -tongue English and just Americans/English people that weren't born here but that have been here for a number of years, which suits me better also as they understand my situation better ... If I go through my health care, not all of them are going to have good enough English which is something very important of course and secondly, culturally, we're different. Just need to make those calls before I hear a nice American accent or something!

---------- Post added at 11:57 PM ---------- Previous post was at 08:44 PM ----------

Not quite understanding something here... I took the 20mg of Paxil yesterday at 7pm. Only at 5pm(ish) today did I start to feel totally weird off of it (asides from this morning feeling sick) - Only at 5pm or so this afternoon did my head start to buzz, eyes flickering can't concentrate and eyes wide open feeling like I was hardly blinking.

Now it's 12am and for the last couple of hours those symptoms are wearing off. In the last hour I feel nauseous (like, extremely) and have a painful stomach and am sweating... I haven't even taken more of this stuff! My body feels exhausted (not surprisingly) but when I close my eyes, it's like my body is sleeping but my mind is still wide awake.

Someone had better tell me that this is going to be worth it in the end, going through this! I need to take the 10mg in the morning and errrrrr, I can't say I am feeling it.

 

[David Baxter PhD]

Patience and a bit of trial and error may be required with this sort of medication in order to find the right drug and the right dose for you.

 

[AmZ]

Oh yes.

To be honest... I'm feeling seriously bad right now. Like my heart is skipping a beat or something now and again and feeling like I'm going to pass out.

I took an Alprazolam an hour ago so it's not anxiety.

 

[Daniel E.]

I took an Alprazolam an hour ago so it's not anxiety.

It could still be anxiety. Typical self-help recommendations for anxiety are relaxation techniques, exercise (which naturally includes deep breathing), taking a walk outside or other ways of changing the environment like going to a bookstore, etc.

OTOH, if your blood sugar is low, eating or drinking something with sugar/glucose could help. And, for all I know, you may also still be at risk of dehydration.

 

[Cat Dancer]

Definitely could still be anxiety. That is one of the symptoms I get. Anxiety can "break through" medications and that is why it is so important to find a good psychologist to help you learn other techniques of dealing with the anxiety besides taking the medications. Medications are good, but it's also good to learning better coping skills.

 

[AmZ]

It could still be anxiety. Typical self-help recommendations for anxiety are relaxation techniques, exercise (which naturally includes deep breathing), taking a walk outside or other ways of changing the environment like going to a bookstore, etc.

Definitely could still be anxiety.

I don't think it was - I was sweating, my head hurting, etc, and had basically the same symptoms which I had when I was taking the 10mg for the first 4 days, but just a lot worse.

OTOH, if your blood sugar is low, eating or drinking something with sugar/glucose could help. And, for all I know, you may also still be at risk of dehydration.

I got an appetite about 8pm last night so had some food. So that should be OK on that side of things.

Managed to sleep 5 hours or so which is good but have woke up feeling very shaky and nauseous still and my head spinning - Something similar to having a hangover.

I guess that I've still gotta take the medication this morning and ride it out hey? Just hope the nauseous thing won't case a problem when I go to take it and have to drink that chocolate milk I have because otherwise the medication may not end up staying too long in my system.

 

[David Baxter PhD]

Taking the medication will very likely relieve some of those symptoms.

 

[Cat Dancer]

I don't think it was - I was sweating, my head hurting, etc, and had basically the same symptoms which I had when I was taking the 10mg for the first 4 days, but just a lot worse.

Oh, ok. You didn't mention those symptoms in the first post. I hope you feel better soon.

 

[AmZ]

Yea, it was definitely because of the 20mg of Paxil. The same this morning also. Felt like I had a hangover or something with my head swooshing around every time I'd open my eyes or move my head.
Slept for about 5 hours last night which was good and even though I woke up feeling very bad, after an hour or so I managed to drink some milk with the 10mg of Paxil and went back to sleep for a few hours also. Once I woke up, the 'hangover' type feeling had gone.
Just feeling a bit weird, have a bad headache and still feeling very hot and sweaty even sitting in front of a fan. Few other mild things, but nothing that's unbearable.

If I can just make it through some bad days on the 10mg and then the side effects can go, it'll be OK.

If today is the 6th day, how much longer can I expect for the side effects to carry on for roughly?

 

[David Baxter PhD]

As I said previously, if you see no signs of diminshing side effects within a week to 10 days, get back to the psychiatrist and ask him to put you on something else.

 

[AmZ]

Thanks for clarifying.
I didn't remember us saying this about the side effects of the 10mg.

 

[Retired]

AmZ,

I don't think I mentioned that although Paxil 20mg is considered the usual therapeutic dose, some people are unable to tolerate the adverse effects of 20 mg yet find relief of symptoms using 10mg. This was my experience, and I have spoken to others who had a similar experience.

Discuss this with your doctor and see if the doctor would concur to let you try the 10 mg dose for a while to see if indeed you found symptom relief. If not, there is always time to try a different dose, or even another compound.

Some SSRI's appear to increase side effects as the dose is increased, while other SSRI/SNRI compounds allow the doctor to increase dose but do not seem to cause further side effects. Your doctor's clinical experience should be a reliable guide in this regard.

 

[AmZ]

Thanks Steve.

Yes, my psychiatrist has said to just go back to 10mg for now and see how I go with it. As Dr Baxter had mentioned, I should give it 7-10 days even on the 10mg to see if the side effects go and if not, I'll make sure to go back to switch to something else or find another solution. Even on the 10mg for 6 days now I still feel very nauseous, bad headache especially in my temples and keep sweating on and off. I don't know if it's 'normal' but even today, sometimes I feel like my body gets paralyzed, I can't move and I find myself staring at something with blurry vision and it can take me a few minutes to snap out of it. Very weird feeling. Is that something within the bounds of a reasonable side effect without worrying about it?
Anyway, I'm going with it and will take 10mg for the rest of the week and see how I feel then and go from there.

The 20mg was something out of this world - Like I was on speed (or as I imagine) or something! I remember as a teenager my friend had taken a 'happy pill' of sorts and I remember seeing these crazy eyes of his when he was on it. Really horrible! That's what I was like. Hardly blinking and my eyes were so wide open, head buzzing and couldn't focus on anything.

Anyway, thanks for the info Muchos appreciated.

---------- Post added July 20th, 2010 at 02:33 PM ---------- Previous post was July 19th, 2010 at 07:17 PM ----------

Not sure what to do with myself. I've had quite a bit of patience here and things don't seem to be getting any better, and only worse.

I've now been on the Paxil for 7 days.

Have been sleeping better the last 2 nights since taking the Paxil in the morning instead of at night, so that is good.

Last 2 days my appetite has totally gone (no doubt, that's why I feel bad also) - Literally all I have had is half a glass of milk in the morning with the medication (which has been difficult to do as it is) and drinking water all the time, that's it. My stomach just feels constantly 'full' and I have no appetite. Before, I was getting an appetite early afternoon and could eat OK then, but now, nothing.

Asides from that, I just feel very strange and it's not a nice feeling. Still have the sweating on and off, nauseous, buzzing inside and the headache won't go. In the last couple of days something else also - It's a bit difficult to explain but I feel at times like my body is 'shutting down' or something and I find myself laying on the sofa with my body feeling numb and can't move (heartbeat and breathing really slows down, almost feels like they've stopped), whilst my head is buzzing. Sometimes it starts to feel so intense, it's like I'm going to have a seizure or something. (Sorry if that sounds like I'm being a 'drama queen' or something, but that is really how it feels). It also feels like someone has filled my head like a balloon or something - A lot of pressure in my head.

The not eating thing is probably the worst thing right now and not sure what I can do about that - I wonder if that's why the side effects are worse also, with the feeling of my body shutting down etc... Of course, coming in very close second position, is the other side effects of the medication.

It was only Sunday that I spoke with the psychologist who said to go down to 10mg. I know that he expects me to give it more time than this but since then what with the not eating and weird comatose feeling, it's been worse.

---------- Post added at 03:04 PM ---------- Previous post was at 02:33 PM ----------

Just spoke with the psychiatrist.

He said that if I feel that bad from not being able to eat then to take myself to the emergency room and they'll have to give me an IV for my sugar levels. That's obviously a very short term solution and isn't going to bring my appetite back.
He told me to eat - Oh, if I had the energy to laugh now, I would. But I physically can't make myself eat.

Asides from that, he said that I just need to keep taking the medication until the side effects go.

No solution, no answers....

 

[David Baxter PhD]

My concern is that some of your described symptoms (e.g., "buzzing") sound very much like the symptoms some people describe as discontinuation effects with Paxil. Now Paxil has a relatively short half-life and in the past I have seen clients go up and down with it even over the course of a day, so that within a day they are experiencing discontinuation-like effects. Perhaps these are rapid metabolizers but certainly the effects are not pleasant.


You have two options:

1. In view of the last post about your conversation with the psychiatrist, you can try to give it another day or so now.
2. Or you can get back to the psychiatrist and say I really cannot tolerate this drug. I need you to prescribe something else for me (Effexor, Celexa, Cipralex/Lexapro, etc.).

Note: Thread title changed to better reflect the content.

 

[AmZ]

Note: Thread title changed to better reflect the content.

Ah, sounds nice when it's worded like 'adventures' lol. It certainly and is being quite an adventure.

My concern is that some of your described symptoms (e.g., "buzzing") sound very much like the symptoms some people describe as discontinuation effects with Paxil. Now Paxil has a relatively short half-life and in the past I have seen clients go up and down with it even over the course of a day, so that within a day they are experiencing discontinuation-like effects. Perhaps these are rapid metabolizers but certainly the effects are not pleasant.

This seems exactly what is happening. For sure. Especially today I can see this. Took it this morning at 8am or so, now it's 5pm, I'm starting to feel that horrible buzzing hangover feeling again and feeling very sleepy. This was what happened on the 20mg but a lot worse. A literal hangover/'come-down' feeling, and like you had mentioned a few posts ago, that once I take the next dose, this feeling should go... and it did. When I was on the 20mg, that was like a ridiculous 48 hours of up and down! With the 10mg, I can see that the same pattern happens but just within the 24 hours before taking the next dose. Really quite unpleasant.

EDIT:
The 'up' part of the day, I just have a very bad headache, feel nauseous and out of it.
The 'down' or 'discontinuation' effects I was trying to describe. It's not all a 'down' as such and that why this part of the day feels so bad also in other ways! On one hand, my head is buzzing, headache has gone off quite a bit and eyes wide open/weird non-blinking and on the other am feeling physically/mentally tired. Like a horrible mix going on there!

Is it just a case of it needing to get more in my system and stay there so that this doesn't happen? No other solution?

I may need to give it more time because I (supposedly) need to go to work tomorrow and Thursday. Thursday morning I have the psychologist in the morning and then need to get to work and Friday, the psychiatrist doesn't work. So I need to wait until Sunday before anything can be changed, if it needs to be in the end. Not much I can do about that unfortunately.

I just managed to eat some rice which is good. Hopefully I can get a control of this because even though I feel like my stomach is full and that I can't eat, I actually can (at least if it is at the time of the day where I am not feeling nauseous!). Looks like with this up and down of the day, the down part is when I can eat.

---------- Post added at 05:42 PM ---------- Previous post was at 05:19 PM ----------

Now my evening sweating starts and the sea sickness type feeling in my head. :bonk:

---------- Post added at 09:11 PM ---------- Previous post was at 05:42 PM ----------

Really can't put up with this for longer. I'm going to demand to see the psychiatrist in the morning and switch or do something because it's not bearable. I can't see how someone is meant to give it more time after having already 7 days of what is classed as 'serious side effects' on this medication:

Paxil side effects:

Sweating, fast or uneven heartbeats, tremors, nausea, vomiting, loss of appetite, headache, trouble concentrating, weakness, shallow breathing or breathing that stops.

Please be 100% honest with me, if you think that I am being unreasonable in calling in the morning to demand that he change the medication from tomorrow then please tell me.

 

[David Baxter PhD]

Really can't put up with this for longer. I'm going to demand to see the psychiatrist in the morning and switch or do something because it's not bearable.

Frankly, if it were me, that's what I would be doing.

 

[AmZ]

Thanks...

This is just very difficult you know. Trying to balance between listening to what the Dr says and between how I feel. I think I've tried to brave it out enough already. But that's really it now. I can't do it for any longer. I've been at home for 3 days now just laying here and trying to ride out the side effects and can't carry on like this.