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Up and down on my SSRI


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Hey all. It's been a while since I have visited the site. Been very busy with school.

Here's the latest.

I was on 20 mg of Paxil for a very long time. I didn't feel great on this regimen (always flat/tired, rarely laughing) , but I was also able to cope better with my symptoms. Over the past 6 months or so, I've tried to ween off of it (with my psychiatrist's blessing), first dropping to 15 mg for a few months, then down to 10 mg.

The program that I'm in is very stressful. I've noticed lately that I've become more introverted, more focused on my visual symptoms, and especially more "foggy" and "depersonalized/derealized". I have difficulty concentrating or retaining/applying new information. I spoke with my doc who suggested I increase my Paxil back to 15 mg. He is convinced the recent decrease in concentration is just a manifestation of anxiety.

I'm not sure if this is the right med, but I've been on it for so long that I don't know any different.

I saw Dr. A who recommended I start Klonopin .25 mg BID, but I'm worried about starting a benzo long term.

Oh yeah, I partook the Sinemet trial, with no effect. Any suggestions?

I'm very depressed with the whole situation. It's been going on for 12 years now. There has to be some relief while still preserving some sort of personality or ability to contribute emotion to this world.

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Klonopin or ativan 0.25 mg is good and virtually homeopathic. Paxil has some funky side effects i think but i have not personally been on that drug. I have been on Celexa and Lexapro in terms of SSRI's. Let's face it Lexapro is the better looking cousin of the two and i have run into several people who had to discontinue Paxil because they wanted to kill someone or themselves or some other weird feeling. HPPD has a way of sucking your soul out of you and leaving you devoid of emotion. I think it is unhealthy because somewhere the emotion still exists but you are out of touch, you are smoothed out to the point that the emotions are absolutely flat, and you cannot conjure up any sort of passion for anything. And you are left with this low-level hum of depression. And for me, my self-esteem, healthy cognition, creativity, abstract thought, and libido seem to be all connected. If one of those are off, my structure collapses like a Jenga tower.

Small amount of benzo's are good. Even though i have found that there is a big difference between HPPD anxiety, anxiety disorders, and, let's say, the anxiety that you get when you have to speak publicly. The latter is almost an adrenaline rush where you may find grace under pressure. With HPPD anxiety it seems that there is little meaning to it and the end result is so flat that there is little enjoying in either complete failure or absolute grace.

Paxil may not be your bag and there are drugs out there that may be a better fit for you. Check out other SSRI's etc.

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Thanks. I plan to continue with the increased dose of Paxil for a month or so, see if there's any improvement, and if not, totally revamp my pharmacological regimen.

The biggest problem is that I've been on Paxil in some form for ~10 years now. I've tried to get off it with no success. I haven't tried bridging my ween with a different SSRI. That may be necessary to cope with the w/d effects associated with Paxil. I am not suicidal per se, but I just don't want to participate in anything. I feel worthless/damaged.

Have you noticed whether the 0.25 mg of Klonopin causes a notable sedation? I need to be as alert as possible for my work. One of my biggest issues is this fuzziness that I cannot shake. I try to avoid alcohol, get 8 hours of sleep, exercise regularly, but no matter what I try, I remain in a fog.

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I feel worthless and damaged too. But imagine how you feel if you were medically untreated. Like i said, i have been on Celexa/Lexapro for over 10 years. If Paxil has made you feel complete/normal/happy in the past, it may be the right drug for you. I don't know when you first got HPPD but eventually these worthless feelings should slowly subside. Fuzziness is a main symptom of HPPD. Klonopin will cause sedation and subsequently fuzziness. 0.25mg is a small amount but while i have done the exact opposite, my neuropsychiatrist says never to drive using any amount of the drug.

If i had the miracle drug i would give it to you, but we don't have it yet and right now you are still recovering from a brain injury.

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  • 2 weeks later...

I wonder if it really is a brain injury with symptoms that will eventually subside. I have had HPPD for 12-13 years now, since I was 17.

I would love to know if being on an SSRI for that long permanently rewires a person's chemistry.

I was initially treated with Klonopin and remember it working...almost to the point where I thought I was cured. May be time to revisit those days.

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I don't know on what level you want to classify HPPD a brain injury or not. But the doctors view it as a brain injury or something similar to a brain injury or at least something with some similar symptoms. I'm guessing you are about 30, as i am too. I have had HPPD or persistant flashbacks 3x in my life starting at about 17.

Antidepressants are often only used for a short amount of time (like a year or two). Some people with worse conditions need to be on them for longer. I think SSRI's can rewire things in that your body/brain gets used to having the presynaptic reuptake receptor/"duct" blocked and it compensates to those changes. But i think that the effects are usually temporary and once you are off the SSRI's your brain should got back to "normal" in a few months or sooner.

You also have to consider if you had some sort of predisposition to ADD or depression or anxiety. These disorders can be latent until you start playing around with hallucinogens, dissociates, etc. Klonopin/Ativan/Valium can all clear up your mind if you have anxiety. But they can also make you really foggy and it can act as a sedative and a sleep aid. When i had very bad HPPD, no drug was helping me at all, not a ssri, not a benzo, not add med, not a nsaid: nothing.

It seems that you have discontinued illegal drug use so that is good. But the HPPD is sticking with you it seems. For some people HPPD will never go away. But HPPD is supposedly rare and HPPD that never goes away seems to me to be very, very, very rare. So the odds are definitely on your side.

Check to see if you are sleeping correctly, and stay hydrated. Since it has been so long for you to have HPPD with any subsequent illegal drug use, and because you are at school and need to be able to concentrate, maybe you should check out the drug Wellbutrin. This was the only drug that got me out of my 2nd episode of persistant flashbacks. It is not an ssri. They use it for ADD sometimes; it's an antidepressant and i think it is used when other ADs are not working. It is related to the Khat plant which i just learned, that seemed a bit weird but nevertheless it has done wonders for me. Look it up.

*****Oh by the way make sure it's the extended-release Wellbutrin; the regular stuff is shit.******

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Thanks again for your input.

I'm actually finishing up a medical program right now and know all about Wellbutrin (and many of the other meds people on here refer to). I tried Wellbutrin for a brief period of time about 5 years into my HPPD. I can't remember if it was effective...

I try to avoid experimenting with too many medications. If I can be on one medication for the rest of my life that will keep me from overanalyzing everything, sign me up. I spend hours every day internalizing... "What should I be thinking right now? Does that look normal? Do people notice me acting weird? My head feels weird."

My HPPD symptoms, as of now, are mostly comprised of a steady DP/DR and distracting floaters. Sometimes I'm annoyed by negative afterimages. But mainly, everything has that "glazed-over", two-dimensional look to it, that makes life seem like I'm viewing it from deep behind my eyes.

I have spent many years coping with alcohol, but I'm doing my best to abstain. This is causing a noticeable elevation of my symptoms.

I have a hunch that depression and anxiety run in my family. It may have popped its head out sooner or later, even without the HPPD.

Do you still have symptoms? How is life going for you?

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You sound self-conscious and slightly paranoid. I am guessing since you are in a medical program that you are not getting the right sleep, also. The question is: are you internalizing unexpressed emotions or are you just in-your-head, introspective? i am 31 and I have had 2 beers in about 5 years. Drinking alcohol can be fairly benign thing with HPPD and i'd doesn't seem to effect the symptoms too much when in moderation. When I got persistant hallucinations the 2nd time, i was essentially psychotic and had terrible dissociation. I had no choice but to discontinue all illegal drug use. If you are still able to drink alcohol, you really don't have a bad case of persistant flashbacks. You have it bad when, can't eat a piece of candy or smoke a cigarette without a full-fledged panic attack, and at all times you almost "climbing up the walls" with fear.

You are on an SSRI so i assume you understand the actions that take place at the synaptic level with those drugs. What are your options? Stick with what you got, add something, or try something else.

I have mild dissociation and some visual disturbances. I have some depression, anxiety and attention deficit. My cognitive functions are coming back. Life is ok.

What do you have that is going to cause HPPD? hallucinogens, dissociates, amphetamines, deliriants, 2cX, DOX, and overdoses of other psychotropic drugs.

Aside from death and becoming a vegetable, i think the worst thing, post-bad trip, is that you become absolutely schizophrenic.

If the visual disturbances, anxiety, depression, and dissociation are all mild than it doesn't compare to what could have REALLY happened given a turn of bad luck. You should be happy to have gotten as far as you have. And remember that all you know is what YOU perceive and what YOU sense; and this is the only reality you know. Can there really be another? .........Try breathing into a paper bag.

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