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Dr. Kaushik
Dr. Kaushik, Psychiatrist
Category: Mental Health
Satisfied Customers: 4000
Experience:  MD Psychiatry
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Im currently seeing a psychiatrist who switched me from Paxil

Resolved Question:

I'm currently seeing a psychiatrist who switched me from Paxil 40 to Celexa. His orders to taper off Paxil 40 were to- day 1: paxil 20, day 2: paxil 10, Day 3: paxil 5, Day 4: no more paxil. Day 4: start Celexa. 4 days later (today) I'm going through what appears to be day 3 severe paxil withdrawals to which my psychiatrist said that "the Paxil is completely out of your system so it has nothing to do with the Paxil. Discontinue Celexa, Paxil and Klonopin until we meet again in 3 days." (Klonopin .5 for anxiety twice a day). I'm suffering severe body shocks, insomnia (even though I'm taking Ambien he prescribed, and severe stomach issues. What should I do in the short term (ie: to get rid of these terrible electric body shocks) and long term (ie: find a new psychiatrist?) Any thoughts/comments would be greatly appreciated.
Submitted: 5 years ago.
Category: Mental Health
Expert:  Dr. Kaushik replied 5 years ago.
Hi there,

        Welcome to Just Answer !

        Well, it seems that definitely you are suffering from what we call as SSRI Discontinuation syndrome( Withdrawl syndrome) , as the characterstic Electric shock sensations of SSRI witthdrawl syndrome are being experienced by you. All these withdrawl symptoms have stemmed from the fact that , your psychiatrist did a fairly fast paced withdrawl of Paxil , which ideally should have been carried out over 1-2 weeks , due to this fast tapering of paxil , you are experiencing these symptoms , i believe you will have to bear these symptoms for 1 more week or so , before they subside on their own , i would have suggested you to start on a low dose of fluoxetine to help you cope up with your withdrawl symptoms , but right now i think against use of it ,as you are already on another SSRI anti derpresant celexa ( citalopram ) , and adding another ssri such as fluoxetine will make matters worse.

So, as of now for short term relief from electric shock symptoms , unfortunately you will have to endure it for 1 more wek and i am sure they will subside on their own ,but please do not commit the same mistake again by tapering celexa and klonopin over three days , as directed by your psychiatrist , as this will further add to the already existing withdrawl symptoms , the withdrawl of celexa should be carried out over a period of 1-2 weeks , for a safe withdrawl.

As for klonopin , reduce the night dose first by 0.125 mg every day ( take three fourth of a 0.5 mg klonopin tab 1 st night, while continuing on 0.5 mg dose in morning, then half tab of 0.5 mg that is 0.25 mg on 2nd night , and again continuing on 0.5 mg morning dose, then 0.125 ( half 0.25 mg tab) on 3rd night , and finally stopping the night klonopin dose on 4 th night , and from 5 th day taper the morning dose by .125 mg , similar to as done during night tapering , so in a week's time you will be safely off from klonopin.

Meanwhile carry out a slow withdrwal of celexa over 2 weeks or so.
You may continue on Ambien , that will be helpful for your insomnia .

In the long term , i would ask you to refer to a new psychiatrist as these withdrawl tactics are basic knowledge for a psychiatrist to know , and unfortunately your psychiatrist does not give too much importance to the withdrawl symptoms.

I am mentioning below a link which will throw more light on withdrawl syndrome of SSRI anti depressants.

http://en.wikipedia.org/wiki/SSRI_discontinuation_syndrome

I wish you best of health and safe withdrawl.

I hope my answer serves your query according to your satisfaction.

Please press the ACCEPT button if you are satisfied with the answer , as only then will i be credited for my service.

Regards...
Dr. Kaushik, Psychiatrist
Category: Mental Health
Satisfied Customers: 4000
Experience: MD Psychiatry
Dr. Kaushik and other Mental Health Specialists are ready to help you
Customer: replied 5 years ago.
Thank you for your answer.

One quick follow-up: Should I discontinue the Klonopin if there are no ill effects from it? It doesn't seem to provide much anxiety relief, but it also is not causing any troubles.

Thanks!
Expert:  Dr. Kaushik replied 5 years ago.
<p>Well, i told you about klonopin withdrawl ,as you only asked for it . However, if klonopin is not causing any ill effects you may continue it, Also, i have already told you how to taper it , so if later when ever you want to get off this drug use the above mentioned tappering process. </p><p> </p><p>As of now , you may continue with Klonopin if it is not causing trouble. No problem there..</p><p> </p><p>Wish you all the best !</p><p> </p><p>I hope my answer helps clearing your doubts.</p><p> </p><p>Please press the ACCEPT button if you are satisfied with the answer , as only then will i be credited for my service.</p><p> </p><p>Regards...</p>
Dr. Kaushik, Psychiatrist
Category: Mental Health
Satisfied Customers: 4000
Experience: MD Psychiatry
Dr. Kaushik and other Mental Health Specialists are ready to help you

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