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What Causes Buzzing Sensation In The Head After Paxil Withdrawal?
I am a psychiatrist. Tomorrow I am scheduled to see (in consultation and for the first time) a 62-year-old woman who, after taking 5 mg of Paxil for over 15 years, suddenly stopped taking it. It is 6 months later and she is experiencing terrible, terrible ( debilitating ) withdrawal symptoms, including the buzzing in the head and tremors. What would you suggest that I recommend for her? Is there any thought that I should put her back on the 5 mg of Paxil and then slowly, slowly, slowly (i.e., 3 days on, 1 day off for 4 weeks; 2 days on, 1 day off for 4 weeks; 1 day on, 1 day off for 4 weeks, 1 day on, 2 days off for 4 weeks, etc.) taper her off or is there something else you would recommend for this desperate, desperate woman? Many, many thanks!! From a desperate psychiatrist, Martha Stark, MD
Tue, 25 Feb 2020
Hello,
6 months after stopping. The drug has been entirely out of her system for most of that time even if it had the longest half-life of 10 days. Mostly it is 7 days.
With less than full duration of treatment, the half-life drops much further like after one dose.
So, desperate woman, odd symptoms; mostly it is somatization. The drug reaches it's steady-state at 2 to 4 weeks.
Her effective dose unless some other medicines were present or her size fell by > 20% or she got a new liver, her effective dose went down over 15 years.
First, she might have a recurrence of the reasons she was put on Paxil. She might have a return or new panic/somatization. There is no downside to paxil.
SO, effective dose equivalent to 5 mg might now be 2.5 but is under 5. it reaches a steady-state in 20 days approx. adjustments should be made at about that interval and one might not want to take her off of it.
Hope I have answered your query. Let me know if I can assist you further.
Take care
Regards,
Dr Matt Wachsman, Addiction Medicine Specialist
6 months after stopping. The drug has been entirely out of her system for most of that time even if it had the longest half-life of 10 days. Mostly it is 7 days.
With less than full duration of treatment, the half-life drops much further like after one dose.
So, desperate woman, odd symptoms; mostly it is somatization. The drug reaches it's steady-state at 2 to 4 weeks.
Her effective dose unless some other medicines were present or her size fell by > 20% or she got a new liver, her effective dose went down over 15 years.
First, she might have a recurrence of the reasons she was put on Paxil. She might have a return or new panic/somatization. There is no downside to paxil.
SO, effective dose equivalent to 5 mg might now be 2.5 but is under 5. it reaches a steady-state in 20 days approx. adjustments should be made at about that interval and one might not want to take her off of it.
Hope I have answered your query. Let me know if I can assist you further.
Take care
Regards,
Dr Matt Wachsman, Addiction Medicine Specialist
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