# Feeling helpless! Can someone help



## Maryc1989 (Apr 8, 2014)

So I was on zoloft for 5 years 50mg. I suffered 3 traumatic events this year and believe it caused zoloft to poop out on me . They have now put me on paxil. 20mg. The pdoc told me to break zoloft in half for 3 days then go to paxil. Today is day 12 on 20mg of paxil and I'm feeling pretty crappy. I am dizzy, spaced out, my head is full of pressure, I feel lost and disoriented, I don't know the difference between day or night everything runs together . I woke up this morning unable to think at all. I don't even know how I got my kids to school and time is going soooo slow. Although something I did this morning feels like I did it a week ago. I'm also having some paranoia. Can someone tell me this is normal and will go away. I don't know if this is zoloft withdrawl the start up of paxil or DP. I feel so helpless.


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## odisa (Sep 2, 2013)

Zoloft.. Sertraline right? I believe the effects you are experiencing may be due to both transition between agents, as well as Paroxetine having anti-cholinergic effects that Sertraline lacks, which certainly fits the disorientation, paranoia, dissociation, vertigo, and especially cognitive issues (though that could be me without meds, haha). Sounds like a moderate case of anticholinergic syndrome. Not to be feared; it should progressively improve and ultimately cease shortly after discontinuing the causative agent. Might be that it improves over time without cessation, but generally you don't want to be on an anticholinergic antidepressant anyway, as there are those without that effect which are preferable.

*Talk to your doctor before changing, adding, or quitting any medication!* Remember, nobody can diagnose you via internet; the best that can be done is a guesstimate.

Best of luck!


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## Maryc1989 (Apr 8, 2014)

So are you saying it will go away once quitting the paxil? I'm a bit confused. Or will it get better in time after taking the paxil?


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## odisa (Sep 2, 2013)

I'm saying both could be the case, though the former with more certainty than the latter. Then again, it's been over 2 weeks. Have you been seeing a reduction in those symptoms yet? Either way, it would be good to discuss it with your doctor. As I mentioned; there are other SSRIs devoid of anticholinergic effects. These would be preferable, and unless there's a good reason you are on Paroxetine in specific, I don't see why not to switch to such an alternative. If then the symptoms still persist after adjusting to the new medication, then you might want to consider other causes. How long was the Sertraline "pooped out" before you switched to Paroxetine? Did you experience any of these symptoms coming off of Sertraline, or before?


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## Maryc1989 (Apr 8, 2014)

So is this normal to be waking up in the morning not being able to think? I honestly couldn't remember where a place was that i would have known on a regular basis. I feel like things are not clear at all!


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## odisa (Sep 2, 2013)

You didn't answer my questions..

Yours a rather ambiguous question. It is normal for me, but that's endogenous unfortunately. Yours seems like an induced case.
Again; go see your doctor. These effects are clearly interrupting your life too significantly.

If you mean if it's a normal reaction to the medication: some people are more susceptible to such effects than others. It's not inconceivable that it would happen, and I think anyone with DP would be more prone to acquiring anticholinergic syndrome, though the latter is mainly conjecture.

Your doctor might advise you to either wait it out another week or two, switch you to a superior substance, or advise you to quit. Or, if you're unlucky, he'll suggest taking another medication to counter the effects.
You might want to bring up the anticholinergic aspect, as he may be unaware of this mechanism of action Paroxetine has.

Meanwhile, eat more eggs, see if that helps.


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## Maryc1989 (Apr 8, 2014)

Ok so, I was on setraline for 5 years before this poop out. I haven't seen a reduction in symptoms since starting the paxil 17 days ago. And I went right from setraline to paxil with a tiny 3 day wean period. So basically cold turkey to me. I don't get what your saying about the paxil? I'm pretty sure I'm having severe withdrawl from the zoloft because of how awful i feel. However the DD had increased a lot starting the paxil. What will eggs do? I do not have a very good psychiatrist he sees me for 15 minutes writes me a new script and sends me on my way. I believe medicine hoping creates worse things how can you adjust to anything if your switching every 8 days and that's all he wants me to do. I see a therapist on Tuesdays but she doesn't have much knowledge of DP. I also believe maybe I've started having partial seizures due to the zoloft withdrawl I feel like I'm paralyzed sometimes and can't move. I do see a neurologist on June 6


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## Maryc1989 (Apr 8, 2014)

I have had an MRI and 2 catscans . They haven't found anything.


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## odisa (Sep 2, 2013)

... Still didn't answer my last 2 questions, but ok.

What I'm saying about Paroxetine is that aside from its SSRI effects, it is also an anti-cholinergic: a function known to induce all the symptoms you listed. Sertraline is not, hence my inclination to believe that it is due to this that you are presenting with these symptoms. Withdrawal seems unlikely, considering both Sertraline and Paroxetine are SSRIs, hence any withdrawal would've most likely occurred (or at least started presenting themselves) within the 3 days when you tapered off the Sertraline (seeing as Paroxetine acts in a similar manner to Sertraline, except for the addition of anticholinergic effects, being more specific, and some minor relatively negligible details, it would essentially replace Sertraline), and I infer from your writing that symptoms only started once you started Paroxetine.

Eggs contain choline; a precursor to acetylcholine, thus may help marginally in mitigating anticholinergic effects. Note that if it doesn't help, it is not a final answer, seeing as precursor loading is arguably the most ineffective way to increase neurotransmitters in the brain.

I understand that "med hopping" is not preferable, as indeed generally you want to take antidepressants for at least 6 weeks to determine efficacy before ceasing them. However, in this case there seems to be ample reason to do so. Why not simply try Citalopram instead? I believe it has either no, or negligible anticholinergic effects (at least less than Paroxetine). That would be my choice, had I cared for SSRIs. Though I'm sure there are other agents devoid of anticholinergic effects as well; seek and you shall find.


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## Maryc1989 (Apr 8, 2014)

Ok i do get what your saying thank you for your reply. I did have a brief and I mean very brief flash of normalness this morning about. 15 seconds. I am on day 18 of paxil so if I continue will it go away? I mean my brain would adjust to it eventually right?


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## Maryc1989 (Apr 8, 2014)

Ok one more thing to add...today I feel euphoric! Ontop of the world my speech is going really fast I can't sit still but I also feel still disoriented and weird. I'm on like overload...


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## Maryc1989 (Apr 8, 2014)

I feel 100x worse since starting the paxil. So I've decided no more paxil for me!!


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## odisa (Sep 2, 2013)

Considering the occurrence of significant adverse effects, I really see no reason to continue the medication. It's simply not worth it.
What did your doctor say about your cessation of Paroxetine? Perhaps it's a good idea to wait 2 weeks before trying anything else.


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## Maryc1989 (Apr 8, 2014)

Can I add to you that paxil has made me manic!!!! It has not done anything else except made me manic and give me horrible side effects. I have wanted to cheat on my husband and do weird things. I still feel confused dizzy and disoriented majorly. I can't drive I feel like it has increased my DP x100. I am going off of all meds for a month at least! Anti-chlonergiic drugs can also make you feel paralyzed


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## Maryc1989 (Apr 8, 2014)

The doctor told me to stay on it. I'm not taking his word


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