How can I wean off Paxil using Prozac?

Question

I'm trying to get off Paxil by cross tapering with Prozac to minimize withdrawal symptoms. Right now I'm on 10mg paxil. but I'm not sure how to proceed? My doctor said to take 20mg prozac along with 10 paxil for a month which I don't agree with. Thats because I think if prozac stays that long in my system I will also have trouble getting off of it. So my plan is:
 
Week 1) 10mg paxil 10mg prozac.
Week 2) 5mg paxil 20mg prozac. 
Week 3) 0mg paxil 20mg prozac. then stop. (I saw a similar plan online).  

What do you think? Please help! I have a sense my doc wants me to consume an ssri (Prozac) and stay on it for I dont know how long (he said I may need it which is bs) that's why I'm not trusting him.

Paxiled · Accepted Answer

There is disagreement about this, so you won't get a consensus answer.  The reason some psychiatrists use Prozac is this:  Paxil is really hard to stop taking, so the theory is that if you can get the person hooked on Prozac doing similar things to serotonin that Paxil was doing the withdrawal will be controlled.  Because Prozac stays in the body much longer than any other ssri (about a month compared to a matter of hours) there are far fewer complaints about withdrawal with Prozac than other ssris or snris.  Now, it could be the withdrawal just comes a lot later and is therefore not reported as much, but we don't know if that's true.  The contrary opinion is that you shouldn't cross taper with any other drug, but should taper off the Paxil (or any other drug) as  slowly as you need to until your brain is able to function normally again without artificially affecting serotonin.  If it takes a year, it takes a year.  And many will have an easy time of it anyway.  This theory posits that anything that artificially affects serotonin will just prolong the withdrawal rather than alleviate it as the brain is still not working normally.  However, there is a lot of research that also shows that after a long time on any antidepressant the brain may not be able to function normally again without one, which is why so many go back on antidepressants.  Most psychiatrist believe this is because anxiety and depression are cyclical and come back, but this research doesn't agree.  I believe nobody understands this stuff and that everyone has a different experience with it -- some do fine, some don't.  Now, my understanding is the way Prozac is used is that at the very end of your taper off Paxil, when you're down to taking drops, if you're still having problems you try a small amount of Prozac to see if it helps the transition.  I think you just have to decide for yourself what you think is best, since you're not going to get a consensus answer.  If it were me, I'd just taper off the Paxil as slowly as needed, and if it goes bad go back on the Paxil and do it even more slowly.  But you have to have a doctor who's willing to do this, and most aren't.  I wish my psychiatrist had done it this way, but he didn't.  As for when to know when to go off a medication, that would be when therapy has solved your problem-- if you still have the problem it's not time to go off the drug.  I'd get a book called The AntiDepressant Solution by Glenmullen, one of the few books to take withdrawal seriously and recommend both when it's time to go off your med and how to do it safely.

MeLarry2 · Answer

None of this makes sense... Is your goal stop all meds? 

If so, you need a short bridge with Prozac only. Paxil has a short 1/2 life so you will experience withdrawal if you stop abruptly. However, if you stop the paxil now and take 20 mg of Prozac for 3-5 days, you're at steady state then with an SSRI. Then you can just stop prozac because of it's long 1/2 life and it self-tapers. It's the only SSRI that self-tapers. So, no discontinuation syndrome. 

If you want to stop Paxil:
1) Stop it.
2) Take prozac 20mg 3-5 days
3) Stop prozac and it will naturally taper you off. 

No need for a 3 month protracted withdrawal plan.

Done.

Paxiled · Answer

I don't believe what you're saying is true.  For one, not everyone metabolizes drugs the same -- when I first took Prozac it was like drinking water because my body just didn't metabolize it.  That's one reason why some drugs work and some don't.  Second, Paxil is a whole lot stronger than Prozac in its affinity for serotonin, so Prozac isn't a substitute, plus it can throw a person back into an earlier state of withdrawal, which it did to me, by blocking the brain's attempts to work normally again.  Paxil is just very very hard to stop taking, and if it were that easy for everyone you wouldn't have dozens of websites just devoted to the problems of Paxil withdrawal.  Perhaps some people would have the experience you describe, but you state it as a guaranteed result, which there aren't any of in this biz.  As for Prozac self-tapering, that's a theory, but many complain of withdrawal of it when it does wear off, but it's just later, so it's possible we just don't know the extent of its withdrawal.  I do believe it's much easier to come off of, but I don't know for sure as you'd have to query people a month after quitting, and to my knowledge nobody has.  I guess what I'm saying is, what works for some doesn't work for others, but a good long slow taper off the Paxil is what's recommended from the materials I've read by those who specialize in withdrawal problems.  Again, it sure didn't work for me, it made it worse.

facethefear · Answer

hi i want to stop paxil and go onto fluoxetine but dont no if to do the straight swap like the doctor wants me to do or to cross taper i have no idea how to cross taper either

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