Getting off Paxil, paroxetine, SSRI with L-Tryptophan
 

I have been working at transitioning off 60 mgs daily of Paxil. I told my new doctor first so it is in my medical record if I have any problems. We could not find any information about dosages so we decided to wing it. The original plan was to reduce to 45 mgs of Paxil and add one capsule of L-Tryptophan. The minimum capsule size is 500 mgs so I cut the Paxil to just 30 mgs thinking 500 mgs was a lot of L-Tryptophan.

I realized by the 2nd day that 500 mgs was not enough so I doubled to 1000 mgs with my 30 mgs of Paxil. I realized I needed more in the morning so I added 500 mgs of L-Tryptophan at bed time with my gabapentin. I have been doing great with this dose for the past week.

In a week or two, I will cut back to 15 mgs of Paxil and add some more L-Tryptophan. Hopefully, I will be off the Paxil completely in a month or 2.

My goal has been to get away from the Paxil side-effects. The sweating, nausea, and sexual dysfunctions have been unpleasant.

I think adding L-Tryptophan to a daily regimen may work good for many who are struggling with anxiety. It also helps with sleep.

L-Tryptophan metabolizes to 5-HTP which metabolizes to Melatonin and Serotonin. Although 5-HTP is cheaper than L-Tryptophan, 5-HTP is risky to take as one can overdose on it. It is more difficult to overdose on L-Tryptophan.

A starting dose of 500 mgs twice a day would be worth trying. Doubling that should not be a problem. Do not take L-Tryptophan without medical advice if you are taking an anti-depressant, especially an SSRI or SNRI . Effexor and Cymbalta, and norepinephrine are SNRI's. Paxil, Zoloft, Celexa, Lexapro and Prozac are SSRI's. Elavil (amitriptyline), a tri-cyclic anti-depressant, nortriptyline, a tetra-cyclic anti-depressant and MAOI's should not be combined with L-Tryptophan.

Natural remedies like St John's Wort and other natural substances that increase serotonin should also not be taken with L-Tryptophan or any anti0depressant.

I heard that 1/4 Cup pumpkin seeds or edamame had the same effect as tryptophan without the side effects. The other one was oolong tea (two cups a day) or kimchi or kefir to replace gabba. Haven't tried them myself but for those that want to try something natural it might be worth a shot.

Sorry if there's spelling errors. 4:30 with no sleep so who knows what I'm typing!

CC

The proper dose of L-Tryptophan should not have any side-effects. If side effects develop, one should reduce the dose until the side effects resolve. L-Tryptophan is a natural substance that is present in many animal and plant proteins.

The natural substances you mention would be very difficult to use daily and on a long term basis. Those who need a short term benefit might find them useful.

Definitely keep us posted with how you are doing Mark. I have been hearing a lot about the dreaded "Paxil Withdrawal". I am interested in more natural substances rather than drugs and if they work. And also, good luck. :)

Good luck with this, I only want to stay on medication short term until the PCS goes away. I think the longer you stay on them the more intense the side effects.

I also would like to one day get off all medication as well and appreciate this information.

Thanks, Mark. Keep us posted as to your progress with this experiment. Good luck.

Best to you Mark. I was on Paxil a few years ago (a lower dose, 30mg if I recall) and like you was unhappy with the side effects.

Was this for depression or other mood disorder? As I have mentioned in other posts I have found mindfulness meditation helpful. If your physical symptoms allow, consider light yoga, I find this very helpful also.

I have been on Paxil to help control looping thoughts, otherwise called perseveration. My mind will get stuck looping on mundane thoughts like lyrics to a song, the spelling of a word, a license plate number, etc. This can go on for hours and is exhausting.

I am dosing just enough to prevent this looping from returning. As I said, right now I take a 30 mg Paxil and 2-500 mgs L-Tryptophan capsules in the am and a 500 mg of L-Tryptophan at night before bed. When I started, I took 30 mgs Paxil and 500 mgs of L-Tryptophan in the am and the looping returned mildly. I increased to 2-500 mgs of L-Tryptophan and the looping stopped.

I am going to try flipping the dose to 2-500 mgs of L-Tryptophan at night and 1-500 mg L-Tryptophan in the am with my 30 mgs of Paxil. It may help with insomnia this way.

L-Tryptophan has a 12 hour half-life so dosing twice a day is suggested.

So far, I don't have any unusual Paxil withdrawal symptoms. I went off Paxil cold turkey last fall for 9 days by mistake and did not suffer any bad effects. My wife says I was a space cadet, though.

btw, I package up 60 days of my meds and vitamins regimen in zip lock bags so I don't need to open 14 bottles every morning. I did not notice that I had started into some bags that still needed Paxil. I was 9 days along before I noticed this error.

I have had a low grade head ache since mid day yesterday. I don't know if this is Paxil withdrawal or just my normal PCS head aches. I've been head ache free for 3 weeks.

Understanding PCS is more an art than a science.

How is it going?
 

Hi Mark,
Just wondering how your doing? I had major problems with Paxil. I had a bad reaction to it and never was able to take it. I have the looping thought thing sometimes. I did not know there was a name for it.
Hope you are coming off of it easy and not having any effects that are too bad so far. Be careful. Managing PCS is an art. Very intricate.
Brain

I switched to taking 2 - 500 mgs of L-Tryptophan at bed time and only 1- 500 mg in the morning with my 30 mgs of Paxil. I slept much better last night. Woke up feeling rested.

I'll stay with this for another week or so before reducing the paxil some more.

L-Tryptophan is very fast acting. I can feel a difference within a hour.

It is a good anti-anxiety supplement if you are not taking anything else for anxiety.

Glad to hear you are doing well. Looks like your plan is working. No complaints from the wife? Where would one get L-Triptophan for anxiety? Is this a vitamin? Would it have any bad reactions with pain meds or seizure, sleep meds? Is it hard on the liver or kidneys?
Who is that cutie pie baby picture of? It always makes me smile when I see it. Is this one of your children? So cute.
Brain

I've been taking 200mg 5-HTP for about a year now per Dr suggestion to help with the anxiety and depression I was having after my son's sTBI. Wellbutrin was horrible for me, made me feel much worse. I was too leary of side effects if I tried Lexapro or anything else, L-Tryptophan didn't do that much for me. 100mg took the edge off and I was functional, but definitely happier and more relaxed with 200mg. Wouldn't go over that though.

If I go a couple of days without 5-HTP, the horror all comes rushing back -- I think I may have some PTSD. So 5-HTP has helped a LOT, and I do notice I sleep better, too, goes well with the Ambien. Whatever works!! Everybody is different.

My son is doing okay, we very much enjoy 3D movies together. Went to a Renaissance Festival recently, he lasted about 3 hours before over-stimulation and noise sensitivity set in. It was a good time! He doesn't appear to have PCS side effects, all fatigued, like he used to; just being his "new normal" playing computer/video games and TV and no nap needed. That's much improvement over a year ago.

I've been betting myself that Marks pic is his new grandbaby. SOOO CUTE!!!

5-HTP does the same as L-Tryptophan except 5-HTP has a risk factor. The body knows how to regulate L-Tryptophan. 5-HTP enters the process after the body's regulation system. It is easy to overdose on 5-HTP. It is difficult to OD on L-Tryptophan.

As L-Tryptophan is metabolized, the body releases the needed amount as 5-HTP which becomes serotonin and melatonin.

Top food-based sources of tryptophan are tofu, flax seeds (ground), roasted pumpkin seeds, gluten flour, sesame seeds, almonds, black walnuts, and blackeyed cowpeas.

Ground flax seeds are a double whammy of tryptophan and omega-3s. I take 3 tbsp in juice in the morning, plus try to eat tryptophan-rich foods throughout the day.

Tryptophan has a major advantage over SSRIs of actually helping your brain produce more serotonin. SSRIs just reduce how much your brain destroys in the reuptake process (or something like that).

If you have adequate levels of vitamin D and calcium, the serotonin will also convert to melatonin at night, helping you sleep better.

Glad you are getting benefit from it, Mark. Hope you are able to reduce or eliminate the troublesome meds soon!

To get as much L-Tryptophan from food sources, I would need to make my whole diet those foods. Tofu has too much free process glutamate to be safe to eat. Plus, the nuts can get very expensive as a source. They are a great addition as they can be afforded.

I am overwhelmed
 

I am honestly overwhelmed how you can write these post so scientifically.Someone like me that has a severe brain injury cannot understand Mark's post and it is kind of overwhelming. All I am getting is that you are making your own regimen to make it work for you.

Is this advisable to anyone trying to get off medication?Or taking Medication period?Sounds to me like a self medicaid program.And at first you say "so this could be in your medical records" curious to why? Is it in case something happens to you while your self medicating?If your post where more simple for brain injured people maybe it would be better understood.Please simplify so some of us DO GET OVERWHELMED and cannot UNDERSTAND.

Mia,

There are sites , where folks have posted small decreasing regimens that have worked for them without the need for supplements, and used longer timelines than Mark has planned out, that one could post a link for anyone .

Mark is resourceful and self sufficient in caring for himself , having so many years of dealing with his problems that he has his own understanding of what he wishes for himself, and setup his plans that way. Many would not use the half dosing plans, but he has the backup of the L-tryptophan for the support side, which is good for that, as long as it does the trick.

If/when you decide to want to withdraw, discuss it with your PCP, and see if they are able to work out a plan with you; if not, look up those plans online and proffer one to the PCP and see if he/she will work with you with it - and setup the Medicaid sponsored drug plan for the withdrawal - I believe you said you had Medicaid? - because you will have to have the number of pills and dosages all delineated on separate prescriptions.

I did not start this transition from Paxil to L-Tryptophan until I spoke with a new doctor who agreed with my goal.

He explained the symptoms of serotonin syndrome so I could be watchful of that risk. He did some L-Tryptophan research while I was in his office.

I wanted this transition listed in my medical records in case I had any bad side-effects or other problems. I did not want to have an emergency without a medical record listing what I was doing as doctor approved.

I am currently at the 30 mgs with 500 mgs of L-Tryptophan in the am and 2-500 mgs of L-Tryptophan in the late pm.

I am doing great. I wish I had started this years ago. My psychiatrist who prescribed the Paxil in 1999 wanted to try L-Tryptophan back then but it was not available on the U S market. It has only become broadly available in the U S in recent years.

No offense was intended Mark.

Just saying, most have used a minimal dosing reduction , even by the 5 miligram reduction dosing in some reports to minimize the withdrawal syndromes in reports.

However, most have also not used supplements along the way, and your choice - or your docs choice of L-tryptophan is a good one. Its good that it is back in the US market. I was saddened when they removed it back during that time of the troubled market.

Ah, well, good luck with your withdrawal regimen.

I started taking 5-HTP to help with my recent bought of extreme anxiety and depression. I am taking propanolol (panic attacks) and trazodone (sleep aid) as well as the vitamin regime that Mark recommends.

I was prescribed tramadol for when my migraines begin. I notice that 5-HTP should not be taken with tramadol to avoid seratonin syndrome.

What do you all take for migraines if you are taking L-tryptophan?

Obviously I will stop the 5HTP and consult with my neurologist. But I loved how I have been feeling with the tryptophan-much more calm and less anxious.

The body does not regulate 5-HTP like it does L-Typtophan. The risk of serotonin syndrome from L-Tryptophan is much lower. My doctor and I discussed the risk of serotonin syndrome. He informed me of the symptoms to watch for.

I had chosen to not use 5-HTP because of the serotonin syndrome risk.

L-Tryptophan is more expensive than 5-HTP but the safety is worth it.

Thanks Mark for all your work on this.

What is appropriate to take with L-tryptophan when migraines occur?

Good Luck Mark
 

Keep us posted as to how it goes.

I have been completely off the Paxil for a few weeks now. I have some strange symptoms still.

I now have a tinnitus that has surging effects, especially when I move my head.

I get itchy feeling at various parts of my body, like I have fleas. This is finally starting to go away.

My central apnea is behaving strangely. Getting some tests just to check.

Still have a dry cough but it is slowly going away.

My skin is in fabulous condition. My face used to be a mess with oiliness and scaliness. It is nice to not need Boraxo to defoliate my face daily.

Erectile Dysfunction is gone but things are still a bit off.

And, I feel 'light.' I used to have a feeling of emotional heaviness. Not anymore.

I am dreaming much better and having nicer dreams.

And, all this while I am fighting 3 criminal charges due to a next door cop who is a problem and wants me thrown in jail because I ridiculed the way he is verbally abusive to his children.
Malicious injury to property for digging in my flower bed and cutting his cable TV cable buried only 3 inches down. Code says it should be buried 18 inches down.
Malicious injury to property for chewing up his sprinkler cover that is on MY property as I went over it with the lawn mower ($4.27 to replace the part)
Trespassing for stepping onto his property to repair my fenced. I have an easement to maintain my fence written into the deed of his and my lot.

All this to say, I have stress but am doing fine without the Paxil.