View Full Version : Increasing Paroxetine dose

27-03-10, 12:05
Have suffered from bad bouts of anxiety/depression for many years....... looking back on it, even had Health Anxiety through my teens though didn't realise thats what it was! Anyway, to cut a long story short...... well shorter anyway!!...been on various antidepressants virtually nonstop for the last 20 years and although I've had a number of relapses/blips, just about kept sane!! These days, I seem to go through a bad blip every 6-8 months which seems to clear all of a sudden after a few weeks..... during the bad spell, I feel so ill just don't know what to do with myself I feel so anxious and depressed. Usually seems to be triggered off by stress or would you believe it, going on holiday!! Anyway, as you probably guessed, going through a really bad patch at the moment...... always worst first thing in the morning..... and I'm having real trouble convincing myself I'll ever get better. Saw my gp on Monday who reckoned I had a big advantage over everyone else he sees as at least I know I'll get better! I'm sure it is true as I must have had absolutely loads of "blips" over the years and everytime feels like the end of the world. I've been on 40mg paroxetine and propanalol but he's now increasing the paroxetine to 60mg and given me a short dose of tamazipam to help me sleep a bit better for a couple of weeks....... got to see him again in 6 weeks to review. I've been taking the increased dose for a few days but not sure its a good idea....... reading the instructions, 60mg is the absolute max dose if you've got ocd which I've haven't got...... depression/anxiety is 40mg I think. . A few years back, the same gp doubled my dosulepin dose to 320mg....... turned out should never be on that dose unless in hospital...... after a few weeks started having fits as a result and ended up in hospital a couple of times and they gave me a brain scan thinking I had epilepsy!! Sorry if rambling here!!............ anyway,switched to Paroxetine 20mg and ticked along ok for couple of years...... hit a bad spell.... increased to 40mg....... ok for while with a few blips but now going through bad patch again which stated a couple of weeks ago out of the blue. Was on fluoxetine for several years..... 20mg....... which I did quite well on..... then had a bad spell and went back on the dosulepin as I knew it had been effective in the past. Couple of years back, another gp in the practice put me on Citalopram and never felt so ill though to be fair, only gave it a week as felt so ill...... then went on the paroxetine which helped.
My wife is really encouraging and says hang on in there....... keep on the 40mg and you'll soon be feeling better..... you always do. I've started going out cycling and doing some fast exercise which usually helps, bought some Omega 3 fish oil so will give that a go as well.
Reading all this, looks like I'm a right mess but to be honest, for about 90% of the time, I'm ok...... its just when I get the dreaded "blips" .
Although my gp has made a mistake in the past, he has the most experience of all the gp's in the practice and has got me through many a bad patch in the past and I don't really think switching gp's is really going to make much difference. He has referred me in the past to the local mental health unit and they were the ones that originally put me on the paroxetine........ I saw them about 4 weeks ago and was feeling absolutely fine so they discharged me and put me back under my gp which I was ok with at the time........ wish they hadn't now!
Anyway, sorry to ramble on and on ..... I just hope I'll be feeling better soon. In the past, it has suddenly started clearing and after a couple of days, back to full power..... just want it to happen now.
Anyway, does anyone else take such a high dose of paroxetine .and has it helped?...... I don't wan't to go on a really high dose which does nothing and then can't get down from very easily

27-03-10, 19:31
I was on 20mg of paroxetine for a long time and couldn't handle anything above that dose. It stopped working after a few years and I had a lot of trouble coming off it but managed it in the end. I'm now on sertraline which is helping (although I still get ups and downs).

I don't think you can expect any med to cure you at any dose. I think that you'll still have blips along the way because it's the nature of this illness.

60mg is the max dose and if you can tolerate it at this dose it would be a good option till you feel better again - at which time you should look to reduce it. I think it's better than starting a new med and going through all the start-up symptoms again, not to mention paroxetine withdrawals.

I think getting in touch with the MHT again and explaining your concerns would also be a good idea - although I think that increasing your med to 60mg is the right thing for you to do if you're feeling like this.

Wish you luck.

22-04-10, 11:11
Im on 60mg, it helped me at the time, basically your body gets used to the amount and to get the same effect i did at 30mg they had to double it (slowley). I didnt have any side effects increasing it, like you do at the beginning and i defo think its better to do that than start a new med with all the side effects involved. Im 2 years on now and still on 60mg im starting to wonder if its still working but have been advised to stay on it and start CBT too, so watch this space.....! LOL

13-06-10, 21:03
Hi my story is a little like urs this is my 3rd time on Paroxetine within 8 years I have been well for 2 year without being on meds but now going thro a bad patch , how is it going on ur new meds ? Hope ur starting to feel better , I started back on paroxotine 4 days ago but please don't laugh on a dose of 2 mg I'm so worried about the side effects could anyone tell me if this really worth it or should I have just started on a higher dose to get the side effects over and done with I plan just to wean myself up a bit each week till I get to 10mg is this worth it will I get side effects each week I up my does a tiny bit ? Thank u for ur time dexx

13-06-10, 21:12
Hi my story is a little like urs this is my 3rd time on Paroxetine within 8 years I have been well for 2 year without being on meds but now going thro a bad patch , how is it going on ur new meds ? Hope ur starting to feel better , I started back on paroxotine 4 days ago but please don't laugh on a dose of 2 mg I'm so worried about the side effects could anyone tell me if this really worth it or should I have just started on a higher dose to get the side effects over and done with I plan just to wean myself up a bit each week till I get to 10mg is this worth it will I get side effects each week I up my does a tiny bit ? Thank u for ur time dexx

Wow, that's a really tiny dose! How do you measure it? I would think you'd need the liquid version to measure such a small amount.

Why don't you go up to 5mg and increase by 5mg a week till you get to the required dose? If you have any problems then go back to the previous dose for a while longer (say another week).

I'm sure you wouldn't have any problems doing it like that but if you do then you could always visit your doc.

14-06-10, 08:16
Hi yes its liquid form had a panic last night could I be gettin side effects on such a low dose now I'm worryed to move up a dose incase I feel even worse thank u for ur time x

14-06-10, 15:50
It could also be anxiety De, not just side effects. It's such a low dose you're on. Try to increase gently and see how you get on. You can always go back down if it gets too much. Have a word with your doc if you're worried but I'm sure you'll be OK.

14-06-10, 16:11
Hey went to the doc today had a bad night last night with panic he said to stay on what I'm on just to get myself used to it then got to see him monday to see how I'm feeling he said just a small amout would be doing something x thanks for replys xx

14-12-11, 23:12
Hi, these posts have been really helpful... I've been taking paroxetine for 4 wks now and this is the 2nd time, before I took 20 mg for about 4 yrs and then came off them no trouble for a year but then had a bad patch and have started on them again, I'm worrying that I have'nt given them a fair chance before upping the dose to 40 mg today from 20mg for a couple of weeks and then 30 mg, I have just read that 40 mg is the highest dose for anxiety ! I have also read that taking them for a second time can take more of a dose to have a full effect.... wishing I had never come off them in the first place ! Just need some reassurance that I've done the right thing by upping the dose... I am feeling 100 times better than I was before taking them but still having the odd bad day which I guess I'm really trying to do away with completley. Any replies gratefully received :) x

15-12-11, 07:08
Hi Ellabell, I'm back on paroxetine for the third time and like you have been on it for about 4 weeks. This time I started on 10mg (which was my maintainance dose for many years). I also wish I'd never come off them in the first place as going back on them (even at only 10mg) has been difficult this time (on previous occassions I couldn't have been in a worse place so the initial SE's were nothing compared to what I was already experiencing). I intend to reach 20mg over the next couple of weeks, I've got to 14mg so far just increasing a couple of mg every few days.

I'm still having the odd bad day, which makes me forget the good days I've had and leave me wondering if I'll ever get better, but I know this is part and parcel of my original condition and the side effects.

I do worry that it will be less effective this time or that I will need a higher dose for a while, but it's worked for me in the past so I'm sure it will work for me again. I am fearful of trying other AD's because of the initial side effects (I had a severe reaction to Prozac many years ago), and the initial period of starting any AD, where you feel so much worse feels like an eternity.

On the up side, whilst there may be the occassional off day, we're over the worst and should start feeling ourselves again very soon so here's to the future :)

15-12-11, 21:12
Hi Lauz, thankyou for your repy it really helps does'nt it to know someone else is experiencing the same kind of thing. like you I had a really bad experience with another AD.. sertraline... god I was so bad, really really depressed and anxiety was through the roof, when I told my gp how I felt he told me stop taking them straight away !! thank goodness... Just keep trying to remind myself how much better I am now than then. My GP did'nt give me the option of taking them so slowly as you are, I started at 20 then 30 then 40 all in 4 wks !!! oh ek !! Like you I just want to feel better and when they work properly I don't ever want to come off them !! Here's to only going up up up !! :)

15-12-11, 21:32
You're right, it's so reassuring to know that someone else out there is experiencing the same thing. You can feel very isolated when you're experiencing mind altering side effects.

My initial GP, who doesn't have much experience didn't really give me the choice about what doseage to be on, I decided myself because I knew I would not be able to function as a mother straight in at 20mg so I decided to start on 10mg myself. I asked to see a different GP for my follow up appointment one week later and she was brilliant. She prescribed me the syrup so that I could up my dose slowly and asked me to come back in a week to see how I was getting on. Again, she was brilliant and whilst she wouldn't normally prescribe Seroxat she listened to me when I told her that I understood the difference between what was my existing condition and what was a side effect. She agreed that I should have the AD I felt comfortable and happy with but wants to see me regularly to see how I'm progressing. Many GP's aren't as compassionate but I know she has a lot of experience in this area which puts me at ease.

I've had a really good 36hrs (with the exception of some increased anxiety/jitters today which were quickly settled by a couple of vigorous walks to burn off the adrenalin that my body was producing).

What coping mechanisms have you found for your bad days? I have a wide variety that work for me ranging from a vigorous shower (shower power is under rated), vigorous short walks, puzzle books, jigsaws etc etc.

18-12-11, 22:23
Hi Lauz, today I feel poo !! :weep:.... coping mechanisims... I'm not sure I have any to be honest !! Thats rubbish is'nt it... I guess I do though thinking about it, I do some cbt exercises that I learned, breathing properly and concentrating on it helps when I feel panicky, talking to my boyfriend about how I feel helps too. I hate it when I get these bad days I just feel like I'm going back instead of forwards, but really I know how it works that the bad days will get less and less. It's nice to have this site I find it really helps. Hope you're ok today, sorry to go on about all my problems !! :shrug: :)

19-12-11, 19:40
Hi Ella, absolutely no need to be sorry, we're in the same boat.

Today is day 28 for me and I've managed to get to 15mg but my quality of sleep is rubbish and my appetite is near non-existant some days, but when I have a good day I can stuff my face.

Have been terribly congested recently which is making me vomit but since I'm feeling crappy anyway I don't really want to take anything that will make me feel even more odd. GP gave me antibiotics today so fingers crossed they shift it.

Anyways, we should start rounding that corner very soon, the 6-8 week time scale is in sight.

20-12-11, 00:29
Hi Lauz, sorry to hear you're full of cold that's rubbish... I wish my appetite would dampen down a bit I can't stop flippin eating !!! lol ! You're right hopefully not to much longer now and we'll see and feel some improvement big time ... fingers crossed eh ! Anyway it's been a good day today for me, Iv'e been able to keep much more busy which is great and helps no end. Hope you're ok today :hugs:

20-12-11, 19:46
Hi Ella, doing a bit better now, in fact, today has been amazing (despite the cold). How you doing now?

21-12-11, 23:17
Hi lauz, that's great I'm really pleased you feel so good. I've had a good week so far thanks, feeling a little bit jittery now but I think that's becauce I fell asleep on the sofa for 2 hours earlier !! not sure if it's that really !! Anyway had a much better week... this is week 5 since starting and 1 week now at taking 40 mg... Things are looking up for us x :yesyes:

22-12-11, 19:02
Hi Ella, so glad you've had a good week. I've felt great the last few days, even the morning anx and jitters have subsided massively, just a little OCD in the morning (cause I keep analysing myself and how I'm feeling, but I've been very successful with kicking myself in the backside).

Have had a very active few days which has no doubt helped a lot and I've slept and ate really well too, the combination of all three has made me feel a lot more positive and energised.

Still only on 15mg but will wait a little while longer before upping any further just to let the remaining SE's settle completely so I can better gauge if increasing the dose does bring any unpleasant SE's with it.

Got my letter for CBT/councelling today, just need to ring and get the ball rolling.

24-12-11, 01:05
Hi Lauz, thats great that you're feeling loads better. Iv'e had a cbt telephone appointment today which was really good and very helpful, I have had a few face to face cbt sessions before too with someone else, the therapist I spoke to today said I sounded like I had learned a lot ! so that's great and she did'nt feel like I needed to actually go for an appointment this time which has made me feel much more positive and much better, she's sending me some information on self help and a couple of book references. Have you had cbt before ? I would definately rate it once you get into that mind set. might not be on here now for a couple of days as a very busy xmas is nearly upon us ! have a good one, happy xmas and here's to a very positive new year x

24-12-11, 09:51
Hi Ella, I rang up to book my CBT telephone session yesterday. It's not until February but that gives me plenty of time to be back to 100%.

Enjoy Christmas, I certainly will this year :)

28-12-11, 23:13
Hi Lauz, hope you had a lovely christmas and are continuing to feel better. Iv'e had a bit of a funny day today, feeling a little anx and a bit jittery ! I am due on though so I'm putting it down to hormones !! Anyway I've got some exciting news..... we got engaged on christmas day !! :D :ohmy: that was a surprise, I'm so happy though. :) trying to continue with the positive thinking because when I have a funny day it tends to scare me again that the meds are'nt working ! x

29-12-11, 19:36

I've been doing really, really well, a couple of OCD moments, usually only in the morning. My sleep has improved an awful lot, and I've got my appetite back (so no doubt I'll get the stone and a half back soon too), and I'm going back to work next Thursday.

Funnily enough, I had a slightly jittery day today myself, but I put it down to the fact that I was popping into the office to see everyone today. I haven't been at work for 5 weeks so was a little nervous about it, but it was fine.

We're over the hump now though, so it should all be good from here on in, with the odd blip thrown in to keep us on our toes.

29-12-11, 23:31
Lauz thats great I'm so so pleased you're feeling so much better. Good luck with starting back to work... you'll be fine ! Definatley all on the up now ! You're right with the odd blip now and again to keep us on our toes, today I've felt much better today than yesterday just a bit jittery this eve when I had a couple of friends round but it soon passed.... take care x

06-01-12, 09:41
well, I had a great period between weeks 4-5 but from the end of week 5 to now (which was 6 weeks on Tuesday), I just feel like I've taken 4 steps back. I feel so awful again. Anxiety back big time, though mainly confined to the mornings, my sleep and appetite are poor again.

I'm not sure what's caused this to be honest, I upped my dose by 2.5 mg gently over a few days to 17.5mg at the end of last week (but I've reduced back to 15mg now), but it could also have been the fear of returning to work. I did go back yesterday and managed 4hrs which was a huge struggle and I had to get one of my bosses to take me home, but today I had such high anxiety that I just couldn't face it. I think I almost had a panic attack and wanted to cry so much, but I just couldn't.

I've managed to get an appointment with the doctor for Monday morning and I think I'll discuss the option of changing meds and see what she suggests as an alternative.

Knowing that I'm not going to work now has settled me down a bit but I just hate feeling in such a bad place.

06-01-12, 23:05
oh Lauz that's really crap !! poor you !..... I wonder why that happens ?when I was taking sertraline ( even that name scares me now !! ) I was really really good on week 5 but then after that really really bad !! my doc told me to stop them right away. see what the doc says on monday. I'm on 40 mg now and no more propranolol... 40s quite high though I think. Hoping more than anything they continue to make me feel better and better and hopefully 1 day I can try and reduce the dose, but the thought of stopping them completley scares me witless ! take care Lauz x chin up and all that x

09-01-12, 11:10
Visit to the GP went well this morning and she thought there was some possible truth that by being on less than the minimum theraputic dose I was not yet feeling the full benefits, so she has signed me off for another two weeks to see how I get on, and if after that time I'm still not feeling any significant improvement she will change my meds, trying Cit first. She isn't happy that I'm feeling worse, not better and doesn't want to prolong it any longer than being able to say "I gave them a chance", so lets see what the next two weeks has in store. She's signed me off again until I see her next.

She suggested Cit because its usually her first med of choice, along with Prozac (which I've tried before and didn't get on with) and has a longer half life so generally works quicker. Plus, having already overcome the worst side effects of SSRI's, I probably won't get a repeat of those first two horrendous weeks. She finds that to the patients she has prescribed Cit too, they usually work wonders and don't have to try anything else - but we're all different so I'm willing to give them a try if necessary.

I felt less anx this morning, and certainly for less time than usual too and considering going to the GP usually fills me with dread, this is GOOD! My appetite has started to return too (my stomach was rumbling so loud last night I could have woke the neighbours so had to have a little late night snack), and I wasn't sick this morning which is also GOOD!

So, lets see what the next couple of weeks bring :smile:

09-01-12, 19:56
Hi Everyone

I started on 26 December 2011, 1 tablet a day 20mg. I am not sure when they are supposed to help and work. At the moment I just feel so depressed. So awful. I am seeing my pschiatrist on 17th January, hopefully, this depression period has gone.

Sorry for the doom and gloom.

09-01-12, 22:50
Hi Lauz.... I have a friend and my mum take cit and they're ok ....mind you that was for depresion rather than anx ! Iv'e stopped taking the propranolol now and feel more jittery but really want to stick with it also trying to stop smoking !! I havent had one now for 3 days and im determined to do it this time, I have to do it for my kids they hate it !! I really hope you start to feel better again really soon... hopefully now youve upped the parox it might kick in a bit more... Im sure I could still do with a bit more but I dare'nt I'd be rattling !! lol x take care lauz keep talking x

---------- Post added at 21:48 ---------- Previous post was at 21:44 ----------

Hi shygirljab, I think paroxetine take a couple of weeks to get into your system and 6 to 8 wks to feel the full affect !! Ive been taking them now for 8 wks all in all... upping the dose now to 40 mg !! I feel 90 times better than I did but not quite 100 percent !! fngers crossed for all of us at our different stages of recovery xx

---------- Post added at 21:50 ---------- Previous post was at 21:48 ----------

sorry shygirlajb.... got your name the wrong way round ! :)

10-01-12, 06:56
Well, I've woken up with a little anx and feeling really flat, can only describe it as depression - no will, motivation, no emotions other than frustration and anger at feeling so, so awful. Its so demoralising and stuggling to find hope that the upped dose will work.

Was sick again this morning (dry heaving I think it is when there's nothing to bring up), but got myself into the shower, which I've been finding hard to do of late - it involves motivation after all.

I keep telling myself its side effects, because I never felt like this before I started taking Seroxat again, but I've never felt like this on the previous occassions (although I've always started straight in at 20mg and never need to go any higher than that).

Starting to believe all the horror stories I've read about Seroxat, which is counter-productive and I MUST stop reading them but I can't stop looking our answers, for a glimmer of hope.

I had an terrible nights sleep as my daughter got in bed with us at 2.30am and I never really went back to sleep properly after that, which could account for feeling worse this morning.

Last night was the 3rd day of 20mg so I am expecting some slight increase in side effects, but nothing of major proportions.

I'm naturally fearful of having to try a new med in a couple of weeks if Seroxat doesn't "kick in", but at the same time I don't want to continue feeling like this so I feel like I'm stuck between a rock and a hard place. I know many people wouldn't have given Seroxat the amount of time I have with the side effects I've experienced, but I feel like I don't want to give up on it just yet because I have so many "what if's".

Sorry for long post, just gotta get it all out of my head and on here.

13-01-12, 23:50
Hi Lauz x I'm really sorry you're still not feeling good... I know what you mean when you say feeling flat and have no motivation,I felt just like that on sertraline. What dose are you on now ? It does'nt sound good that it's making you sick, thats horrible ! If it's any consolation I feel crap at the moment !! Me and the BF have just had a massive barny and I told him to get out and he did... I'm worried about him now and he's left his door key here too !!! (git) lol, not good for the anx.. anyway to top it all off and probably the reason I flew off the handle is that I've just found out I'm pregnant !! Great news and we're chuffed to bits.. despite the tiff.. prob me and my hormones lol !! also not good for the anx !! all I can think is please let everthing be ok with the seroxat. keep me posted on how you're feeling take care.. sorry for long post too ! It helps though does'nt it ! :)

14-01-12, 17:45
WOW - engaged and pregnant, no wonder you're not feeling good, but hormones and the natural worries around pregnancy have a lot to answer for.

Whilst I was pregnant with my daughter I took Seroxat and reduced from 20mg to 10mg which no problems or withdrawal effects and my daughter was very healthy, but you should discuss it with your doctor as ANY medication during pregnany needs to be monitored (can't even eat nuts or eggs lol).

On Tuesday, after my post my day continued to sink into utter despair. I've NEVER felt so desperate. I spoke to my GP on the phone and she prescribed 15mg per day of Mirtazepine and to reduce the Paroxetine back down to 15mg. So far, so good, but I've still got the mind chatter/ruminations, which is annoying because it's at its peak first thing in the morning which makes it hard to counteract unless I get busy.

I keep using the internet and this forum to search for answers/cures but I can only hope it will pass with time.

11-08-12, 09:40
Any updates on how things are going?

01-11-12, 16:00
Hi guys,don't mean to hijack this thread but my paroxetine was increased from 40 to 60mg today.My doctor actually offered me the choice of upping it or going over to venlafaxine instead.He said if I get no joy on this 60mg paroxetine,then he would have the venlafaxine option in hand.Considering my mirtazapine was upped to 45mg 4 weeks ago,I'm hoping the combined paroxetine/mirtazapine upping will work and thus render the venlafaxine unnecessary for the time being.

26-07-13, 08:01
My Paroxetine dose (http://sizer.org/paroxetinedosage) is much smaller. I take 10mg and 20mg when I need it really badly. I couldn't imagine being on the maximum of 60mg. That would mess me up.