Worse before better on paroxetine?

[jonjon]

So a quick update.

This week I have managed to do more than I have done for a while so there must be some positives. I think I will feel better when I see my pay check.

Today is Saturday and I have a bad headache which started yesterday afternoon.

I have been trying to up my dosage ever so slightly the last 3 days by weighing the pills on some digital jewellers scales and increasing dose by one hundredth of a gram per day. I have calculated that it will take 12 days to go from 10mg to 20mg. (Pill weighs 0.25g)

Sleep issues are no better but no worse.
Sexual side effects have disappeared.
No nausea.
No appetite in the morning but hungry at night.
Mood still fluctuates.
Anxiety maybe 10 percent better.
Still grinding teeth occasionally.
Headaches are pretty bad. I am living off Panadol and Nurofen. :(
I even took 2mg Valium last night in the hope it would somehow help my headache!

Anyway that is it for today. Keep you posted.

[Catkins]

With the no appetite in the morning, I'm very much like that. I struggle in the mornings to eat but as the day goes on my appetite improves. I believe it's connected to the anxiety rather than the pills. My anxiety is always highest in the mornings.

[panic_down_under]

I even took 2mg Valium last night in the hope it would somehow help my headache!

Did it?

[jonjon]

Did it?

No but I slept well

[jonjon]

Think I will switch to taking the paroxetine in the mornings.

Had another really bad nights sleep last night and barley dragged myself to work for half a day.

I think it at the start the pills were sedating but are now stimulating. Can this happen?

[jonjon]

Just saw my GP regarding insomnia and got prescribed melatonin. She wants me to take 10mg tonight and see how I go.

Trazodone is not available in Australia.

[panic_down_under]

Just saw my GP regarding insomnia and got prescribed melatonin. She wants me to take 10mg tonight and see how I go.

Please let me know how it goes.

Trazodone is not available in Australia.

Not on the PBS, but doctors can prescribe it via a compounding pharmacy. Veterinarians can and do prescribe it fairly frequently to ease anxiety. Unfortunately, the best of the alternatives, hydroxyzine isn't available on the PBS either as they regard the hydroxyzine metabolite cetirizine a better antihistamine specifically because it isn't sedating.

Another antihistamine, diphenhydramine, which is the active ingredient in some versions of Benadryl, is available over-the-counter at pharmacies in Unisom Sleepgel, Snuzaid Gel and Snuzaid Tab. It is also the active ingredient in some liquid cold and cough remedies and decongestants, however, these may also contain the opioid analogue dextromethorphan as the cough suppressant which theoretically could trigger serotonin syndrome when taken with a SSRI. Whether remedies actually contain enough to cause an issue I can't say though my guess is they don't, however, I'd give them a miss anyway.

[Catkins]

I've used melatonin before. Had to buy it from the US on the internet as it's not available over here. I thought it was quite good. I could get a solid 5 hours before I woke up and then I could go back to sleep and if I wasn't very anxious would sleep 8 hours. Only thing I found was that (and this is only my opinion) was that after a while it became less effective. So I found it best not to use for long periods. I would use it again.

[panic_down_under]

Only thing I found was that (and this is only my opinion) was that after a while it became less effective.

This seems true with all insomnia aids to varying degrees. Tolerance to benzodiazepines and the related 'Z' hypnotics can occur within a few weeks. It usually takes considerably longer with the antihistamines and I'm not sure about melatonin. The evidence is contradictory.

[jonjon]

I decided to take the day off work considering I am changing medication timing.

I skipped my nighttime dose of paroxetine and took it this morning instead.

Last night I took 4mg of melatonin an hour or so before bedtime. I got to sleep ok but woke up about four hours later and had broken sleep the rest of the night.

This is my main problem! I can get to sleep ok but once I wake up to go to the toilet I have trouble falling asleep again.

I will give this new regime another week or two but if it does not improve I will have to give up/switch antidepressants.

I am currently approaching the end of week six.

Thanks for the input guys and gals.