I took Paxil 20mg for 15 years, weened off myself last year with no issues. Started back after an ER visit from combining kava root(large dose, somewhat new to kava) and 5 htp. Gave myself(fell strongly I did anyway) Serotonin Syndrome by combining MAOI(kava) and 5HTP last september. Was Dx as anxiety at ER(2mg ativan shot) and put back on Paxil the next morning at Primary Care. I felt horrible adding paxil to SS, and benzos didnt even help at all. I didnt sleep barely at all during that first month. Dialted pupils, diahreah, felt uncomfortable in a strange way.
My main clue of my self Dx of SS is the main symptom I had(for about 3 hours right after downing the kava and 5htp). It was a horrible pacing akathisia. I had no idea what it was but I only lasted about an hour before going to ER. It was extremely I knew it was certainly not anxiety or a panic attack. I feel like he should have shined a light in my eyes at some point based on my symptoms and 5HTP being involved. I brought the box of supplements. Mostly vitamins, tyrosine, phenyletheline(was actually first time I combined with tryosine but never considered either to play a role), theanine.
So anyway, I realized I had ADHD last March, and mentioned this to my nurse prac(non-psych) the morning after my ER visit. She agreed to test me at one month follow up. Put on paxil and clonasapam(I did request these myself, as it seemed correct). After 20 days of throwing paxil on top of lingering Serotonin Syndrome symptoms, as well as the nasal issue, I felt so bad I had to ask to be seen right away. When I told her that I realized akathisia was what I had at the ER, it must have freaked her out. She left to get the ADHD test and came back with a bi-polar test. I was polite but switched back to my old doctor (insurance thing is why I left).
After 2 months, feeling a little better, kind of. I requested a referral for ADHD. I was increased to Trazadone 100mg and it did get me some good sleep although not dependable at all. I never really fell asleep in less that 3 hours for the last 8 months. It wasnt intentional, but I always overstated the usefulness of the Trazadone to both doctors. At least with 100mg, I was getting some solid sleepis here and there, and 14 hours worth on occasion.
I was Dx w ADHD and Rx adderall xr at my 2nd meeting. I took 10mg, then 20mg, then wanted 30mg but denied due to my poor communication.
Now that the Rx seem to be working more efficiently due to genuine sleep for first time in 8 months(I fell asleep in 1 minute I think the other night.), I think I need a reduction to 20mg paxil. The adderall could actually be OK at 20mg. It seems to work better now. I wasnt really felling the first wave before(xr=2 waves), but today I did.