Hi Sherry,
I'm in central VA, so relatively speaking I'm not so far away.

Here's my take on your situation.

- I firmly believe, that barring a life-threatening emergency, all changes in p-meds should be done gradually, and ONE at a time. My doctors have been in agreement with me.

- I have a nightmare of a time getting off most drugs, and my experience is that it's very unpredictable what I'll feel or think and how long it will take to taper.

- I have learned to keep a little notebook with dates, times, and doses as I taper up and down. I put any unusual, uncomfortable or upsetting feelings along with each dose. I've found it's close to impossible to accurately recall what I felt on which dose, on what day. It helps the doc to help me, also.

- Particularly with you being on a combo of meds, if you change more than one thing at a time no one will be able to tell which drug taper may be causing which symptom.

- Yes, Paxil is one of the meds with a more difficult 'discontinuation syndrome'.

- I don't think you should feel afraid of your pdoc. You said your area has limited resources. Is there another pdoc in the mental health ctr? It's important that you trust your doc, and that he/she listens to you - particularly when you're changing meds, and when you are new. They should be getting to know you in order for you to be able to trust them (yeah, I know easier said than done with pdocs).

I hope something here helps. Take care of yourself. Trust yourself as much as you can.

Mary
ps liked your screen name! I've got 3 dogs and a herd of cats!