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[TheSecondBorn]

Hi folks,

In 2006 I was diagnosed with GAD and OCD. My doctor started me on 12.5MG of Paxil CR. This was not helping with the panic attacks so my doc upped the dose to 25MG CR. This worked GREAT and I felt like myself again. (He put me on Xanax .50 for a month, upped it to 1MG twice daily but once the Paxil started working I no longer need the Xanax; I hate that drug but I know many need it to function). However, about mid-2007 the Paxil seemed to be losing its potency. My new doc (current doc) took me off Paxil CR and put me on 40MG Paxil/daily. This did not much help, either. Gradually my panic attacks returned (as did my obsessions). I started noticing this considerably in January 2008. Last month my workload doubled. I have panic attacks and nervousness all the time now.

I'm also having outbursts of anger again. The Paxil started helping my outbursts (losing my temper). Now the Paxil doesn't help this, either.

Anyway, I have some questions.

1). Which SSRI would be good to switch to? If I switch to another SSRI will I withdrawal from Paxil? I once went several days without Paxil because CVS had problems with my insurance. I became very ill. If I do go on another SSRI, will it be necessary to quit Paxil or simply reduce it a little?

2). What would be the best SSRI to switch to? I've read that Zoloft also helps OCD, but in children and adolescents. I am 24. Would this not apply to adults, either? I've also read that Lexapro is good, but I do not believe my insurance will pay for it, but it will pay for the generic form of Celexa.

3). Like I said, I do not like Xanax. A good friend I've known who is like a grandmother to me uses Buspar to help her anxiety. I know it is not instant like Xanax and other benzos. Wikipedia says that it can take 1-3 weeks before it begins working. Should I ask my doc about this drug?

Any advice would be appreciated. I'm a little scared because life seems to be returning to pre-2006 when things were really bad.

Joseph

[lambvet]

Hi SecondBorn,

Sorry the hear that paroxetine (Paxil) stopped working for you. I experienced something similar where paroxetine worked early in my MH issues but all SSRIs progressively started turning into bad Serotonin Syndrome reactions. The last three times that my old pDoc tried me out of SSRIs, I ended up self committing myself. You see, I am an alcoholic and alcohol was the only thing other than diphenhydramine (Benedryl) that would help with the symptoms I incurred, so in order to protect myself from myself, I chose a stay in a pWard. But back to your questions.

SSRIs are totally out of the picture for me, however I now take mirtazapine (Remeron) and it works great for me. And in the past I have taken busparone (BuSpar) and it helped a little. I have also taken trazadone and serzone early on but I didn't like a particular SE that was causing me to get ''charlie horses''. I felt like my muscles had lost all their elasticity. Your experience could be different or these alternatives might work for you. And there are a number of SSRIs that are now used in Anxiety/Panic Disorder, so you could try some of them. I good point about that is normally you can pretty much just change over without having to taper off.

And speaking of tapering, that is a question for your doc if you are switching, you have hired him/her to have the necessary experience concerning changing  from one SSRI to another SSRI. Generally speaking, the most conservative tapering schedule I have seen is 5% reduction per week. That means it should take approximately 20 weeks. And of course there are other schedules as well. But it is rarely without problematic symptoms.

Citalopram (Celexa) and escitalopram (Lexapro) are basically the same drug, escitalopram is the S-stereoisomer (enantiomer) of citalopram. The difference is that escitalopram is more selective for serotonin reuptake synapses. And hence, hopefully, less side effects. So certainly citalopram is an option for you if that is the only one your insurance covers.

Sertraline (Zoloft) is also recommend for GAD as are most of the SSRIs nowadays. But it is well known that were one SSRI works another one won't work. So you have quite a few options left, there are several SSRIs (FDA approved), buspirone (FDA approved) and mirtazapine (Off label use). And I have seen a lot of tricyclics ADs (Off label) being used today for GAD. So there really are a lot of options left for you.

But hopefully you will find the right one for you sooner rather than later and when you do, you will return to the ''you'' you want. Keep us posted...

Peace and Love... wayne

[fingaz]

Hi,

paxil "pooped" out on me as well, (the second time around), don't worry because there are so many other meds available i am sure you will find anotheer that works just as well, if not better.

Good Luck

[TheSecondBorn]

Wow, thanks for the quick replies, Wayne and fingas.

So if I do switch to another SSRI, I will not have those awful Paxil withdrawals? I can simply jump to another SSRI and not experience those awful brain zaps?

Thanks!

TSB

[lambvet]

TheSecondBorn, on Apr 7 2008, 03:32 PM, said:

Wow, thanks for the quick replies, Wayne and fingas.
So if I do switch to another SSRI, I will not have those awful Paxil withdrawals? I can simply jump to another SSRI and not experience those awful brain zaps?
Thanks!
TSB

Hi TSB,

Sometimes the switch from one SSRI to another can be very smooth without any withdrawal symptoms at all. However, not all SSRIs effect the same neurotransmitter sites, so there can sometimes be a need for taping of one while you start up another. Hopefully, yours will be one of those smooth ones....

Peace and Love... wayne

[TheSecondBorn]

lambvet, on Apr 8 2008, 02:44 PM, said:

TheSecondBorn, on Apr 7 2008, 03:32 PM, said:

Wow, thanks for the quick replies, Wayne and fingas.
So if I do switch to another SSRI, I will not have those awful Paxil withdrawals? I can simply jump to another SSRI and not experience those awful brain zaps?
Thanks!
TSB

Hi TSB,

Sometimes the switch from one SSRI to another can be very smooth without any withdrawal symptoms at all. However, not all SSRIs effect the same neurotransmitter sites, so there can sometimes be a need for taping of one while you start up another. Hopefully, yours will be one of those smooth ones....

Peace and Love... wayne

Hi Wayne,

Do you know if Paxil and Zoloft affect the same neurotransmitter?

BTW, I heard Klonpin is better to use for long-term use, My grandmother gave me several and I've been taking 2MG 4 times a day. I'm no longer freaked out about everything, no longer have obsessions (I'd say I'm "cured" OCD now), and I don't have any more panic attack. Today at my job I was able to converse on a personal basis with the computer newbies. The Klonopin does not make make me sleepy, but it does make me look "drunk." Will this eventually go away? I'm a minister part-time and I don't want to set a bad example for my flock.

Funny thing happened to me the other night. I had taken 4MG of Xanax and I was running into the walls with my wheelchair.   I was supposed to do bible Study that night and don't remember it at all!

Anyway, will the "drunk look" eventually pass away?

Joseph

Edited by TheSecondBorn, 09 April 2008 - 10:37 PM.

[lambvet]

TheSecondBorn, on Apr 9 2008, 07:34 PM, said:

lambvet, on Apr 8 2008, 02:44 PM, said:

TheSecondBorn, on Apr 7 2008, 03:32 PM, said:

Wow, thanks for the quick replies, Wayne and fingas.
So if I do switch to another SSRI, I will not have those awful Paxil withdrawals? I can simply jump to another SSRI and not experience those awful brain zaps?
Thanks!
TSB

Hi TSB,

Sometimes the switch from one SSRI to another can be very smooth without any withdrawal symptoms at all. However, not all SSRIs effect the same neurotransmitter sites, so there can sometimes be a need for taping of one while you start up another. Hopefully, yours will be one of those smooth ones....

Peace and Love... wayne

Hi Wayne,

Do you know if Paxil and Zoloft affect the same neurotransmitter?

BTW, I heard Klonpin is better to use for long-term use, My grandmother gave me several and I've been taking 2MG 4 times a day. I'm no longer freaked out about everything, no longer have obsessions (I'd say I'm "cured" OCD now), and I don't have any more panic attack. Today at my job I was able to converse on a personal basis with the computer newbies. The Klonopin does not make make me sleepy, but it does make me look "drunk." Will this eventually go away? I'm a minister part-time and I don't want to set a bad example for my flock.

Funny thing happened to me the other night. I had taken 4MG of Xanax and I was running into the walls with my wheelchair.   I was supposed to do bible Study that night and don't remember it at all!

Anyway, will the "drunk look" eventually pass away?

Joseph

Hi Joseph,

There is some controversy about just how effective Paxil really is, but they supposedly affect pretty much the same receptor sites...

Tsk, tsk, one should never take someone else's meds. But that being said, klonopin is a benzodiazepine which has a dependency problem attached to it. And the detox is terrible, very rocky. And that being said, 2 mg. x 4 daily is a pretty advanced dosage. The usual starting dose is 0.5 mg. three times per day, it is no wonder that it makes you look drunk, you are. Benzo's are often called alcohol in pill form. 4 mg. of Xanax at once is about 16 times the normal starting dose, I am surprised you didn't pass out. You really need to be careful with what you are taking. That it why you need to get your own prescription, at least you will be given instructions on how to take it properly.

I hope you use better judgement in the future, if you want one. Wow....

Peace and Love... wayne

[TheSecondBorn]

lambvet, on Apr 10 2008, 02:11 AM, said:

TheSecondBorn, on Apr 9 2008, 07:34 PM, said:

lambvet, on Apr 8 2008, 02:44 PM, said:

TheSecondBorn, on Apr 7 2008, 03:32 PM, said:

Wow, thanks for the quick replies, Wayne and fingas.
So if I do switch to another SSRI, I will not have those awful Paxil withdrawals? I can simply jump to another SSRI and not experience those awful brain zaps?
Thanks!
TSB

Hi TSB,

Sometimes the switch from one SSRI to another can be very smooth without any withdrawal symptoms at all. However, not all SSRIs effect the same neurotransmitter sites, so there can sometimes be a need for taping of one while you start up another. Hopefully, yours will be one of those smooth ones....

Peace and Love... wayne

Hi Wayne,

Do you know if Paxil and Zoloft affect the same neurotransmitter?

BTW, I heard Klonpin is better to use for long-term use, My grandmother gave me several and I've been taking 2MG 4 times a day. I'm no longer freaked out about everything, no longer have obsessions (I'd say I'm "cured" OCD now), and I don't have any more panic attack. Today at my job I was able to converse on a personal basis with the computer newbies. The Klonopin does not make make me sleepy, but it does make me look "drunk." Will this eventually go away? I'm a minister part-time and I don't want to set a bad example for my flock.

Funny thing happened to me the other night. I had taken 4MG of Xanax and I was running into the walls with my wheelchair.   I was supposed to do bible Study that night and don't remember it at all!

Anyway, will the "drunk look" eventually pass away?

Joseph

Hi Joseph,

There is some controversy about just how effective Paxil really is, but they supposedly affect pretty much the same receptor sites...

Tsk, tsk, one should never take someone else's meds. But that being said, klonopin is a benzodiazepine which has a dependency problem attached to it. And the detox is terrible, very rocky. And that being said, 2 mg. x 4 daily is a pretty advanced dosage. The usual starting dose is 0.5 mg. three times per day, it is no wonder that it makes you look drunk, you are. Benzo's are often called alcohol in pill form. 4 mg. of Xanax at once is about 16 times the normal starting dose, I am surprised you didn't pass out. You really need to be careful with what you are taking. That it why you need to get your own prescription, at least you will be given instructions on how to take it properly.

I hope you use better judgement in the future, if you want one. Wow....

Peace and Love... wayne

Wayne,

I apologize for overdoing it. My grandmother said it worked well for her. I was desperate. Couldn't work with the panic attacks. However, these are no excuses. I made a mistake. I am sorry.

OK, so I went to my doc yesterday. He said I should not be on 8MG of Klon every day. He said I should be on 4MG/day. I don't feel drunk anymore, but relaxed and feel no anxiety. He also switched my Paxil to Prozac, 20MG twice daily.

Thank you for all your help.

Joe

[lambvet]

TheSecondBorn, on Apr 12 2008, 10:41 AM, said:

lambvet, on Apr 10 2008, 02:11 AM, said:

TheSecondBorn, on Apr 9 2008, 07:34 PM, said:

lambvet, on Apr 8 2008, 02:44 PM, said:

TheSecondBorn, on Apr 7 2008, 03:32 PM, said:

Wow, thanks for the quick replies, Wayne and fingas.
So if I do switch to another SSRI, I will not have those awful Paxil withdrawals? I can simply jump to another SSRI and not experience those awful brain zaps?
Thanks!
TSB

Hi TSB,

Sometimes the switch from one SSRI to another can be very smooth without any withdrawal symptoms at all. However, not all SSRIs effect the same neurotransmitter sites, so there can sometimes be a need for taping of one while you start up another. Hopefully, yours will be one of those smooth ones....

Peace and Love... wayne

Hi Wayne,

Do you know if Paxil and Zoloft affect the same neurotransmitter?

BTW, I heard Klonpin is better to use for long-term use, My grandmother gave me several and I've been taking 2MG 4 times a day. I'm no longer freaked out about everything, no longer have obsessions (I'd say I'm "cured" OCD now), and I don't have any more panic attack. Today at my job I was able to converse on a personal basis with the computer newbies. The Klonopin does not make make me sleepy, but it does make me look "drunk." Will this eventually go away? I'm a minister part-time and I don't want to set a bad example for my flock.

Funny thing happened to me the other night. I had taken 4MG of Xanax and I was running into the walls with my wheelchair.   I was supposed to do bible Study that night and don't remember it at all!

Anyway, will the "drunk look" eventually pass away?

Joseph

Hi Joseph,

There is some controversy about just how effective Paxil really is, but they supposedly affect pretty much the same receptor sites...

Tsk, tsk, one should never take someone else's meds. But that being said, klonopin is a benzodiazepine which has a dependency problem attached to it. And the detox is terrible, very rocky. And that being said, 2 mg. x 4 daily is a pretty advanced dosage. The usual starting dose is 0.5 mg. three times per day, it is no wonder that it makes you look drunk, you are. Benzo's are often called alcohol in pill form. 4 mg. of Xanax at once is about 16 times the normal starting dose, I am surprised you didn't pass out. You really need to be careful with what you are taking. That it why you need to get your own prescription, at least you will be given instructions on how to take it properly.

I hope you use better judgement in the future, if you want one. Wow....

Peace and Love... wayne

Wayne,

I apologize for overdoing it. My grandmother said it worked well for her. I was desperate. Couldn't work with the panic attacks. However, these are no excuses. I made a mistake. I am sorry.

OK, so I went to my doc yesterday. He said I should not be on 8MG of Klon every day. He said I should be on 4MG/day. I don't feel drunk anymore, but relaxed and feel no anxiety. He also switched my Paxil to Prozac, 20MG twice daily.

Thank you for all your help.

Joe

Hey Joe,

You have no reason to apologize to me, lol. Just trying to help out, wouldn't want you to unknowingly OD. Am glad to hear you are getting some relief, I can totally relate to anxiety paralysis, lol. Also good to hear that you have your own proper Rx.

Peace and Love.... wayne

[Tweet]

Paxil worked pretty well for me at first. After a year or so, besides the loss of libido, I started getting enraged for little or no reason.
So I stopped taking them.