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      National Mental Health Awareness Month, 2016   05/01/2016

      Proclamation 9433 of April 28, 2016 National Mental Health Awareness Month, 2016 A Proclamation Nearly 44 million American adults, and millions of children, experience mental health conditions each year, including depression, anxiety, bipolar disorder, schizophrenia, and post-traumatic stress. Although we have made progress expanding mental health coverage and elevating the conversation about mental health, too many people still do not get the help they need. Our Nation is founded on the belief that we must look out for one another—and whether it affects our family members, friends, co-workers, or those unknown to us—we do a service for each other when we reach out and help those struggling with mental health issues. This month, we renew our commitment to ridding our society of the stigma associated with mental illness, encourage those living with mental health conditions to get the help they need, and reaffirm our pledge to ensure those who need help have access to the support, acceptance, and resources they deserve. In the last 7 years, our country has made extraordinary progress in expanding mental health coverage for more people across America. The Affordable Care Act prohibits insurance companies from discriminating against people based on pre-existing conditions, requires coverage of mental health and substance use disorder services in individual and small group markets, and expands mental health and substance use disorder parity policies, which are estimated to help more than 60 million Americans. Nearly 15 million more Americans have gained Medicaid coverage since October 2013, significantly improving access to mental health care. And because of more than $100 million in funding from the Affordable Care Act, community health centers have expanded behavioral health services for nearly 900,000 people nationwide over the past 2 years. Still, far too few Americans experiencing mental illnesses do not receive the care and treatment they need. That is why my most recent Budget proposal includes a new half-billion dollar investment to improve access to mental health care, engage individuals with serious mental illness in care, and help ensure behavioral health care systems work for everyone. Our Nation has made strong advances in improving prevention, increasing early intervention, and expanding treatment of mental illnesses. Earlier this year, I established a Mental Health and Substance Use Disorder Parity Task Force, which aims to ensure that coverage for mental health benefits is comparable to coverage for medical and surgical care, improve understanding of the requirements of the law, and expand compliance with it. Mental health should be treated as part of a person's overall health, and we must ensure individuals living with mental health conditions can get the treatment they need. My Administration also continues to invest in science and research through the BRAIN initiative to enhance our understanding of the complexities of the human brain and to make it easier to diagnose and treat mental health disorders early. One of our most profound obligations as a Nation is to support the men and women in uniform who return home and continue fighting battles against mental illness. Last year, I signed the Clay Hunt SAV Act, which fills critical gaps in serving veterans with post-traumatic stress and other illnesses, increases peer support and outreach, and recruits more talented individuals to work on mental health issues at the Department of Veterans Affairs. This law will make it easier for veterans to get the care they need when they need it. All Americans, including service members, can get immediate assistance by calling the National Suicide Prevention Lifeline at 1-800-273-TALK or by calling 1-800-662-HELP. During National Mental Health Awareness Month, we recognize those Americans who live with mental illness and substance use disorders, and we pledge solidarity with their families who need our support as well. Let us strive to ensure people living with mental health conditions know that they are not alone, that hope exists, and that the possibility of healing and thriving is real. Together, we can help everyone get the support they need to recover as they continue along the journey to get well. NOW, THEREFORE, I, BARACK OBAMA, President of the United States of America, by virtue of the authority vested in me by the Constitution and the laws of the United States, do hereby proclaim May 2016 as National Mental Health Awareness Month. I call upon citizens, government agencies, organizations, health care providers, and research institutions to raise mental health awareness and continue helping Americans live longer, healthier lives. IN WITNESS WHEREOF, I have hereunto set my hand this twenty-eighth day of April, in the year of our Lord two thousand sixteen, and of the Independence of the United States of America the two hundred and fortieth.  
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frosk

Can you take Paxil and Effexor together?

4 posts in this topic

Posted

Doc just said that he would give me samples of effexor to try and eventually taper off Paxil. He said it is not recommended to take both because of drug to drug interaction but is still saying I can try it. I think he is going to give me a low dose. Is this something that would lead to serotonin syndrome? I dont know what to do.

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Posted

I'm finding it difficult to answer your questions. I think that only you can make this decision in consultation with your dr. I've asked some questions and given a reference to a web site with a drug interaction checker (always useful when looking for info on drugs).

It can be okay sometimes to cross taper that is go straight from taking Effexor to an SSRI such as Prozac but I've not heard of taking Paxil and Efexor at the same time.

I looked at www.drugs.com (which is where the quotes come from, but do check it out yourself).

I did a quick check on their drug Interactions checker and it does say that there is a risk of serotonin syndrome when taking drugs of these types together. But it is a "rare but serious and potentially fatal condition".

It might be that your dr doesn't want you to have to come off of Paxil first before going onto Effexor, because that might make your depression come back. I presume that he is suggesting doing it this way so that you don't suffer too much from the depression. But how do you feel? It might be that he doesn't want you to suffer any possible discontinuation symptoms from stopping the Paxil. Why does he want you to take them both before stopping the Paxil?

The drug checker did say that using different types of ADs ("serotonergic agents" at the same time "should be avoided if possible" or "used with caution" if their use is considered beneficial and therefore worth taking the risk. Your dr must think so before he suggests this. Is there a risk to yourself in not being on an AD? Do you have suicidal feelings? Or is the depression so bad that you can't cope?

The checker also lists the symptoms of serotonin syndrome, so if you do decide to take both drugs then watch out for these symptoms and if you get them, go to your local emergency room AT ONCE. The symptoms "of excessive serotonergic activity such as CNS irritability, altered consciousness, confusion, myoclonus, ataxia, abdominal cramping, hyperpyrexia, shivering, pupillary dilation, diaphoresis, hypertension, and tachycardia."

Anyone should watch out for these symptoms when changing or increasing doseages.

I really can't say yes do it or no don't do it. I haven't been in the position you are in just now. Do think about it. On the one hand, serotonin syndrone is very rare but mixing the two meds might increase that risk.

How long would you be on the two drugs for? It might be ok at low doseages of either drug.

Do you think that you could tolerate the period of time it would take to come off Paxil (could be weeks) and then start Efexor?

Is it possible to just stop taking paxili and immediately start Effexor? But maybe that would cause problems with discontinuation symptoms.

Do talk it over again with your dr.

I'm sorry to have come back with so many questions, but I think the answer really should come from yourself. I think because you are having doubts maybe answers your own question.

I think you are right to be questioning this.

Whatever you decide do let us know what happens.

I hope that things go ok with you.

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Posted

Thank you for the response. I am sure he doesnt want me to go through terrible withdrawals and that is why he was suggesting this. I called back and left a message and asked if there was a risk of seretonin syndrome as I was worried about the drug interaction he talked about. His secretary called me back and said just to continue on the meds I am now taking. I guess by me questioning he thought it might not be worth it. My meds are not working so I am pretty much desperate for a med that works. I think the way to do this is to come off Paxil and go to something else in this case he was going to substitute Effexor. Again thank you very much for your detailed response, that was very nice.

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Posted

Thanks for letting us know the end of the story.

I hope that if you do change to Effexor that it goes ok.

Are you having problems with discontinuing Paxil? Oops that should be in the Paxil room.

Eileen

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