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Dr. Vikas
Dr. Vikas, Doctor (MD)
Category: Health
Satisfied Customers: 2219
Experience:  M.B.B.S ; M.D (Psychiatry and Deaddiction), MS. Health Informatics
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Hello, My doctor want to switch me from Lexabro after 2

Resolved Question:

Hello,

My doctor want to switch me from Lexabro after 2 months using to combo of (Paxil and remeron) directly .. Is this mixing (Paxil and remeron) good ?
Submitted: 1 year ago.
Category: Health
Expert:  Chris C. replied 1 year ago.

Chris C. :

Lexapro is a first choice medication that is well tolerated. Remeron/Paxil are normally only used if the patient does not respond to the Lexapro or preferred ssri/snri medications.

Chris C. :

Remeron/Paxil is effective in many people but it does have many more side efffects than Lexapro and similar drugs.

Chris C. :

Many people that take the combo have a significant weight loss, stomach problems, dizziness, and other side effects.

Chris C. :

This is something you will want to discuss with your doctor to see if this is in fact the best option. It may be effective but as I said it does have a higher rate of side effects.

Expert:  Dr. Vikas replied 1 year ago.
Hello,

Thanks for your question.

See, both Paxil (Paroxetine) and Lexapro (Escitalopram) are SSRI antidepressants while Remeron (Mirtazapine) has totally different mechanism of action.

In those patients who are not responding to a SSRI antidepressant like Lexapro, we frequently add another antidepressant like Remeron to augment the antidepressant effect of SSRI antidepressant. The advantage of adding Remeron will be that it will add to the antidepressant and antianxiety effect of SSRI antidepressant and can also counteract certain side effects of SSRI antidepressant.

Now Paxil itself is a sedating antidepressant and Remeron can also cause significant sedation so as a whole, this combination can be very sedative in some patients.

I personally prefer to use a combination of Escitalopram (Lexapro) with Mirtazapine (Remeron) instead of Paxil with Remeron.

So to summarize, combination of SSRI antidepressant with Remeron is a very good combination but you can discuss with your doctor about trying a combination of Lexapro with Remeron instead of Paxil with Remeron in my view.

Please feel free to discuss further if you have any other query.

Kind regards

Vikas
Customer: replied 1 year ago.

Hello,


 


The doctor would like to switch me to Paxil because it is the first medication I have used and respond to before 6 years then I stopped Paxil for 9 months and started with Lexapro for 2 month until now and the responding not completly good especially in depression, so that why I want to go back to Paxil and add Remeron, so what do you think please ?


Best Regards

Expert:  Dr. Vikas replied 1 year ago.


Thanks for your reply.

As I mentioned earlier, both Paxil and Lexapro are SSRI antidepressant and have more or less similar mechanism of action. However Paxil is comparatively more sedative than Lexapro.

If you are able to tolerate the combined sedative effect because of these two medicines then the combination of Paxil with Remeron is also a good option specially because you responded well to Paxil earlier.
Expert:  Dr. Vikas replied 1 year ago.
I hope I’ve provided the information you were seeking, if not, please let me know so that l can continue to help you. If you need more help, please use the reply tab to continue our conversation.


If you do not require further assistance,please rate one of the positive ratings (3,4,5 / smiley faces) as this is the only way how we are compensated for our time and expertise.


Please take a moment to rate the answer.


Kind regards


Vikas
Customer: replied 1 year ago.

Hello again,


 


I would ask you Dear doctor, if someone not respond to lexapro that mean he will not respond to other medications ?


 


Best Regards


 

Expert:  Dr. Vikas replied 1 year ago.
If a patient does not respond to Lexapro he or she may respond to another antidepressant belonging to the same or different family.

For example, Lexapro is a SSRI antidepressant and so are Paxil or Prozac but it is possible that a patient may not respond to Lexapro and respond very well to Paxil or Prozac.
Dr. Vikas, Doctor (MD)
Category: Health
Satisfied Customers: 2219
Experience: M.B.B.S ; M.D (Psychiatry and Deaddiction), MS. Health Informatics
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Dr. Vikas
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M.B.B.S ; M.D (Psychiatry and Deaddiction), MS. Health Informatics