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Selah R, M.S. LPC
Selah R, M.S. LPC, Therapist
Category: Mental Health
Satisfied Customers: 582
Experience:  Licensed Professional Counselor; over 13+ yrs exp working with adults, teens, & families/couples.
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I have been taking Seroxat for many years, the last few years

Resolved Question:

I have been taking Seroxat for many years, the last few years on 10mg, the last 6 months I have felt more anxious with fatigue, muscle tension and stiffness and a feeling of my old symptoms returning. I do want to come off Seroxat (Paxil) but do you feel these symptons are a return of my anxiety or that Seroxat has pooped out at 10mg and should I increase Seroxat back to 20MG, or switch to say Citalopram (Celexa) or Lexapro, what do you recommend? If I switch will I get seroxat withdrawal and should I titrate seroxat down and at the same time titrate citalopram/lexapro up.
Submitted: 3 years ago.
Category: Mental Health
Expert:  Dr. Ed Wilfong replied 3 years ago.
I believe I answer before. Do you want me to reply again or prefer second opinion.
Customer: replied 3 years ago.
I would like a second opinion. I want to have opinions on this as my GP has left it to my decision on how to go forward with this.
Expert:  Selah R, M.S. LPC replied 3 years ago.
Thank you for trusting JustAnswer with your important question.

You are on a low dose, so it's probably worth trying an increase for 2-4 weeks to see if your symptoms improve (then stay on the Paxil and taper up to a dose that works again) or if your symptoms worsen (then it's time to change SSRIs because the body is rejecting the Paxil).

If you have to change medications, I tend to see better responses with fewer side-effects on Lexapro than Celexa. Zoloft would be the other one worth trying in the SSRI family. When switching from one SSRI to another there is usually very limited negative side-effects.

If your anxiety, fatigue, and muscle aches do not respond to changing SSRIs then it might be time to consider something like Effexor XR that works on both serotonin and norepinephrine.

Best wishes,
Selah
Customer: replied 3 years ago.
I am not ken on increasing paxil due to the documented withdrawal effects and while I am on a low dose it could be a good time to switch, although I am concerned that I will have start up side effects of an another ssri as well as paxil withdrawal. I I do switch to say lexapro would you recommend a taper off paxil as I taper up on lexapro, so for a time I will have 2 ssri's in my body.
Expert:  Selah R, M.S. LPC replied 3 years ago.
If you have a history of being sensitive to medications, then you could go to 5mg of Paxil and 5mg of Lexapro for a week or two, then move over to 10mg of Lexapro. Luckily, at the dose you're on, and moving to a drug that's very similar, you should have very mild symptoms of withdrawal/change. I've had very few people report negative side effects from Lexapro, it is generally one of the best tolerated in the class.

Selah
Selah R, M.S. LPC, Therapist
Category: Mental Health
Satisfied Customers: 582
Experience: Licensed Professional Counselor; over 13+ yrs exp working with adults, teens, & families/couples.
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