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TherapistMarryAnn, Therapist
Category: Mental Health
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Experience:  Over 20 years experience specializing in anxiety, depression, drug and alcohol, and relationship issues.
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can paxil & trazadone be taken together what is the difference

Customer Question

can paxil & trazadone be taken together? what is the difference between SSRI 's & SARI's?
Submitted: 5 years ago via HealthBoards.
Category: Mental Health
Expert:  TherapistMarryAnn replied 5 years ago.

Hi, I'd like to help you with your question.


It is not advisable to take Paxil and Trazadone together as they both work to increase Serotonin, a naturally occurring chemical in your brain known as the "feel good" chemical. Using both together can cause serotonin syndrome, which is a rare but serious (and possibly fatal) reaction to serotonin syndrome. The side effects are:


irritability, confusion, hallucinations, and coma, change in heart rhythm, blood pressure, tremors, stomach cramping and other physical reactions.


You should only be taking a combination like this if the benefits are deemed to outweigh the risks and under strict supervision of a doctor.


SSRI's are selective serotonin reuptake inhibitors, which affect the serotonin in your brain. They work by affecting certain neurotransmitters in your brain. An SSRI changes the re absorption rate of serotonin in your brain so you feel better. It helps your brain cells better receive messages which in turn affects your mood.


As far as I know, there are no medications called SARI's. But there are SNRI's, which may be what you meant. They work similar to SSRI's by affecting the reabsorbion of serotonin and also of norepinephrine in your brain. This affects certain neurotransmitters and therefore affects your mood.


The reason that your friend may be reacting well to their medication is because medications all work differently for different people, depending on a person's individual chemical make up. That is why there are so many different kinds of medications in each group of medicines. You will have several anxiety medications, several depression medications, etc. It helps people find which medications work best for them. It is very common to try several before you find one that works for you.


I hope this has helped,

TherapistMarryAnn, Therapist
Category: Mental Health
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Experience: Over 20 years experience specializing in anxiety, depression, drug and alcohol, and relationship issues.
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Expert:  Dr. Ed Wilfong replied 5 years ago.
SSRI's are drugs such as Paxil. The block the re-uptake of Serotonin, which effectively increases the amount of serotonin available in the synapse. Trazadone is one of 2 SARI's which are Serotonin/Antagonist re uptake inhibitors. SARI's not only slow re-uptake but also block action of serotonin at 5HT2A receptors, one of the many types of serotonin receptors, in addition to blocking histamine 1 and alpha 1 receptors. The blockade of 5HT2A may account for trazadone being sedating.
Often an SSRI at a therapeutic dose is combine with Trazadone at a low dose so Trazadone can assist with sedation and hopefully anxiety. Although Trazadone and SSRI's should not be both used at therapeutic doses, It is common practice to add Trazadone in low dose with SSRI. (Therapeutic dose of trazadone is 300 mg - most people cannot tolerate that much sedation. Use at 25-50mg is common practice and safe with SSRIs). SARIs are seldom used alone for depression.
As for Zoloft and Trazadone, Zoloft is different that usual SSRI and often helpful in anxiety/depression, but people respond differently to different medications. There is no reason to prefer one over the other, but it may be worth a try if your combo doesn't work out. Describing the mechanism of Zoloft is another question.

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