Ask a Psychiatrist and Get Answers to Mental Health Questions ASAP
Because of your specializing in psychopharmacology, I want to tell you what I have been through over the past 7 months and get your advice. I had been trying to wean myself from Paxil 20 mg (which I had been on for 10 years or so) when I had a health scare. My anxiety came back because they made me wait 28 days for a test to see what was wrong with me (I am fine; test was negative) and very likely because I had not been taking my Paxil regularly. I went back on 20 mg Paxil daily, but I still had terrible shaking when I got up in the morning. Lorazapam took care of that. I was on the 20mg when my doctor had me try Paxil e.r. to see if it would help the shaking in the morning. It did get somewhat better. Then I saw a doctor who switched me to Celexa 20mg. I took it for a week and felt okay, but was still shaking, so I went up to 40 mg., which gave me the most horrible depression, borderline suicidal. So, my doctor put me on 40mg. of Paxil. I felt awful. So I saw a psychiatrist who put me back on 20mg of Paxil, and Lorazapam (2mg. a day) I have been on the 20 mg. of Paxil for 4 weeks now. I still shake, but not nearly as bad as in the beginning of this, but I feel kind of sick to my stomach all the time, and I still have no interest in anything much. You answered my question about switching back to Paxil 25 mg. e.r. and I think I will try it again. Now, my question is: do you think I have waited long enough for results from the Paxil? Should I give it 8 weeks to see if it will work? I am about at the end of my very frayed rope. Did switching medication so often interfere with the regime I am on now to work more quickly, or is 6 to 8 weeks standard for acheiving relief? I went through terrible anxiety/depression (anxiety was the worse of the two) 10 years ago and it took about 2-3 months to get completely over it. I was doing great for 10 years until I decided to see if I needed medication anymore. Huge mistake, and I seem to be paying for it now. So, should I give the Paxil more time? I know you are not available right now, but would appreciate an answer as soon as you re available. Thank you.
I want to mention that I am not feeling any better. I feel the same lousy way every day, and the anxiety is still with me---I just don't shake quite as much as when this started. It seems as though I should start feeling some improvement after 4 1/2 weeks, or am I wrong? Do I just suddenly feel better after 6-8 weeks, or should there be some gradual progression toward feeling better. I feel pretty good at night, and when I was on the Paxil 25 e.r. I would fell completely normal by around dinner time. I would also have brief moments when I would feel normal, usually at night. Is it possible that Paxil simply isn't working for me anymore? Did I not give Celexa 20mg. enough time. I was only on it for a week and went to 40 mg, which as I mentioned made me much worse.
Thank you for your answer. I am just starting my 5th week of the Paxil e.r. Because of all the changes I have been through, I am willing to give the Paxil more time. The first time I had this problem it took about 2-3 months to get over it.
I can take up to 2 mg. of Lorazapam. I take 1/2 in the morning, and 1/2 in the afternoon, if I need it, and I take 1mg. when I go to bed. I'm not really sure I need to do that. I don't have trouble sleeping, but maybe it's because I take the Lorazapam.
I'm pretty sure this is not related to another medical problem, except the need for a hip replacement, which I'm not too thrilled about. But I had the hip problem before this started, although I didn't know I needed a new hip until this summer.
You mentioned Zoloft, Pristiq, Cymbalta, or something similar. What is "something similar" and what do all of these drugs have in common?
The psychiatric nurse I saw seemed to be a big fan of Prozac, but I wasn't willing to change drugs again at that time, so we went with the Paxil e.r., which seemed to be working for me until I tried the other things. I tried the others to see if they would stop the anxiety. The other things being 40mg. of Celexa and Paxil. The doses were too high. The psychiatrist I saw put me back on Paxil 20mg. and Lorazapam
You say that Paxil is not your favorite drug. What is your favorite drug?
I started with Xanax, went off of it immediately. It made me feel wired. Then I went on Paxil. Then a colleague of my doctor put me on Effexor. Quit that very soon because it gave me horrible headaches and raised my blood pressure. I went back to Paxil for 8- 10 years and did great, until my weaning trial!
The psychiatric nurse I saw seemed to be a big fan of Prozac, but I didn't want to change drugs again, so she put me on Paxil e.r. which I was doing pretty well on until I tried other things to see if they would stop the anxiety: 40 mg of Paxil and Celexa. The doses were too high, so the psychiatrist put me back on Paxil 20 mg. and Lorazapam.
If the Paxil e.r. doesn't fix me completely in another 2-4 of weeks, do you have any idea what might be the best drug for me to try?
Thank you very much for all the information. I am very impatient I'm afraid, but I will continue on the Paxil. I am feeling a little bit better,except I just don't feel like doing anything---very frustrating. Perhaps I would feel better if I forced myself to do something, whether I feel like it or not!
I will keep your recommendations in mind, and tell my doctor, if Paxil doesn't come through for me this time.