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MN Psychiatrist
MN Psychiatrist, Psychiatrist
Category: Mental Health
Satisfied Customers: 792
Experience:  Physician for 17 years, adult psychiatrist for 13 years working with a wide variety of patients.
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I have been on Paxil for 15 years for OCD anxiety and it has

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I have been on Paxil for 15 years for OCD anxiety and it has worked for the most part. I went in to see my Internist today to discuss late day anxiety breakthough issues and sleep issues. She prescribed 50 of Serequel. It concerns me a bit that it is an anti-psychotic med. Does this seem like a wise choice that my doctor put me on this? I am a high functioning Sales Person and am concerned about potential long term problems from this
Hello, I am a psychiatrist.
For me to best answer this, I need a bit more information, What dose of the Paxil are you taking? Are you taking any other medications at all? If so, what are their doses?
Customer: replied 4 years ago.

I am on 45mg of Paxil. I also am on Nexium 20mg and 10mg of crestor.

 

Hope that helps.

I see.
One option would be to simply increase the Paxil. That would be the most straightforward thing. Paxil is commonly used at doses of up to 60-80mg daily. That said, Seroquel is often used to help with anxiety and insomnia, but my preference would be to either increase the Paxil or use Vistaril (hydroxyzine) for the additional anxiety. Vistaril is a prescription medication; it is an antihistamine medication that has some anti-anxiety properties. It is quite safe and non-addictive. It's biggest drawback is that it might make you tired (which Seroquel can certainly do, too).

Does this make sense?
Customer: replied 4 years ago.
Thank You, XXXXX XXXXX very helpful. I mentioned to my primary doctor that I thought Paxil above 45 would be useful and she felt this was already a high dose. I think she put me on the serequel because she knows I am not sleeping. My biggest fear of the Serequel is I know antipsychotic meds can have some crazy side affects that concern me like TD and neorological concerns.
I see.
Seroquel is probably the best of the bunch when it comes to having a low risk of Tardive Dyskinesia, and it really is commonly used for sleep/anxiety by psychiatrists, but that doesn't mean it's as "benign" on a long term basis as Paxil or Vistaril.
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