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Ask Dr. Arun Phophalia Your Own Question
Dr. Arun Phophalia
Dr. Arun Phophalia, Doctor (MD)
Category: Health
Satisfied Customers: 35496
Experience:  MBBS, MS (General Surgery), Fellowship in Sports Medicine
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I am suffering an episode of general anxiety and depression

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I am suffering an episode of general anxiety and depression for 9 weeks.
I am taking 20 mg paroxetine (after trying Cipralex which did not work even in high dose) and in the evening clonazepam an for calming down, and later for sleep, nitrazepam and Trittico. I still do not sleep well, but at least I do...
Besides that, as always for me during these times, this is accompanied by slight diarheea and the sensation of urinating.
For this, I am taking in the morning 1 Tiorfan and the paroxetine after 1 hour, and I drink 1 dose of herbal supplement (cranberries and other similar) for the prevention of urinary infections.
My question now is related to my period that just started: I have dismenorheea, so this is always accompanied w/ severe pains. Normally I take No Spa (drotaverin) and nimesulide or ibuprofen. Last month while on Cipralex I had no adverse reactions. Now I'm afraid since I changed on paroxetine that there could be interaction w/ either that or the benzos.
I am also confused by how should I take them. in which order....
Foremost I have to take the Tiorfan so the rest is not just "flushed out", not being properly absorbed. But then?
Can I take the pain medication w paroxetine or should I keep an interval between them?
Thanks for helping me sort this out.

Hello Ana,
I am Dr. Arun and will be helping you today.

Ibuprofen and nimsulide cannot be taken with the paroxetine. As there is a significant drug interaction and chance of stomach bleeding. The only analgesics one can take is acetaminophen which is over the counter. Otherwise you would need prescription of the narcotic analgesic from your doctor.

Please feel free for your follow up questions.

I would be happy to assist you further, if you need any more information.

Thanks for using Just Answer.

Customer: replied 4 years ago.

I have taken them together for years in this situation and never had issues. I always eat something for protecting my stomach. And in my country I do not need prescription for them, I already have some. Tried acetaminofen, does not work...

I can take them separately, different hours.

Yes Ana, you can take them in the difference of about an hour or more. For caution you may take an Omeprazole or Pantaprazole, which will prevent the risk of bleeding. You may also take an antacid.

It is privilege assisting you.

Customer: replied 4 years ago.

Confused now... first you said no way, than ok... Just making sure...


Classical advice is that there is a drug interaction. And these should be avoided together. Individual variations (customized advice) had to be done as you mentioned that you have been taking it.
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