Mental Health

Have mental health questions? Ask a psychiatrist online

Ask an Expert,
Get an Answer ASAP!

I am 64 years old and have suffered with depression for the…

Customer Question
I am 64 years old...
I am 64 years old and have suffered with depression for the past 38 years. I was originally on amitriptyline and this was changed to paroxetine 12 years ago. I have been going through a particularly bad patch these last two months and my GP has now prescribed mirtazapine 30 mg. Is it O.K. to start on this dose and cut out the paroxetine. I have seen a number of psychiatrists who tell me that I am one of those people who should not come off antidepressants because when I did in the 70's and 80's i suffered really bad relapses resulting in complete breakdowns. I have heard quite a few bad reports about the side effects of mirtazapine and am rather hesitant to try it. Perhaps I should try increasing the paroxetine. I am currently taking 20 mg. What do you think. I am so tired and lethargic all the time and hardly ever go out and my self esteem is practically nil. I have very negative thoughts and wish I wasn't here.
Submitted: 8 years ago.Category: Mental Health
Show More
Show Less
Ask Your Own Mental Health Question
Answered in 1 day by:
6/10/2010
Mental Health Professional: Dr. Ed Wilfong, Psychologist replied 8 years ago
Dr. Ed Wilfong
Dr. Ed Wilfong, Psychologist
Category: Mental Health
Satisfied Customers: 1,528
Experience: Twenty-five years treating all ages; Specialities: psychopharmacology & diagnosis, MMPI-2, testing.
Verified
Changing to Mitrazapine and quitting Paxil is fine, actually good. Paxil is very sedating. Online I hear bad reports about all meds. On practice it is usually just a very low percent. I never recommend Paxil because of the side effects. You can ask for something different than Mitrazapine if you don't like that idea. Pristiq and Cymbalta are pretty good for energy. Hang in there through transition.
Ask Your Own Mental Health Question
Customer reply replied 8 years ago
lt;p>Is it O.K to stop paroxetine completely or should it be reduced gradually?  What is the recommended dosage on first starting mirtazepine?</p><p> </p><p>Thank you</p>
Mental Health Professional: Dr. Ed Wilfong, Psychologist replied 8 years ago
I recommend talking to your doctor. If not possible, I would try a half dose of each for 5 days, then Mitrazapine. Starting dose of Mitrazapine is 15 mg. If you are on 20 mg of paxil, you should be ok on 10mg Paxil and 15 of mitrazapine for 5-7 days before switching to 30 of mitrazapine. If on more than 20 of Paxil, I would cut it to 20 for 5 days before adding mitrazapine. You can just cut out Paxil totally and start Mitrazapine 15 for 5 days and then go to 30. To some extent, let the side effects guide you. If quitting Paxil is uncomfortable, the do the 50/50. If you can comfortably quit paxil and start Mitrazapine, (Most people can) that is fine.
I hope you feel better soon.
Ask Your Own Mental Health Question
Was this answer helpful?

How JustAnswer works

step-image
Describe your issueThe assistant will guide you
step-image
Chat 1:1 with a mental health professionalLicensed Experts are available 24/7
step-image
100% satisfaction guaranteeGet all the answers you need
Ask Dr. Ed Wilfong Your Own Question
Dr. Ed Wilfong
Dr. Ed Wilfong
Dr. Ed Wilfong, Psychologist
Category: Mental Health
Satisfied Customers: 1,528
1,528 Satisfied Customers
Experience: Twenty-five years treating all ages; Specialities: psychopharmacology & diagnosis, MMPI-2, testing.

Dr. Ed Wilfong is online now

A new question is answered every 9 seconds

How JustAnswer works:

  • Ask an ExpertExperts are full of valuable knowledge and are ready to help with any question. Credentials confirmed by a Fortune 500 verification firm.
  • Get a Professional AnswerVia email, text message, or notification as you wait on our site. Ask follow up questions if you need to.
  • 100% Satisfaction GuaranteeRate the answer you receive.

JustAnswer in the News:

Ask-a-doc Web sites: If you've got a quick question, you can try to get an answer from sites that say they have various specialists on hand to give quick answers... Justanswer.com.
JustAnswer.com...has seen a spike since October in legal questions from readers about layoffs, unemployment and severance.
Web sites like justanswer.com/legal
...leave nothing to chance.
Traffic on JustAnswer rose 14 percent...and had nearly 400,000 page views in 30 days...inquiries related to stress, high blood pressure, drinking and heart pain jumped 33 percent.
Tory Johnson, GMA Workplace Contributor, discusses work-from-home jobs, such as JustAnswer in which verified Experts answer people’s questions.
I will tell you that...the things you have to go through to be an Expert are quite rigorous.

What Customers are Saying:

I can go as far as to say it could have resulted in saving my sons life and our entire family now knows what bipolar is and how to assist and understand my most wonderful son, brother and friend to all who loves him dearly. Thank you very much

Corrie MollPretoria, South Africa

I thank-you so much! It really helped to have this information and confirmation. We will watch her carefully and get her in for the examination and US right away if things do not improve. God bless you as well!

ClaudiaAlbuquerque, NM

Outstanding response time less than 6 minutes. Answered the question professionally and with a great deal of compassion.

KevinBeaverton, OR

Suggested diagnosis was what I hoped and will take this info to my doctor's appointment next week.
I feel better already! Thank you.

ElanorTracy, CA

Thank you to the Physician who answered my question today. The answer was far more informative than what I got from the Physicians I saw in person for my problem.

JulieLockesburg, AR

You have been more help than you know. I seriously don't know what my sisters situation would be today if you had not gone above and beyond just answering my questions.

John and StefanieTucson, AZ

I have been dealing with an extremely serious health crisis for over three years, and one your physicians asked me more questions, gave me more answers and encouragement than a dozen different doctors who have been treating me!!

Janet VPhoenix, AZ

< Previous | Next >

Meet the Experts:

Dr. Keane

Dr. Keane

Therapist

1,379 satisfied customers

Clinical Psychology PhD, Licensed Professional Counselor with experience in marriage/family, teens and child psychology.

TherapistMaryAnn

TherapistMaryAnn

Therapist

4,111 satisfied customers

Over 20 years experience specializing in anxiety, depression, drug and alcohol, and relationship issues.

Dr. Olsen

Dr. Olsen

Psychologist

2,336 satisfied customers

PsyD Psychologist

Norman M.

Norman M.

Principal psychotherapist in private practice. Newspaper contributor, over 2000 satisfied clients on JA

2,246 satisfied customers

ADHP(NC), DEHP(NC), ECP, UKCP Registered.

Dr. Michael

Dr. Michael

Psychologist

2,177 satisfied customers

Licensed Ph.D. Clinical Health Psychology with 30 years of experience in private practive and as a clinical psychology university professor.

Steven Olsen

Steven Olsen

Therapist

1,728 satisfied customers

More than twenty years of expertise in counseling, psychological diagnosis and education

Anna

Anna

Mental Health Professional

1,656 satisfied customers

Licensed Clinical Social Worker with 29 years in addictions and mental health.

< Previous | Next >

Related Mental Health Questions
I have been taking 5ml of ambien for sleep at night. I get
I have been taking 5ml of ambien for sleep at night. I get to sleep and wake up 3 hours later. I can't get back to sleep after my 2 years wakes me up. What do you suggest? … read more
Dr. Vikas
Dr. Vikas
Professor & Head
M.D (Psychiatry)
33 satisfied customers
Been taking amitriptyline (to aid in sleep) and have been
been taking amitriptyline (to aid in sleep) and have been feeling psychotic. Cruel to my pets at times and thinking bad things towards people. Then I feel bad after for the way I have acted. Whats goi… read more
Dr. Vikas
Dr. Vikas
Professor & Head
M.D (Psychiatry)
33 satisfied customers
I've been seeing my psychiatrist for anxiety, mental ocd,
I've been seeing my psychiatrist for anxiety, mental ocd, and depression for 16 years now. He has raised my prozac dosage to 140 mg. At 140 mg, I was buzzing, so I took it down to 120 mg. I'm now at 8… read more
Dr. Vikas
Dr. Vikas
Professor & Head
M.D (Psychiatry)
33 satisfied customers
I have Hyperthyroid and High Blood Pressure, and I always
I have Hyperthyroid and High Blood Pressure, and I always feel the pressure in my head and neck. I can't focus and am feel fear people in public place. I have a very fast metabolism and I look angry a… read more
Dr. Vikas
Dr. Vikas
Professor & Head
M.D (Psychiatry)
33 satisfied customers
I have been taking Remeron at 45mg dose for 1 month and find
I have been taking Remeron at 45mg dose for 1 month and find that i have a VERY cloudy head, can't concentrate, have cold and hot flashes, muscle spasms and seem to have light sensitivity. I also am n… read more
Dr. Vikas
Dr. Vikas
Professor & Head
M.D (Psychiatry)
33 satisfied customers
I am currently trying to find a sleep medication that will
I am currently trying to find a sleep medication that will help me calm my anxiety and fall asleep. I plan on being on this for awhile since i have let my sleep issues get out of control. Any ideas? I… read more
Dr. Vikas
Dr. Vikas
Professor & Head
M.D (Psychiatry)
33 satisfied customers
If I am taking paroxetine and it does not seem to be
If I am taking paroxetine and it does not seem to be working, could i take imipramine instead?… read more
Dr. Vikas
Dr. Vikas
Professor & Head
M.D (Psychiatry)
33 satisfied customers
I have a 20 year old son that has anxiety diarrohea we have
I have a 20 year old son that has anxiety diarrohea we have been to a phycologist ,natropath and homepath Whenever he goes out of his comfort zone his stomach goes crazy and he gets this diarrohae I t… read more
Dr. Vikas
Dr. Vikas
Professor & Head
M.D (Psychiatry)
33 satisfied customers
I am writing a fictional novel. The scene I am writing takes
I am writing a fictional novel. The scene I am writing takes place in the early to mid 80's. The character I'm writing about is a woman who has suffered a miscarriage in the first trimester. Is it pos… read more
Dr. Ed Wilfong
Dr. Ed Wilfong
Psychologist
Doctoral Degree
1,528 satisfied customers
What is the best way to get pooped out cymbalta to work
What is the best way to get pooped out cymbalta to work again, I have been on it over 4 years… read more
Dr. Vikas
Dr. Vikas
Professor & Head
M.D (Psychiatry)
33 satisfied customers
Is it safe to give a 93 year old woman (my Mom) 15 mg
Is it safe to give a 93 year old woman (my Mom) 15 mg Remeron for insomnia (for 3 weeks now), and then also to start her on 25 mg Zoloft for depression (which can cause insomnia)? Since moving into a … read more
Dr. Vikas
Dr. Vikas
Professor & Head
M.D (Psychiatry)
33 satisfied customers
I am currently taking an antidepressant medication, 30 mg
Hi there, I am currently taking an antidepressant medication, 30 mg mirtazapine every night about an hour before bed. I have a history of major depression. I am 37 years old with 2 children, (2 and 4)… read more
Dr. Vikas
Dr. Vikas
Professor & Head
M.D (Psychiatry)
33 satisfied customers
Please I'm fairly desperate. I suffer severe depression and
Please I'm fairly desperate. I suffer severe depression and went into crisis during the changeover from Mirtazapine to venlafaxine, at the weekend. I became pretty catatonic and very unsafe ie. physic… read more
Fabio Goderecci
Fabio Goderecci
Private Psychiatrist, CEO
Psychiatrist, Psychotherapist, MD
135 satisfied customers
My sex drive has been low with my boyfriend for a time
My sex drive has been low with my boyfriend for a long time (about 5 years). We are currently going through couples therapy for this issue. I came across a supplement in the drug store called "FemMED … read more
Dr. Vikas
Dr. Vikas
Professor & Head
M.D (Psychiatry)
33 satisfied customers
I was prescribed Lexapro for early menopause and weight
Hi I was prescribed Lexapro for early menopause and weight gain. Not sure it is working. I have been taking for about 3 months. Any advise? Thank you.… read more
Dr. Vikas
Dr. Vikas
Professor & Head
M.D (Psychiatry)
33 satisfied customers
My wife suffers bad depression.(She is 54) She complains
My wife suffers bad depression.(She is 54) She complains that she has never been loved as a child. Her mother has never told her she loves her. She left home at 16 years of age and lived alone in a fl… read more
Dr. Vikas
Dr. Vikas
Professor & Head
M.D (Psychiatry)
33 satisfied customers
What is the most immediate way to really increase self
What is the most immediate way to really increase self esteem and feel good about yourself for more than a fleeting moment?… read more
Dr. Vikas
Dr. Vikas
Professor & Head
M.D (Psychiatry)
33 satisfied customers
I asked question to pauline some months ago.Suffered
I asked question to pauline some months ago.Suffered depression all my life and was prescribed phenelzine and librium in my twenties.Since then prothiaden 25 mg x3 ,effexor ,and various others and for… read more
Dr. Vikas
Dr. Vikas
Professor & Head
M.D (Psychiatry)
33 satisfied customers
Disclaimer: Information in questions, answers, and other posts on this site ("Posts") comes from individual users, not JustAnswer; JustAnswer is not responsible for Posts. Posts are for general information, are not intended to substitute for informed professional advice (medical, legal, veterinary, financial, etc.), or to establish a professional-client relationship. The site and services are provided "as is" with no warranty or representations by JustAnswer regarding the qualifications of Experts. To see what credentials have been verified by a third-party service, please click on the "Verified" symbol in some Experts' profiles. JustAnswer is not intended or designed for EMERGENCY questions which should be directed immediately by telephone or in-person to qualified professionals.

Disclaimer: Information in questions, answers, and other posts on this site ("Posts") comes from individual users, not JustAnswer; JustAnswer is not responsible for Posts. Posts are for general information, are not intended to substitute for informed professional advice (medical, legal, veterinary, financial, etc.), or to establish a professional-client relationship. The site and services are provided "as is" with no warranty or representations by JustAnswer regarding the qualifications of Experts. To see what credentials have been verified by a third-party service, please click on the "Verified" symbol in some Experts' profiles. JustAnswer is not intended or designed for EMERGENCY questions which should be directed immediately by telephone or in-person to qualified professionals.

Show MoreShow Less

Ask Your Question

x