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Dr. Z
Dr. Z, Psychologist
Category: Mental Health
Satisfied Customers: 10643
Experience:  Psy.D. in Clinical Forensic Psychology with a background in treating severe mental illnesses.
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How do I cross taper from 20 Laxapro and 50 strattera to 40

Customer Question

How do I cross taper from 20 Laxapro and 50 strattera to 40 paxil and strattera?
Submitted: 1 year ago.
Category: Mental Health
Expert:  Dr. Z replied 1 year ago.

*This website DOES NOT constitute treatment and only provides information and advice in a Q&A format. For treatment (therapy and/or medications) you must go to a licensed professional in your area. Please note that anything said here is not private or confidential, as this is a public forum.

Hello and thank you for using JustAnswer. May I ask, for how long have you been taking the Lexapro and Strattera? Also you ask how to cross taper from Strattera to Strattera, is this correct or did you mean to write another medication here?

Customer: replied 1 year ago.
6 months.
that's the real question. The cross taper from Lex to Pax is not that difficult. It's the strattera I'm concerned about as It interacts so much different with pax then Lex.
Customer: replied 1 year ago.
In other words. Strattera will remain the same (except for the CYP2D6 interaction), the only change is with the SSRI.
Expert:  Dr. Z replied 1 year ago.

Thank you for your response. So the good news is that Strattera does not need to be tapered according to the manufacturers of this medication, so it can just be discontinued or lowered in dose abruptly without fear of withdrawal symptoms. That is one of the benefits of the Strattera. So the good news is that it will not have to change the dose of the Strattera when tapering from Lexapro to Paxil, but now how the Strattera will interact with the Paxil is impossible to predict as it depends on how your body chemistry reacts. Unfortunately this can only be done with a trial and error approach, so it would be best to monitor how you react as you gradually increase the Paxil.

As for the cross-taper of the Lexapro to Paxil, here is a good approach that you can discuss with your doctor:

-Reduce Lexapro to 10mg/day and start Paxil at 10mg/day for 7-10 days

-Reduce Lexapro to 5mg/day and increase Paxil to 20mg/day for 7-10 days

-Discontinue the Lexapro completely and increase Paxil to 30mg/day for 10-14 days

-Increase Paxil to 40mg

This should help to minimize any withdrawal symptoms that can occur. I wish you all the best with your continued treatment and hope this new medication regimen works to minimize your symptoms.

Customer: replied 1 year ago.
Last question. So is 20 Lexapro comparable to 40 Paxil, or more like 30 Paxil?
Expert:  Dr. Z replied 1 year ago.

That is very difficult to answer because the two antidepressants are in the SSRI class, but they are very chemically different, so there really is no such thing as comparable or not in this instance. 50mg of the Paxil is the maximum dose and 20mg of the Lexapro is considered the maximum dose, so that would be comparable on that front in terms of maximum dose, but it also depends on how you react to the medication as some people respond better to Lexapro than Paxil and vice versa. So like I said comparing one antidepressant to another is really hard to do because they are chemically different and it really depends on how the individual's own body chemistry responds. I hope that makes sense.

Expert:  Dr. Z replied 1 year ago.

I hope this answers your questions and gives you some guidance on this issue. Please let me know if you have any questions or concerns as I am happy to assist and support you regarding this issue.

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