Is it safe to take Paxil, Klonopin, and Propranolol together?

[Ssanford12]

I was currently on Leaxpro and just got changed to Paxil and Klonopin. I also take propranolol for my heart twice a day. Is it safe for these medications to be taken together?

[safetydave720]

Your system can become passive to Paxil within one year. Withdrawals are brutal and some withdrawal symptoms can be permanent, like brain zaps. I do not recommend remaining on Paxil. Only take propranolol with other psych meds if you have high diastolic BP or too fast a heart beat. Propranolol is very mildly effective for anxiety. I take Klonopin only at the onset of a panic attack. I let it disolve under my tongue. The combination of the three should not be routinely taken.

[Paxiled]

One point -- Paxil isn't any different than any other medication for anxiety -- they all can stop working at any time and they all can keep working for many many years.  It depends on the person. There is also very well accepted and researched proof that augmenting drugs with more drugs does work better than taking one drug when that one drug doesn't do the job well enough.  Whether that's a good idea or not for other reasons is a different issue.

[Paxiled]

As with Mom, I'm a bit confused -- you also don't say if you're tapering slowly off the Lexapro to avoid withdrawals.  You don't want to be on both Lexapro and Paxil unless, as some psychiatrists do, you're switching at the very end of the taper and therefore almost off the Lexapro.  So assuming you're off the Lexapro and not suffering withdrawal from quitting it, the question you didn't answer for us is why the switch, and why to Paxil, and why to two drugs at the same time?  While it's true many or even most anxiety sufferers are put on a benzo and an antidepressant at the same time, it's not necessarily a good practice.  It depends on if you're using the benzo as needed or regularly, because in the latter case you're using an addictive drug every day to address the same issue the antidepressant is supposed to eventually handle and one drug might do the job.  As to safety, other than the problem if you're saying you're being put on Lexapro and Paxil at the same time, which we're hoping you're not saying, these drugs are sometimes used together, but again, if you're taking them all for anxiety, a process called augmentation, you're supposed to start with one and see if it does the trick.  If it doesn't, you add another.  But most docs are still handing them out in bunches.  More details would help us tell you how it accords with out experience.

[Ssanford12]

I have been on Propranolol for quiet some time now. I was prescribed it for a heart condition. I never new until now that it was also used for anxiety also. I still take the Propranolol twice a day as directed for my heart. I was currently on Lexapro twice a day for anxiety. The Lexapro wasn't working so they switched me to Paxil once a day. They also added Klonipon twice a day as needed. So to clear things up I take Propranolol twice a day everyday, Paxil once a day, and Klonopin twice a day as needed until the Paxil has time to get into my system to see if it will work any better than the Lexapro did.

[Paxiled]

Mom has answered the safety question, but I'll just add to one thing she said -- taking klonopin twice a day isn't as needed. As needed is just taking it when needed.  Klonopin also isn't the best as-needed benzo out there, as it takes longer to start working than with other benzos, though it also works longer for those it works for at all than the others.  But shorter acting benzos go to work more quickly.  But my main point is, as needed is different than twice a day.

[Paxiled]

And let me add, there was no reason to take the Lexapro twice a day.  The reason this is done is when the side effects, especially sedation, is strong, and you can minimize it by splitting your daily dose into two.  You an also do this with Paxil if you find it necessary, but most people take antidepressants once a day.  You also still don't say if you tapered off the Lexapro or quit abruptly to switch, but don't try this with Paxil.  If you decide to stop that one, do it slowly, as slowly as you need to.  Good luck.

[specialmom]

When you were switched, I'm assuming a doctor made this decision to switch out Lexapro for Paxil and add on Klonopin?  Are they aware of your also taking propranolol?  Drug interactions are real but typically doctors try to be aware of a patients full history as long as you provide it to them.  A pharmacist where you fulfil your prescriptions is also a great source of information.  In general, paxil and klonopin are frequently prescribed together.  They are safe in terms of drug interactions but for the patient, side effects can increase.  That is individual to the patient though.  Do you take the beta blocker on a regular basis for your heart or for acute bouts of anxiety such as giving a speech?  

[Ssanford12]

I was currently taking Lexapro twice a day. I also take the Propranolol twice a day for my heart. The Propranolol was prescribed for my heart and never for anything else. Now I am currently taking Propranolol in the morning along with Paxil, at night I take Propranolol again. I take the Klonopin is taken as needed twice a day.

[specialmom]

Okay, got it.  Is your doctor aware of the Propranolol use?  Sometimes when see different doctors, communication of what all we are on doesn't happen as it should.  So, that's first.  That the doctor is aware of all meds you currently take both prescribed and OTC.  SSRI's can be used with beta blockers generally.  You will find patients on both without issues.  But that is, of course, unique to the person taking them as anyone can have an individual reaction different from what is considered the normal reaction.  Does that make sense?  There is no warning to not take together but with ANY medications taken at the same time, people have to be aware as to how their own body reacts to it.  Side effects can get compounded such as something like fatigue for example.  Same the beta blocker causes some fatigue and you have the transient symptom of fatigue when starting paxil, you may have more fatigue overall than if you just took one of the meds.  Again, very individual and you have to be the judge of how you tolerate it.  Klonopin on an as needed basis is also often given but be careful of that.  Don't take unless you really need it in my opinion.  And understand that it is scheduled because it is addictive.  So, use with caution.  good luck