Paxil to cipralex/lexapro/escitalopram?

[Emh1997]

I was on cipralex (lexapro in the US) for almost 3 years and initially experienced some dry mouth, but no extreme side effects at all. It worked amazingly for me. I started on 10mg and then doubled to 20mg after 1 year. I recently switched to Paxil about 1 month ago, and have really disliked the way it makes me feel. My anxiety has been much worse and the side effects are just awful. It has been so much worse than cipralex. I can barely keep my eyes open even after 15 hours of sleep, and I consistently feel just awful. I am only on 20mg (the starting dose) and would like to switch back to cipralex. Should I do it cold turkey over night? Or should I do a gradual decrease of the Paxil while increasing the Cipralex? Thanks!!

[Paxiled]

I would quit the Paxil completely before starting again on the Lexapro.  That way you can distinguish withdrawal symptoms from side effects of starting Lexapro -- sometimes going back on a drug is different than the first time you took it.  Since you've only been on Paxil such a short time, this shouldn't be a big problem, just a safety precaution.  I got your PM, and this is what I would have said there.  My own view is, when you start a new drug while withdrawing from an old one you're really on two drugs at once in different stages -- too complicated for most psychiatrists to handle, so it's best not to confuse them!

[Paxiled]

You've only been on it a month, so quitting shouldn't be a big deal.  Still, this is the most difficult of all the antidepressants to stop taking, so just to be safe you should taper down off it and not go cold turkey.

[Emh1997]

What would be your suggestion for how to switch from the Paxil to cipralex? I know that 20mg Paxil equals about 10mg cipralex. What rate would you decrease + increase? Perhaps you could give me a rough outline of how to make the transition? Thanks so much!