New Dr. asked me to get off of Paxil

[jrosenbomb]

I've been taking Anxiety meds for the last few years.  It runs in the family and when I had a panic attack a few years ago that I knew was caused from nothing I had an issue.  After some time I ended up with Paxil 10mg and Wellbutrin.  I have been fine and it all seems ok, but my prescription ran out and I had changed insurance so I had to go to a different doctor.  This new Doctor tells me that Paxil is an older medicine and I shouldn't really take it.  He also said that Webutrin does the same thing and I don't need either.  He mentioned that I should get off both, first Paxil, then Welbutrin. His thought was that how do you know if it's working.

So I'm now taking a half dose every other day.  I'm feeling anxious and agitated with occasional mild panic attacks.  First of all, is this just part of coming off of Paxil?

Second, does his advice seem norma?  Is Paxil old, and should I not take it with Welbutrin?  

I kind of feel like if it ain't broke, don't fix it.

[Paxiled]

Your doctor is certainly interesting, if nothing else.  This is why you should always do this with a psychiatrist who specializes in these meds, not a general doc who treats a million things but specializes in none.  But he does have a point, and it's this:  one panic attack doesn't require medication, it usually would end up with you being referred to a therapist if it continued.  Now, you say after some time, so there's probably more than that one attack, but you should still have been referred first for therapy and, if you needed meds, Paxil shouldn't have been the first tried because of its reputation for being very hard to stop taking.  But you make a very good point as well that, if you indeed did need meds because nothing else was working and your life was not tenable, that if it ain't broke you certainly don't fix it.  It's very hard to find meds that work and don't have a lot of problems for you and they can be murder to stop taking.  When you've been on them for a long time you're also possibly at a point where your brain might never function properly again anyway without medication.  As to what you're feeling, Paxil packs a wallop of a withdrawal for most people who take it -- some have an easy time, but most don't.  You're not on a high dose, but when a drug works, it means you're metabolizing it well and it will be harder on you when you stop.  That means tapering off very slowly, as slowly as you need to, not by some preset schedule.  But you have a complication, which is that you're also on wellbutrin for some reason.  This is a very stimulating antidepressant not used for anxiety unless it's caused by depression because it's stimulating nature often causes anxiety even in people who didn't have any to begin with.  If you were going to quit both drugs, the first one to stop would be the wellbutrin, as it's easier to stop taking and you wouldn't be left on a drug that by itself increases anxiety in many people who take it.  You could be suffering, therefore, from Paxil withdrawal or by increasing the effects of wellbutrin, or from both at the same time.  And they do not do the same thing -- wellbutrin, again, isn't used if anxiety is your primary problem, whereas for all its downsides Paxil is.  And finally, your doc is right -- you'll never know if you still need the meds or ever needed them in the first place if you never quit taking them.  Personally, I'm kind of in your if it ain't broke don't fix it camp because you're already on these meds and you're doing well and the Paxil is going to be hard to stop taking and it will be hard once you've been on Paxil for a long time to find another med that works or to go back on Paxil again and have it work because of the peculiar nature of that drug -- but you can also have a very easy time of it, it's a very individual thing and you've been on a small dose and if you taper off slowly enough you'll probably be fine.  I just worry that leaves you on wellbutrin, so again, if you were to do this, that would be the drug to stop first.  I'd try to get your doc or your old doc to renew the prescription and then decide what you want to do -- it's your life, not your doctor's -- and I'd not see this doc again as he or she sounds too doctrinaire, arrogant, and uninformed about these drugs.  Find a good psychiatrist to talk it over with.  Lastly, old drugs are best -- we know exactly what they do and don't do, whether they work or don't work, how hard they are to stop taking, whether they have unknown severe side effects, and they're cheap.  New drugs are approved before a lot of people have taken them, so it's an experiment with you as the guinea pig.  There is no indication new drugs in this area work any better than older ones, it's more a question of side effects.  We haven't learned anything new about why people suffer depression or anxiety, so there nothing new to attack.  The new drugs are me too drugs in the snri and ssri category, and snri drugs are also very stimulating and not usually used if anxiety is the main problem.  Sorry you ran into this, but I hope my experience over many years has helped you sort this out.

[Aroseformom]

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