Aa
medication change from Lexapro. Prozac vs Paxil
I have been on Lexapro for a while, but due to some side effects I am switching. I am exhausted on Lexapro. I cannot get through the day without needing a nap. I can barley keep my eyes open through the day. This is unlike me. I also am having slight nausea. It's also not helping me as much as I'd like for anxiety, although it has been great for my depression. My doc wanted to switch me to Prozac. I was told I wouldn't be as tired on Prozac and that it might help me better with anxiety. I chose against it. I asked for Paxil. I have read that Paxil is good for anxiety. My doc was willing to let me try Paxil so I left with a script for Paxil. I wonder if I should've tried the Prozac. I had a doc tell me once that Paxil causes significant weight gain. Should I have tried Prozac? I don't want to gain a bunch of weight or stay tired all day long. However, I can't take anything that is too stimulating, because it'll make me too jittery.
also must add....I had quite the alcohol problem while on Paxil. After getting out of REHAB I googled Paxil, when I decided to stop taking it, and, lo and behold...Paxil has been associated with increased drinking....especially in females!! If you don't believe me, google "alcohol and Paxil". You will be amazed. Still drink responsibly...but NO MORE PAXIL!!
I was on Paxil for a long time....10 years or so. Dr. kept upping the dose until I was on a pretty high dosage. It never seemed to help as much as I thought it should. I suffered insomnia, weight gain, sexual disinterest, and again, no real results. I decide to go off it cold turkey. BAD CHOICE! I went through serious withdrawals for about a month.....nausea, brain zaps, etc. But dammit! I survived, and will never take it again. Change in my living situation seemed to do more for me than Paxil ever did. I would suggest Wellbutrin or Prozac if you really need something. (I had tried Wellbutrin...helped me stop smoking, but made me combative...or maybe that was just deciding not to let people walk on me anymore!!) Good luck!
My mother has Alzheimer's and is in a skilled facility. Recently she is experiencing a bout of insomnia and is pacing the halls. She has taking therapeutic dose of Prozac for 20 years, and Restoril at night. She suffers mood disorder with depression. She also takes .25 Xanax PRN for anxiety. Her mood is generally good. Now it seems the doctors are wanting to switch up her meds, talking about Lexapro, Cymbalta,doubling her Restoril at night. I would like some information as it is clear she won't get better with her Alzheimer's, but don't want to make her nuts with all the change ups. She also is on Aricept and Namenda. Help.
I just want to let you know that I wasn't recommending to REPLACE Prozac with Effexor as you seemed to have gathered from Paxiled's post. If anything it should go the other way around as one should always start with the known least side effect producing antidepressant. I was only pointing out that when someone has been taking an antidepressant with a short half-life (using Effexor as an example due to its extremely short half-life) then Prozac with its long half-life taken at the end of a taper is great for Serotonin Discontinuation Syndrome.
And like I said in my last post, switching antidepressants when done correctly should not cause more harm than good. I agree that most primary care physicians don't really know how most antidepressants work and what side effects they can produce, but instead rely on what drug reps say about their "amazing new product that will change the face of mental health for good".
I believe many antidepressants are over-prescribed for very mild cases of this or that and may cause more harm than good in the sense of the long-term. Although I'm not discounting those whose lives are disrupted on a daily basis due to depression or anxiety, and these cases are certainly warranted for antidepressant use. It's the cases where a patient expresses occasional mild anxiety to their doctor in passing, and he's grabbing the script pad before anything else can be said that worries me.
And like I said in my last post, switching antidepressants when done correctly should not cause more harm than good. I agree that most primary care physicians don't really know how most antidepressants work and what side effects they can produce, but instead rely on what drug reps say about their "amazing new product that will change the face of mental health for good".
I believe many antidepressants are over-prescribed for very mild cases of this or that and may cause more harm than good in the sense of the long-term. Although I'm not discounting those whose lives are disrupted on a daily basis due to depression or anxiety, and these cases are certainly warranted for antidepressant use. It's the cases where a patient expresses occasional mild anxiety to their doctor in passing, and he's grabbing the script pad before anything else can be said that worries me.
I have gotten my information from college courses and personal experience, and yes, I have had to stop taking Effexor in the past because it wasn't helping my anxiety issues. I've also tried almost every type of antidepressant out there recommended for anxiety: tricyclics, SSRI's, and Effexor (the only SNRI I've tried). Effexor was most definitely the hardest one to get off of due to serotonin discontinuation syndrome. I stopped taking it without the help of my doctor because I started getting discontinuation symptoms if I had just missed my dose by only a few hours. The only way I got through the withdrawal is by downing up to 8 fish oil caps/day which helped tremendously.
I also didn't say that the antidepressant with the longer half-life should be administered at the beginning of the taper, and actually I was implying the contrary as like you said administering it at the beginning of a taper just mixes discontinuation symptoms and new side effects, so I figured I didn't have to go into detail, but here is the detail I left out: administering one low-dose long half-life antidepressant such as Prozac at the end of a taper should reduce most symptoms of serotonin discontinuation syndrome, and if it doesn't fish oil should.
But my point is this, if someone is having a difficult time on one antidepressant and hasn't seen the results they should within the specified time frame it is perfectly fine to switch to a different antidepressant after tapering to the lowest dose possible of the first one. Yes, at first there may be some discomfort with discontinuation syndrome from one antidepressant to the next depending on how much and what neurotransmitters are affected and how closely related the two antidepressants are, but it takes up to 3-4 weeks from some antidepressants to work in some cases so by that time one should have normalized to the new one and stopped feeling discontinuation symptoms from the first one.
I personally never did well with any of the antidepressants I was prescribed. Zoloft and other SSRIs gave me a flat affect, nortriptyline did nothing, amitriptyline gave me odd sensations that it was summer in the winter when I had no view to the outdoors, and Effexor continually gave me "brain zaps", so I ended up switching to clonazepam, and that was the end of it.
I also didn't say that the antidepressant with the longer half-life should be administered at the beginning of the taper, and actually I was implying the contrary as like you said administering it at the beginning of a taper just mixes discontinuation symptoms and new side effects, so I figured I didn't have to go into detail, but here is the detail I left out: administering one low-dose long half-life antidepressant such as Prozac at the end of a taper should reduce most symptoms of serotonin discontinuation syndrome, and if it doesn't fish oil should.
But my point is this, if someone is having a difficult time on one antidepressant and hasn't seen the results they should within the specified time frame it is perfectly fine to switch to a different antidepressant after tapering to the lowest dose possible of the first one. Yes, at first there may be some discomfort with discontinuation syndrome from one antidepressant to the next depending on how much and what neurotransmitters are affected and how closely related the two antidepressants are, but it takes up to 3-4 weeks from some antidepressants to work in some cases so by that time one should have normalized to the new one and stopped feeling discontinuation symptoms from the first one.
I personally never did well with any of the antidepressants I was prescribed. Zoloft and other SSRIs gave me a flat affect, nortriptyline did nothing, amitriptyline gave me odd sensations that it was summer in the winter when I had no view to the outdoors, and Effexor continually gave me "brain zaps", so I ended up switching to clonazepam, and that was the end of it.
I was concerned with the SS too! But my psychiatrist said its very rare and its also is usually seen with massive amounts of medications. She just explained that it would lessen the withdrawl from using the lexapro while i'm coming down off of the zoloft. But like you said whats done is done. It was a heck of a lot better than stopping cold turkey lol....
But I get what you are saying. I just hope i get there soon because i'm sick of taking this damn xanax! haha.
But I get what you are saying. I just hope i get there soon because i'm sick of taking this damn xanax! haha.
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