# Better Meds Than Paxil for SAD?



## agoraguy (Oct 23, 2010)

Ok, here is my situation, as brief as my long winded self can make it. 

I currently have no shrink, and no therapist. I had both, but lost them due to retirement, medical reasons, or insurance. However, when I did have them, I was on 40 mg of Paxil which did wonders for my SAD, but at the same time it literally made me a zombie. I know you hear it often, but I was out there eating brains, it wasn't pretty. Ok, maybe some hyperbole there, but you get the idea. 

I hated that when I woke up for the day, I was still tired. I would pass out everywhere I went, and never feel awake. I couldn't focus on work (web design) and of course the other annoying side effects like tight jaw, dry mouth, and sexual issues. 

I dropped it down to 20 to try and cope with that, and still felt pretty decent but the biggest issue, feeling tired all day, stuck around. That was probably the most irritating one. I absolutely hate the feeling of being tired after getting 7-8 hours of sleep. It's not me. Sure, I'm a night owl, but once I'm up, I'm usually good to go till bedtime. 

So, despite losing my doctors, my regular doc still prescribes me 20mg which I break in half every night and get by with 10.. and that essentially feels like nothing at all. I have tons of moments of anxiety, worry about ridiculous things, and have random panic attacks. Almost feels like I felt prior to any meds. 

My choices are:
A) Increase my dose back at least to 20mg since that's what I can easily get prescribed. 

B) Try to find a doctor, which is hard with my insurance, who will try me on some newer SSRI's, as I believe Paxil is a really old generation one. Hopefully finding one that kicks the SAD a bit, but doesn't destroy me every other aspect of my life. 

C) Similar to B, but except find a doctor who is knowledgeable, play a Dr myself and go to my regular doctor and recommend I switch to something else, which he'll likely give me. This saves me the trouble of finding a shrink who's only job is to write down prescriptions, but it makes it so I don't get their 'professional' opinion on them. Granted, their opinion is usually "Everyone reacts differently, it's all trial and error" which lead me to believe playing a DR in (C) may be the best option for me to try something new. 

If C is a good option, what do you guys recommend that works like Paxil (maybe better) but doesn't have the horrific side effects that come along with that drug. I assume most SSRI's are similar, but maybe someone who has had similar experiences may share similar brain structure and can recommend a good one to me 

Thanks for any tips! And any suggestions to my options above


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## agoraguy (Oct 23, 2010)

Bump. 

So I'm on a lousy insurance plan, and it has become nearly impossible to find a shrink with my plan. Spent all day on the phone today with no luck, the best I can do is I found a shrink who will see me in 3 months. Unreal. 

I am really tossing around the idea of heading to my regular doctor who is currently prescribing me paxil and see if he's willing to change me to something else, but I'd like to be able to suggest him a medication. I know self diagnosing is bad, but at this stage It's almost all I have left. 

So any recommendations on newer meds that help with social anxiety / panic attacks? Like I said earlier, I'm on Paxil, and it worked pretty good at 40mg but I was a zombie and miserable. Looking for something with similar or better results (non benzo) with less dramatic side effects. Of course all meds work differently on people, but I'm willing to change and try different ones to see if I can find a good one. 

Thanks!


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## Kon (Oct 21, 2010)

Try Lexapro (5-20 mg) or Celexa (10-40 mg). You're less likely to feel sedation, and these drugs have arguably the fewest drug interactions of all SSRIs. Lexapro is more expensive but they're basically the same drug. Celexa has both enantiomers, while Lexapro only has the active enantiomer.


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## Bacon (Jul 4, 2010)

Lexapro is a very clean new medication. Much well tolerated then your traditional batch (Paxil,Prozac,Zoloft) Paxil being the worst tolerated in my opinion, Prozac and Zoloft being the cleanest in the batch. Lexapro was approved in 2002 so i think that's your best choice right now, Or Celexa which is a very mild antidepressant, Similar to Lexapro.


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## MBL (Oct 5, 2010)

Paxil is a dirty, crappy, evil drug!
Try Effexor 
Anything is better than Paxil IMHO.


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## Noca (Jun 24, 2005)

MBL said:


> Paxil is a dirty, crappy, evil drug!
> Try Effexor
> Anything is better than Paxil IMHO.


Paxil fits my needs(appetite increase and sedative)


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## areq1987 (Jul 10, 2010)

MBL said:


> Paxil is a dirty, crappy, evil drug!
> Try Effexor
> Anything is better than Paxil IMHO.


Effexor is a dirty, crappy, expensive evil drug!
Stay on Paxil 
Anything is better than Effexor IMHO.


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## agoraguy (Oct 23, 2010)

Interesting replies guys, thanks  I may see if I can swing by my dr's office sometime this week and check on Lexapro first (though doubt my insurance covers it), then maybe Celexa. 

What will my experience be going from 10mg of Paxil to a new SSRI? Since they're in the same family, can I stop taking Paxil one night and just take the new SSRI instead with little to no withdrawal effects?


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## Kon (Oct 21, 2010)

agoraguy said:


> What will my experience be going from 10mg of Paxil to a new SSRI? Since they're in the same family, can I stop taking Paxil one night and just take the new SSRI instead with little to no withdrawal effects?


Taper the paxil over 7 days prior to initiating the lexapro. Some SSRIs can be switched without tapering that long but paxil is one of the ones that have higher withdrawal reactions. Check table 3:

"Switching Antidepressants: Washout periods in DAYS for outpatients:

http://www.rxfiles.ca/rxfiles/uploads/documents/Antidepr3.pdf

These are the older guidelines (1 day taper). The new ones recommend 7 days for paxil as I wrote above.


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## jim_morrison (Aug 17, 2008)

OP; I think you said that you were taking your dose at night? Perhaps try switching your dosing time to the morning, SSRI's can interfere with sleep quality, especially deep sleep which can cause fatigue, so you should take them as far away from bedtime as possible IMO.

I think sometimes people confuse this effect on sleep architecture which causes somnolence (not sedation) with sedation, and so they start taking their SSRI at night time which only makes matters worse.


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## Canadian4Life (Sep 27, 2010)

Zoloft,gabapentin,lyrica,Benzos,nardil,inderal


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## agoraguy (Oct 23, 2010)

Kon, thank you for that info, it really helps 

Jim, yea that's not a bad idea actually. One of my biggest issues at 20 or 40mg of paxil was that I was so tired all day, I hated it. I'd go visit my parents and end up passed out on their couch most of the time there. I'm hoping with a switch of meds and switch of time, maybe the fatigue won't be as drastic.


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## agoraguy (Oct 23, 2010)

Hey everyone. To update the situation, I went to my doctor and he put me on 20mg of Celexa. I am taking 10mg for the first 2 weeks then 20mg after that, all while weaning off of Paxil (I was down to 10mg before I even started Celexa). 

Right now I'm taking 5mg of Paxil every other day, and hoepfully if no headaches, just stop taking them all together very soon. However, a problem I've had seems to be sinus issues and it's driving me crazy. 

When I first started Paxil a few years back, I was on 40mg and seem to remember a lot of sinus problems. My last apt I thought it was because of a cat that lived there prior to me moving in. Then I moved in with my gf and still had them, so I got air purifiers, mold tests, etc with no luck. I lived with it but it seemed to go away sometime between 40mg and the 10mg I've been on for the past year. 

My doctor over that time prescribed me Trazadone to aid in sleep, I took it one night and literally 20 mins later I had a massive stuffy nose and couldn't sleep because of it. I didn't take any more and have been fine since.. until I started the Celexa. Again, within 20 mins of my first pill, I've had constant stuffy nose that's lasted a week now. 

Does this go away? I know it's listed as a rare side effect, but I do seem to suffer from it. I am going to stay on for at least this month until I see my dr again in 3 weeks and talk to him, but what if it doesn't go away? I can't live with a stuffy nose the rest of my life, that will drive me insane worse than having anxiety. 

So what should I do?  Any advice from those who suffered sinus problems on these meds would be fantastic! I may start a new thread but wanted to update this one first. Thanks!


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## pixies (Oct 28, 2009)

It's funny because I took Paxil for many years and didn't have any of those problems except for the sexual one. Then I switched to Cipralex and I have all the ones you mention. I have been on this drug for an entire year, and I still have all the same problem. My nose is stuffy all the time, so it's basically like I've had a cold for an entire year. I am very lethargic and feel tired all the time, and I feel kind of zombie like.

I guess the reality of SSRI's is that they all affect each of us in different ways. This is proved even more just in this thread. For example I loved Paxil but the guy above said it was horrible and evil and people should try Effexor instead, and then someone else said Effexor is no good. In other words, it doesn't seem like anyone can recommend anything because they all work different for each of us  Which sucks.

As for your help, the sinus thing may or may not go. I've had mine for a year, but it may ease up. Mine kind of comes and goes, but I also sniff Olbas Oil to help clear my head if it's bad. I also have terrible dry lips which is something to keep an eye out for. They got so bad they started cracking and bleeding so I now use lip balm daily which sorted it out.

Personally I would have suggested you stay on the Paxil. I'm amazed you coped so long with taking it at night because that is a really bad thing to do. I remember a pharmacist asking me when I took it and he actually shouted at me in front of other customers which I was annoyed about! But I spoke to my doctor about it and my doctor apologised and said that he should have already told me. It's important that you take it in the morning because, "It lifts you up during the day, and then makes you tired come late evening". So if you were taking it at night, it was probably making your sleep not very good, and then making you tired by the time you woke up. Nasty. 

But hopefully your new drug will work well for you anyway, and hopefully the side effects won't stick around. Even with the side effects, I still took my Cipralex for a whole year because it worked for me. Let us know how it goes.


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## In8Senses (Nov 5, 2010)

SSRIs suck in my experience.


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## i_against_i (Nov 29, 2007)

Nardil > Paxil


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## leon21 (Nov 8, 2009)

@agoraguy:

If you need more energy, motivation: Zoloft, Prozac.
If you want to be a zombie: Paxil, Celexa.
Lexapro and Luvox are somewhere in between.

I can tell you....Lyrica is THE ****! Works for many people even on a lower dose.
But tolerance is an issue.


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## leon21 (Nov 8, 2009)

...


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## MattJH (Dec 20, 2010)

Try something different all SSRI's act somewhat differently if your head. All though it takes anywhere from 3-6 weeks to feel its full effects. I've taking ALOT of SSRI's ; paxil, zoloft, celexa, prozac. No success but im on benzodiazepines (LAST RESORT, and I mean last). Try different ones out and take supplements like centrum 1 a day. It gives a boost to pretty much all your vitamin levels and minerals making you feel maybe more energized and happy overall. GOODLUCK. oh and yea remember your diet is important as well dont eat like me, I eat **** all day and i know its not good.


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## i_against_i (Nov 29, 2007)

New nardil all i know, and it works great.


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## Canadian4Life (Sep 27, 2010)

Dr House said:


> Paxil fits my needs(appetite increase and sedative)


 That's exactly how you gotta look at it. You say paxil fits your needs (increases appetite and sedation) so it Is an effective med for you. It's all about finding a med that suits you and offers side effects (like appetite increase and sedation) that are actually helpful. I take zoloft..and like you it fits my needs (stimulating). You can't really know if a med will work til you try it. Glad paxil is working for you..alot of people bash it because of the withdrawal but if it works then what's better.. being depressed and very socially anxious or not? Glad to hear your success with paxil


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## pixies (Oct 28, 2009)

I agree. Some work for some people and not for others, and vice versa. They are all different for each person which makes them hard to judge. Personally Paxil gave me the best years of my life, by far, and I took it for a very long time until it finally wore off. 

For the last year I was on Escitalopram which my doc told me was modern and more precise and efficient or something. It worked quite well, but only for about a year. Now I'm going back to Paroxetine again. Hope it works!


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## BearFan (Mar 22, 2008)

There is also Pexeva and Paxil CR, which may be worth a try. Paxil worked pretty well on the anxiety spectrum symptoms, but had a subtle appetite increase which caused weight gain. It also really affected libido. Lexapro, in my experience, wasn't really 'better', than paxil, just slightly less side effects. I really don't understand why scientist and R&D can't come up with improvements in these 2nd gen antidepressants which have been out for 20 years now.


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