# Prozac, Paxil, or Zoloft?



## fashionista

Could someone lay out clearly the pros & cons of Prozac, Paxil, Zoloft, Ativan, for social anxiety? I'll probably be starting medication at some point, just need to know what to ask my doctor for if some have less side effects and are better than others? I already have some sleep issues so don't want something to mess that up, but I have severe social anxiety that needs some kind of treatment. Thanks.


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## bazinga

Paxil is going to be the strongest. Its probably going to have the most side effects, but I hear its really good for social anxiety.

If you're afraid of meds you.might want to try a different one first. Prozac and zoloft are good choices. Out of those 3, Zoloft would probably be a good first start.


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## Ben12

Zoloft would be my choice. However I've never liked the SSRI's personally. But everyone is different. With Paxil there is weight gain and whereas prozac and zoloft are unlikely to cause that side effect.


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## yourfavestoner

Kick to the left testicle, right testicle, or both?

If forced at gunpoint, I'd pick Paxil.


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## A Sense of Purpose

I'd go with zoloft, and try it at each incremental dosage for a month at a time until relief is found.

If symptoms dont resolve then i'd try paxil


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## GotAnxiety

Prozac has a 2 to 3 day halflife.

Zoloft has a 25 to 26 hour halflife both drugs have alot of metabolites. 

Zoloft doesn't have the fluoride molecule in it if that mean anything. Zoloft has weak dri properties.

Prozac is also antagonist to the 5ht2c recepter i think.

Both drugs can take 2 - 3 months to work.


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## GotAnxiety

Zoloft maybe better for Hiv it has anti-fungal and anti-bactial properties i heard. 

Prozac has the longest halflife and it the easiest on the withdrawal sydrome. I think it the only ssri they prescribe to minors.

Prozac may be a good place to start. Im not sure which one more activating. 

Zoloft maybe better for sleep then Prozac? i dunno. It depends on what ya need.


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## riptide991

Zoloft if you want to maintain your mental vigilance. Although in some it could be very activating. Like A sense of purpose mentioned, take your time don't expect results too quickly.


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## fashionista

Thanks everyone! I am going to see my former general practicioner this week and get her opinion about what meds if any I should try for my anxiety. My two main concerns are stopping my anxiety of course, and also NOT disrupting my fragile sleep at nigt, which I need! Or else I get VERY panicky.


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## metamorphosis

Lexapro, the only pure serotonin reuptake inhibitor. Has less side effects than the others and the therapeutic doses are low. Usually 10-20 mg but some respond to 5mg. Especially if used synergistically with another med. Least likely out of all the SSRI's to give you sexual side-effects. That should be the kicker right there!


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## fashionista

Lexapro sounds like a winner! I am a young guy in my prime and I couldn't deal with losing my sex drive all because of an anxiety pill! I have heard so many horror stories about ssri's ruining sex drive in men. I am also thinking, I don't have a very addictive personality, and I do not suffer from depression, merely severe social anxiety, so maybe the benzos in a low dose might be better fit for me than ssris? Like klonopin, ativan, or xanax. I think I'd want something I could take in the morning before a stressful day, and then it be nearly out of my system by evening, so I could sleep normally, and not have to worry about the sexual side effects as much. And I hear that the benzos are easier on the sex side of things than ssris! And being a guy, that's really important to me!


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## yourfavestoner

fashionista said:


> Lexapro sounds like a winner! I am a young guy in my prime and I couldn't deal with losing my sex drive all because of an anxiety pill! I have heard so many horror stories about ssri's ruining sex drive in men. I am also thinking, I don't have a very addictive personality, and I do not suffer from depression, merely severe social anxiety, so maybe the benzos in a low dose might be better fit for me than ssris? Like klonopin, ativan, or xanax. I think I'd want something I could take in the morning before a stressful day, and then it be nearly out of my system by evening, so I could sleep normally, and not have to worry about the sexual side effects as much. And I hear that the benzos are easier on the sex side of things than ssris! And being a guy, that's really important to me!


Not all ruin sex drives. Some just leave you with erectile difficulties or anorgasmia.

I have a normal sex drive, but ever since coming off Cymcrapta I've had erectile issues and I orgasm TOO quickly. Ridiculously fast.

Yes, Benzos are better than SSRIs for anxiety. Don't be afraid of benzos. Benzophobia is a crippling disorder that afflicts certain psychiatrists and is a serious problem.

If anxiety is really your big ticket issue and not depression, I wouldn't go within ten feet of an SSRI - well, I wouldn't go within ten feet of an SSRI anyway but you get the picture.


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## BladeRunnerB26354

A Sense of Purpose said:


> I'd go with zoloft, and try it at each incremental dosage for a month at a time until relief is found.
> 
> If symptoms dont resolve then i'd try paxil


I started sertraline a week ago, it's been pretty activating for me so far. I used to nap for 2 hours everyday, after just 6 hours of being awake. I've not needed to do that, or indeed felt fatigue the last 6 days.

Currently on 50mg/day, I'll talk with my doc about an increase to 100mg after a month of use, and see how that fairs


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## fashionista

Hm, so which is considered the least stimulating? Paxil, Prozac, or Zoloft? I need something for social anxiety but I don't want to feel wired all the time. I value my down-time and sleep time! I guess I am asking which is best for mild to moderate social anxiety without damaging sleep or causing insomnia, which we all know causes MAJOR anxiety!


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## A Sense of Purpose

Stimulation from most to least:

Prozac > Zoloft > Paxil

However its strange because paxil is argued as the strongest serotonergic AD in the ssri class. The stimulating properties of the others appears to come from (in prozac) 5-HT2c antagonism and (in zoloft) a weak DAT affinity.

Furthermore, you need to understand that each of these drugs will vary in efficacy and side effects depending on the individual. Some people cant stand the stimulation of prozac, whereas others find it calming.

Some people like the sedation gained from paxil and others find it zombifying.
I personally find Zoloft to be the best 50/50 for anxiety and depression/anhedonia.
Some find it too stimulating or (oddly, tiring).


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## fashionista

A Sense of Purpose said:


> Stimulation from most to least:
> 
> Prozac > Zoloft > Paxil
> 
> However its strange because paxil is argued as the strongest serotonergic AD in the ssri class. The stimulating properties of the others appears to come from (in prozac) 5-HT2c antagonism and (in zoloft) a weak DAT affinity.
> 
> Furthermore, you need to understand that each of these drugs will vary in efficacy and side effects depending on the individual. Some people cant stand the stimulation of prozac, whereas others find it calming.
> 
> Some people like the sedation gained from paxil and others find it zombifying.
> I personally find Zoloft to be the best 50/50 for anxiety and depression/anhedonia.
> Some find it too stimulating or (oddly, tiring).


Thanks, with my sleep issues, if my doctor insists on an ssri, I guess my inclination would be to go with a low-dose Paxil since it is the least stimulating. Is it better to take them at night, or in the morning? I would want to not be anxious during the day, but also be able to sleep okay at night. And don't you have to take ssri's everyday? Regardless of whether you have a particularly stressful day that day or not? So as to keep them in your system consistent?


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## A Sense of Purpose

fashionista said:


> And don't you have to take ssri's everyday? Regardless of whether you have a particularly stressful day that day or not? So as to keep them in your system consistent?


Yes. If you receive an ssri you need to take it daily for months> 1 year for efficacy.

If you chose paxil i'd take it at night time and use it for sleep. The therapeutic effects should last through til the next day once steady serum levels have been reached. This will occur round the 3-6 week mark and re-apply if you increase or decrease the dosage from that point.


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## metamorphosis

lol, is this t.c.???,
No, nah, I don't think so.
Just the similar mode of repeating questions in an almost (idiosyncratic) way makes me wonder.
BTW that is not an insult.
Albert Einstein famously had lots of idiosyncratic habits.
Idio is ancient Greek for "one's own." An idiosyncratic person is someone who does things in his own way.


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## crossfadex

Out of those 3, I'd personally choose Zoloft since it affects dopamine in higher doses. If Zoloft doesn't work, perhaps try an SNRI. If you want, go the Paxil route but the side effects are the most relentless of all SSRIs. 

SSRIs are borderline usesless, but I'd say Zoloft would be my preference. Paxil and Effexor are some of the more stronger SNRIs/SSRIs. If neither of those work, you probably shouldn't bother with the others in the class unless you're on the med-go-round to get the good stuff - maoi's.


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## Spungo

fashionista said:


> Could someone lay out clearly the pros & cons of Prozac, Paxil, Zoloft, Ativan, for social anxiety? I'll probably be starting medication at some point, just need to know what to ask my doctor for if some have less side effects and are better than others? I already have some sleep issues so don't want something to mess that up, but I have severe social anxiety that needs some kind of treatment. Thanks.


Remember to take these reviews with a grain of salt. Everyone has a different brain with different chemicals, so the effects of drugs are slightly different for everyone.

Paxil - *0/5*
Absolutely horrible drug. I was extremely tired, but I couldn't sleep. That alone made everything worse. Going with no sleep = total zombie behavior, extreme depression, everything is impossible. I had no social "anxiety" per se, but I had no social skills or desire either. When you're extremely sleep deprived, all you want is sleep. Sleep deprivation is officially recognized as a form of torture.
The people who have good luck with Paxil say that it has very intense withdrawal effects. That sucks.

Zoloft - *3/5* 
I felt ok instead of depressed, but I wasn't happy or excitable. It was very neutral. For depression, this drug is definitely better than no treatment at all, but it's not the best treatment available. It fixed social anxiety by making me not really care too much for social interaction. I could be surrounded by people and it was all ok. I didn't really feel like talking to anyone, but I didn't feel anxious either. Again, taking this drug is better than nothing, but it's not the best.
Sleep wasn't the best on this drug. I seemed to sweat a hell of a lot at night.

Prozac - *5/5*
This drug made me feel happy. My gf said it was very noticable how much my mood improved. This drug is stimulating and sedating at the same time. When doing anything physical, it felt stimulating. I could change car tires in cold weather while only wearing gloves because the Prozac would raise my body temperature and get the blood flowing. When doing mental work, Prozac was very sedating. It was very hard to do something like write a letter or work on a computer. 
The half-life of this drug is so long that it never crashes. You can skip the dose for several days and still not crash.



> Stimulation from most to least:
> 
> Prozac > Zoloft > Paxil


That was my experience too. On Prozac, physical work was not a problem. I would gladly shovel snow. On Paxil, doing something like not fall out of my chair was very difficult.



> Zoloft if you want to maintain your mental vigilance.


I agree with this too. I found that doing mortgage calculations and making graphs on Zoloft was quite easy. I didn't feel impaired in any way.


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## GotAnxiety

Id say try prozac then zoloft and if those failed try lexapro. Give each one a few months. Then you would have a good experienced starting baseline or you could just jump to lexapro that what im taking. But i find it so powerful. i take breaks and use a much lower dose. Too make it more suitable for my needs .


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## fashionista

Well I saw my doc today and she seemed to think a low-dose Paxil would be a good way to start, and see how I do on it. I will be taking Paroxitene. Some people make it sound really scary, but I guess all I can do it try it. My doc told me it can make you drowsy so you can play around with it and figure out of a morning or evening dose works better. My doc knows all about my occasional sleep issues, and showed me a chart of side effects which indicated that that Paxil actually has lower rates of insomnia than Zoloft, which is good. I told her I wanted something to control my anxiety, but not mess up my sleep cycle. So I'm hoping the Paxil works for me.


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## rounak

fashionista said:


> Well I saw my doc today and she seemed to think a low-dose Paxil would be a good way to start, and see how I do on it. I will be taking Paroxitene. Some people make it sound really scary, but I guess all I can do it try it. My doc told me it can make you drowsy so you can play around with it and figure out of a morning or evening dose works better. My doc knows all about my occasional sleep issues, and showed me a chart of side effects which indicated that that Paxil actually has lower rates of insomnia than Zoloft, which is good. I told her I wanted something to control my anxiety, but not mess up my sleep cycle. So I'm hoping the Paxil works for me.


how are you doing now with paxil ?is that good?what is your dose?any side effects?i recently have prescribed with paxil


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## forgetmylife

fashionista said:


> Could someone lay out clearly the pros & cons of Prozac, Paxil, Zoloft, Ativan, for social anxiety? I'll probably be starting medication at some point, just need to know what to ask my doctor for if some have less side effects and are better than others? I already have some sleep issues so don't want something to mess that up, but I have severe social anxiety that needs some kind of treatment. Thanks.


imo I wouldn't even waste my time with ssri's, however I've only tried Zoloft and it's horrible...

Ativan is a benzo, totally different drug... I like Remeron and it's safe.


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