# Paxil vs. Lexapro for SA?



## 10PercentExtra (Nov 8, 2009)

I have been on both, but for only about 1 month each. I want to start back on one and give it a longer try.

On Paxil, my SA was completely gone by day 2. But it made me LAZY.
On Lexapro, it did not seem to go away.

I realize ssri's take up to 3 months to kick in.

My doc tells me lexapro is a "cleaner" (more selective, fewer other agonist actions) ssri than paxil.

But Paxil is approved for SA and Lexapro is not.

I know meds affect different people differently, but which one do you think I should try? Maybe lexapro first? Or am I wasting my time with lexapro? My doc gave me some adderall to help w/ laziness...

Thank you.


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## jim_morrison (Aug 17, 2008)

I've been on both, and although neither particularly helped, lexapro was 100 times more tolerable in my experience, so my vote would definitly go to lexapro if it was between the two.

As much as the whole lexapro being "cleaner" thing sounds like a bit of marketing hype, there was a noticeable feeling of it being better, for example, paxil honestly made me so agitated in my own skin that I felt like I was a danger to myself and everyone around me, whereas lexapro caused none of that, and almost felt like I wasn't taking anything.


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## ecotec83 (Sep 7, 2009)

Lex is actually approved for anxiety. While my depression went away within a couple of days it took a few weeks for my anxiety to fade to a more tolerable level. I still have a bit on occasion depending on the day but it sure beats having frayed nerves from worrying about everything.


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## 10PercentExtra (Nov 8, 2009)

jim_morrison said:


> I've been on both, and although neither particularly helped, lexapro was 100 times more tolerable in my experience, so my vote would definitly go to lexapro if it was between the two.
> 
> As much as the whole lexapro being "cleaner" thing sounds like a bit of marketing hype, there was a noticeable feeling of it being better, for example, paxil honestly made me so agitated in my own skin that I felt like I was a danger to myself and everyone around me, whereas lexapro caused none of that, and almost felt like I wasn't taking anything.


Thanks for your experiences.

btw, according to Stahl's "Essential Pharmacoloy", paroxetine in addition to being an SSRI, also has some muscarinic antagonist action, weak norepinephrine reuptake action and NOS action. Those additional actions may account for the unpleasant sides.

citalopram is straight ssri, no other actions.


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## jim_morrison (Aug 17, 2008)

10PercentExtra said:


> Thanks for your experiences.
> 
> btw, according to Stahl's "Essential Pharmacoloy", paroxetine in addition to being an SSRI, also has some muscarinic antagonist action, weak norepinephrine reuptake action and NOS action. Those additional actions may account for the unpleasant sides.
> 
> citalopram is straight ssri, no other actions.


Yeah thats correct, I have that text book too, and the NOS supposedly adds to the sexual dysfunction. But I think it's paroxetines super high affinity for the SERT pump which causes the most trouble, it's a bit too potent, even for adults. Short half life may be a limiting factor in it's tolerability also.


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## 10PercentExtra (Nov 8, 2009)

jim_morrison said:


> Yeah thats correct, I have that text book too, and the NOS supposedly adds to the sexual dysfunction. But I think it's paroxetines super high affinity for the SERT pump which causes the most trouble, it's a bit too potent, even for adults. Short half life may be a limiting factor in it's tolerability also.


interesting. thanks


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## RockiNToM (Jun 15, 2009)

I think you just need to try one and see it out. What works great for one person may not for another.


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## RockiNToM (Jun 15, 2009)

For me I had the best response to Paxil. I was more extroverted and social. I felt more confident and felt like I was manic quite a few times. Paxil was the best experience of any anti-depressant I tried, but after a while it pooped out on me and didn't work when I tried it again. Whereas, for other people I've heard Paxil made their anxiety much worse and unbearable. Therefore showing that meds don't necessarily work the same way for everyone.

The only way to know how something works is to try one and wait it out.


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## gordonjohnson008 (Nov 2, 2008)

RockiNToM, how long were you on Paxil before it pooped out?


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## pixies (Oct 28, 2009)

I took paxil for 8 years, it was awesome. It does wear off though after a while. I had a mild panic attack on it one day, after several months which is a sign that it was either starting to wear off a bit, or it was not quite 100% curing me. But really, the stuff was amazing because I lived a great life for that first year. The next several years were ok but it's effect faded year after year. It was still doing enough though that I stayed on it for all that time. 

I stopped it about 3 years ago because I wanted to experience life without any meds. It was ok for all this time, but recently things really caught up with me and I felt terrible. So I had to see my doc and put me on Escitalopram because he insisted it was better than me going back on paxil again. I've only been on it for a week though so far, so I can't really comment how well it's working. Give me a month or so and I'll be able to compare the two pretty well hopefully. It is promising though because the leaflet specifically mentions Social Anxiety Disorder, whereas it never mentioned that when I used to take Paxil. The Paxil was mainly for depression but it did mention Agoraphobia which is similar to our condition but not quite the same. Perhaps modern Paxil claims to work for SA too, but whatever.


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## RockiNToM (Jun 15, 2009)

gordonjohnson008 said:


> RockiNToM, how long were you on Paxil before it pooped out?


I think I was on it as long as 2 years maybe 3, I can't fully remember. Since then I've been on a lot of other anti-depressants and none of them really have done the job that Paxil had done.



pixies said:


> I took paxil for 8 years, it was awesome. It does wear off though after a while. I had a mild panic attack on it one day, after several months which is a sign that it was either starting to wear off a bit, or it was not quite 100% curing me. But really, the stuff was amazing because I lived a great life for that first year. The next several years were ok but it's effect faded year after year. It was still doing enough though that I stayed on it for all that time.
> 
> I stopped it about 3 years ago because I wanted to experience life without any meds. It was ok for all this time, but recently things really caught up with me and I felt terrible. So I had to see my doc and put me on Escitalopram because he insisted it was better than me going back on paxil again. I've only been on it for a week though so far, so I can't really comment how well it's working. Give me a month or so and I'll be able to compare the two pretty well hopefully. It is promising though because the leaflet specifically mentions Social Anxiety Disorder, whereas it never mentioned that when I used to take Paxil. The Paxil was mainly for depression but it did mention Agoraphobia which is similar to our condition but not quite the same. Perhaps modern Paxil claims to work for SA too, but whatever.


You know what's weird? Whenever I went to see a doc about an illness or just generally something not associated with my anxiety and depression, they would always ask me about why I was taking Paxil after seeing medical notes. It seemed like a lot of doctors had a problem with the med 'Paxil' or something. One doctor who wasn't even my primary doctor tried to switch me to another SSRI because he didn't agree with me being on Paxil, I told him where to go anyway.

I would have to agree that my life was also vastly improved while on Paxil - some of the best years of my life. I was doing things I had never done in my entire life. I was socialising, doing a job that was a very anxiety provoking yet feeling unaffected, and learning to drive (which I had put off for many years), everything was going really well. Then 2-3years later it starts pooping out and my anxiety and depression are coming back all while I'm on the max dose. So inevitably I didn't have much choice but to switch to another SSRI which was Zoloft. I stayed on that for while but it never even worked anywhere near as good. So I came off it and tried Paxil again but it just didn't work still. Since then I persevered with many other anti-depressants and still not had the happiness I had when I was on Paxil.

I haven't tried Lexapro/Escitalopram but if it is similar to Celexa/Citalopram then it probably wouldn't be right for me. I was very depressed when I was on Celexa.


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## pixies (Oct 28, 2009)

Yep similar story here. The first few years on Paxil when it was working to the full, were amazing. I could do anything.


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## Rydan (Nov 11, 2009)

jim_morrison said:


> for example, paxil honestly made me so agitated in my own skin that I felt like I was a danger to myself and everyone around me


That might be the best desciption I've heard for the way it made me feel. I think it's called akathisia. I've never tried lexapro, but know I can't handle Paxil again. I did notice some benefits from the paxil, but just couldn't deal with that feeling. Personally I'd try the Lexapro first and see if that helps, you can always switch. Everyone is different.


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## metamorphosis (Dec 18, 2008)

I'm currently on 10mg of Lexapro and it seems to really not be doing anything as far as my SA or depression.What it has done is made me feel lethargic and caused sexual problems.Does Paxil cause the weight gain 
which I've heard so much about or lethargy.Those are two things I don't need but if it helps SA as much as people have posted on these ehreads than than I'm willing to try.I also take 150mg Wellbutrin and the doctor sounds open to adderall and maybe Dexedrine which would help.Any thoughts on these combos guys/girls.


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## pixies (Oct 28, 2009)

I don't think any of these drugs actually cause weight gain directly, what they do is just change your appetite. It's very slight though, at least it has been for me. Also you have to take the pill with food or you can feel really sick, so the pills encouraged me to have a decent breakfast to take the pill with. 

For me my weight didn't change at all on Paxil. And it's not like you become powerless to control it anyway, even if it did. You can still exercise or diet or eat more or eat less as you prefer.

The lethargy/sexual problems are a bigger concern though. I'm on Lexapro now and I can barely get myself out of the chair. I feel so tired and so weary and lethargic. I'm hoping that will improve if only a bit, in week 2.


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## RockiNToM (Jun 15, 2009)

I gained quite a bit on Paxil but I felt great, so I actually didn't care. My main interest was getting better, which I was. Screw worrying about weight gain, unless it's an issue already.


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## metamorphosis (Dec 18, 2008)

Pixies,why did you change from Paxil to Lexapro?
Weight isn't that big of an issue for me since I cut back on the beer.I'm just concerned of the metabolism issues.I cycle alot and eat pretty good.But as Pixies was saying Lexapro just drains me.So how does Paxil effect your energy and sex drive?Also Dexedrine or Adderall for prolonged use for energy/SA.


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## pixies (Oct 28, 2009)

Sorry for the late reply. I took Paxil for many many years. After so many years I think it had done all it could do for me and my depression had long gone. So I just stopped taking it and I was off it for about 2-3 years. But things caught up with me a few months back and I started feeling really bad with anxiety, so I went to see my doc. I assumed I would go back on Paxil again but he didn't want to prescribe it because of all the bad press. He instead gave me this Escitalopram stuff.


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## Dane (Jul 27, 2009)

I've been on Paxil for 7 years and as far as I can tell it's working as well as ever. It hasn't been a "miracle cure" but it has made me a lot better. I haven't had a single panic attack since I've been on it, even in very stressful situations. No real side effects except it's a little harder to get going in the morning and the effects of alcohol are intensified. I tried Zoloft first and it didn't do anything.


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## Pen_is_mightier (Dec 8, 2009)

I took Lexapro for a few months. Experienced weight gain, which wasn't that big of a deal since I'm pretty skinny. It did "work" for anxiety, but it also knocked me out. Like, I'd wake up and in an hour I'd have to take a nap.


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## Havalina (Dec 18, 2004)

Paxil was life changing for me. I started succeeding in school, in relationships, got a house, even had a baby. I forgot what it was like to have SA. 

Unfortunately..after getting pregnant, I cut out the paxil cold turkey (paxil kills fetuses pretty much). I have been off since (this was 2.5 years ago). I miss it , the anxiety is slowly returning to its former strength but I don't have coverage anymore.


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## pixies (Oct 28, 2009)

Similar situation with me! The best years of my life were on Paxil. I did lots with my life and had girlfriends and moved out of my parents house and got a good job and everything was great. 

After stopping it, I lasted about 2.5 years as well, without any problems. But then everything came back. This Lexapro is helping me so far, but I preferred the Paxil I think. I had less side effects on the Paxil and I was far happier and more confident. I am going to stick with the Lexapro to see what happens though.


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## bben (Oct 24, 2009)

All SSRIS will lower dopamine firing due to the elevation of serotonin. This usually results in a loss of concentration and fatigue. You could add in something to counteract that though. Id go with lexapro also.


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