# Lexapro > Paxil ?



## jakejohnson007 (Jul 27, 2006)

The question: Is Lexapro better at treating SA than Paxil, and by how much?


The story: Paxil has helped me somewhat before. I have depression too, so now I want to go on SSRI + benzo that I'm already on. Doc wants to prescribe Lexapro over Paxil. Should I take his advice, or go back to my Paxil? (He'd let me)


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## Noca (Jun 24, 2005)

I think Paxil is better at treating SA than Lexapro as its more sedating, just Lexapro has less and weaker side effects.


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## Jimiam (Jan 8, 2007)

I've taken both paxil; and Lexapro. Yes. Paxil is more sedating. Makes me kind of drowsy during the day which sucks but still not as bad as the SA though. Lexapro seemed to take about a week to take an affect with me but when it did Boy did I feel great. Lexapro is a great drug. I felt no drowsiness the next day either which is great too. I recommend Lexapro.

I took Paxil for the past 10 years. I did not even no what I was missing not trying Lexapro.


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## Speak Easy (Jun 27, 2006)

paxil might be more effective (although this is arguable and lexapro is a newer med, which means less research), but lexapro definitely shows fewer side effects, especially come withdrawal time.


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## jakejohnson007 (Jul 27, 2006)

so Lexapro is more sedating. With the difference in efficacy, is Lexapro almost on a par with Paxil or is there a considerable gap between the two?


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## PassTheXanax (Apr 1, 2007)

I took Paxil in the past and honestly don't remember what it did for me. I am now on Lexapro and after 4 days have seen a slight difference. No sexual side effects (yet) and have a decrease in appetite. Can't wait til it's really in my system so I can function properly.


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## Speak Easy (Jun 27, 2006)

jakejohnson007 said:


> so Lexapro is more sedating. With the difference in efficacy, is Lexapro almost on a par with Paxil or is there a considerable gap between the two?


i'd say it's pretty close


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## imstuckinmyhead (Apr 14, 2007)

i took lexapro for 9 months and it did nothing at all for me. i waited and waited for it to cure my SA and panick. As my doc upped the dosage over the following months my anxiety/depression only got worse. the next thing i tried was paxil. after allowing two weeks for it to build up in my system i felt better than i had in two years. i felt capable of functioning and finally got out of bed. so if left between the choice of paxil or lexapro id go for paxil.

the doc told me lexapro is prefered if your depression is more of an issue than the anxiety, and said depression is causing a loss in appetite.

paxil is the prefered ssri for SA


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## David1976 (Nov 8, 2003)

I have been on paxil and I have been on lexapro... lexapro is definelty easier to get off of than paxil... if someone is having a tough time getting off paxil I would recomend switch to lexapro for a while and then getting off that...
But anxiety-wise I feel no difference between the two... I gained more weight on paxil but lexapro made me soo tired all the time.. made my joints ache and yawning constantly...


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## Nae (Nov 10, 2003)

Looking at the remedyfind chart here: http://www.remedyfind.com/healthconditions/65

Lexapro is rated a 6.7 while Paxil is rated lower at 5.7.

Here is a study done comparing paxil and lexapro in treating depression:

http://www.biopsychiatry.com/paroxvlexapro.htm

_
A total of 89 patients (28%) withdrew during the study; significantly (P<0.01) more patients withdrew from the paroxetine group (34%) than from the escitalopram group (21%), and significantly (P<0.05) more paroxetine patients withdrew due to lack of efficacy. The mean MADRS total score improved for both treatment groups from baseline to week 8, with no statistical difference between groups. In severely depressed patients (baseline MADRS total score >/=30), escitalopram was superior (P<0.05) to paroxetine at week 27 (end of maintenance treatment)._

But, IMO, how these drugs affect a persons anxiety is very much subjective and it is a toss up on which will work better for you..anxiety wise and side effect wise as you can see by the replies in this thread.

A bit off topic:

Can anyone explain why Paxil is supposedly more effective than Lexapro in the treament of anxiety or vice versa? I'm not even sure psychiatrists know. My Doc says he has roughly 25 patients on Lexapro who respond well for anxiety. And then turns around and says Paxil is supposedly the SSRI of choice for social anxiety.

(as for me, paxil sucked: I was tired most of the day. I had less side effects while on Lexapro [and celexa]. I can't say whether any of them did much for me anxiety wise.)

edit: changed my post a bit.


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## Jean (Jan 18, 2007)

i never noticed much of a difference between the two, to be honest, neither did anything good for me. guess it all depends on your chemistry though, everyone's different.


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## happyponcho42 (Apr 5, 2007)

I don't think that medication is a cure all for SA. I wouldn't expect a pill to be able to change your thoughts. My impression of Lexapro is that it just numbs me to the point where my heart stops racing and my thinking slows down but it's up to me to make the effort to put myself out, prevent the avoidance and omittance of any fellowship opportunities.

If pills were capable of just flat out changing what we think...imagine how non-advantageous that would be to the world.

Sometimes I think people who totally downplay medication simply wait for the pills to change their way of thinking. Hopefully I can stand corrected of this.


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## Noca (Jun 24, 2005)

happyponcho42 said:


> I don't think that medication is a cure all for SA. I wouldn't expect a pill to be able to change your thoughts. My impression of Lexapro is that it just numbs me to the point where my heart stops racing and my thinking slows down but it's up to me to make the effort to put myself out, prevent the avoidance and omittance of any fellowship opportunities.
> 
> If pills were capable of just flat out changing what we think...imagine how non-advantageous that would be to the world.
> 
> Sometimes I think people who totally downplay medication simply wait for the pills to change their way of thinking. Hopefully I can stand corrected of this.


Klonopin and other benzos can change your anxious thoughts. They can make it seem as if not everyone is staring at your anymore. They can make you feel more relaxed by fixing mental thoughts and physical symptoms.


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## happyponcho42 (Apr 5, 2007)

I guess I do stand corrected since I have no experience with benzos.

I was not aware that they directly modified thoughts but after reading http://www.cesar.umd.edu/cesar/drugs/benzos.asp I am still somewhat convinced that since it is essentially another muscle relaxant, it just eases up the person physically so they can formulate thoughts on their own that would otherwise trigger muscle tension and other anxiety symptoms.

My opinion is probably biased as I do consider medication to be just another step in overcoming SA but not the sole means. I have an older friend who suffered through SA and simply went through therapy to overcome it. He used to work in LA under Ashton Kutcher and if I hadn't known about his childhood SA, I would have never guessed he had any anxiety. He suggested that to supplement medication, therapy should be a consideration as it can be a means to motivate action as opposed to just sitting back.

To each their own.


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## Speak Easy (Jun 27, 2006)

happyponcho42 said:


> I am still somewhat convinced that since it is essentially another muscle relaxant, it just eases up the person physically so they can formulate thoughts on their own that would otherwise trigger muscle tension and other anxiety symptoms.


benzos are also muscle relaxants, but this is not their primary mode of action. benzos are not primary physical medications like for instance a beta blocker. they produce GABA in your brain (GABA is an inhibitory neurotransmitter that basically stops rushing thoughts and calms you down). so the chemical/mental aspect of the medication is implemented before the physical aspects take on.



happyponcho42 said:


> My opinion is probably biased as I do consider medication to be just another step in overcoming SA but not the sole means.


i agree that medication is not the sole means of overcoming SA, and actually i think that if someone can overcome SA with just therapy, then more power to them. but not everyone is this fortunate, so sometimes it becomes necessary to try medication just to get someone to the level where they are able to respond to CBT.


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