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Question: Hi,
My name is xxxx and I am currently being treated for anxiety/panic disorder (GAD) and OCD. I was treated for this 2 years ago and was on Paxil 10 mg for 18 months. I was put on Paxil back then because I had a lot of anxiety/panic attacks related to school (I was an undergraduate in college at the time and had a difficult time accepting anything below an A). I went off of Paxil in May because I thought I didn't need it anymore (weened off of it). I had no anxiety at all during the 18 months I was on it. However, I started graduate school in August and my anxiety came back, but 100 times worse. I felt like I was living in a dream/like I was unreal. I was having a panic or anxiety attack almost everyday at work. I also developed new anxieties. I was scared my heart was going to stop beating, that I was having a heart attack, that I was going to stop breathing, etc. My psychiatrist, primary care physician, and therapist all suggested I start taking Paxil 10 mg and Xanax .5 mg as needed. I have been following this plan since September 2 when I started the Paxil again. My anxiety has definitely started to decrease, but it is not completely gone. I have no appetite and have been throwing up as a result of eating sometimes. I have also lost 12 pounds.
Like I said, I am less anxious than in August/September. However, I am very anxious in the mornings (I get a tingly feeling in my chest and have a little trouble breathing), so I am still taking a Xanax every morning. I met with my psychiatrist yesterday and he said the fact that I am taking a Xanax everyday shows the Paxil is not working 100%. He also said the reason why I may be anxious in the morning is because the "half life" of Paxil is 21 hours. He suggested I either start taking 12.5 mg of controlled release Paxil or a 10 mg of Paxil in the morning and a 5 mg of Paxil (cut the pill in half) before bed. I am nervous to increase my dose, but realize it is probably necessary.
My questions are: Will these symptoms I am experiencing go away? I am scared I will feel like this forever. Do you think the 12.5 mg of CR Paxil or the 10 mg coupled with the 5 mg at night is a better idea? Is it normal to not feel 100% better after taking Paxil for 5 weeks? Is it common to be more anxious in the morning if I take my Paxil around 10:30 AM (because of the half life)? Like I said, I never experienced any of these symptoms last time I took Paxil. I actually gained weight while I was on it, but never had any other side effects. I wish my appetite would come back and am scared it never will. Please let me know when you get a chance, thanks. I look forward to hearing from you.
My name is xxxx and I am currently being treated for anxiety/panic disorder (GAD) and OCD. I was treated for this 2 years ago and was on Paxil 10 mg for 18 months. I was put on Paxil back then because I had a lot of anxiety/panic attacks related to school (I was an undergraduate in college at the time and had a difficult time accepting anything below an A). I went off of Paxil in May because I thought I didn't need it anymore (weened off of it). I had no anxiety at all during the 18 months I was on it. However, I started graduate school in August and my anxiety came back, but 100 times worse. I felt like I was living in a dream/like I was unreal. I was having a panic or anxiety attack almost everyday at work. I also developed new anxieties. I was scared my heart was going to stop beating, that I was having a heart attack, that I was going to stop breathing, etc. My psychiatrist, primary care physician, and therapist all suggested I start taking Paxil 10 mg and Xanax .5 mg as needed. I have been following this plan since September 2 when I started the Paxil again. My anxiety has definitely started to decrease, but it is not completely gone. I have no appetite and have been throwing up as a result of eating sometimes. I have also lost 12 pounds.
Like I said, I am less anxious than in August/September. However, I am very anxious in the mornings (I get a tingly feeling in my chest and have a little trouble breathing), so I am still taking a Xanax every morning. I met with my psychiatrist yesterday and he said the fact that I am taking a Xanax everyday shows the Paxil is not working 100%. He also said the reason why I may be anxious in the morning is because the "half life" of Paxil is 21 hours. He suggested I either start taking 12.5 mg of controlled release Paxil or a 10 mg of Paxil in the morning and a 5 mg of Paxil (cut the pill in half) before bed. I am nervous to increase my dose, but realize it is probably necessary.
My questions are: Will these symptoms I am experiencing go away? I am scared I will feel like this forever. Do you think the 12.5 mg of CR Paxil or the 10 mg coupled with the 5 mg at night is a better idea? Is it normal to not feel 100% better after taking Paxil for 5 weeks? Is it common to be more anxious in the morning if I take my Paxil around 10:30 AM (because of the half life)? Like I said, I never experienced any of these symptoms last time I took Paxil. I actually gained weight while I was on it, but never had any other side effects. I wish my appetite would come back and am scared it never will. Please let me know when you get a chance, thanks. I look forward to hearing from you.
Brief Answer:
paxil 12.5mg is a better choice.
Detailed Answer:
Hello Dear XXXXXXX
Welcome to HCM.
I have gone through your query. I understand that you are going through a difficult phase.
You have anxiety which is worse in morning and poor appetite.
I would like to assure you that these symptoms are not permanent and will surely go away. It may time but you will be fine.
In my opinion, paxil-CR 12.5mg is a better choice. It will work throughout the day.
I have used doses as high as 37.5mg.
Not feeling well even after 5 weeks of paxil treatment may due to inadequate dose.
Sometimes the dose requirements increase depending on severity of symptoms.
I agree with your doctor that due to short half life, the effects may not be sustained till morning. So you feel more anxious in morning.
So, to sum up,
I would suggest you to take paxil 12.5mg in night. If needed, dose can be increased depending on response. The symptoms will remit once optimum dose is attained. Paxil does cause weight gain due to increased appetite. Your appetite will improve as your anxiety decreases.
Kindly discuss this with your doctor.
Hope this helps.
Feel free to ask further.
Thanks.
paxil 12.5mg is a better choice.
Detailed Answer:
Hello Dear XXXXXXX
Welcome to HCM.
I have gone through your query. I understand that you are going through a difficult phase.
You have anxiety which is worse in morning and poor appetite.
I would like to assure you that these symptoms are not permanent and will surely go away. It may time but you will be fine.
In my opinion, paxil-CR 12.5mg is a better choice. It will work throughout the day.
I have used doses as high as 37.5mg.
Not feeling well even after 5 weeks of paxil treatment may due to inadequate dose.
Sometimes the dose requirements increase depending on severity of symptoms.
I agree with your doctor that due to short half life, the effects may not be sustained till morning. So you feel more anxious in morning.
So, to sum up,
I would suggest you to take paxil 12.5mg in night. If needed, dose can be increased depending on response. The symptoms will remit once optimum dose is attained. Paxil does cause weight gain due to increased appetite. Your appetite will improve as your anxiety decreases.
Kindly discuss this with your doctor.
Hope this helps.
Feel free to ask further.
Thanks.
Note: For further guidance on mental health, Click here.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Answered by
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