Sign-in to Ask A Doctor - 24x7
OR
Sign in with Google
What Causes Severe Anxiety After Switching From Lexapro To Paxil?
Brief Answer:
add etizolam & increase dose of paxil
Detailed Answer:
Hello,
I have read your question and it says that you have been on lexapro 20mg for two years but now switched to paxil 10mg and have severe anxiety.
I would like to know -
1.If you have completely stopped lexapro and started paxil or taking reduced dosage of lexapro along with paxil?
2. Why have you been shifted to paxil if you were having response with lexapro?
The main reason for anxiety here is that there is sudden change in drugs and
the insufficient dosage of paxil. 10mg paxil is very low dose.
Had I been treating you, I would have started a long acting preparation of paxil (CR preparation available in the dosage of 12.5, 25, 37.5mg). And, as any new molecule takes time to act, I would have started an anti anxiety drug like etizolam or clonazepam in low dosage to give some cover. Later these medicines can be easily stopped and paxil would continue.
Please talk to your doctor for starting etizolam or some short term anti anxiety medicine and raise the dosage of paxil. This can be taken in day time as it is non sedative in nature.
If there are sleeping problem at night, it will be best to add a sedative for short term which is non addictive and safe. Early recovery of good sleep is very effective in managing anxiety.
Hope the reply helps.
wish you good luck.
Please feel free to ask more questions for clarification.
Dr. Manisha Gopal
MD Neuropsychiatry
add etizolam & increase dose of paxil
Detailed Answer:
Hello,
I have read your question and it says that you have been on lexapro 20mg for two years but now switched to paxil 10mg and have severe anxiety.
I would like to know -
1.If you have completely stopped lexapro and started paxil or taking reduced dosage of lexapro along with paxil?
2. Why have you been shifted to paxil if you were having response with lexapro?
The main reason for anxiety here is that there is sudden change in drugs and
the insufficient dosage of paxil. 10mg paxil is very low dose.
Had I been treating you, I would have started a long acting preparation of paxil (CR preparation available in the dosage of 12.5, 25, 37.5mg). And, as any new molecule takes time to act, I would have started an anti anxiety drug like etizolam or clonazepam in low dosage to give some cover. Later these medicines can be easily stopped and paxil would continue.
Please talk to your doctor for starting etizolam or some short term anti anxiety medicine and raise the dosage of paxil. This can be taken in day time as it is non sedative in nature.
If there are sleeping problem at night, it will be best to add a sedative for short term which is non addictive and safe. Early recovery of good sleep is very effective in managing anxiety.
Hope the reply helps.
wish you good luck.
Please feel free to ask more questions for clarification.
Dr. Manisha Gopal
MD Neuropsychiatry
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Brief Answer:
you will recover, please dont worry; ↑ paxil dose
Detailed Answer:
Hello,
You had relapse of anxiety while taking lexapro so your doctor changed the medicine and there is past history of response to paxil.
It would have helped me to know the case properly had you mentioned the dosage of paxil at which you had response in the past (of paxil) ;
And if you are cross tapering lexapro with paxil or just stopped lexapro completely.
I know the situation is difficult for you at present but I would lije to assure you that please dont loose hope as you will surely feel better with paxil in some days and with increased dosage.
Its just the matter of time. Paxil is definitely a better drug to lexapro for managing anxiety disorder.
There are some other things which should be looked into while treating a relapse case of anxiety. Please check your blood pressure and treat if it is on the higher side consistently.
Please get thyroid test and treat it if disturbed.
Many times I have seen that the levels of sr. Vit. B 12 is low and treating it helps in recovery.
If there is so much anxiety right now that you cant work properly - I think adding etizolam 0.5mg in morning and in afternoon will help a lot.
You may take zolpidem 12.5mg at night for sleep for a week or so and then you can stop it.
It will be good if you shift to controlled release preparation of paxil (CR) instead of plain formulation. If your doctor wishes to keep you on plain paxil, then a higher dosage is needed and it should be tiwce a day to give proper cover all day long.
Please talk to your treating team about the above mentioned points .
Wish you speedy recovery.
Feel free to ask more queries for any clarification.
Dr. Manisha Gopal
MD Neuropsychiatry
you will recover, please dont worry; ↑ paxil dose
Detailed Answer:
Hello,
You had relapse of anxiety while taking lexapro so your doctor changed the medicine and there is past history of response to paxil.
It would have helped me to know the case properly had you mentioned the dosage of paxil at which you had response in the past (of paxil) ;
And if you are cross tapering lexapro with paxil or just stopped lexapro completely.
I know the situation is difficult for you at present but I would lije to assure you that please dont loose hope as you will surely feel better with paxil in some days and with increased dosage.
Its just the matter of time. Paxil is definitely a better drug to lexapro for managing anxiety disorder.
There are some other things which should be looked into while treating a relapse case of anxiety. Please check your blood pressure and treat if it is on the higher side consistently.
Please get thyroid test and treat it if disturbed.
Many times I have seen that the levels of sr. Vit. B 12 is low and treating it helps in recovery.
If there is so much anxiety right now that you cant work properly - I think adding etizolam 0.5mg in morning and in afternoon will help a lot.
You may take zolpidem 12.5mg at night for sleep for a week or so and then you can stop it.
It will be good if you shift to controlled release preparation of paxil (CR) instead of plain formulation. If your doctor wishes to keep you on plain paxil, then a higher dosage is needed and it should be tiwce a day to give proper cover all day long.
Please talk to your treating team about the above mentioned points .
Wish you speedy recovery.
Feel free to ask more queries for any clarification.
Dr. Manisha Gopal
MD Neuropsychiatry
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
You have been so helpful..my thryoid levels were ok i had them tested and many years ago i took 20 mg of paxil which helped ....i will get the rest of my blooodwork done too....i wish you were my doctor
Brief Answer:
learn jpmr & good luck!
Detailed Answer:
Hello,
If thyroid levels were ok last time (within an year from now) then you dont need to repeat them.
Paxil 20mg was helpful earlier but this time I think you might need more dosage for getting better, so dont worry while increasing it.
Please try to maintain the dosage at which you feel best for some time . Dont reduce it even after an year without consulting your treating team.
If you can manage to learn jpmr (jacobsons progressive muscular relaxation) from someone or from internet and do it daily- it is amazingly helpful in managing anxiety disorder and helps in reducing the dosage of anti anxiety medicine. I routinely teach them to my patients.
Every doctor is good, what is more important is -with whom the patient feels most comfortable!
Feel free to ask more queries directly to me in future if you need. I will try my best to help you.
Wish you speedy recovery.
Dr. Manisha Gopal
MD Neuropsychiatry
learn jpmr & good luck!
Detailed Answer:
Hello,
If thyroid levels were ok last time (within an year from now) then you dont need to repeat them.
Paxil 20mg was helpful earlier but this time I think you might need more dosage for getting better, so dont worry while increasing it.
Please try to maintain the dosage at which you feel best for some time . Dont reduce it even after an year without consulting your treating team.
If you can manage to learn jpmr (jacobsons progressive muscular relaxation) from someone or from internet and do it daily- it is amazingly helpful in managing anxiety disorder and helps in reducing the dosage of anti anxiety medicine. I routinely teach them to my patients.
Every doctor is good, what is more important is -with whom the patient feels most comfortable!
Feel free to ask more queries directly to me in future if you need. I will try my best to help you.
Wish you speedy recovery.
Dr. Manisha Gopal
MD Neuropsychiatry
Note: For further guidance on mental health, Click here.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Answered by
Get personalised answers from verified doctor in minutes across 80+ specialties
