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What Causes Anxiety While On Paroxetine?
Question: I have talked with you before & liked you advise, so here I am again. Been on Paroxetine 40mg for 10 years,went off & had bad withdrawal symptons went back on Paroxetine 60 mg. Have done great for about 6 weeks & having some anxiety, don't understand what is going on, any suggestions!
Brief Answer:
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Detailed Answer:
Hello, and thanks so much for using my premium direct service. I now consider you my private patient, and will do everything in my power to help you. You get 4 followup questions/responses as part of this thread, so I encourage you to use that fully!
Let me clarify your question a little bit. You are currently taking paroxetine 60mg daily and lorazepam 10mg daily. You were previously stable on paroxetine 40mg daily. Can I ask why the paroxetine was increased? Or in other words, why not simply go back to paroxetine 40mg which seemed to be worked for you? Also, do you take lorazepam 10mg all at once at night? This would be an enormously high dose and there are many many problems with that. Also, are you currently seeing a therapist for weekly psychotherapy?
Dr. Sheppe
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Detailed Answer:
Hello, and thanks so much for using my premium direct service. I now consider you my private patient, and will do everything in my power to help you. You get 4 followup questions/responses as part of this thread, so I encourage you to use that fully!
Let me clarify your question a little bit. You are currently taking paroxetine 60mg daily and lorazepam 10mg daily. You were previously stable on paroxetine 40mg daily. Can I ask why the paroxetine was increased? Or in other words, why not simply go back to paroxetine 40mg which seemed to be worked for you? Also, do you take lorazepam 10mg all at once at night? This would be an enormously high dose and there are many many problems with that. Also, are you currently seeing a therapist for weekly psychotherapy?
Dr. Sheppe
Above answer was peer-reviewed by :
Dr. Naveen Kumar
I was having anxiety so the dr. Wanted me to try Lexipro but it didn't work for me, only made my anxiety worse. I have been retired for 2 years & can't get adjusted to not working & lost my dad 2 years ago also. The doctor put me back on Paroxetine & raised the dose to 60mg. It has helped to take away the anxiety for the last 6 weeks but last week I started having anxiety again. The dose on the Lorazepam is .10 mg, & I only take it for sleeping. Why is the Paroxetine not working as well as it was? It was a great medicine when I took it 10 years ago & this is my first time with it not working like it used to!
Brief Answer:
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Detailed Answer:
Did you type lorazepam 0.10mg? or 10mg? I'm still not sure, because 0.10 is not a real dosage available, and 10mg is incredibly high.
Sometimes antidepressants such as paroxetine can "burn out" or lose efficacy over time. You are currently on the maximum dosage of paroxetine, and you are still having anxiety. So paroxetine has apparently burned out for you. I would recommend switching to a different antidepressant, which is often a very effective strategy. Since Lexapro did not work well, I would choose sertraline (Zoloft) for you. This would be my recommendation for you at this time.
Dr. Sheppe
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Detailed Answer:
Did you type lorazepam 0.10mg? or 10mg? I'm still not sure, because 0.10 is not a real dosage available, and 10mg is incredibly high.
Sometimes antidepressants such as paroxetine can "burn out" or lose efficacy over time. You are currently on the maximum dosage of paroxetine, and you are still having anxiety. So paroxetine has apparently burned out for you. I would recommend switching to a different antidepressant, which is often a very effective strategy. Since Lexapro did not work well, I would choose sertraline (Zoloft) for you. This would be my recommendation for you at this time.
Dr. Sheppe
Above answer was peer-reviewed by :
Dr. Raju A.T
The Lorazepam bottle says .5mg & I take 2at bedtime. How do I get off of the paroxetine, I have been ready reviews & it is very hard to get off of, the withdrawals are bad. Can I start something new while reducing the paroxetine? This just really worries me so I am having anxiety over the thought of having to change medicines!
Brief Answer:
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Detailed Answer:
Thank you for clarifying the lorazepam dose. So it is actually 1mg total at bedtime. I understand now -- that is a much more reasonable dose!
You will need to work closely with your prescribing physician to switch from paroxetine to another antidepressant such as sertraline. It is very possible to start sertraline while at the same time slowly weaning off paroxetine. This is called a "cross-taper" and is the best way to switch antidepressants. It reduces the side effects and avoids withdrawal. So don't worry, changing medications won't be too difficult for you!
There are 2 more followup questions for you in this thread.
Dr. Sheppe
Private Followup
Detailed Answer:
Thank you for clarifying the lorazepam dose. So it is actually 1mg total at bedtime. I understand now -- that is a much more reasonable dose!
You will need to work closely with your prescribing physician to switch from paroxetine to another antidepressant such as sertraline. It is very possible to start sertraline while at the same time slowly weaning off paroxetine. This is called a "cross-taper" and is the best way to switch antidepressants. It reduces the side effects and avoids withdrawal. So don't worry, changing medications won't be too difficult for you!
There are 2 more followup questions for you in this thread.
Dr. Sheppe
Above answer was peer-reviewed by :
Dr. Naveen Kumar
Couldn't get in to see my doctor but talked to his nurse, she talked with the doctor & they have added Buspirone 10mg. twice a day. how long before I see any relief? Do you think I still need to change from the Paroxetine because of it not working anymore? Totally frustrated, want to enjoy the summer but this anxiety is taking over.
Brief Answer:
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Detailed Answer:
The addition of buspirone is a perfectly acceptable strategy for managing anxiety. It is essentially equivalent to switching the paroxetine to something else. So, maybe this will do the trick, and perhaps the paroxetine will not need to be changed after all. I suggested simply changing the paroxetine to keep you on as few medications as possible, but this strategy will work perfectly fine as well. It may take up to 4 weeks to see the full effect of buspirone. We can certainly talk to keep your anxiety at bay in the meantime.
One question left on this thread!
Dr. Sheppe
Private Followup
Detailed Answer:
The addition of buspirone is a perfectly acceptable strategy for managing anxiety. It is essentially equivalent to switching the paroxetine to something else. So, maybe this will do the trick, and perhaps the paroxetine will not need to be changed after all. I suggested simply changing the paroxetine to keep you on as few medications as possible, but this strategy will work perfectly fine as well. It may take up to 4 weeks to see the full effect of buspirone. We can certainly talk to keep your anxiety at bay in the meantime.
One question left on this thread!
Dr. Sheppe
Note: For further follow up on related General & Family Physician Click here.
Above answer was peer-reviewed by :
Dr. Arnab Banerjee
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