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Dr. Andrew Rynne

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Why Am I Suffering From Anxiety And Depression After Reducing Paxil Dosage?

MY forty year old daughter is on 20mg.of paxil.She went down to 10mg.for a few months.The dosage is back to 20mg. but she is suffering with severe anxiety and depression.Have had her at the emerge a couple of times thinking she is taking a heart attack.with good reports. Still not enough. Please help.We have no family doctor.
Wed, 5 Feb 2014
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Psychiatrist 's  Response
Welcome to HCM!

You daughter needs a higher dosage if Paxil as her anxeity is still uncontrolled.

The symptoms of severe anxeity in which there can be dry mouth, palpitation, perspiration -are suggestive of panic attacks ( they resemble heart attacks but reports turn out to be normal like your daughter's). All this indicate that her anxeity disorder is increasing.

The dosage of Paxil should be increased to 40 mg. Along with it she can take etizolam 0.5 mg whenever she has sever anxeity attack for some time ( on SOS basis). If her sleep is also deficient, then she should take something like - clonazepam 1-2 mg at night for some days, than taper it and stop.
Paxil should continue for may be an year or so even after she gets 100% better.

Hope the reply is useful
Dr. Manisha Gopal
MD psychiatry
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Why Am I Suffering From Anxiety And Depression After Reducing Paxil Dosage?

Welcome to HCM! You daughter needs a higher dosage if Paxil as her anxeity is still uncontrolled. The symptoms of severe anxeity in which there can be dry mouth, palpitation, perspiration -are suggestive of panic attacks ( they resemble heart attacks but reports turn out to be normal like your daughter s). All this indicate that her anxeity disorder is increasing. The dosage of Paxil should be increased to 40 mg. Along with it she can take etizolam 0.5 mg whenever she has sever anxeity attack for some time ( on SOS basis). If her sleep is also deficient, then she should take something like - clonazepam 1-2 mg at night for some days, than taper it and stop. Paxil should continue for may be an year or so even after she gets 100% better. Hope the reply is useful Dr. Manisha Gopal MD psychiatry