I was prescribed Paxil for anxiety.

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DanOhioAwesome
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I was prescribed Paxil for anxiety.

Post by DanOhioAwesome » Tue Oct 01, 2019 12:28 pm

So today my suboxone doctor prescribed me paxil for anxiety. Couple questions. 1) has anyone else taken this while on suboxone? Are you still and did you see improvments?
2) Is this something I wanna even take for general anxiety and the occasional panic attack? I get 1 maybe every couple months. Outside of that my anxiety isnt really crippiling.

Thanks

Dan

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suboxdoc
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Re: I was prescribed Paxil for anxiety.

Post by suboxdoc » Wed Oct 02, 2019 12:28 pm

Paxil (paroxetine) is a selective serotonin reuptake inhibitor, or SSRI. All SSRIs are indicated for anxiety, and they all work in the exact same way. Some are more potent, like Lexapro (escitalopram). They all have selling points and detractions. I rarely prescribe Paxil because it has the most weight gain associated with it of all the SSRIs, and it has a short half-life, so some people feel mild discontinuation symptoms early in the morning. But it is also the most sedating of the SSRIs, so it can be useful in people with insomnia.

Prozac is almost the opposite. It has a long half-life, promotes a small amount of weight loss, and is 'activating'. Celexa is thought to be weight-neutral and not activating or sedating.

Lexapro is the most powerful of the first-generation SSRIs. Lexapro 20 mg has an effect similar to 60-80 mg of Paxil. But some people don't tolerate Lexapro because of that potency.

All SSRIs can be used to eliminate panic attacks, at least in most patients. They take a month or two to START working. Their effect is nothing at all like that of benzos; you cannot 'feel' the effect of an SSRI, and if you feel anything at all, it is a side effect. They reduce the obsessiveness of our thoughts, and help keep worry from building on worry. For social anxiety, they reduce the tendency to ruminate over things we said or did wrong.

SSRIs are used as often, if not more often, for anxiety as they are for depression. But they have absolutely no value as 'as needed' medications. They must be taken every day to have their effect. One mechanism of their action is to promote the branching of dendrites on neurons - and that takes time.

There is no interaction or concern with SSRIs and buprenorphine.

Good luck!

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Amy-Work In Progress
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Re: I was prescribed Paxil for anxiety.

Post by Amy-Work In Progress » Sun Oct 06, 2019 12:29 pm

Thanks, Dr. Junig, for educating us about SSRIs!

Amy
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TeeJay
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Re: I was prescribed Paxil for anxiety.

Post by TeeJay » Sun Nov 24, 2019 1:11 pm

My mother's been on Paroxetine for years and says it's helped a lot with her anxiety. Only issue is she's tried to come off it a few times and struggled, gone back on it.

Myself, I'm a 3.5 off Pristiq after getting through the gnarly 2 weeks of withdrawal. Since then it's been pretty difficult mood swings, agitation, insomnia etc. I've been biting my nails bad and feel like yelling at people who annoy me over silly things. Right now there's a woman next to me and she is venting on twitter, aggressively pummeling her keyboard with oversized french fry greasy hands. I feel like telling her tweets won't garner any larger audience by destroying the keyboard.

Normally I'm a happy-go-lucky guy but coming off this SNRI has turned me into a complete asshole. I've nearly bitten my nails off these last couple of weeks.

So yeah. Right now I'm regretting taking the script and not spending a bit more time investigating mindfulness based CBT or something. Cos now I have an opioid dependence as well as an anti-depressant dependence. Beginning to wonder if life is just a gradual accruance of things to be dependent on.

I think I'ma go back on the Pristiq today.

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Re: I was prescribed Paxil for anxiety.

Post by Amy-Work In Progress » Sat Nov 30, 2019 11:30 am

I'm sorry you're struggling, TeeJay.

Did you end up going back on Pristiq? I hope that things feels more bearable today than they did when you posted.

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rule62
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Re: I was prescribed Paxil for anxiety.

Post by rule62 » Sat Nov 30, 2019 7:14 pm

Kind of disturbing reading what our good doctor said about it. My wife has been on it for many years. When it first came out she read an article stating it worked well in stopping panic attacks. It did the trick and she hasn't had one since. And even with the side effects she'll never go off it.

It does affect the sex life as does all of them. My doctor put me on Lexapro and it made me climb the walls. Ended up on Effexor which worked quite well. Getting off them is another story. Lucky for me, Effexor is a capsule with small time release balls inside. Each one was 1 mg. That made tapering off so much easier. It took a few months but I got off it successfully which my doctor said I wouldn't be able to do. Hah! Tapering is always the best way for any drug.

Good luck going forward whatever you decide to do.
Don't take yourself so damn seriously

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Re: I was prescribed Paxil for anxiety.

Post by TeeJay » Wed Dec 04, 2019 11:50 pm

Yeah I'm back on Pristiq. The agitation disappeared within a couple of days.

I'll talk to my doctor about going on Effexor when I choose to attempt coming off again. Effexor and Pristiq are pretty much the same drug, but Pristiq doesn't permit tapering given it's a tablet rather than a capsule.

Counting out those little baubles certainly will try my patience!

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