Posted by Mitch on August 2, 2001, at 9:10:09
In reply to Re: Is 60mg Paxil safe? Or should I switch to Prozac? » Mitch, posted by Jackster on August 2, 2001, at 5:25:39
> > > 40mg Paxil has pooped out on me for Panic Disorder. Is 60mg safe? And is Prozac used for Panic Disorder - I hear so much that it can bring on panic attacks.
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> > > Jackie
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> > Your pdoc probably would suggest an increase to 60mg although the manufacturer suggests that dosage increases above a certain level aren't particularly helpful. I think a read a "tip" in here once about simply switching SSRi's when they poopout (assuming of course that they were effective when they worked). Jumping from Paxil to Prozac might be a little too "buzzy" for you, though, though for some it works quite well for panic.
> >
> > This is a little of a stretch but you might try a "cross-taper" with Zoloft and see how you do with that. You could add 12.5mg of Zoloft to your 40mg of Paxil and see how you do for a week, and if you aren't seeing any worsening or you see an improvement reduce your Paxil from 40mg >30mg and increase the Zoloft to 25mg for example the following week until you are just on the Z and off the Paxil. If you are currently taking a benzo as well you may need to increase it a little while you do this. Zoloft is fairly activating, but generally not near as much as Prozac.
> >
> > Mitch
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> I am actually on Zoloft (75mg) at the moment after the Paxil pooped out. But I can't afford any higher because it's not subsidised here. (NZ). I could afford 100mg, but I feel if I've had no effect from 75mg, I'd probably need at least 150mg.
>
> My PDoc has suggested that perhaps I could go up to 60mg of Paxil (to kick start it again, I guess) and then gradually go down to 40mg again. Any thoughts on if this would work?
Jackie,This may be beating a dead horse, but given your dosage requirements (of SSri) and the expense, have you been adequately controlled with just clonazepam or alprazolam for your PD?? I just wonder if you have a pdoc that is anti-benzo and is wasting a lot of time (and *your* money) trying to get you controlled on just antidepressants when a benzo could work a lot better and be a HELL of a lot cheaper (and in my opinion not addictive either).
Perhaps you also have some depression problems as well, then maybe a lower dose of SSri *combined* with some clonazepam would be the answer. I know that generic Prozac should be available any time now(fluoxetine) which could save you a lot of money. You just said you are taking 75mg of Zoloft (assuming you are tolerating it ok). Given that I doubt if you would find Prozac too activating.
Yep, my suggestion is keep some money in your pocket, swap the Zoloft for 10-20mg/day of generic fluoxetine (don't bother trying to taper withdraw the Zoloft vis a vis the fluoxetine), keeping your Paxil at 40mg/day.
Then if you aren't already on some clonazepam or alprazolam-see if you can get your pdoc to add it.
THEN try to taperdown the Paxil and maybe increase the fluoxetine with the benzo in place.
Hopefully you can be taking just two generic meds-say clonazepam and fluoxetine (much less expensive!).Mitch
poster:Mitch
thread:72854
URL: http://www.dr-bob.org/babble/20010731/msgs/73087.html