Posted by bleauberry on February 10, 2010, at 16:56:12
In reply to Anyone switch from Paxil to Prozac, posted by Laney on February 10, 2010, at 11:52:56
Have you tried things to revive Paxil's efficacy? I'm thinking Risperdal, Abilify, Zyprexa, Ritalin, Savella, Nortriptyline...things that will bring the norepinephrine and dopamine circuits up to par with the Paxil serotonin circuits. I would certainly try a few of those things before abandoning it completely.
I was on Paxil for one year. I weaned off in about 2 months, shaving small amounts off the pills, maybe going a little bit lower in dose every 4 days or so, staying at a steady dose for a few days, and so on, feeling it out on the fly. After the final dose, which was down to just crumbs, maybe 1mg or 2mg, the next few days were a bit harder than I thought, with some extreme dizziness and nausea and such. I went back to the crumbs, stabilized a week or so, and then got off without much problem.
With you it is likely to be more traumatic and problematic. Thirteen years is a very long time and your body is completely dependent on that Paxil molecule. The fact that it has pooped out is irrelevent. Your body can't function without that molecule. It is more complicated than merely serotonin reuptake or whatever. Prozac will only partially make up for the loss of Paxil. Each med has unique functions on genes, enzymes, and detailed obscure things we don't talk about much. We know Paxil hits some of the other neurotransmitter systems, such as cholinergic, and others, that other SSRIs do not.
I think you just have to whittle the doses down in very tiny steps. Razor blades are good for shaving off small amounts from pills. Cutting a pill in half makes it easier to shave small amounts off of corners. Tricks like are, in my mind, absolute necessities if the goal is to have the smoothest ride possible. If you are planning on going from 20mg to 10mg 5mg to 0mg, forget it, that will never work without going through hell for a few weeks or months. The slow wean in tiny steps is much smoother.
All that said, not to rain on the party, I have doubts any SSRI is going to work very well after 13 years of another one. It is probably going to involve a combo of meds that hits serotonin, NE, and dopamine. Serotonin has been ruling the show for too long at the expense of the others.
My two cents anyway.
poster:bleauberry
thread:936561
URL: http://www.dr-bob.org/babble/20100204/msgs/936599.html