Posted by bleauberry on April 6, 2010, at 17:28:29
In reply to Scott, Bleauberry, Ed, anyone with some good know, posted by Laney on April 5, 2010, at 14:54:41
The biggest issue here is the 13 years on paxil. That is huge. The weaning process is going to be long and troublesome, and you already know that. The longstanding adaptations during and after it are going to overlap into whatever else you do, causing some confusing times.
Is that right? 13 years? Or was it 13 months? Either way, paxil is a tough one.
If I were you, I would try adding a noradrenergic agent to it. A common top choice would Wellbutrin, which you are doing, but I personally disagree with that choice. I see that drug used far too often and I don't know why. I don't know how it ever got past the FDA, because in other countries it performs so poorly as an AD they won't approve it for that. Only for smoking cessation, not depression.
My top choice would be adding Savella, which is what they do in Japan. Paxil+Savella. Another option is Paxil+Nortriptyline. Paxil+Ritalin. Paxil+low dose abilify. Paxil+Zyprexa. Paxil+low dose Risperdal. All viable options.
I do not believe even a little bit that switching to a different SSRI is going to work. Not after that long of a time period on one.
You might consider taking 10mg doses of Prozac 2 or 3 times a week if you want to continue weaning off paxil. It will help buffer things, with its long halflife.
poster:bleauberry
thread:942370
URL: http://www.dr-bob.org/babble/20100406/msgs/942523.html