Posted by Ritch on December 18, 2004, at 16:20:53
In reply to Where should we go from here?, posted by celticmom on December 18, 2004, at 15:01:06
> DH was on 20 mg of Lex after switching from 40mg of Paxil. He was doing well on Paxil, except he had become forgetful, so pdoc switched him to Lex.
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> He had very little withdrawal from Paxil to Lex, but 5 weeks later started experiencing headaches and break through panic attacks. Pdoc increased the Lex 5 mg and a week later he is still getting the headaches. He also has chills and night sweats. This morning he woke up with a sense of despair. He knew there was no reason for it, but he was overwhelmed. After moving about for a while he felt better. But he is still more anxious than he used to be on Paxil and he's still clammy.
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> He has been taking motrin an sudaphed daily to help with the chills and fogginess and that seems to work. However, DH is at the end of his ropes. He has been sleeping all day. Pdoc isn't very helpful. Doesn't believe that the symptoms have anything to do with the medication - but I don't believe in coincidence.
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> She said to go ahead and wean off of Lex and then he can try Zoloft. Should he just give it more time? Has anyone experienced symptoms that didn't start until weeks after being on the med?
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> Any thoughts or suggestions are appreciated!
It may be possible that the Paxil was providing an antipanic effect that the Lexapro can't provide. Paxil has a fairly strong norepinephrine reuptake blockade effect compared to the rest of the SSRI drugs. Many folks that have panic (myself included) find that the norepi effect is what truly blocks the panic attacks, the serotonergic activity of the drugs acts more as a general anxiolytic. It might be a good idea to add a low dose (maybe more later) of a non-sedating TCA (nortriptyline or desipramine, i.e.) to the Lexapro to see if that gets his breakthrough panic under control. Hope this helps.
poster:Ritch
thread:431299
URL: http://www.dr-bob.org/babble/20041217/msgs/431327.html