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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 8 of 8. This is the beginning of the thread.
Posted by keilia on May 9, 2002, at 15:14:23
I was given paxil today for anxiety/panic, doc said it would help me taper off my xanax. I am hearing soo much about all the weight gain it will cause. Does the weight gain happen because paxil will make you tired therefore you dont do as much, or because maybe it makes you eat more? or do you just gain weight no matter what you do? Has anyone lost weight while taking paxil?
I dont even know if I want to start a new drug...just something else to get dependent on, I dont think it will ease the xanax dependency much. I dont think anything will. The way he talked he wants to get me off of them pretty fast. What was your experience on paxil? Thanks
Posted by katekite on May 9, 2002, at 19:02:24
In reply to Just starting to take paxil, posted by keilia on May 9, 2002, at 15:14:23
Paxil worked well for me for social anxiety. It made me sleepy for a few weeks starting out. I had no weight gain. I would guess that yes, the weight gain would be mostly sedation and feeling more like hanging out with people eating.
kate
Posted by Rathrbfishn on May 9, 2002, at 22:36:24
In reply to Just starting to take paxil, posted by keilia on May 9, 2002, at 15:14:23
> I was given paxil today for anxiety/panic, doc said it would help me taper off my xanax. I am hearing soo much about all the weight gain it will cause. Does the weight gain happen because paxil will make you tired therefore you dont do as much, or because maybe it makes you eat more? or do you just gain weight no matter what you do? Has anyone lost weight while taking paxil?
> I dont even know if I want to start a new drug...just something else to get dependent on, I dont think it will ease the xanax dependency much. I dont think anything will. The way he talked he wants to get me off of them pretty fast. What was your experience on paxil? Thankskeilia...I have never heard of a doctor using paxil to help someone withdraw from paxil. But then there are lots of things I have never heard of.
I have some questions if you don't mind. Why does he want you to withdraw from xanax? You mentioned dependence, how much are you taking daily? Is the xanax creating problems in your life? Is your doctor a psychiatrist? What were you using the xanax for, PAD? Was the xanax helping your problem? Do you want to get off xanax, you sound a little reluctant.
Usually it's the other way around. Small doses of a benzo are rx'd with initiation of paxil therapy, until the common side affects from the AD abate.
I would really like to know how your doctor thinks that rx'ing paxil is going to help you withdraw from xanax. What's his theory about how this will help.
It's unusual these days for pdocs to withdraw someone from xanax "pretty fast", unless there is something unusual going on, such as a medical necessity. The side affects of withdrawing from xanax can be greatly diminished with a proper, slow tapering process.
I don't know all the particulars of your situation, but if my pdoc suggested this approach to withdrawing from xanax, (he never would), I'd get a second opinion, a third and a fourth. JMO.
Posted by Carlos on May 10, 2002, at 0:09:41
In reply to Re: Just starting to take paxil » keilia, posted by Rathrbfishn on May 9, 2002, at 22:36:24
I personally gained weight on paxil. I am a VERY strict dieter and a gym rat. I used to be 5' 10" 150lbs, 6-7% body fat. On Paxil (still working out and dieting) I went up tp 168lbs about 12-13% body fat.
It's strang that your doc is putting you on a SSRI's from a benzo. Benzo's seem to be the best treatment with least amount of side-effects. I'll NEVER go back to SSRI therapy for anxiety again. I'm sticking with my Klonopin, Dexedrine, and a little Celexa (for depression).
Posted by Sparrow on May 10, 2002, at 1:58:45
In reply to Just starting to take paxil, posted by keilia on May 9, 2002, at 15:14:23
My experience with Paxil has been interesting.
I suffered from anxiety for several years without taking any meds. In May 1999 my primary doc suggested Paxil. I started out at 40 mg. The first week on the med I basically slept and called into work. I lowered the dosage and almost immediately noticed a vast improvement. I was calm and felt in control of myself for the first time in years. I considered this almost a miracle in my life. I was overjoyed at the benefits Paxil brought to me.
Over the last 3 years, since taking Paxil, without even noticing it I've slowed down. Looking back, each day I became a teeny, tiny bit more tired, a bit more dull, unmotivated. I gained weight like crazy. I was 145 lbs in May 1999 and now weight 222, May 2002. I've never been obese before and it does not run in my family. I can't blame the Paxil for the entire weight problem because Paxil doesn't make me order Big Macs. BUT, my experience has been that I'm so tired all the time that it's all I can do to go through the drive thru!
I examined if it was depression,...but although I can have "blue" days, I feel pretty content and happy with my life 90% of the time. Moreover, I have no history of depression, etc....so I ruled that out.
I didn't know it was the Paxil though! I have been beating myself up for the past 2 years because I thought I was just being lazy. My husband would come home from work on a Saturday, it would be 6 p.m., the house would be an absolute mess and I'm still in my pajamas sleeping on the couch. I can sleep anywhere, anytime -- and I mean that sincerely -- anytime. I can get up after a 12 hour sleep, eat breakfast and then lay back down for a 3 hour nap. I'm too tired to socialize or to even care that I don't socialize. When I clean my house I divide the rooms into sections and clean 1 section about every other day. For instance on Monday I'll clean the kitchen counter. On Wed. I might empty the dishwasher. I'm hoping that someday I catch up and my house is clean all at once.
My fatigue became so overwhelming and my life so lacking that in desperation I searched for and found a new doctor last week. I thought something was really wrong with me. She listened and told me that I had "Paxil Poop Out" and that I needed to come off it (which I am doing slowly) and possibly try another med. I should mention that we did a full battery of tests, however, to rule out any other causes for the fatigue and zombie-like way of life
So...I don't feel comfortable giving advice, I can only tell you my experience. What works for one person doesn't always work the for the next. I will recommend keeping a *sharp* eye out for any numbing, sleepy side effects.
-Sandra
Posted by keilia on May 10, 2002, at 6:45:02
In reply to Re: Just starting to take paxil » keilia, posted by Rathrbfishn on May 9, 2002, at 22:36:24
The doc did not tell me alot about the withdrawl off of the xanax. He basically said Ok you are addicted (DUH) and you will not be able to come off of the xanax alone, you need paxil to help with depression first. I have been on 2mg xanax for about 4 years. I don't want off them as they help my panic attacks greatly....however I worry all the time I will run out and will not be able to find a doc to perscribe them. I have had horrid luck with docs. The docs I have seen know NOTHING about withdrawl. The doc had perscribed me 12mg before she lost her lisense, I never took that high of a amount thank god! When she lost her lisense, I had another perscribtion to be filled. I thought i'd go ahead and fill it even though I had stored up alot of extras over the years where I only took the 2mg. The pharmist would not fill it with it being the doc had lost her lisense. I asked what does a person do then ( they ofcourse did not know I had any saved up) and he said well just quit them, I knew better ofcourse as I had tried to get off them in the past and had horrid withdrawls.He acted as if yes it was that easy to get off them. I searched for a year for a doc who would perscribe xanax to me as I knew my supply would run out. I had no luck...its a year and half later and my supply is out and I just now am finding a doc ( moved to new location) who would give them to me.This is doc 5 in this area ..the other 4 would not give to me or help me find a doc who would. Why he wants me off I am not sure. I dont have problems with them, I just need to make sure I can get them. I have no bad side effects from them. Just dont think I will ever be able to get off of them..without them I dont function....well reducing from 2mg I dont function. So I dont see that paxil will change this very much.
Posted by Rathrbfishn on May 10, 2002, at 7:26:41
In reply to Re: Just starting to take paxil, posted by keilia on May 10, 2002, at 6:45:02
keilia...You certainly are involved in a complicated situation. It's very late and I need to get to work. I will respond this evening. I had a similar situation in the mid 80's. I'll post tonight and explain. I'm sure you'll receive some other advice also. If you really are just taking 2mgs/day you may be suffering the consequences of having been treated by the doctor who lost her liscence. That is most unfortunate. Your options may be limited with xanax, but there are still options that are available. Thanks for answering some of my questions. Your post has cleared up some questions I had and now I have some thoughts that may help. I knew something was funky, I had never heard of a doc using paxil to help with xanax withdrawal. It doesn't make good medical sense. Hang in there.
Posted by Rathrbfishn on May 10, 2002, at 22:08:11
In reply to Re: Just starting to take paxil, posted by keilia on May 10, 2002, at 6:45:02
keilia...if your current doc is not a psychiatrist, find one. You have PAD, a psychiatric condition, your taking xanax, a psychiatric drug. You need to have this aspect of your health handled by a pdoc. If your current doc is a pdoc, fire him/her and find another one.
Any average pdoc would not rx paxil to help with the side effects when starting to withdraw from xanax. I posed this question on a web site I have frequented for the last 4 years that is dedicated to anxiety disorders almost exclusively, and know many of the posters who take a benzo or an ssri that are very very knowledgable, and no one has ever heard of starting paxil to alleviate the symptoms when withdrawing from xanax. All paxil will do is add more suffering due to it's start up side affects to the withdrawal of the xanax. Paxil can take weeks before you see any AD effects, if at all.
No legit pdoc would have you withdraw from xanax without explaining what to expect. Besides, you have already tried to withdraw and found it difficult. PCP's and family doctors will conclude that if you have difficulty withdrawing from xanax you are probably addicted. They are not specialists in psychiatric disorders. I had a very good PCP for a while. One day we were talking about my xanax use and he said he didn't even know they made a 1mg tab of xanax.
If you are really only taking 2mgs of xanax a day and not having any problems in your life, not abusing any illegal drugs, drinking, functioning well, no cognitive problems, etc., and find it works well for your PAD, there is no good reason I can think of that you should be taken off it. 2mgs of xanax/day is not a very large dose for PAD sufferers. Another reason to stick with xanax is that benzo's have been used for over 40 years with good results if used with the appropriate diagnosis, especially chronic PAD. And the side effect profile for xanax is much milder than almost any other drug used for treating PAD, including paxil. Also, the more recent term for long term benzo use is medical dependency, not addiction. Addiction implies something completely different than medical dependency, but this is where your condition gets a little gray. I'll get back to you on that later.
If, for some reason, you can't find a pdoc that will allow you to stay on 2mgs of xanax and insists on having you withdraw from it, ask about the pdocs withdrawal procedure. Withdrawing from xanax is much easier if you do it very slowly, I mean something like taking 1.75mgs for a couple of weeks or longer, until your body adjusts to the reduced dosage. Then drop another .25mgs for a few weeks, and so forth.
You may be uncomfortable reducing at this rate and dosage, but it shouldn't be unbearable. Remember, you've been taking xanax quite a while.A good pdoc will be able to tell the difference from rebound anxiety and re-emergence of the PAD during the withdrawal.
Also, the ssri's, which paxil is, do help many people who suffer from PAD. I don't understand why the doc you have now doesn't just add the paxil and leave you on the xanax. Once the ssri's start to work, 2-3-4 weeks usually, sometimes longer, and they really do help many people, then the pdoc will taper you off the xanax. It is very common for a pdoc to rx an ssri and a small dose of a benzo at first.
Now lets discuss the gray area I mentioned. You don't have to answer these questions of course.
Why were you letting a doctor prescribe xanax at 12mgs/day when you were only taking 2mgs? What you were doing was stocking up on xanax instead of having your doctor follow up at appropriate intervals to see how things were going and if all was well, you would receive another script for 2mgs/day until the next follow up visit or refill.Stocking up on a potentially addictive drug is a sign all good docs look for when watching for an addictive personality.
Another sign of an addictive personality is doctor shopping. That is going from one doctor to another until you find one that will prescribe the drug you want. Again, good doctors will recognize this as a symptom of addiction and will not enable you to continue your use of your drug by giving you a script. How many docs turned you down, 4, or was it five?
Please don't get upset, but most GP's reading your post above will assume that you are addicted and refuse your request for a script to xanax. They don't have the specialized training and experience psychiatrists do with PAD and the use of xanax.
Another aspect to all this is that if you do not live in a large city, most doctors in your town will find out about another doctor who has had their liscense revoked. The pharmacies get involved and patients the ex doc was treating inappropriately will eventually get around to all the other doctors and pharmacies and you will find it next to impossible to get a doctor to give you a script. I've had a pharmacist refuse to fill 4mgs/day of xanax before. I had been going to this pharmacy for years, but she was new and felt like 4mgs of xanax was too high. She even called my pdoc and chewed him out. He told me he just laughed and said fine. He then called another phamacy and they filled the script.
Bottom line is this. You need to have a pdoc evaluate you for PAD. Then, if you have it, you need to let him/her control your meds, with appropriate follow ups and at appropriate dosages. No doctor in their right mind is going to prescribe 12mgs of xanax when your PAD is controlled by 2mgs. If they do, they'll lose their liscense to practice also. This may be difficult for you now if you don't live in a very large city.
Find a pdoc, be honest, and you'll begin to gain the pdocs trust. If 2mgs is all you need, and the pdoc feels you have PAD, that's what will be scripted. If your taking more than 2 a day, you will run out before your next refil or follow up, and the doctor will be very skeptical about your story.
Sorry about the long post. Your story had lots of elements to it. Get back to me by email if you like, >rspringer@prodigy.net< I'll be happy to tell you about my experience with taking xanax at 13mgs/day in the mid 80's, prescribed by a pdoc. At that time I knew nothing about xanax, PAD, or any of the other issues I've discussed. I just blindly followed the pdocs instructions and it was one wild ride for a couple of years.
This is the end of the thread.
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