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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 6 of 6. This is the beginning of the thread.
Posted by Laney on January 2, 2010, at 21:00:26
Just curious! Not sure what to do. I'm on paxil and it is soooo hard for me to discontinue. I've never switched and I'm even afraid to do that.
Any ideas?
Thanks! Laney
Posted by mtdewcmu on January 2, 2010, at 21:46:38
In reply to Can you add a SNRI to an SSRI?, posted by Laney on January 2, 2010, at 21:00:26
> Just curious! Not sure what to do. I'm on paxil and it is soooo hard for me to discontinue. I've never switched and I'm even afraid to do that.
>
> Any ideas?
>
> Thanks! LaneySure you can. Just don't take too large a dose of each at the same time. One possible consideration, however, is that Paxil is a strong inhibitor of a certain liver enzyme that also breaks down most other antidepressants. So that's why you should do it with professional help.
Posted by Phillipa on January 2, 2010, at 22:01:35
In reply to Can you add a SNRI to an SSRI?, posted by Laney on January 2, 2010, at 21:00:26
Laney why do you want to add to the paxil is it not working? Phillipa
Posted by RocketMan on January 2, 2010, at 23:10:29
In reply to Re: Can you add a SNRI to an SSRI?, posted by mtdewcmu on January 2, 2010, at 21:46:38
Why not try adding low dose lamictal or lithium first.....
Posted by janejane on January 3, 2010, at 9:27:07
In reply to Can you add a SNRI to an SSRI?, posted by Laney on January 2, 2010, at 21:00:26
This is because of SSRI-induced apathy right? You might want to just try reducing the dose. I just wrote about this is the other thread, but I'll repeat it here too... a friend of mine got rid of her apathy by cutting her paxil dose in half. (It's still working on her depression, but she just seems to need less now than she used to.) A pill splitter would probably be handy here. Maybe try 3/4 of a dose first. If the apathy persists, cut down to half. Don't do too much at once since you don't want to get discontinuation symptoms.
If the depression comes back and the apathy doesn't go away, I think you should try adding wellbutrin to the paxil (or something else that works on norepinephrine or dopamine). This is because you already know that the paxil works for your depression, and you don't know that other drugs would, which makes switching to something totally different a bit risky. (This is because the paxil might not stop being effective for you if you discontinue it for a while then try to go back to it again.) If Wellbutrin augmentation doesn't work, I think switching to an SNRI might be in order. Just my opinion.
Posted by Laney on January 3, 2010, at 11:39:17
In reply to Re: Can you add a SNRI to an SSRI? » Laney, posted by janejane on January 3, 2010, at 9:27:07
Thanks Janejane,
I have been on paxil for 13 years and didn't go on it for depression. This is truly the first time in my life that I've had depression that wasn't situational. I've tried getting off paxil a few times within a 3 yr. period and I'm only on 10mg. I'm going to cut down to 7.5 and see how it goes.
Thanks so much!
Alayna
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