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Mental Health (Expert Forum)
Antidepressants. Paxil to Wellbutrin?
Answered by
Roger Gould, M.D. - Mental Health, Wellness
Questions posted in the Mental Health forum are being answered by Dr. Roger L. Gould, author of the Mastering Stress and Depression program and affiliated with the UCLA. Department of Psychiatry. Topics covered include anger, attention deficit disorder (ADD), bipolar disorder, dementia, electroconvulsive therapy (ECT), learning disabilities, memory, obsessive compulsive disorder (OCD), panic, personality disorders, phobias, post-traumatic stress disorder (PTSD), schizophrenia, stress, transitions, and work problems.
Antidepressants. Paxil to Wellbutrin?
by curious_cat, May 20, 2004 12:00AM
I am a 27 year old female. I have probably had issues with anxiety and depression since I was a child, but only started going to a therapist a little over 2 years ago, which has been very helpful. In February 2003 (after a year of therapy), I began taking 12.5 mg of Paxil CR at my therapist's suggestion. I felt it was a very good thing for me. Six months later, in August 2003, I increased to 25 mg of Paxil CR, because I was not dealing well with life - and there were a lot of difficult things going on in my life. I feel it has been excellent for me - to be more clear, less anxious, less depressed, better able to deal with life. But I am slowly gaining weight, maybe 15 pounds, and I am not happy about that. I also have sexual side effects, _especially_ with the Paxil 25 mg CR, and I am not happy about that either.
So, 3 weeks ago, late April 2004, after 8 months on 25 mg, I switched back down to Paxil 12.5 mg CR. (Mostly because everything is going pretty well in my life). From the decrease in Paxil, I can definitely tell an increase in my anxiety level and general tendency towards melancholy, and in depressive episodes and their tendency to get heavy and stay and be difficult to deal with, and in circular obsessive thinking of just not being happy. I miss the clarity I had and how I felt like I was dealing well with life on Paxil 25 mg CR. But if I go back on that, I'll gain more weight and not have a good sex life. What to do?
Thought/ Question: Could the increase of depression and anxiety just be an adjustment to the decrease in Paxil? Or after 3 weeks and 2 days, is this what it's going to be?
Main question: I am considering asking my doctor to prescribe Wellbutrin for me. I heard it does not have the side effects of weight gain and sexual side effects that the Paxil does. Does the Wellbutrin sound like a good option for me? Would that allow me more of the clarity and detachment and distance to not get so upset about things, and have less anxiety and depression? Or should I give it a few more months and see how I'm doing?
A caveat is that I am getting ready to move to a new city in a month to begin grad school. Yes, I know this is a busy/ hectic time to be switching medications. But at the same time, my life is always busy and hectic - lots of moves and changes and excitement. I function well on the outside, but on the inside I definitely struggle with depression and anxiety.
Thank you so much for your advice and information.
So, 3 weeks ago, late April 2004, after 8 months on 25 mg, I switched back down to Paxil 12.5 mg CR. (Mostly because everything is going pretty well in my life). From the decrease in Paxil, I can definitely tell an increase in my anxiety level and general tendency towards melancholy, and in depressive episodes and their tendency to get heavy and stay and be difficult to deal with, and in circular obsessive thinking of just not being happy. I miss the clarity I had and how I felt like I was dealing well with life on Paxil 25 mg CR. But if I go back on that, I'll gain more weight and not have a good sex life. What to do?
Thought/ Question: Could the increase of depression and anxiety just be an adjustment to the decrease in Paxil? Or after 3 weeks and 2 days, is this what it's going to be?
Main question: I am considering asking my doctor to prescribe Wellbutrin for me. I heard it does not have the side effects of weight gain and sexual side effects that the Paxil does. Does the Wellbutrin sound like a good option for me? Would that allow me more of the clarity and detachment and distance to not get so upset about things, and have less anxiety and depression? Or should I give it a few more months and see how I'm doing?
A caveat is that I am getting ready to move to a new city in a month to begin grad school. Yes, I know this is a busy/ hectic time to be switching medications. But at the same time, my life is always busy and hectic - lots of moves and changes and excitement. I function well on the outside, but on the inside I definitely struggle with depression and anxiety.
Thank you so much for your advice and information.
Doctor's Answer
by Roger Gould, M.D., May 27, 2004 12:00AM
, May 27, 2004 12:00AM
Most people choose to switch to wellbutrin for just the reasons you describe, but I suggest you stay with the lower dose of paxil for a while longer because you may be a very sensitive person who notes the small changes in moods and then because hyper-aware, making them seem bigger than they actually are. So give yourself another 3 weeks to adjust, and actually try to be less self aware of these symtpoms and concentrate more on active problem solving of the issues that come up.
Good-Luck,
Jerry
best wishes
HeyHeyHey
Good-Luck,
Jerry
My doctor has swtiched me to Lexapro, which I just had filled today. I've been searching online to see if there's any long term side affects of taking Paxil, because it seems as though--quite suddenly I might add--something is wrong inside me. My thinking is ... abnormal. My emotions out of control. Crying is almost constant. Frightening recurrent and intense suicidal thoughts are very present, though I have no real desire to do such a thing. Feelings of emptiness and being hollowed inside nearly consume me. I don't want to be feeling these things, but can't seem to shake it off, and it's come on so very quickly.
Are these symptoms of long term use of paxil? Are these things common?
My doctor has swtiched me to Lexapro, which I just had filled today. I've been searching online to see if there's any long term side affects of taking Paxil, because it seems as though--quite suddenly I might add--something is wrong inside me. My thinking is ... abnormal. My emotions out of control. Crying is almost constant. Frightening recurrent and intense suicidal thoughts are very present, though I have no real desire to do such a thing. Feelings of emptiness and being hollowed inside nearly consume me. I don't want to be feeling these things, but can't seem to shake it off, and it's come on so very quickly.
Are these symptoms of long term use of paxil? Are these things common?