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Mental Health (Expert Forum)
Effexor vs. Paxil for GAD--side effect differences
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.
Effexor vs. Paxil for GAD--side effect differences
by kcwdad, Nov 14, 2003 12:00AM
I took Paxil 20mg for 1 yr from my PCP (not a psychiatrist)--great results in reducing what I believe is GAD (constant "nervous" feeling in stomach, hair twirling/nervous habits, social withdrawl, negative thought spirals and over-introspection, negative outlook on everything, etc.)
I went off Paxil due to frustration over 1) somnolence (sleeping good part of weekend days away), 2) asthenia (the 5 mile run I'd done for years became a difficult chore), 3) lessened motivation (one of the good parts of anxiety, I guess), 4) sexual dysfunction and 5) weight gain (5 side-effects in one patient--not bad, eh?) Withdrawl symptoms were unpleasant but not near as crippling as I've read about (mostly brain zaps).
Now I've been on Wellbutrin for about 4 months--not doing much for me. Anxiety has crept back but all side effects gone--I feel like my old self again--good and the bad. So do I strike a new Faustian bargain with Effexor? I wouldn't hesitate to give up Wellbutrin, but I found SSRIs to be a "commitment": the odds of success need to be sufficiently high to outweigh the pain of withdrawl.
Specifically:
1) Given I experienced these 5 side effects above with SSRI, would that same SSRI action in Effexor be *likely* to cause same effects (i.e. how often does the norepinephrine action counteract each of these 5 side effects)? Which of the 5 most/least likely not to recur with Effexor?
2) Am I better off with Paxil/Zoloft + Wellbutrin or Buspar, or is my non-reaction to Wellbutrin a sign that it wouldn't do much in combination w/ Paxil?
3) Any other drug/combo better for my condition and side effects experience?
"Anxious" for your reply,
KCWDAD
I went off Paxil due to frustration over 1) somnolence (sleeping good part of weekend days away), 2) asthenia (the 5 mile run I'd done for years became a difficult chore), 3) lessened motivation (one of the good parts of anxiety, I guess), 4) sexual dysfunction and 5) weight gain (5 side-effects in one patient--not bad, eh?) Withdrawl symptoms were unpleasant but not near as crippling as I've read about (mostly brain zaps).
Now I've been on Wellbutrin for about 4 months--not doing much for me. Anxiety has crept back but all side effects gone--I feel like my old self again--good and the bad. So do I strike a new Faustian bargain with Effexor? I wouldn't hesitate to give up Wellbutrin, but I found SSRIs to be a "commitment": the odds of success need to be sufficiently high to outweigh the pain of withdrawl.
Specifically:
1) Given I experienced these 5 side effects above with SSRI, would that same SSRI action in Effexor be *likely* to cause same effects (i.e. how often does the norepinephrine action counteract each of these 5 side effects)? Which of the 5 most/least likely not to recur with Effexor?
2) Am I better off with Paxil/Zoloft + Wellbutrin or Buspar, or is my non-reaction to Wellbutrin a sign that it wouldn't do much in combination w/ Paxil?
3) Any other drug/combo better for my condition and side effects experience?
"Anxious" for your reply,
KCWDAD
Doctor's Answer
by Roger Gould, M.D., Nov 16, 2003 12:00AM
, Nov 16, 2003 12:00AM
This is an intelligent well formed question, I wish their was enough information to respond accordingly. It turns out that the only way to answer the question is by trial and error. "less likely" is a statistical answer but does mean much here because people respond in an idiosyncratic way to these medications, and to these combinations. Secondly, your life changes, and with that your anxiety level changes. The one question you didn't asked is the most important..how about using your mind to control your symptoms...how about therapy, talking through your anxieties, increasing your wisdom in life. That's the way to avoid all side effects. That would be my advice, help yourself to some insight, minimize the medications, and grow out of your symptoms...
4
1.5
5
3
4
0
6
2
breathless/
chest tightness.
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unreal,
breathless.
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6