New meds safe? paxil and buspar

[jfunk13]

I've been on Prozac 10mg daily and .05 lorazepam twice daily as needed for a month with no improvement to my panic disorder. On a second opinion my new dr. has put me on 20mg paxil once daily, 15mg buspar twice daily, and 1mg lorazepam three times as needed. A little research on the web indicates that you should stop taking Prozac for a week before starting a new SSRI. Both my doctors are out for a week and I need some advise. Should I continue with the Prozac and Lorazepam until I can speak with my dr. or should I start my new set of drugs and hope for the best?

[michelleanne]

Try calling a few different pharmacists and get their take.  Good luck to you!

[RCA7591]

"On a second opinion my new dr. has put me on 20mg paxil once daily, 15mg buspar twice daily, and 1mg lorazepam three times as needed."

^quote

Get a third opinion. If your diagnosis is panic disorder, Paxil and BuSpar will be ineffective, and the Paxil will cancel out the benefits of Ativan (Lorazepam).

Furthermore, Ativan is not to be used over the long-term. The short half-life precludes its use over the long-term, and tolerance to the clinical benefit will result. Ativan will lose its effectiveness over the long-term.

In the case of panic disorder, the most effective agent is Klonopin, which is two-times more potent than Ativan, and Klonopin's long half-life makes the drug well suited for long-term use. Klonopin in monotherapy is more effective than the combination of Ativan, BuSpar, and Paxil (which will likely WORSEN the panic).

Since you've not yet started on the drugs, I would advise you not to. Prozac worsens panic as it is a stimulating antidepressant, and the peanut sized dose of Ativan 0.5 mg, b.i.d. would be less effective or completely ineffective in the presence of Prozac.

Find a psychiatrist with a brain, and inquire about Klonopin, 0.5 mg, b.i.d. The Klonopin will replace the Ativan, and the Prozac can simply be dropped at this point (under medical supervision).

Ryan