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Paxil VS Celexa
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Paxil VS Celexa

Hi Everyone!
                  Just one fast question here...

I really need to start again a SSRI for my extreme panic disorder and I want to know if the Celexa will work to stop the panic disorder, since I took it for my social phobia at 60 mg/day back in 1999 for 6 months and it did nothing for the social anxiety and my anxiety level didn't improve on it?

I ask that question cause last year I wanted to try again the Lexxapro, who is the improve Celexa and I had strong side-effects on it, wasn't able to tolerate a little dose of 2.5 mg for more than 1 week... Can I react differently to the Celexa than the Lexapro?  Is it possible that with the Celexa I will have less side-effects since it's a more dirty version of the Lexapro it's suppose to have more side-effects no?

Also, the only one SSRI who work in the past for my panic disorder is the Paxil... but hte Paxil do nothing for the social anxiety, like all the antidepressant meds I try... anyway,  the main problem is that I try to be back on The Paxil at least 10 times in 2010 and wasn't able to tolerate more than 1 mg at the time... I had increase anxiety to the point that I had to go to the ER...

So I don't know what do to? I don't want to take the chance to try the Celexa at a small dose of 1 mg and have the same kind of increase anxiety state like I had on the Paxil...

Anyway, someone else have a severe panic disorder with a lot of cardiac related symptoms (Cardiophobia)?

Witch one to choose and also what is the best time to take it? Morning, evening?... For the dose, start at 0.5 mg of Celexa or Paxil can maybe seem to be ridiculous, but  if I increase it by 0.5 mg every week, after 10 weeks I will be at 4 mg, maybe that after I reach that dose, my brain will be used to the increase serotonine level and I will be able to increase it faster?

Thanks for any kind of input!!! ;-)
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Avatar_m_tn
Forgive me about the mistakes... lol When i'm anxious my english is not very good... lol

After 10 weeks I will be at 5 mg and not 4 mg... also the LExxapro is the Lexapro... lol

For the Celexa, what I really wanted to say and ask is IF I will have more side-effects than with the Lexapro... since both drugs are very similar but the Celexa is more dirty, that's mean that taking a small dose of Celexa like 1 mg will be = to 0.5 mg of Lexapro no?...

For the Paxil, we don't have the oral suspension version of it in the Canada... and crush the 10 mg pill into podwer and try to only take 1 mg at the time is really hard... Someone have a trick to achieve that???

Thanks again!
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Avatar_f_tn
I would ask the Dr. for something to calm the initial increase in anxiety while starting the SSRI.  There are many benzos that can be taken just for this short period of time.  Many people have difficulty starting anti-depressant meds.  They can work for both anxiety and panic attacks when they reach full efficacy.  Everyone is different and there are many anti anxiety meds (ie: buspar).  Talk it over with your doc.  I'm sure he will have some options for you.
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480448_tn?1403547723
Unforunately, this isn't something anyone can answer for you.  You've had experiences with more than one SSRI, so you know first hand that they all act a little differently, some people have harder times tolerating one over another.  Also, if you had taken something in the past, there is no way to know how you will do on it a second time around.  Some people report a much HARDER time tolerating the med, some report similar effectiveness, and some say it was better.

I know that isn't very helpful, but this is really something you need to talk thru with your doc.  Make a list ahead of times of all of your concerns/questions about meds so you can discuss them with the doc.  If I recall, you're on a fairly high dose of a benzo already right?  You may want to discuss that with your doc as well, sometimes as we build a tolerance, we can have horrible re-bound anxiety.  It may be time to look into other options, even a different benzo...as that may be part of the culprit here in the poor management of your panic disorder.

Keep fighting the fight!

Good luck.
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1663704_tn?1302915977
I deal with extreme panic attacks, as well.  I've had anxiety since early teens, but I never had a panic attack until I was 24 years old (2009).  I have only taken Celexa.  I started out with 20 mg and moved up to 40 mg.  It helped me within 30 days, but I started noticing a difference within 4 days.  The heart palpitations, chest/heart pain, pinched nerves, etc. all ceased.  I was no longer petrified of waking up or going to bed, eating, being alone, etc.  I got off of it in December 2009 because I was two months pregnant.  I got back on it in August 2010 because my anxiety/panic attacks started in again, full force.  I was afraid to eat because my throat would constrict so I was afraid of choking, plus the other unpleasant effects of anxiety/panic attacks.  I automatically started back on 40 mg which was a mistake because I started getting muscle twitches so I cut back to 20 mg and I'm now doing fine; the anxiety is gone.  Every medication works differently for different people.  I know of people who are against Celexa, while others love it.  I know of people who take Paxil and won't try anything else.  Trust your body and weigh the pros/cons of each and decide which is best for you.  Just remember, give each medication at least 4-6 weeks to take its full effect.
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Avatar_m_tn
Hi ;-)
       I already take a HIGH dose of Klonopin daily (8 mg), who is not effective anymore and we add 1 mg of Xanax, who work for3 weeks and stop working... so I don't see how my PDoc would be able to add more benzo meds to calm the initial anxiety when I will start the SSRI...

For the SSRI, i'm used to all of them... They was like candy for me in the past, no side-effects like increase anxiety but MAJOR weight gain... they lead to my morbid obesity problem and that's because of the Paxil that I had the gastric by-pass surgery to loose some weight... Ok, I was a fat kid already before the Paxil and drinking a glass of water was making me gaining 2 pounds... but the SSRI's didn't help me...

My first med I try for my anxiety was the Buspar, it was new at the time in 1994... didn't react well on it, in fact my anxiety get 1000000 times worse so I was put on the Paxil 40-60 mg day from 1994 (when I strat having panic attacks daily) until 1996 when I had to stop cause I had gain more than 200 pounds on it!!!

Was of SSRI for 3 years and was put back on the Paxil for social phobia, no panic disorder this time, and had gain 60 pounds in less than 3 months, when my PDoc saw this, he ask me to stop the Paxil and give to me some sample box of the newer Celexa at the time (1999) and I start it at 20 mg, increase at 40 mg after 1month and it was doing nothing at all for my anxiety and the social phobia, also, I had gain another 20 pounds in 2 months on the Celexa and my PDoc was a lot worried about my weight who was around 450 pounds at the time... so he give to mea RX for the Zoloft...The Zoloft was A LOT stimulating, too much for me,I was much more anxious when I was in a crownd, at school, walking in the streets and I the panic attacks return because of the Zoloft... after 4 months on the Zoloft I give up and stop seeing my PDoc for almost 6 years... Was doing better off all meds, had my gastric by-pass, lost more than 260 pounds... and when I start the university and move to a new city, I had to make some new friends and my social phobia get worse and I had panic attacks mostly when I had to do oral presentation at the university...

I call again my Pdoc in 2005 and he put me on the Klonopin... we start at 2 mg a day and to my surprise, it was working very well at first... BUT we don't know why, my brain build up a tolerance very fast on the Klonopin... we increase the dose at 4 mg after2 months... 6 mg after 6 months and reach the 8 mg after 8 months... Remember that it was back in 2005-2006...

In 2006 we start trying OLDER antidepressants meds... we start with the famous Nardil (MAOI)... we find out that I had a big problem with the orthostatic hypotension, I was not able to reach the minimaleffective dose of 75 mg of Nardil... normal dose is 90 mg... even after 3 months on it I wasn't able to increase to 90mg cause of the hypotension... I faint several times on that med... so we move on and try the Neurontin... I reach the maximum dose of 3600 mg day very fast but with the 8 mg of Klonopin it was too much sedating... also it was doing nothing at all for my anxiety, just pins and needles effect... so we move on with the Lyrica, who was the same as the Neurontin, no improve at all...

In the summer of 2007 I choose to withdraw the Klonopin... we taper it with a big dose of Valium... cut to 6 mg of Klonopin + 80 mg of Valium a day, who was a lot sedating at first. I was able to cut very fast my Klonopin dose and be only on the Valium 40 mg a day... and was down to 10 mg day of Valium after 4 months... the withdraw was horrible... had panic attacks all the times... I stop all the benzo meds for 3 weeks but had to be back on the 10 mg of Valium cause of the panic...

The panic stop but the social phobia return with vengeance... so the PDoc put me on the Xanax... what a mistake!!! Start at 2 mg a day... increase to 8 mg a day in less than 2 months, was at 12 mg after 3 months... it was very good for my social phobia but I had panic on it, don't know why... The PDoc put me on several antidepressant meds... Effexor-Xr, Cymbalta, Pristiq, older TCA's (Imipramine, Nortriptyline, Despiramine... I react very badly to all of them...). We try also the Prozac, Remeron and a lot of them that I don't even remember the name...

The xanax became a big problem and I had too much memories problems as well as muscles cramps and pain all over my body... so I withdraw the Xanax with the same tapering method we used for the Klonopin... after 3 months of pure hell I was at a low 20 mg of Valium and stay on that dose from october 2008 until march 2009...

Was put on the Lexapro 20 mg in october 2008, gain 40 pounds in 2 months... was doing nothing for the social phobia (panic was under control)... So the PDoc put me on the Parnate (old MAOI like the Nardil), again I had a lot of problem with my heart, hypertensive crisis who lead to several trips to the ER... Again I choose to stop the antidepressant meds and stay on the low dose of Valium...

I subscribe to a gym back in march 2009 and the panic disorder start again, but 1000000 times worse than before... so was put back on the Klonopin 6 mg and 8 mg after 2 months... (we try all the other benzo meds before, none of them work very well...). Anyway, was put on the Paxil in July 2009 and was free of panic after 2months  on it at 20 mg... was also on the Seroquel for my insomnia at the time... was able to cut my Klonopin dose to 4 mg day... Had a surgery for the hemmorroids and had gain 40 pounds in 2 months so I choose to stop the Paxil cause I was free of panic but it wasa mistake...

Since that surgery in November 2009 my panic disorder get worse and worse... I start having headache all the time, start to have panic while I had to drive, start to have panic in the shower, start to have agoraphobia and wasn't able to stay alone at home, start having panic all the time... and start having hearrt problems in the summer of 2010...

My PDoc and GP think that I have a problem with the Gaba-A receptors in my brains and that's why the benzo meds don't work on me anymore, but the PDoc continue to RX them cause he know I will be worse without them and I can withdraw them  for now... We try the Paxil again but I react very bad to it, we also try low dose of Lexapro and had the same reaction (very fast pulse rate for 2-3days non-stop at a low dose of 2,5 mg...)... we try the zoloft again who lead to the same side-effect...

So for now i'm stuck... I know the Paxil work for the panic, it's the only one, but I know the initial increase of anxiety will be very hard for me... so that's why I ask that question...

Honnestly, I don't know why I react badly to only 1 mg of Paxil... it's not only psychological side-effects, I have real physical side-effects... but starting at 0.5 mg and go very slowly can be a good choice no?
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1663704_tn?1302915977
If Paxil works and the initial side effects go away, I'd stay on that.  Start off with a smaller dosage so your body becomes familiar with it.  After a certain amount of time (approximately 4 weeks, or whatever you're comfortable with) try upping the dosage (if needed).  I'd stick with what works.  Like I stated before, if the side effects typically subside, then it's worth it.  Just remember... when you realize a panic attack is coming on, try and tell yourself you know what it is and you are not dying.  Breathe through your nose and out of your mouth.  I do that and it calms me down after 5 minutes or so.  Sometimes I start out breathing fast then going slower because it helps me.
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324184_tn?1308079803
Hi I saw where you posted about knowing people who have tried paxil and you said they won't try anything else. Did you mean b/c they hated it so much, or because it worked for them so they didn't switch to anything else. I ask b/c I just recently started taking it myself and would LOVE any feedback I can get. Thank you in advance.

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