Week 6 since switch....question?

[Natron247]

So I'm starting week 6 since I switched from Paxil CR 25mg to Lexapro 15mg.  I still have anxiety which gets better throughout the day and some depressed feelings.  I also take 1mg of Klonopin at night.  My doc stated that I could switch over to Lexapro from Paxil so I took both for 2 weeks then dropped Paxil all together.  Could I still be feeling the affects of Paxil withdrawal?  I felt good after 2 weeks and even tried to come down on my Klonopin a couple of days after my paxil ended.  Mistake!  Just wanting to know if anybody had the same issues and how long do I need to plan on suffering?  This is getting old and I'm ready to feel like my old self again.  Before the Paxil stopped working!

[Paxiled]

The notion that switching from one med to another helps with withdrawal isn't backed up by any research.  It's just done.  There is no reason why one med, which works one way, will have any effect on withdrawing from another med, which works another.  The way those who pay attention to this stuff would do this is to slowly taper you down off one med and only start another when you were at the very end of the taper, so you and your psychiatrist could tell which was a withdrawal symptom and which was a side effect of the new med or the return of your original condition.  Now, as to the reason for withdrawal, all ssris and snris and many other meds are associated with withdrawals.  With ssris, the main reason is the reawakening of serotonin receptors that went dormant while you were on the med because the body felt they were no longer needed.  So while M4 is correct that Paxil seems to have a worse withdrawal than other ssris because it has a stronger effect on choline receptors, most of the withdrawal is for the same reason you could get a withdrawal from any ssri, which is the reawakening serotonin receptors.  The brain has a hard time for many of us in adjusting to not having the drug doing its work for it anymore.  Taking choline might actually make it worse in the short run, because it would target those choline receptors and increase their stimulation at a time when they're trying to adjust to working normally again.  This is why many who try the amino acid 5-HTP to limit withdrawal often will have a worse withdrawal -- it will stimulate the serotonin receptors that are already stressed trying to adjust.  Now, in your case, since you were put on another ssri without tapering off the Paxil first, there's really no way to tell -- if you hadn't done it that way, you could go back on a dose of Paxil and if the problem disappeared, you'd know it was withdrawal.  You can't do that now, so I would just try to relax and wait it out.  After all, most people don't get the really bad Paxil withdrawals, and what you're suffering doesn't sound like a huge withdrawal effect like some people get.  Hopefully, this resolves, but none of us can give you any certain answers to your situation because nobody knows, not even the people who invented these meds.

[M4Y0U]

Sometimes doctors don't understand how hard and how long it can be to come off a medication. My doctor wanted to wean me off diazepam in 2 weeks after chronic b.i.d use for over one year.

Fact is that you have the right to make your own decisions when it comes to how long the tapering should be. No one is the same and the slower the tapering the less severe withdrawals you get.

I suggest getting off Klonopin very slowly and certainly not until you are weaned off Paxil completely.

It is possible that you will feel that Lexapro is not doing the job done even when you are totally weaned off Paxil because it is less potent than Paxil.

M4

[Natron247]

Thanks!  I appreciate your response.  My symptoms seem to be located to low grade anxiety and depression (which I am never a depressed person until my anxiety comes about), stomach issues/diarhea.  The thing is, I just can't tell if the anxiety is still there from the paxil withdrawal or if the Lexapro 15mg isn't doing the job.  I am functioning though, which is good.  Going to work, exercising, etc.  I just don't feel 100%.  Maybe about 75-80%.  How long should I give these symptoms to continue before I go back and ask my doctor?  One of my concerns is that my doctor got me to come off paxil in 2 weeks and was willing to let me come off Klonopin at the same time.  Now I read where people have slowly come off Paxil over months and the same with Klonopin.  I just don't want to feel like a guinea pig if you know what I mean...