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question about paxil dose

I just went to the ER today for extreme anxiety. I have been obsessed with thinking that I have herpes even though my blood test has come back negative. I research symptoms of herpes constantly every single day since I had unprotected sex with 2 different guys when me and my husband were seperated which was about a year ago. Finally I guess because it was around the same time last year I have been really anxious and depressed lately. Even having panic attacks at night thinking that I have herpes. The doctor in the ER said that I have developed an obsession with this and that I need to let it go. I could not stop crying in the ER when I was talking to the doctor. He had the priest from the hospital come in and talk to me to. I cried so much. I have so much guilt in my heart. The priest said that god forgives me and that I need to forgive myself so that I can move on and be happy with my husband and kids. But I am just having the hardest time forgiving myself.  I couldn't believe it. I didn't even know that I was depressed or had OCD. I thought it was just anxiety. Anyway, the ER doctor gave me a prescription for Paxil 20 mg. He said that I can take half or the whole thing. I just really want to feel back to normal and enjoy my life without obsessing about herpes or being so depressed about my guilt. Should I take the whole 20 mg tablet or just half? Also, how long will it take for me to feel better and back to normal?
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Avatar_m_tn
My advice is to avoid that med.  It's very hard to quit once you're on it.  Others will disagree, but given you seem to know your trigger, I'd advise therapy and not medication to work this out.  Medication will only cover up your symptoms, if it works, and comes with its own problems, so unless your life is severely disrupted try and see if you can work this out with therapy.  Not every obsession needs to be medicated, and going on one of the most difficult meds out there as your first choice seems not to be the way to go here.  Just my opinion.  If I were to start on any ssri, I would start with Prozac, which is the least problematic and the easiest to stop taking, but I still think when you know what's causing your problem therapy is a good place to start.
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Avatar_f_tn
Thank you for the advice! I really never wanted to go on meds to begin with. I really hate taking meds because my body is usually really sensitive to meds. But right now my situation is so hard. I have severe anxiety all day long and panic attacks at night. The reason I went to the ER is because my anxiety is so bad that I haven't been able to eat for 3 days. I would love to get therapy but I have been calling therapist that are on my insurance plan and either they are not accepting new patients or the are making appointments like almost 2 months out. I don't know what to do. I cannot deal with this anxiety for 2 months without therapy or treatment. When I called the therapists I even told them about my not being able to eat but they didn't seem to care. I don't understand how they deal with people in crisis. I don't know if mine is considered a crisis but to me it is because I have never felt this terrible.
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Avatar_m_tn
That sounds like a possible med situation -- it is affecting your life considerably.  But I'd still keep Paxil in reserve.  I would consult a psychiatrist and see what they recommend, but for anxiety, they usually like Zoloft the best, with Lexapro second.  The problem you're having finding a therapist is common -- not taking new patients is code for not working with insurance.  I've found that the best therapists and psychiatrist don't work with insurance, because it's so limiting on both their income and their time for giving treatment.  Once one of them develops a clientele, they stop taking insurance, but the insurance companies still list them because they have patients still who started when they were still working with the insurance company.  I've had the same problem.  Insurance companies don't pay these folks all that much, and they didn't go to school all those years not to get rich.  A lot of semi-retired folks or hacks are what you find with many insurance companies, particularly HMOs, so you often have to go outside insurance to find good people, though some idealistic types stay on insurance to help out those who can't afford to pay for it without insurance.  
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