Alternatives to Paxil

[molly]

I have been taking Paxil for approximately 2 years and I have weaned myself off once during this time period. I took myself off very gradually over a period of 6 weeks.  I quickly began feeling physically ill as if I had the flu or a viral infection.  After my physician did over $700 in lab work to rule out other illnesses, we both came to the conclusion that my symptoms were actually a return of my anxiety. The Paxil (40 mg)makes me feel sleepy until late morning,sexual desire is virtually non-existent, I still have lots of muscle tension in my back and shoulders, and bouts of panic.
-- Could these symptoms have been caused by the withdrawel and not from anxiety?  
-- Are there alternatives to Paxil, preferably herbal?
-- Is there another RX with less side effects as mentioned?

[HFHS MD - RG]

Dear Molly,

Paxil does not have a "withdrawal" syndrome per se, but some patients will develop physical symptoms when discontinuing it, especially if the medication is abruptly stopped or tapered too rapidly. In thoroughly assessing your condition, it is important to consider other factors such as your age, other preexisting illness, and other medications that you are currently taking.
     However, if you have do not have any of the conditions mentioned, you may be suffering a withdrawal like syndrome. It is helpful to slowly taper all antidepressants to prevent recurrence of depression as well as to prevent any "rebound" physical symptoms. How slow the taper should be depends on the dose of the antidepressant, as well as other medications and illnesses you may have. If the dose has been tapered too quickly, it is sometimes helpful to reintroduce a lower dose, and then taper off more slowly. For most people the physical discomfort stops within a week or two.

Other medications that can be used on to treat anxiety could be Effexor (venlafaxine) or Remeron (mirtazapine) which has a lower incidence of sexual side effects. Because of limited data on its efficacy and side effects profile, I would not recommend the use of herbal medications.

     The information provided in this forum is presented for general educational purposes only. Specific questions you have pertaining to your health should always be directed to your personal physician or you may call Henry Ford Behavioral Health at [phone].

     I wish you the best,

     HFHS MD - RG

     *Keyword: Paxil

[PamD]

Have you ever talked to your doctor about taking Paxil before bed?  I'm doing that with my anti-depressant, because it makes me sleepy.