Switching from Paxil to Effexor

My husband has been on 10mg of Paxil for almost 3 years.  It stopped working as well for him and the MD increased his dose to 20mg.  Unfortunately, this dose gives him a terrible headache and nausea.  The MD has now decided to have him try 37.5mg of Effexor.  She did not give him any instructions for the switch.  Should he start the Effexor and continue the 10mg of Paxil for a period of time or should he just stop the Paxil and start the Effexor?  Thanks in advance for your advice.

[Abhijeet Deshmukh, MD]

Hello.

Since Effexor works as a dual (serotonin and norepinephrine) re-uptake inhibitor, you can go in for a direct switch from Paxil to Effexor (stop Paxil and start Effexor). However, there is no conclusive and standard way of making the switch. The effects still vary from person to person and it is advised that you consult your treating MD. A direct switch is considered relatively safe when Paxil and Effexor are involved.