Increased Anxiety

[roger7]

I have been taking Paxil (30 mg) for nearly three years for panic attacks, anticipatory anxiety, and insomnia.  I have always responded really well to Paxil - within 4 days of taking it, I felt like myself again, with no sleep issues (after living through 4 months of insomnia and axiety).  I am currently pregnant and decided to switch to Zoloft due to potential withdrawl effects for the baby with Paxil.  I started Zoloft at 25 mg, continued Paxil at 30 mg. for one week, and had no problems.  At the beginning of week two of the transition, I decreased Paxil to 20 mg. and increased Zoloft to 50 mg.  I continued this for 3 days before experiencing intense insomnia, stomach aches, diarreha, and an increased feeling of anxiety.  I immediately discontinued the Zoloft and increased my Paxil to 30 mg. again.  Since (it's now been 9 days without Zoloft), I have been experiencing continued sleep issues, lack of appetite (I've lost 10 pounds), on and off diarreha, and extreme anxiety, especially anticipatory anxiety regarding sleep.  These issues have resulted in depression and an overall lack of confidence in the Paxil (which I have always responded to very well).  I should mention that in the past I have tried to discontinue Paxil use, but have experienced a relapse of anxiety/panic/insomnia symptoms which required me to continue Paxil at my normal dosage.  It usually takes a week or two to restablize on the Paxil (my last attempt to discontinue, I was down to 10 mg./day and had been there for several weeks).  I'm trying hard to understand what may be happening now.  At first, I strictly thought it was the Zoloft and assumed that after it was out of my system, I would return to "normal" (I was told that the Zoloft would take approx. 6 days to leave my system).  As mentioned previously, it has been 9 days since Zoloft discontinuation and I'm continuing to experience symptoms as if I was not on medication at all.  I'm wondering if I should speak to my doctor regarding an increase in Paxil?  Or, should I wait longer for my body to restablize?  Please advise.

[Roger Gould, M.D.]

I think your loss of confidence in Paxil and your fear of being without it( the paradox) is the source of your symptoms so changing the dose probably is not the best thing to do. YOu have underlying anxiety and have been reliant on medications and want to get off, so why don't you get some short term therapy in order to deal with your fears and dependency on the medication. It will probably be better for you and the baby.  It is worth a good try.

[anacyde]

Just a few things that might help you...

I was diagnosed with panic/anxiety in 1999.  I use Ativan 0.5 mg for acute attacks, otherwise no medications.  I became pregnant in 2003.  Almost immediately, I noticed an increase in my anxiety symptoms.  I've read extensively about correlations between certain hormones and symptoms of anxiety.  Additionally, anxiety is common among many new mothers-to-be anyway.

I found that prenatal yoga and other pregnancy-approved mild exercises helped ease my symptoms a LOT.  Also, beware of drops in blood sugar while you're pregnant...your need for glucose increases and drops in blood sugar can trigger symptoms that are very panic attack-like.

I researched SSRIs extensively during my pregnancy, weighing the risks versus benefits of such a drug in place of my Ativan.  I opted to stick with the Ativan, but I haven't ever heard of Paxil withdrawal in infants.  In fact, I've heard of more clinically significant side effects from Zoloft (in adults), which would lead me to believe that your original medication was not a bad one.  SSRI medications are generally believed to be safe during pregnancies.  Besides, the anxiety's adverse effects may be worse for you and baby both than the Paxil.

Finally, consider "placebo effect".  When I was initially diagnosed with panic/anxiety, I took the Ativan twice daily.  If I forgot a dose, I'd usually be just fine until I remembered that I'd forgotten...at which point I'd immediately begin feeling anxious.  If you believe that the Zoloft isn't working...it may be a mind over matter issue.

I hope this helps!  I know how frustrating it can be.

[sport1]

Anxiety(intermittent)CAN be a symptom of thyroid dysfunction. If you look at posts on Mary Shomon's website at about.com, you'll find out about it there.

[annelrm]

I am so thankful for this site.  I have been really sick for 3months. I couldnt get out of bed, was throwing up all the time, and wanted to die. I lost almost 20lbs and my doctor almost wanted to institutionalize me for anorexia. I was in and out of the hospital for a month, then was seeing a doctor and a psychologist both once a week, still am.  I was diagnosed with panic disorder and anxiety. It was hard for me to believe.  I tried depecoat for a couple of weeks, then got on paxil and ativan, and have been on them since beginning of january 2004. I stopped the ativan a couple weeks ago. I went through bad withdrawals for a couple days, but I was better after that.  I was only taking 10 mg of paxil for almost 2months. A week ago I cut it in half and it actually made me feel better, after I cut it. I havent taken any paxil since monday night.  Im having bad nightmares if I fall asleep after waking up in the morning, but other than that my chest pain went away and most of my breathing problems, Im wondering if I will have any more withdrawal sypmtoms or long term effects, I think the paxil was giving me even more anxiety and making me even sicker. my doctors wanted me to take even more.  I definetly dont want to take paxil or any meds. Im not taking anything now, and Im doing so much better, just a little shaky but Im sure its because of my anxiety. I know I can deal with this without drugs.  Im just kinda scared right now, of withdrawals or relapse.  Im finally eating an sleeping, I must be doing something right.  To everyone out there, just think positive, do things you enjoy and eat healthy. thats what Im doing and its working, and doctors dont know everything.