GAD and Paxil

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      Re: GAD and Paxil
    


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Posted by CCF NEURO MD on June 12, 1997 at 10:31:45:

In Reply to: GAD and Paxil posted by E.D.P. on April 30, 1997 at 23:38:57:

:    For the last six-months I have had persistent daily severe panic attacks. I was put on Ativan and take 3-5 mg/d which helps somewhat.
     In my effort to get off of this med. due to its dependency factors my Doctor put me on Buspar, which made me more anxious. He then put me on Paxil. Since that time I have taken it only two times because each time I seem to perceive an increase in my anxiety and a mild arrhythmia. (though increasing the anxiety)
     When I mentioned this to my Doctor he said that it ouldn't be caused by the Paxil because it takes 4-6  weeks before it has any physical affect on the body. By the way the the PDR details the studies on Paxil it sounds like the wonder drug for anxiety, and I would like to take it consistently, but am unsure of whether the symptoms I describe are real, or just another side of the anxiety which already exists. Any help, advice or suggestions would be greatly apprecieated as I feel like my life is falling apart. It is very difficult to bear. If it is convenient, please respond via my e-mail address. (***@****) Thank you in advance!
  (Note: I also take Dilantin 600 mg/d for a seizure disorder and 90-100 mg/d Inderal for a mild heart arrhythmia)
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Sorry it took so long to answer your question.  It was somehow missed and was not until we were reviewing questions that we noticed it was not answered.
Paxil (paroxetine hydrochloride) is an antidepressant that works by inhibition of neuronal reuptake of serotonin.  Side effects are common in almost all drugs.  Paxil has been reported to cause anxiety in 5% of patients in their clinical trials in which they received doses of 20-50 mg/d.  People may experience these anytime after their initial dose.  However, some adaptation may occur over 4-6 wks at which time the patient would be able to tolerate the medication better if they were able to continue taking it during that time.  Although you may experience some side effects initially, the full antidepressant effects may take 4 -6 weeks to achieve effectiveness.  Some people are exquisetly sensitive to medication, and you may be one of them.  You should let your physicians know this when prescribing medication.  It is often helpful to start off with small doses and taper upward.  It is often difficult to differentiate anxiety from adverse reactions. A trial of another medication may be beneficial since you are not currently taking the prescribed medication now anyway.  I would discuss this with your physician.  If they are unable to help you, a referral to a psychiatrist would be helpful if you are not already seeing one.  There are a number of new medications out that may help you.  If you would like to come to the Cleveland Clinic call 1-800-223-2273 and ask for ext 45812.
This information is provided for general medical education purposes only.  Please consult your physician for diagnostic and treatment options of your specific medical condition.