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Mental Health  (Expert Forum)
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Professional analysis
Answered by
Roger Gould, M.D. - Mental Health, Wellness
Questions posted in the Mental Health forum are being answered by Dr. Roger L. Gould, author of the Mastering Stress and Depression program and affiliated with the UCLA. Department of Psychiatry. Topics covered include anger, attention deficit disorder (ADD), bipolar disorder, dementia, electroconvulsive therapy (ECT), learning disabilities, memory, obsessive compulsive disorder (OCD), panic, personality disorders, phobias, post-traumatic stress disorder (PTSD), schizophrenia, stress, transitions, and work problems.

Professional analysis

by Gilad, Apr 10, 2002 12:00AM
Could you kindly advise?



I was taking Effexor for 2 mos. then changed onto: Seroxat.



I was given Seroxat which is also known (Paroxetine) 20 mg (as HCI)and had lots of side affects which after 4 mos. gradually subsided.



Then somehow my paharmacist made a human mistake I was was given Recital (Citalopram) as HBr for 3 weeks once again causing terrible side affects, stress attack, nightmares, screaming, once singing in my sleep, breathlessness, sweat, etc.



Now as the pharmacy dont have Seroxat anymore I have begun Paxxet (Paroxetine as HCI) 20mg



When I first began Seroxat I had bad side affects which improved. Then with Recital they began again just as bad.



I am back to Paxxet and sleep very badly waking up at least 3 times a night.  I have nightmares or dreams every night waking up exhausted and with terrible headaches and exhaustion all day.



I regret but my psychiatrist is not too sympathetic I will be seeing him Tues.





Could someone explain the difference between Paroxetine and Citalopram, and why the reoccurrence of side affects having stopped Paroxetine suddenly and returning back to it after 3 weeks. Is it logical that I go thru' all the side affects with Paroxetine once again?  According to M.D. RG going back to Paroxetine should not be problematic and should be quite OK.



Will this whole upset take another 4 mos. for me to get used to again?  Also I have become extremely short tempered of late getting upset with everyone at times not even nice.  Also I'm drowsy and yawning nearly all day?



TY for your help.



S. Freeman

by Roger Gould, M.D., Apr 11, 2002 12:00AM
The latest large scale studies tell us that both of these drugs are equally effective and have an equal number of side effects. You have used Paxil in the past successfully, and now that you have restarted your body is going through the same kind of accomodation.  Unfortunately, this happens and there isn't much you can do about it, except to keep the dose low and gradually go up.
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