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From Lexapro to Effexor to Lexapro to Paxil and a little Abilify

My husband has been battling depression for almost 3 years now.  We are newlyweds and are just looking for something that will finally do the trick so that we can enjoy being newlyweds before that phase has passed.  He started out on 10mg of Lexapro in October of 2006.  It was WONDERFUL for about 6 months until his body got used to it.  When he went back to his doctor they switched him to Effexor.  It made him very sick and nearly suicidal.  We went back to the doctor and questioned why they did not just increase his does of Lexapro since we knew it worked. His doctor agreed to switch him back to lexapro, but after 6 weeks she had still not gotten around to calling in his prescription.  We switched doctors and got him on 20mg of Lexapro.  It worked WONDERFUL and he was back to old John which was great.  Then again...6 month later it seemed to stop working.  In December of 2008, his doctor put him on Paxil.  He is really tired all of the time, he is angry a lot, he has no interest in anything anymore, he wakes up multiple times a night drenched in sweat and it is all he can do just to go to work each day.  He is never happy and feels like he never will be.  We spoke to his doctor who added Abilify.  It had little or no effect and caused the anxiety to worsen.  He took himself off the abilify and is still trying to make do with Paxil.  What should we do?  Do we try another medicine?  Do we go back to Lexapro since we know it works even though it only seems to help for about 6 months?  Is it possible that going back to Lexapro and adding Abilify could do the trick?  I'm at a loss and just want my husband to be happy so that I can be happy!
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Avatar universal
Keep in mind that Paxil can be one of the more difficult to quit, so make sure he takes it slowly.  Fatigue with Paxil usually goes away with time, but the interrupted sleep may be due to the fact that Paxil does cause some personality changes, such as angry or obsessive thoughts.  Sweating is common, actually more common even with Lexapro.  I did take Prozac, but it did nothing for me, so I got no side effects.  You have to metabolize a drug well for it to work, but when you do, you get side effects.  Fun, eh?  Look, all these meds can be problematic.  It's also odd for one to conk out as quickly as six months.  If you've been through the tricyclics and the whole rigamarole, what he might want to consider going back on the Lexapro and augmenting it with something else.  Studies you can find on the NIMH website show that combining meds does work better.  On the other hand, it also increases the possibility of side effects.  But without therapy, he'll never get "cured," and may very well not get cured even with it but it's the only cure we know of.  Depression tends to be episodic as well.  Think of it like cancer -- never cured, just sometimes in remission, but better to live in remission and hope it never comes back.  I urge you to get him into therapy, but don't expect quick results, and you might find switching therapists a few times is necessary before one clicks.  I've never found a cure for my anxiety, but I've taken a lot of meds and know the cure isn't there, though some have helped and some have squeezed the very life out of me.  It's unfortunately something you don't know until you try.  Also, there is a depression forum on this website which might offer more help than the anxiety forum.  Good luck to both of you, and remember, the depression isn't him, it's just a part of him.
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Avatar universal
Thanks for the feedback.  He is actually not in therapy at this point.  His biggest probelm is the depression right now, but he does suffer occasional anxiety.  Some days he handles the depression well and is able to keep himself busy and focus on other things and seems moderately content with life, but on the days when its bad its like he gets stuck in a rut and it will be several days in a row.  The first day he is just down and really tired and then its like he gets frustrated with the fact that he is having a down day and it snowballs into a down week.  By the end of a down week the anxiety kicks in and he can't sit still or make decisions and is just miserable.  He has always weened off the meds when they change him to something else, but its like no matter how slowly he weens off it, he seems to have one or two days when he gets flu like symptoms and just has to sleep it off.  By day 3 he usually wakes up feeling great.  We have seen little or no change in the nearly a year that he has been on Paxil.  I would compare him now to the way he was when we first convinced him to seek help in 2006.  He is scared to try something new because he doesn't want to "waste" another year or get sick from changing meds.  We talked about going back on Lexapro last night but were not sure what to do about the fact that it conks out after 6 months.  It can't be healthy to have to switch those types of meds every 6th months can it?  What can you tell me about Prozac?  Have you taken it?  How bad are the side effects?  The ones that seem to bother him the most with Paxil are the fatigue, excessive sweating and interrupted sleep at night.
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Avatar universal
First of all, is he in therapy?  The meds won't cure him, they just treat symptoms.  Second, you say he is suffering depression.  Does he also suffer anxiety?  I ask because some pure antidepressants are stimulating and can cause anxiety.  And did he wean off Lexapro, or quit cold turkey and to immediately to Paxil?  He could be suffering Lexapro withdrawal if he did, and Paxil won't necessarily do anything about that.  And keep in mind that for many people, these meds do conk out, though usually not that quickly.  Effexor can be a tough med because it works on two neurotransmitters and can cause anxiety because of that.  Lexapro is reputed to have fewer side effects than, say, Paxil, which because it also strongly affects choline as well as serotonin can cause anger and such.  But if he went directly from Lexapro to Paxil, there's no way of knowing if its withdrawal from the one or side effects of the other.  The purest antidepressant of the ssris is Prozac, and he could try the tricyclics.  But make sure he withdraws slowly from whatever he takes, especially meds like Effexor and Paxil and Lexapro, so he's spared bad withdrawals along with everything else.  
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Avatar universal
Yeah I'd give the lexapro another shot
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