Afraid of My Medicine

[moonie91]

I have had anxiety disorder (GAD and Panic) for twenty years.  I have been on Paxil off and on for ten years and never had any trouble with it.  I recently have had an unbearable increase in my anxiety.  I went to the doc and he prescribe Paxil and Buspar.  20 mg Paxil once a day and Bupsar 3x's a day @ 10 mg each.  I stopped taking the Paxil after a week because I was afraid of Serotonin Syndrome and what I read about Paxil and withdrawl.  My anxiety has improved but I am not were I want to be.  I also feel that I am suffering from mild depression and hypochondriasis which has been exacerbated by a finding of iron defiency anemia and occult blood found in one of three stool samples.  How should I take the paxil and buspar?  I took them together once as i felt flushed and ill but i wasn't sure if it was serontonin syndrome or my anxiety/hypochondiriasis.  I am 36 years old and have basically been fairly healthy all my life.  Please Help!

[Paxiled]

Serotonin syndrome is extremely rare.  Not that it doesn't exist, but it's unlikely to occur unless very high dosages are used or you are extremely sensitive to meds.  Buspar was prescribed because current research indicates some benefit to combining Buspar with the Paxil, but the Paxil was the main med.  Buspar alone hasn't shown to work better than placebo in studies, though you could be the exception, and placebo is a lot safer than real medicine!  Don't know why you had the symptoms you had, and I wouldn't particularly advise Paxil or Effexor unless you'd tried everything else first, but you probably don't need to worry about serotonin syndrome.

[Jaquta]

I just wanted to write to offer support.
I think taking the buspar three times a day is a good idea.  I was put on buspar several years ago (for anxiety) and found that with fewer doses my anxiety wasn't very well contained.
I would try and persevere without the paxil if at all possible.

If you took the meds together after feeling flushed and ill it doesn't sound like the effect is due to taking both at once.  Anxiety symptoms can mimic so many other conditions it's not funny.  It can be difficult to differentiate between them.  You may have found this with the anemia.  How often did you feel tired but just attribute it to anxiety?
I can relate because I was diagnosed with anemia just over three weeks ago.

It's likely that your mood is low.  Struggling to do stuff seems to lower it.  Also there must be significant concern about your health and the bleeding.  It may be nothing but combined with the anemia it could be a red flag.
Just as some miscellaneous information, my GP said that if you take ibuprofen or an anti-inflammatory just prior to your period you can reduce blood loss by a third.  I'm younger than you but I guess the same still applies to you.  Your doctor may have discussed this with you.

I did a Wikipedia search on anemia awhile back and it mentioned hypochondria as a ... not sure if it was a complication but something anyway.  Don't beat yourself up about worrying about your health.  It should resolve with resolution of the iron deficiency and once you have more answers concerning your other issues.
If you have fears about your health discuss them with your doctor.  I had some concerns last year and felt stink taking them to my doctor but I ended up having surgery and radiation and some say talking to my GP early about it saved my life.  

Have you tried psychotherapy for your anxiety/ panic?  That can be extremely beneficial.  Having someone to talk too can also reduce the burden from all the issues you carry with you.

Take care and good luck for any future tests.

J  

[Roger Gould, M.D.]

From what you said, it seems that you would be better just continuing with the Buspar rather than trying to do both again. If you don't get flushed that will tell you something you need to know about the combination, and with that information you and your doctor can decide what to do next.