Paxil and Acute Anxiety

[DaniellaS]

My husband has had mental health problems all his life - suffers from manic depression/bipolar. He has tried many different drugs. Four months ago he started on Paxil - 10mg. There were no side effects to speak of and we credit Paxil for significantly reducing his manic episodes. However. for the past 3 weeks, he has been seized with the most debilitating anxiety. He has never suffered from anxiety before. His shrink upped the Paxil to 20mg and gave him a low dose of xanax (0.25mg and later 0.5mg) to take as needed. He also takes clonozapan as needed, but both these drugs make him fuzzy or put him to sleep, so he can't function/work when he takes them. The past week has been horrendous. He wakes up terrified!  Sweating, heart racing, crying, and terrified to leave the house. I have never seen him this way and he is suffering terribly, paralysed by the anxiety, can't go out.
As the fear is so irrational and as this is a totally new thing - I am wondering if the Paxil is to blame here. Is it possible for this to manifest after taking the drug for a few months?   I know withdrawl is horrendous and I am afraid of him going through that - plus it has helped him -- but this has to be a chemical issue as he can't control the anxiety and it never dissipates even when I say, ok, stay home, no need to leave the house etc.
Please help!
DaniellaS

[Roger Gould, M.D.]

Many psychiatrist do not give this kind of medication to people with manic depressive illness because there is some evidence that it triggers a manic episode.  Your husband's anxiety does not yet sound like mania, but it is a state of excitement like mania, so given that, yes, the paxil may be contributing to his anxiety.  You will have to go back to your doctor and ask him to help with the withdrawals of paxil, if that is the decision, and if so, to do it over a three week period....and use the clonopin at night to help maintain sleep and cover some of the anxiety during the day.   at any rate, this is what you should discuss with your doctor who knows your husband, and has more information, which may lead to a different course of action.

[fd11]

Paxil to Klonopin in 10 days -    Ok I was on Paxil (SSRI) for 9 months which targets then serotonin in your brain.  Then I was weaned off of Paxil and crossed over to Clonazepam (Benzo) in 10 days which targets the GABA receptors.  Now I am no doctor, but why would anyone do this?  If you ask me, there has to be a better way to get someone off of Paxil.  Two drugs, two distinct actions. Klonopin is a bad way of masking SSRI withdrawal and vice-versa. The half-life of Klonopin is 50 hours, duration of action is 12 hours for as-needed use, 12-18 hours for single daily use, and 18 hours for twice daily dosing. Paxil targets 5-HT (serotonin) receptor sites, and nine months was a prolonged period of use. Ideally, the Paxil should've been withdrawn very gradually. Of the SSRI's, Paxil carries the highest risk of withdrawal phenomena. Reports indicate that it may be severe. A class-action lawsuit appears to confirm that it is indeed severe.

[fd11]

I had one Panic attack and was then put on Paxil after one panic attack.  It was a nightmare, same symthoms as you husband.  Then I was cold turkeyed off the Paxil in 10 days and put on .5mg of clonozapan at night for 6 months.  Can very close to cashing in my chips becuse of these drugs.  They are two seperate drugs working on to seprate parts of the brain.  It is almost impossible to wean off of clonozapan.  Unfortunately I had to cross over to diazepam and I am almost off of that The problem is that half these doctors are like legalized drug dealers.  If you want to ask me anything, email me at dferraro18 just put yahoo . com at the end. I know what your husband is going through.  There is a light at the end of the tunnell.  

P.S. remember, these meds can do the exact opposite that they are intended to do.  They have taken 2 years of my life.  Couldn't enjoy getting married or have my first baby boy like I always imaged.  Enjoyed it, but it was a nightmare.