how to switch from paxil cr to lexapro

[alh1978]

I have taken 12.5 mg of Paxil cr for almost a year. I am not liking it or feeling better. My doc just switched me today from that to 5 mg of lexapro for two weeks then up to 10 mg of it. Said I can just switch cold turkey. I have read mostly people being tapered off slowly to switch. Has anyone here successfully switched immediately or should I wean somehow??  Thanks for any help

[alh1978]

Thanks for the detailed answer! I preferred taper down on Paxil but since I'm on the lowest CR dose I knew I couldn't just cut it in half. I called the nurse line at my docs office and she said If I want I can take one every other day for a couple weeks but she wasn't clear on my vcmail as to if I should start lexapro in the meantime or wait til I'm done with paxil?? What do u think? Can I be on both meds at the same time? Or do I quit Paxil first?  Thanks so much I've been so anxious and stressed just figuring how to switch lol

[nursegirl6572]

(cont...)
Just keep in mind, that either way, you may experience some side effects, while you're adjusting.  Those could include an increase in anxiety, feeling "jittery", sleep disturbances, GI upset, brain "zaps", etc.  Just keep the lines of communication open with your doctor...if you have side effects that are becoming too much, let him/her know.  If you have mild symptoms, that's normal, you just have to kind of ride it out.  Typically, those kinds of side effects will abate within 2-3 weeks.  The Lexapro will take up to 4-6 weeks to really start doing its thing.  That's 4-6 weeks after you start the 10mg dose.  The adjustment period may be a little longer, just because you're changing meds.

Best of luck to you, congrats for being proactive, and asking for a new regimen.  Many people just stick with the staus quo, even though it may not really be keeping their depression/anxiety at a manageable level.

Let us know how it's going, okay?

(Sorry about the split post, MH is working on a glitch related to longer replies not being saved..)

[nursegirl6572]

All doctors approach this kind of thing differently.

My PERSONAL opinion, based on my knowledge, is that a gradual taper down of the first med, along with a gradual step UP of the new med works well, simply because, even though two meds are in the same class, their mechanism of action actually differs quite significantly from one med to another.  They are not "interchangable".

However, that being said, a lot of docs will transition patients like yours is doing, and they do just fine.  You're dealing with pretty low doses, of both meds, so that will minimize any kind of discontinuation syndrome you may have.  The only thing I would be concerned about is the fact that Paxil is quite notorious for being difficult to taper off.  The Lexapro MAY help to avoid any problems related to the Paxil, but if it were me, I would probably prefer to do the dual taper.

If you're concerned about it, why not ask your doc if you can do a taper, even just for a few weeks, while starting the Lexapro?  This isn't something you would have to do for months, but a few weeks may help to minimize any side effects related to the adjustment phase.  Tell him/her you would feel more comfortable doing it that way, if you feel strongly about this.

(cont..)

[RainLover71]

They are both SSRIs so it really shouldn't be an issue--and if the doc gave you the green light then you should be fine.