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Re: Remeron and Paxil

Posted by Scott Pecora on December 14, 1999, at 18:11:56

In reply to Remeron and Paxil, posted by Mark T. on November 17, 1998, at 14:50:18

> I am currently taking 40mg. of Paxil in the daytime and 30mg. Remeron at night.. Still, I wake up and have some anxiety through most of the day on and off. The physical effects of the anxiety bother me..I have been diagnosed as major depression.. If I still have anxiety, does that mean the anti-depressants are not working??? I've been on both of the meds now for around two months.. Is there any info you could give on my situation??
I'm a Psych Nurse Pracititioner Intern. My first thought is that is a lot of serotonin/norepinephrine blocking agents and both are metabolized through the same enzyme pathway system in the liver, so they tend to raise the potency of each other. Paxil is frequently activating. I would suggest you look at dropping the Paxil, stick with the Remeron, and if you still have anxiety to the point of bothering you after a couple weeks, either try Zoloft (high rate of GI distress, and Sexual dysfuntion, but great for anxiety based depression) or augment with Buspar.
What ever you do, say away from Benzo's (ativan, xanax, klonopin, valuim, especially xanax and klonopin. Anyway this give you some directions to explore with your provider. Also if your only seeing a general provider, ASK to see a psych specialist! After two months on two antidepressants your approaching refractory.




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