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Re: Paxil vs. Celexa - differences, similarities?

Posted by ben on December 22, 2001, at 11:18:24

In reply to Re: Paxil vs. Celexa - differences, similarities? ben, posted by Cindylou on December 21, 2001, at 23:03:45

Hi Cindy

Unfortunately (for you) I dont live in the US. I am from Switzerland (not Sweden !) and there Reboxetine is available under the name EDRONAX since spring this year. I tried it two times as adjnct to an SSRI. I got a relative quick boost in energy but mood improvements didnt last long. I recommend to increase the dose slowly (not like its recommended of Pharmacia Upjohn and a lot of pdocs) because of possible and nasty side effects (theoretically they should not appear but in practice they often do - and are often persistant: mild tachycardia, orthostatic probs, urinary hesitance and impotence as well ). You should try it instead. Why to risk nasty side effects with an inital dose of 2x 4 mg ? Thats not worth because side effects can be frustrating (naturaly not for the docs if you know what I mean). I had to come off it because of urinary probs and no persistant mood improvement. This was really disappointing because it worked very well for energy/drive.
Be free if you have any questions.


> Thanks so much for the information. It does concern me that Paxil interacts with other meds, since I am on quite a few at the time!
> I'm interested in hearing more about your experience with Reboxetine ... were you able to get it here in the U.S. with a prescription? Or is it still on trial in the U.S.? If so, how did you acquire it? Just curious in case my pdoc and I decide to try it out one of these days.
> Thanks again,
> cindy
> > Hi
> >
> > Here is my experience but remember that everyone may react different.
> >
> > I tried Celexa 8 (over one year) with a good initial response at 20 mg which pooped out quickly. My pdoc increased the dose slowly up to 80 mg but only with short improvements. Side effects were minimal but the higher the dose the more sedation I got. Unfortunately I had problems with coming off instead of very slow tapering (10 mg/week).
> > Then I tried Zoloft....only for about 6 weeks and had to come off it because of the persistant nausea. It was more activating than Celexa.
> > Paxil was my next SSRI - the best concerning depression (mood) but the worsest by side effects: slow weight gain, sedation (sleepy on 40 mg) bruxism (triggered by Paxil) and periodic limb movements (disturbed sleep). For this reason I am coming off Paxil now.
> >
> > My impression is that Paxil is (for the majority) the most sedating SSRI and a long term weight gain is often seen. But it is the strongest SSRI (Celexa the selectivest = cleanest).
> >
> > I would try Celexa first (use drops to titrate up) because of the better side effect and safety profile. It hasnt strong kinetic interactions with other drugs. Paxil (Prozac an Luvox as well) instead is very potent inhibitor of the CYP450 enzyme 2D6 -- > interactions with a lot of drugs are clinical relevant (tricyclics, antiepileptics...). Peronaly I was sedated on every SSRI (didnt tried Prozac). Reboxetine was very stimulating to me (more than Ritalin !!!) and really fast acting but poop out as fast as well. You can try Reboxetine with an SSRI or alone, but go slowly up (2 mg for 2 days then 4 mg for a week and ev. 6 mg for the next week) and watch about your habit of urination (frequency, feeling...).
> >
> > Best wishes and keep trying
> >
> > &( > > Can someone tell me the differences and similarities of Celexa vs. Paxil?
> > > >
> > > > What are the advantages and disadvantages of them both?
> > > >
> > > > I know Paxil is an SSRI that's good for social anxiety, but don't know much about Celexa.
> > > >
> > > > For someone who's med sensitive, especially with fatigue as a side effect, which would be the better choice?
> > > >
> > > > Thanks in advance for any help here,
> > > > cindy
> > > >
> > > > PS - I'm currently taking 100 mg Lamictal with 100 mg Serzone -- but I cannot tolerate any more Serzone due to the fatigue, so I need to try another AD. I have tried all of them except Paxil, Celexa and Remeron (and I haven't tried any of the meds on trial, like Reboxitine.)
> > > >
> > > > I have also combined ADs with Wellbutrin to help with the fatigue, but it doesn't help much. Can't handle stimulants either because of the crash effect after a few days.
> > > >
> > > > Just some background info in case you needed it!
> > >
> > > Cindy,
> > >
> > > Try the Celexa. It is a little sedative, but not as much as Paxil. So, you found Prozac and Zoloft too tiring? If you were to try an SSRI and wanted something more activating those two should get you up and out. Although, the usual YMMV. Some people become fatigued on all of the SSRI's.
> >
> > ben
> > >
> > > Mitch




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