Posted by house on July 30, 2002, at 14:35:32
In reply to Re: Paxil and Anxiety » house, posted by CamW. on July 30, 2002, at 14:08:58
Thanks for the great info.. One point that strikes me a little odd is that the panic side of my disorder is usually help by an ssri within a matter of days. The rest of my condition has never been remoted effected, except when nardil relieved me of all symptoms for about two week. Do you think that another MAOI or even nardil is worth another shot since it had the best results of anything I've ever taken. By the way I only took nardil for 6 weeks. The two weeks in the middle were good and the rest where miserable. Should I have stayed with it for a little longer?
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House - PaxilŸ (paroxetine) has been used quite extensively for a variety of anxiety disorders (eg. panic disorder, GAD, social phobia, etc.). Paxil is thought to have much more anti-anxiety activity than the other SSRIs. This is thought to be due to it's greater affinity for blocking muscarinic-M1 receptors.
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> I have seen much success in the use of Paxil in panic/phobic disorders, such as in the fear of flying. The success rate seems to be greatly enhanced when Paxil is combined with cognitive &/or behavior therapies. This is mostly from my personal observations, so it may be tainted with my subjective feelings.
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> In panic-type anxiety treatment, I see doses that are higher than normally would be used in a majority of major depressions (eg. 20mg to 30mg of Paxil daily for depression, as opposed to 30mg to 40mg generally used in panic disorders).
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> This is in contrast to Effexor XRŸ (venlafaxine) which tends to be recommended in lower dosages for GAD, than are normally prescribed. Whether Effexor XR is actually prescribed in lower dosages for GAD, I am not absolutely certain what is prescribed in other areas, aside from where I live. Here the pdocs tend to write approximately equivalent doses for anxiety disorders (all types) and depression; with a wide range of dosages used in both disorders (generally 75mg to 225mg daily, but I have seen dosages slightly outside this range - sometimes 37.5mg or 300mg daily are prescribed).
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> I have noticed that, in general, people with anxiety disorders are more sensitive to the side effects (especially the start-up side effects) of both Paxil and Effexor XR, and also require a longer period of time on these drugs before a therapeutic effect is noticed. For example, 8 to 10 weeks of treatment at the target dose is usually required in anxiety disorders (especially panic disorder) as opposed to depressive disorders where the 4 to 6 weeks of treatment at the target dose is generally required before full effect of the treatment is attained. I find that this holds true for any SSRI (and Effexor XR) used in the treatment of anziety disorders.
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> Again, the above are generalizations that I have noticed, and not backed by any hard data.
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> I hope that this is of some help - Cam
poster:house
thread:114402
URL: http://www.dr-bob.org/babble/20020725/msgs/114417.html