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Re: Advice on switching from Paxil to Nardil

Posted by tomcat on May 26, 2004, at 20:25:42

In reply to Re: Advice on switching from Paxil to Nardil, posted by King Vultan on May 26, 2004, at 19:15:13

> Your course of action seems well thought out, and I wish you luck. Two weeks seems to be the standard washout period switching from other antidepressants to MAOIs. Of course, it is particularly important to allow adequate washout with SSRIs, as combining an SSRI and MAOI will generally result in instant serotonin syndrome.
> In all likelihood, the Paxil will actually be all out of your bloodstream well before the two weeks are up, as it takes five half lives to completely clear. With Paxil's half live of 21 hours, 5 x 21 = 105 hours or 4+ days. If you're an efficient 2D6 metabolizer, as most people are, a week would actually appear to be adequate, but if you're a poor 2D6 metabolizer (varies by ethnicity, 3%-8.9% of caucasians are poor 2D6 metabolizers, for instance), two weeks would be much more prudent. If it is not too much of a hardship, I would probably wait the two weeks just to be safe.
> I haven't tried Paxil, but Nardil is an excellent drug for social anxiety disorder/social phobia and is likely superior. I honestly never had much luck with the SSRIs for mine and found some of the tricyclics to actually be much better, but serotonin does seem to be the neurotransmitter most identified with social phobia, which Nardil certainly has a strong effect on. It also has an effect on GABA similar to the benzodiazepines and is quite calming--I do not take a benzo myself and find the Nardil totally adequate for my anxiety and stress needs. However, I've made a great deal of progress over the years in reducing stress and anxiety by changing the way I look at things. I do find the Nardil to be a very constructive drug, though, and certainly the most beneficial I've taken.
> Todd

Thanks very much for this reply -- it is encouraging. I will wait 2 weeks to wash out the paxil before beginning the Nardil.

As you mention, I do not feel that Paxil has had a direct effect on my SAD whereas I find Klonopin to be very effective due to its calming effects. I am hopeful that Nardil will have this effect and over time I can adjust my lifestyle and thought patterns so that drugs become less critical.

thanks again.




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