Psycho-Babble Medication Thread 3497

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Paxil then Zoloft now Paxil

Posted by JennyAnn on March 8, 1999, at 20:16:42

I initially took paxil for depression and found great relief. After 8 months, found a great well of anxiety depression had masked. I decided (with my Doc) to change to Zoloft to try to minimize anxiety. I feel crazy...after 21 days I am in a deep depression and really hurting...now I am going to stabalize on paxil and then...? who knows....is there a window of therapeutic benefit for SSRI's? Is there a habituation effect wherein i would need to increase the dose after so many months? Has there been a reported negative response to zoloft? am I alone?
JA

 

Re: Paxil then Zoloft now Paxil

Posted by Wayne R. on March 9, 1999, at 4:43:13

In reply to Paxil then Zoloft now Paxil, posted by JennyAnn on March 8, 1999, at 20:16:42

> Is there a habituation effect wherein i would need to increase the dose after so many months? Has there been a reported negative response to zoloft? am I alone?
> JA
Unfortunately, this problem of SSRI "poop-out" is not uncommon for some people. My experience with SSRIs working and then not working was often like a light switch. For me it happened with Celexa, Prozac, Zoloft, Paxil, and many more. It would kick in after a week or so and then last a week to a month. Then I would wake up one morning and know the bottom had dropped out. We would increase the dosage and one morning I would get up and the world was bright again. But now it would only last half as long until the bottom fell out. And on and on for years... So, you are not alone. BUT... this does not have to be your fate! There are augmentation techniques that your Dr can try to keep the meds working. If the Paxil should "poop-out" talk about an augmentation strategy. Hang in there... Wayne


 

Re: Paxil then Zoloft now Paxil

Posted by Terry on March 9, 1999, at 14:01:21

In reply to Paxil then Zoloft now Paxil, posted by JennyAnn on March 8, 1999, at 20:16:42

JA -- all of the SSRIs are different, so you may feel great on one of them and terrible on another, so it's not surprising that you did OK on Paxil and not on Zoloft. If the SSRIs are going to work, they should work after 4-6 weeks. If they don't work by that time, it's time to try something else. Or, you may need to try another drug with the SSRI, such as BuSpar, for anxiety. Be careful that your "anxiety" isn't actually hypomania or mania, which can be brought on with SSRIs if you are actually manic-depressive (bipolar) and not just depressed. That happened to me, and that's how I was diagnosed as bipolar. If you are bipolar, you will need a mood stabilizer such as lithium or Depakote.


> I initially took paxil for depression and found great relief. After 8 months, found a great well of anxiety depression had masked. I decided (with my Doc) to change to Zoloft to try to minimize anxiety. I feel crazy...after 21 days I am in a deep depression and really hurting...now I am going to stabalize on paxil and then...? who knows....is there a window of therapeutic benefit for SSRI's? Is there a habituation effect wherein i would need to increase the dose after so many months? Has there been a reported negative response to zoloft? am I alone?
> JA

 

Re: Paxil then Zoloft now Paxil

Posted by Matt on March 12, 1999, at 23:02:32

In reply to Paxil then Zoloft now Paxil, posted by JennyAnn on March 8, 1999, at 20:16:42

> I initially took paxil for depression and found great relief. After 8 months, found a great well of anxiety depression had masked. I decided (with my Doc) to change to Zoloft to try to minimize anxiety. I feel crazy...after 21 days I am in a deep depression and really hurting...now I am going to stabalize on paxil and then...? who knows....is there a window of therapeutic benefit for SSRI's? Is there a habituation effect wherein i would need to increase the dose after so many months? Has there been a reported negative response to zoloft? am I alone?
> JA

Did you try upping the dose of Paxil prior to switching to Zoloft? Have you considered adding a benzodiazepine like Klonopin? (IME it helped hugely with my anxiety.) It would help with the anxiety and sleeplessness.

Remeron is terrific with anxiety, and it's great with sleep. It can cause sedation initially and weight gain, though there is less weight gain at higher doses.

As has been mentioned, SSRIs can poop out. There's lots of hypotheses as to why this happens, but no one really is sure why it does. There are lots of things that one can use to augment an SSRI (e.g. a tricyclic, or BuSpar.)

Good luck with things. I hope you feel better soon.

Matt


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