Psycho-Babble Medication Thread 64364

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Cam, hard time switching from Paxil to Zoloft

Posted by Jackster on May 26, 2001, at 18:19:34

Hi Cam

You seem to know a lot about this stuff and I just wanted your advice. I was on Paxil for 3 years (40mg) for Agoraphobia with Panic attacks. Was brilliant. Weaned myself off - but the PAs came back. When I went back onto Paxil it didn't work nearly as well - apparently a common thing. Anyway - have decided to try Zoloft. Went straight from 40mg Paxil to Zoloft 50. First couple of weeks were OK, but I am now having the Panic attacks from hell - worse than I ever had before I started any drug. I'm only just keeping them under control with Xanax. I know it will be a couple weeks before the Zoloft kicks in - I just want to be sure that it's probably withdrawal from the Paxil that's causing the reaction? (and not the Zoloft). I know about the lawsuit against Paxil and am determined to get through this withdrawal.



Re: Cam, hard time switching from Paxil to Zoloft » Jackster

Posted by Cam W. on May 27, 2001, at 0:11:46

In reply to Cam, hard time switching from Paxil to Zoloft, posted by Jackster on May 26, 2001, at 18:19:34

Jackster - Many people switch directly from Paxil™ (paroxetine) to Zoloft™ (sertraline), but even though the two drugs are SSRIs, they have different secondary receptor binding profiles.

I do not believe what is happening to you is Paxil withdrawl. You are still getting a serotonergic effect from the Zoloft. More likely you are experiencing start-up side effects (eg increase anxiety and panic attacks) that are common at the initiation of an SSRI. These panic attacks should subside within a week or so. The Zoloft is a more activating drug than Paxil and this could be contributing to the increased panic attacks at the initiation of Zoloft therapy.

Ask your doctor, you may need to increase your dose of a benzodiazepine (Xanax) for a week or so, to try to decrease the number and severity of these attacks.

Good luck and keep us posted. - Cam

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