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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 9 of 9. This is the beginning of the thread.
Posted by Cindylou on December 19, 2001, at 13:48:17
Hi,
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,
cindyPS - 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!
Posted by IsoM on December 19, 2001, at 14:16:09
In reply to Paxil vs. Celexa - differences, similarities?, posted by Cindylou on December 19, 2001, at 13:48:17
Please don't think that because these meds work like I'm going to describe, that it'll be the same for you as for me. It may or may not.
I took Paxil for a couple of years & it worked wonderfully but I hated that if I was late for my dose or forgot about it, the horrible effects told me right away I needed it. I wanted a medication that I wasn't *chained* to & wanted to switch to something else. I found out later that Paxil is either the worse or one of the worse SSRIs to come off (a pharmacist tipped me off on that). The withdrawal or discontinuation symptoms was a hideous nightmare. I wished I was dead then. I've never, NEVER been so sick in my life & it went on for months even though I tapered off very, very slowly. I have a very sensitive CNS which is probably why it was so bad for me.
I'm currently taking Celexa which doesn't give these withdrawal feelings if I don't take it at the same time each day. It does all of what Paxil does & more. I feel more euphoric on it than Paxil but not hypomanic or anything. Just happier. I'm still taking a very small dose of Paxil along with the Celexa. Even after a couple of years, it's the only way I was able to completely stop these weird symptoms. I hate Paxil - while it's not addictive, it might as well be for me. I'm going to give it a shot next summer of stopping it very slowly again. I think summer would be a better time for me than now.
If you want to be on a med forever, Paxil would be fine, but if you ever wish to reach a point where you would like to go without to see how you do, I'd never recommend Paxil to anyone. I really HATE it for its ability to get in your system & make you depend on it.
****************************************************************************************************
> Hi,
> 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!
Posted by Cindylou on December 19, 2001, at 15:05:57
In reply to Re: Paxil vs. Celexa - differences, similarities? » Cindylou, posted by IsoM on December 19, 2001, at 14:16:09
Thank you for the excellent information. I had a horrible time getting off of Effexor, and never want to go through something like that again.
Quick question ... does Celexa make you at all tired, or did it to start with?
Thanks again,
cindy> Please don't think that because these meds work like I'm going to describe, that it'll be the same for you as for me. It may or may not.
>
> I took Paxil for a couple of years & it worked wonderfully but I hated that if I was late for my dose or forgot about it, the horrible effects told me right away I needed it. I wanted a medication that I wasn't *chained* to & wanted to switch to something else. I found out later that Paxil is either the worse or one of the worse SSRIs to come off (a pharmacist tipped me off on that). The withdrawal or discontinuation symptoms was a hideous nightmare. I wished I was dead then. I've never, NEVER been so sick in my life & it went on for months even though I tapered off very, very slowly. I have a very sensitive CNS which is probably why it was so bad for me.
>
> I'm currently taking Celexa which doesn't give these withdrawal feelings if I don't take it at the same time each day. It does all of what Paxil does & more. I feel more euphoric on it than Paxil but not hypomanic or anything. Just happier. I'm still taking a very small dose of Paxil along with the Celexa. Even after a couple of years, it's the only way I was able to completely stop these weird symptoms. I hate Paxil - while it's not addictive, it might as well be for me. I'm going to give it a shot next summer of stopping it very slowly again. I think summer would be a better time for me than now.
>
> If you want to be on a med forever, Paxil would be fine, but if you ever wish to reach a point where you would like to go without to see how you do, I'd never recommend Paxil to anyone. I really HATE it for its ability to get in your system & make you depend on it.
>
> ****************************************************************************************************
>
> > Hi,
> > 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!
Posted by IsoM on December 19, 2001, at 16:24:23
In reply to Re: Paxil vs. Celexa - differences, similarities? » IsoM, posted by Cindylou on December 19, 2001, at 15:05:57
I might be the wrong to person to ask that question because I have relatively mild narcolepsy & can fall asleep so easy if I'm not actively doing something. BUT I also have ADHD, so when I do things, it can often seem like I'm speeding to others, even without any stimulants.
Two speeds, either barely idling or maximum over-drive :)The Celexa, if anything helped me to be a little more awake, but that may be because it improved my mood over Paxil & I wanted to do more. Celexa (with the small amount of Paxil) & my thyroid hormone replacement isn't enough though to keep me awake & alert at quieter or less energetic jobs though. I've now augmented my meds with adrafinil (Olmifon) from overseas & now can stay awake & alert any time without feeling a little too wired or jittery like Ritalin or Dexedrine do for me.
I wouldn't really have thought that those two made me wired until I've had the opporunity to compare how I feel on adrafinil as compared to them. The adrafinil brings me an alertness & wakefulness that stims did but with a calm & mellow feeling that's level all the time - no ups & downs.
****************************************************************************************************
> Thank you for the excellent information. I had a horrible time getting off of Effexor, and never want to go through something like that again.
>
> Quick question ... does Celexa make you at all tired, or did it to start with?
>
> Thanks again,
> cindy
Posted by Daveman on December 21, 2001, at 0:44:11
In reply to Re: Paxil vs. Celexa - differences, similarities? » Cindylou, posted by IsoM on December 19, 2001, at 14:16:09
Hi Iso:
I'm no expert, but I'd bet one of the reasons you don't get the immediate "withdrawal blues" on Celexa as you did on Paxil is the difference in half-life. Paxil's half-life is around 20 hours, so if you miss one dose you start getting withdrawal immediately. Celexa, by contrast, has a half-life of 35-40 hours. It is well known that shorter half-life meds are almost always harder to get off. Since I'm about to try tapering down Celexa, I will certainly find out for myself:)
Dave
Posted by Mitch on December 21, 2001, at 9:35:56
In reply to Paxil vs. Celexa - differences, similarities?, posted by Cindylou on December 19, 2001, at 13:48:17
> Hi,
> 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.
Mitch
Posted by ben on December 21, 2001, at 14:14:20
In reply to Re: Paxil vs. Celexa - differences, similarities? » Cindylou, posted by Mitch on December 21, 2001, at 9:35:56
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
Posted by Cindylou on December 21, 2001, at 23:03:45
In reply to Re: Paxil vs. Celexa - differences, similarities?, posted by ben on December 21, 2001, at 14:14:20
Hi Ben,
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
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.ben
> 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
This is the end of the thread.
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