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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 7 of 7. This is the beginning of the thread.
Posted by Justy on March 30, 2005, at 8:36:34
I'm bipolar and lexapro is now becoming available in Canada. He said I could try switching right away from Paxil to Lexapro but I'm really scared to do that.
Has anyone here done that or should I titrate down.
He advised that if I experienced side effects to keep on the lexapro and titrate down the paxil, but I would like to just get it over with.
Posted by banga on March 30, 2005, at 11:26:59
In reply to HELP info on switching meds - scared, posted by Justy on March 30, 2005, at 8:36:34
I, being pretty impulsive, have done very rapid titration down for three days or so, then start adding the new one at MINISCULE amounts (remember that adding larger amounts of two SSRIs brings risk of serotonin syndrome), then stop the old one by say the fifth day and begin increases of the new one.
I have had very little to no side effects in doing so.
So a happy medium would be doing a swith over say five days rather than a "cold turkey switch".
It sound like he suggests the reverse--adding the Lexapro and then lessening Paxil--so the amounts of the two you are taking must not be worrisome RE serotonin syndrome.
So maybe you, again, do the happy medium and not do it in one day, but also not titrate slowly over an extended time--set up a schedule for a 4-5day switch.
Posted by Justy on March 30, 2005, at 11:31:24
In reply to Re: HELP info on switching meds - scared, posted by banga on March 30, 2005, at 11:26:59
Thanks Banga. I think that's what I'll do and hope I don't get the good old paxil withdrawal.
Posted by banga on March 30, 2005, at 11:52:54
In reply to Re: HELP info on switching meds - scared, posted by Justy on March 30, 2005, at 11:31:24
Switching from one SSRI to another I never had bad w/d effects.
Posted by celticmom on March 30, 2005, at 15:24:52
In reply to Re: HELP info on switching meds - scared, posted by banga on March 30, 2005, at 11:52:54
Justy - I second "don't go cold turkey approach". My DH switched directly from Paxil to Lexapro, and while initially it seemed to be okay, he had some freaky rebound/withdrawal/? thing happen about 6 weeks later. He ended up having to wean off of Lexapro and is now on zoloft.
Posted by Phillipa on March 30, 2005, at 17:03:27
In reply to Re: HELP info on switching meds - scared, posted by celticmom on March 30, 2005, at 15:24:52
I've always had pdocs who just switched from one to another without any days in between. Maybe if I had visited this Board, in the past, I wouldn't have had so many negative reactions to AD's, and I wouldn't have had to switch. Fondly, Phillipa
Posted by Emily Elizabeth on March 30, 2005, at 22:13:50
In reply to Re: HELP info on switching meds - scared, posted by Phillipa on March 30, 2005, at 17:03:27
Not to freak you out, but I really thought that it might help to share what happened to me. I had a nightmare withdrawal doing the same sort of switch between paxil and prozac. I was on paxil for 1.5 yrs, and I don't know if that makes a difference, but it was extremely difficult. The physical stuff (sleepiness, headache, dizziness) was not nearly as bad as the deep depression and suicidal feelings that seemed to be a direct result of switching the meds. My pdoc actually said that she was NEVER going to do that again with any other patient!
I also should say that I am typically the type of person who is pretty resistant to side effects. On the other hand, I usually need high doses (I was on 50mg of Paxil).
If you do decide to do something like what you described, please make sure that you get in to see your pdoc w/in a week after the switch. Also it might help to have a friend/partner/therapist who can give you feedback about how you seem to be acting. I didn't realize how "off" I was acting until my T told me.
Please be careful. I hope that you find the right med soon!
Best,
EE
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