Advice Please

[JHR]

I'm on Day 5 of paroxetine and I feel worse than I did before I went to the docs. Doc told me to take it in the morning and take Piriton at night to help me sleep. Does anyone have any advice please

[panic_down_under]

I'm on Day 5 of paroxetine and I feel worse than I did before I went to the docs.

Unfortunately, antidepressants (ADs) often worsen anxiety at the beginning due to an increase in serotonin activity. The side-effects should diminish within a couple of weeks as bio-feedback mechanisms respond by reducing serotonin synthesis and expression.

Starting on a low dose, no more than 10mg for immediate-release tablets or 12.5mg for slow-release, and increasing the dose at 7 day intervals often reduces the side-effects to tolerable levels. A few may need to start on an even lower dose.

Apart from that it's a matter of treating the side-effects symptoms. Ginger and/or vitamin B6 for nausea, loperamide (Imodium) for diarrhea (check with your GP or pharmacist before taking it), etc.

Doc told me to take it in the morning and take Piriton at night to help me sleep. Does anyone have any advice please

Chlorphenamine is a sedating antihistamine which should help with SSRI induced insomnia. It has a short range of effectiveness, 4-6 hours, so probably won't leave you groggy in the morning as some other antihistamines can. But don't exceed the recommended dose as it may affect the rate at which paroxetine is metabolized (your GP should have factored this in).

[JHR]

Unfortunately, antidepressants (ADs) often worsen anxiety at the beginning due to an increase in serotonin activity. The side-effects should diminish within a couple of weeks as bio-feedback mechanisms respond by reducing serotonin synthesis and expression.

Starting on a low dose, no more than 10mg for immediate-release tablets or 12.5mg for slow-release, and increasing the dose at 7 day intervals often reduces the side-effects to tolerable levels. A few may need to start on an even lower dose.

Apart from that it's a matter of treating the side-effects symptoms. Ginger and/or vitamin B6 for nausea, loperamide (Imodium) for diarrhea (check with your GP or pharmacist before taking it), etc.



Chlorphenamine is a sedating antihistamine which should help with SSRI induced insomnia. It has a short range of effectiveness, 4-6 hours, so probably won't leave you groggy in the morning as some other antihistamines can. But don't exceed the recommended dose as it may affect the rate at which paroxetine is metabolized (your GP should have factored this in).

Oh thank you so much PDU, it feels pretty brutal at the moment she started me on 20mg I am sleeping through the night but its the teeth chattering, the shaking, and the overall tiredness that's worse now, the nausea and upset tummy has subsided.

O

[Catkins]

Hang on in there JHR, it does get easier.

[panic_down_under]

she started me on 20mg

Sigh! On any given day probably 20-30% of the patient's in a doctor's waiting room are really there because of a anxiety disorder and/or depression, often unrecognized, and not the malady they came in for. So you'd think GPs would have a better understanding of how to start patients on ADs and also take the time to explain how they work, the likely initial side-effects and what to do about them. A good 'bedside' manner does not involve treating patients like mushrooms!

I am sleeping through the night but its the teeth chattering, the shaking, and the overall tiredness that's worse now, the nausea and upset tummy has subsided.

It does get better and often quicker with paroxetine due to its short half-life. If it gets too difficult I urge you to see your GP asap to either get the okay for a dose reduction to 10mg for a week or so, or another solution if she has one.

[JHR]

Thank you so much PDU, I'm not holding my breath but I think I'm beginning to see a slight improvement. Do you know if it's OK to take omozeraple for acid reflux with these meds my appetite decreased somewhat over the last week and it improved yesterday but started a bit of reflux up

[panic_down_under]

Do you know if it's OK to take omozeraple for acid reflux with these meds

There don't appear to be any drug interaction issues with omeprazole and paroxetine. If these weren't prescribed by the same GP let both know the next time you see them.