Re: Worse before better on paroxetine?
Originally Posted by
jonjon
I was on pristiq for 6 weeks at 100mg but it just made anxiety much worse. Was a bit better for depression.
Was on lexapro for 6 weeks also starting at 10mg and working up to 20mg but had the same results as the pristiq.
The MAOI was parnate for 7 days. I felt really hyped up and there was no way I could continue.
I was on nortriptyline for about 2 months at low dose 10mg but didn’t do much and amitriptyline couldn’t go past 30mg because of sedation. Again I wasn’t on this medication very long.
As I suspected you were never on any of these either long enough, or at a high enough dose of some to get a therapeutic response.
I find it 'interesting' that you were prescribed 3 TCAs, but not imipramine (Tofranil) which was the 'gold standard' panic disorder AD for decades before the SSRIs hit the market and bewitched psychiatrists and GPs with promises not all could keep.
Also tried deptran for about a week but stopped due to abnormal aggression. Very strange for me as I’m pretty peaceful.
Very strange indeed as despite the claims doxepin (Deptran) is only a powerful antihistamine, not an antidepressant. If 30mg amitriptyline was too sedating then doxepin should have rendered you comatose. But all these meds can be very unpredictable. It all comes down to how they mesh with individual biology
Regarding paroxetine dose I can only guess that the 10mg is upping my serotonin because of all the increase anxiety/depression (side effects?)
Serotonergic ADs increase serotonin activity within the first hour of the first dose. The fact that this often makes anxiety worse is one of the clues that anxiety and depression aren't caused by too little serotonin as popular mythology claims. Fortunately, after a few weeks bio-feedback mechanisms kick-in to significantly down-regulate its synthesis and expression in areas of the brain that manifest anxiety and the heightened anxiety and other side-effects then usually diminish.
On another note I’ve seen online that there is a slow release version of paroxetine that might help reduce the start up anxiety. I wonder if anyone has had luck with that vs immediate release?
Give it a try if you can get it prescribed, but there's no guarantee that it will reduce the severity of the initial side-effects. If paroxetine proves successful then you should take a slow/extended-release formulation to avoid any potential yo-yo effect as the med enters and drops out of your system.
I really hate the fact that anxiety is a side effect for an anti anxiety medication. Grrr
Who said the gods don't have a sense of humour?!
Not really sure what to do but looks like I’ll be sticking to 10mg as I’m frightened of heightening my anxiety and depression. Thanks
Unfortunately, you need to break eggs to make an omelet. I urge you not to remain on 10mg indefinitely as it will likely cause the med to poop-out.
__________________
The opinions expressed above are based on my observations and, where applicable, interpretation of cited data and are general in nature. Consult your physician before acting on anything stated.