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Re: depressed again and I'm scared !

Posted by JohnL on October 26, 2000, at 5:41:36

In reply to Re: depressed again and I'm scared !, posted by Amo on October 25, 2000, at 20:29:18

> Still feel lousy! I've been taking paxil for 6 weeks-the 40 mg for a week now-and still feel miserable. I'm considering changing, perhaps to effexor. Has anyone had success with this drug after being treated with an SSRI? If so what was your experience? Did you completely taper off the SSRI before you started the effexor? Any comments would be very helpful! Thanks folks.

Amo,
So sorry. Six weeks is a long long time when you're not feeling better, isn't it? I think two weeks would have been enough to make some kind of judgement. There should have been at least a hint of improvement by then IF the medicine was going to work. But at six weeks, you've definitely given it a fair shot.

Effexor could be a good choice, because unlike the SSRIs it will provide some action on norepinephrine and dopamine, not just serotonin. In clinical studies, Effexor does have an edge statistically for treating depression and treatment resistant depression over the SSRIs. You won't need to do a washout. You could start taking a very low dose of Effexor and taper it in, while at the same time taper down the Paxil.

Hopefully Effexor will work better for you. In a worst case scenario, if it doesn't work, then it would probably be best to look at other classes of medicines instead of antidepressants. You could briefly, for example, try Zoloft and then Prozac for about one or two weeks each, just to compare to Paxil, and then choose your favorite of the bunch for a low dose longterm base. Then add to it other things, like Lithium, Zyprexa, Ritalin, whatever. Hopefully Effexor alone will do the job. But if not, it may be time to consider that your symptoms are due to some other chemistry, and that a different kind of medicine will target that chemistry in a way that antidepressants can't.

Hope this is somehow helpful.
John


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