Posted by bleauberry on June 11, 2008, at 14:55:24
In reply to Paxil CR., posted by MattSanz on June 10, 2008, at 20:13:47
Just wanted to comment that your doc is wrong about having to come off paxil for 4 weeks before starting zoloft. Kind of makes me wonder about his/her fluency with psych meds. Anyway, you could do one of several things.
One would be to do a cross taper. Cut the paxil in half and add in about 6mg zoloft to start (cut the pill in approximate chunks). Cut the paxil down a bit more and raise the zoloft another 6mg. Keep at it until paxil is gone, then begin the journey to your target dose of zoloft. The purpose of adding in zoloft at very low doses is to help minimize the withdrawals of paxil, and yet avoid serotonin sydrome at the same time.
Another method would be to wean off paxil over a period of several weeks. After it has been completely stopped for 2 days, start zoloft. This will likely involve some difficult paxil withdrawal symptoms. As soon as zoloft is started those symptoms should ease significantly.
With either of these approaches, there will be paxil withdrawals, there will be brain readjustments to the lack of paxil, there will be start-up side effects to zoloft. No way to predict, but the whole switch could go amazingly smooth or it could be a rough ride.
In any case, a 4 week wash out of paxil is, well, absurd. As an example, the drug that stays in your body the longest is prozac, with a halflife of about a week; and the most dangerous drug to start after prozac would be an maoi. The washout time for that switch is 4 weeks.
Generally a couple days to a week is all the washout needed, though you can avoid one completely by doing a modest crossover taper.
poster:bleauberry
thread:834059
URL: http://www.dr-bob.org/babble/20080606/msgs/834185.html