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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 3 of 3. This is the beginning of the thread.
Posted by Vincent_QC on September 12, 2009, at 14:34:46
Hi Everyone,
It's been a while since I write a message. I'm a little bit more sick than usual, severe anemia and low hemoglobin, so no energy to write e-mails or doing physical things.I have one essential question.
First of all, let me teel you that with or without any AD, i'm already very tired normally, it's linked to the anemia who is not control for now, but I recieve intravenous iron weekly and blood transfusion.
Last july, I was put on the Paxil (10mg for 3 weeks) for uncontroled panic attacks that occurs always while I Was driving my car, at the gym and also when I Was alone at home. All of those panic attacks was linked to my fear of dying of an heart attack, since I had high blood pressure and always a rapid heart beat.
The first thing I notice is that at 10mg day, the Paxil was not enought effective to stop all the panic attacks. I was less anxious by my blood pressure, and I had a lower blood pressure reading from the machine I have... but I had severals side-effects, mostly sweating hands and feets all the times, very sleepy at daytime, a higher mental fatigue, a lack of any interrest and emotion... I had to stop the gym totally and I was mostly of the time sleeping all day long and I was always hungry... I gain more than 15 pounds in 3 weeks... who is not acceptable for me.
I meet my PDoc in the middle of August and he agree to increase my dosage of Paxil to 20mg to have a full blocking effect of my panic attack problem.
I do 2 weeks at 20mg. First thing I notice was that is was very effective for panic attack. I almost recover at 100% from my panic problem. I was still very anxious, general anxiety, I was also very hungry and was eating more and more, even wake up at night to eat... something that I don't do normally.
1 1/2 weeks ago, I call my PDoc just before he leave for a 3 weeks vacation. I explain to him that the Paxil was making me too tired, even if I was taking it at bedtime. I talk also about the weight gain, I go from 208 pounds to 233 pounds in less than 5 weeks, that's a huge amount of weight for me, making me more depress and more anxious. HE say that it was too dangerous for me to continue the Paxil and agree with me and understand my problems...
I ask my Doctor if it was ok to switch to the Cipralex, since I had some left over pills in a sample box. He agree and told me that I will have less craving for food and the same blocking effect of panic attacks at 10 mg day of Cipralex compare to the 20mg of PAxil.
The problem is that I changed to the Cipralex... but it'S not helping at all like the Paxil... the hungry feeling and the physical fatigue continue. I always have moist hands and feets, I sweat even if i'm in a air conditionning place. My blood pressure return to a more higher level and I have more heart palpitations than ever... with sometimes orthastic hypotension, especially when I climb stairs.
Even worse, at 10mg of Cipralex at bedtime, my night sleep is disturb. I have vivid dreams, I wake up more than 6-7 times by night, so at daytime I feel overtired... I agree that I have less side-effects than on the PAxil, hard to explain but physically, it's more easier... even if I can't go for a long walk or do anything who ask for physical exercises.
On the Cipralex, I continue to eat like a pig, I can't control myself and I continue to gain weight...worse of all, the panic attacks return... not to the state I was in june, but I have often panic attacks while I drive my car and when i'm in a social situation.
I admit that the Paxil was better to covering the social anxiety and the panic attacks overall, but was worse for the side-effects... the fatigue especially, mentally...
I have to mention that on both meds, I use a lot of Benzo drugs. I have a RX of 8mg of Rivotril (Clonazepam) /day, but I use only 4-5 mg maximum. The clonazepam is not enought strong by itself to stop my panic attacks... and with or without a SSRI, I don't feel that I can decrease the Rivotril. I continue to feel the craving for it...
So since my PDoc is in vacation for another 2 weeks, I wonder if I can switch to the Pristiq directly?
I have a new bootle of sample pills of Pristiq. I know that the Effexor-xr tend to increase the anxiety at first, especially social and general anxiety, but I can deal with more anxiety for now, what I want is a decrease of my panic attacks and also a decrease of the hungry feeling I always have.... I will maybe just use the 8mg day of Rivotril, insistead of the 4-5 mg I take normally.
The important is the full covering of the panic attack problem. I wonder if the Pristiq is enought good to cover it or not? Since it's new, well it's an effexor-xr upgrade, I wonder if it's good for the panic attacks?
IF so, I was wondering how many days of washout time I have to do to change from the Cipralex to the Pristiq.
Can I just change it directly, without tapering the Cipralex, like I do with the Paxil??? Take before bedtime the Pristiq 50 mg pills and don't think about a serotonin syndrome?
That's my question... if I have to stop completely the Cipralex and wait at least 5 days before begining the Pristiq, is it ok?
I just want some feedback about the way to switch from the Cipralex to the Pristiq and also know if someone have a positives stories of success for his panic attack problem on the Pristiq?
Thanks for any advice!
I appreciate it a lot!
Vincent ;-)
Posted by Phillipa on September 12, 2009, at 21:42:25
In reply to Cipralex to Pristiq (Washout period), posted by Vincent_QC on September 12, 2009, at 14:34:46
Vincent your're back. My pdocs always had me switch right to another ad but some now say wean off. But I've always just started the new ad. Any news on the medical stuff? Love Phillipa
Posted by SLS on September 13, 2009, at 5:44:19
In reply to Cipralex to Pristiq (Washout period), posted by Vincent_QC on September 12, 2009, at 14:34:46
I believe that 5 days is long enough to wait between discontinuing Cipralex and beginning Pristiq. You could probably do a direct crossover like you did between Paxil and Cipralex, but if you are willing to wait the 5 days, you avoid the risk of developing serotonin syndrome. You might need to prepare for a temporary increase in anxiety.
I hope the Pristiq works well for you.
- Scott
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