Cross-taper from Paxil to Lexapro, progress reports

[soManyProblems]

I am 28 years old, and I have been on Paxil (paroxetine) since I was about 11. I did take a full 6 months off at age 19, it was awful. Not because of withdrawal, but because I really need an antidepressant to address my anxiety.

My psychiatrist and I decided to cross-taper me onto Lexapro (escitalopram). I have looked at a lot of the scientific literature, Lexapro does especially well in head-to-head trials of antidepressants. Several psychiatrists have said Lexapro and Prozac (fluoxetine) are their favorites.

I am on Day 5 now. I am still taking 40 mg / day of Paxil, as two divided doses, but I am also taking 2.5 mg of Lexapro at night. The first two days were hard, lots of nausea and a general feeling of being unwell and uneasy, but now I feel normal again.

I hope the Lexapro suits me better than Paxil, because I need to be at least a little more healthy, both mentally and physically.

[soManyProblems]

I took my cross-taper to the next step: 5 mg per day of Lexapro (all at night) and I decreased Paxil from 40 to 35 mg per day (as two divided doses). The result? I slept 16 hours two nights ago, and I slept 14 hours last night. I hope and suspect that I will gain tolerance to the sedative effects.

[Anne1221]

The Lexapro alone makes me tired. If I was taking two SSRI's, I'd really sleep a lot too. Do you plan to eventually take
lexapro alone?

[HockeyRules]

I took my cross-taper to the next step: 5 mg per day of Lexapro (all at night) and I decreased Paxil from 40 to 35 mg per day (as two divided doses). The result? I slept 16 hours two nights ago, and I slept 14 hours last night. I hope and suspect that I will gain tolerance to the sedative effects.


That's a lot of Paxil...lol. I'd taper more the lexapro direction if that's your goal. Paxil at 20mg would knock me down....I can't imagine 40mg......but maybe you were on them a lot longer than me too. Hope all goes well !,

[Ritch]

My father has had great results with lexapro, I hope it has the desired effect :)

[soManyProblems]

I am now on the third step of my taper:
30 mg Paxil per day
7.5 mg Lexapro per day

I am planning (and hoping) to completely eliminate the Paxil.

Things are going okay. Apart from the original drowsiness on the Lexapro, which has worn off, I am not sure if I notice anything. My anxiety has been a little better than average, and my nausea has been a little worse than average. However, this is all within the margin of error.

[soManyProblems]

I am still on Step Three:
30 mg Paxil
7.5 mg Lexapro

Things seem to be going okay.

[Anne1221]

I hated Paxil and I love Lexapro. All of the pharmacists I talked to said Lexapro was a "newer, cleaner drug" and it has less side effects than other SSRI's.

[soManyProblems]

Paxil is one of the worst antidepressants on the US market, and Lexapro is one of the best. Most psychiatrists agree with this, especially the ones who read scientific literature often.

Paxil is not actually an SSRI, which stands for selective serotonin reuptake inhibitor. Paxil also inhibits the reuptake of norepinephrine, making it non-selective. Paxil also has a very short half-life which is really not suitable for once-daily dosing. And for whatever reason, Paxil has just about the worst withdrawal.

Lexapro is a pure SSRI, and it often wins in head-to-head trials against other SSRIs and antidepressants from all classes. Lexapro is more potent and has fewer off-target side effects.

The only "SSRI" that is worse than Paxil is probably Luvox, which is very low potency and has tons of off-target side effects. However, Luvox has novel metabolism and drug-drug interactions in the liver, so there might conceivably be a place for in the arsenal.

[Anne1221]

Plus, Paxil made me gain weight, not good. And it was terrible getting off of it! The only other one that was killer for me to get off of was Effexor. I had to open the capsule and go down by beads, all the way down to one bead! The Lexapro makes me feel fatigued, and I have thought of trying Zoloft, but everyone says Zoloft would probably make me feel just as tired. I don't know though.

[soManyProblems]

I am now on Step Four:
25 mg Paxil
10 mg Lexapro

I am not sure, but I think my anxiety is better now that I am on Lexapro. However, I am fairly certain it is causing headaches. I get so much nausea all the time that it is hard to tell, but I think the Lexapro may cause some nausea too.

I really hope the headaches wear off, but if I keep upping the dose (which is the plan), that might not happen for a while.

Huge note: Thus far, I have gone down from 40 mg to 25 mg Paxil per day. I have done that many times in the past. It was much more pleasant this time, the Lexapro really blunts the Paxil withdrawal. I haven't felt any Paxil withdrawal, except perhaps the headaches, which might be caused by the Lexapro itself. Normally Paxil withdrawal is pretty harsh.