Need advice regarding medication

[Bilo]

Hi everybody :-),

I hope someone here can help me. My fortune (which is basically a computer, 2 jeans and a half eaten snickers) to the one that can help me. I will try to keep the story short:

I am a man of 35 years old . I have taken Seroxat (paroxetine) for 15 years now against an anxiety disorder. The last 10 years 20 mg and last 10 months 15 mg (so a pretty mild dose for anxiety). In my opinion i am one of those persons who will need it for the rest of his life. Because I always lived in fear,..as a baby, infant, toddler and young grownup. So its a part of me.

Now last 3 months after 8 years of living rather stable I once again suffer from panic attacks and anxiety. On the advice of the psychiatrist I switched to Lexapro. A start-stop principle. So one day I took 15 mg of paroxetine and the next day i took 10 mg lexapro.
This is now three weeks ago and my life is a hell. I feel very sad all day, anxious, angry, my body temperature is weird, very cold and very hot the next hour. I am very shaky and dizzy. I feel like i I live in a dream, like i watch a movie and can not tolerate noise or light. Really HELL. I take each day 1 alprazolam now, but I'd rather not because I am afraid it will be an addiction pretty fast.

I doubt now what to do and I want your advice. my questions:

1.) Although the psychiatrist said so (may he burn in hell), its clear to me that you can not suddenly change from one SSRI to another SSRI without having withdrawal problems. You still get withdrawal symptoms from the one you quit and problems from the one you started with. Especially after 15 years use. Does anyone have experience here? Anyone ever switched after a long time to another SSRI?

2.) I can do two things, or wait and pray it will get better or go back to the Paxil ( Seroxat) and take a higher dose. Only I'm afraid I might, after 15 years have developed a certain tolerance against paxil. You read very often that some antidepressants can not be taken more than 12 years cause tolerance hits in. I dont know if thats why i got problems again in the first place. (could also be i had probs cause i was tapering from 20 to 15 mg). Anyone experienced this before?

3.) I really feel like I'm living in a dream world. It's really scary. Could this by cause of stopping the Seroxat or is it origine in starting with lexapro?

Any form of support, assistance, advice, answers, etc. is much appreciated. Because I feel without hope. Which is the worst thing in life

Thanks

[Ziggy925]

IMHO I don't think anyone can answer your questions because everybody reacts differently to different meds in different doses. I have heard of people switching over to another SSRI with no problems, so I think it can be done. Again, IMHO, I think what you need to do is when you talk to your doc ask him how it's worked for other patients. At least you'll know whether he's experimenting on you, and I'm not saying that's a bad thing. You just want to know expected outcomes.

Hang in there. Just remember that whatever you are feeling is some kind of chemical imbalance and you are not going nuts. You will feel better!!!

[foxyboy]

sure switch straight over ssri to ssri thats the american way for years

[alankay]

Bilo, I feel for you. Yes you can switch directly but paxil is kind of known to have a nasty discontinuation syndrome. Rest assured it will pass in time. I switched from prozac to zoloft then to celexa and now lexapro(right from one to the next) with no problems except for stopping the prozac after taking it from 1992 to 2010. Brain zaps, felt weird but no as bad as you do. It faded away in a few weeks. Prozac is easy to stop because it has a super long half life, paxil does not and that's why discontinuation is hideous. Paxil also has a stronger action on serotonin.
I have a couple suggestions.
1. Return to paxil at the lowest dose you feel "OK" on and then do a slower taper down(at least a week between dose reductions minimum). The main reason you feel so bad is the absence of paxil(withdrawl) when you had it soooo long. 10mg lexapro is right and you'd likely feel even worse without another ssri at all. Imagine that! Having said that I don't know how low you could go before adding/switching to lexapro but that would be the basic scenario. Taper slow to the transition. They may have a liquid available(they do here) to do a super fine gradual taper down.
2. Common here is the US is the switch from paxil to the super long half life ssri fluoxetine(prozac). Celexa/Lexapro also have a long half life but not as long as prozac(fluoxetine) so prozac might be an option and I read is what is often tried here to help with paxil withdrawl as well as taking alprazolam or other benzo at night for sleep. A longer acting benzo might be safer with regard to dependence but to be clear the use of the benzo will be just to help you get through the hideous pazil withdrawl. You have to take benzos for a while for dependence to develop but your concern is justified, but not fear in your case. Use the benzo to get through the rough parts knowing you gonna stop it at some point soon. You need to get some relief from the suffering you're in but at the same time we all need to tolerate what we can as anxiety suffers. Hang in there and message me if you'd like.

[alankay]

Bilo, I've also read that Theraflu helps allot with paxil discontinuation symptoms. I guess it called Lemsip in the UK but suppose(hope and pray) they have an equivalent in Holland.