I'm switching meds from a combo of 40 mg Celexa/40 mg to Paxil to Effexor XR (unknown top dose right now).

Before I switched, we tried to increase my Paxil to 50 mg - so I was on 40 mg of Celexa + 50 mg of Paxil for 2 days. That made me throw up and diarrhea. My pdoc was very worried about serotonin syndrome even before we tried that. So we decided to switch meds.

Fast forward 10 days. I'm now on 10 mg of Celexa, 40 mg of Paxil and 37.5 of Effexor. My anxiety is sky high. My doc told me to go to 75 mg of Effexor before I try weaning completely off the Celexa. (We were going to do the reverse, but my anxiety is spiraling out of control.) I haven't taken the full 75 mg dose yet.

I just threw up again. How can I tell if this is anxiety induced or too much serotonin? My anxiety is making it impossible for me to tell what's rational or not.