Paxil Stop Working?
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I have been taking 30-40mg of Paxil daily for the past 8 months. I have experienced great success unil recently. The past several weeks some hopelessness and depressed thoughts have come back. Is this common after 8 months of antidepressant therapy. I did get good therapeutic value from Paxil at first. I cannot increase my dose due to sleepiness. There have been no events in my life to cause this change. Any insight into this would be valued.
Answer:
I take Paxil with a combination of Serzone. Sometimes instead of quitting or higher doses, combinations may solve the problem. Just a thought. i recently found an old email i sent to an online shrink wherein i reported precisely the same thing. i HAD, however, just quit smoking so there were other factors affecting my mood than just the paxil alone. insofar as i can isolate the situation however, i experienced a similar downturn while on paxil 30 mg/day. I've tried quite a few anti-depressants since 1994. I started with fluvoxamine (Luvox), then nortriptyline (can't remember brand name), then I was hospitalized, then I was put on paroxetine (Paxil), then when that stopped working, I was put on venlafaxine (Effexor) which worked but I had bad gi side effects. After my depression got better for a while my doctor took me off the Effexor. When I started getting depressed again I tried taking Effexor again but couldn't tolerate the side effects and the worsening depression at the same time. So then my GP put me on sertraline (Zoloft) on the recommendation of a consulting psychiatrist. However, even when I eventually got up to a therapeutic dose, my mood was still bad. My depression is fairly atypical in that I am hypersomniac (14-18 hours of sleep per day) and I lose my appetite. For me, 200mg of Zoloft meant I was awake for 16 hours but in a terrible funk. I found myself wishing that I could go back to the oblivion of sleep. The turning point for me was when I got in to see a psychiatrist a friend had recommended and he added 250 mg of divalproex sodium (Epival) twice a day. Epival (it has a different brand name in the States), is used in the treatment of epilepsy. However, it is also used instead of lithium to potentiate the effects of the SSRI. I haven't had any side effects on this combination and I haven't felt this normal in years. Given my past history however, it is possible that my body will get used to this combination after about a year or less. I haven't heard of any other unipolar people on Epival so I expect it's a fairly new treatment. Anyway, the point of this long post is that I don't think it is uncommon for medication to stop working. I believe (but don't quote me on this) that there are many types of serotonin which is why there are different SSRIs.
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