Posted by Cam W. on November 1, 2001, at 18:46:45
In reply to Re: 4 Weeks off Effexor, posted by BobS. on November 1, 2001, at 18:11:37
Bob - Ask your doctor about giving you 2 to 4 weeks of Prozac™ 10mg (or generic fluoxetine 10mg). Decrease your Paxil to as low a dose as comfortable, then add the Prozac 10mg in the morning. Take the two SSRIs together for a week or two (depending on the severity of the Paxil symptoms you have experienced in the past), then stop the Paxil. Continue the Prozac 10mg for another week or two and then stop. If withdrawl symptoms return after stopping the Paxil, have your doctor raise the Prozac dose to 20mg (2x10mg) for a week, and then decrease to Prozac 10mg for another week.
Because of Prozac's long half-life and active metabolite (desmethylfluoxetine - aka norfluoxetine), this SSRI should leave the body slow enough not to cause any withdrawl symptoms.
Personally, I have seen the most problems with the regular Effexor, with it's 5 hour half-life. I have seen one elderly gentleman go through mini-withdrawls every night, because the pharmacy had given him 37.5mg regular tablets and not the XR capsules.
Paxil's cholinergic rebound can be troublesome in some people withdrawing from it. It can mimic some of the symptoms of serotonin withdrawl (eg sweating and tremor). If this is the case, your doc may have to give you a low dose (0.5mg to 1mg/day) of an anticholinergic like Cogentin™ (benztropine) or some other similar drug and withdraw from one effect at a time.
I hope that this is of some help. - Cam
P.S. Perhaps, print this out and take it to your doctor.
poster:Cam W.
thread:13781
URL: http://www.dr-bob.org/babble/20011025/msgs/82918.html