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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 4 of 4. This is the beginning of the thread.
Posted by Janelle on October 12, 2001, at 23:00:05
I added Paxil back to my med mix and after reading a post further above about Lamictal and Effexor, which is an SRI, I'm now wondering if Paxil (SRI) and the Lamictal I'm on (100 mg/day) is too much?
I'm feeling increasingly lightheaded, spacey, cannot concentrate on even the simplest things (like TV shows!) and am very anxious about feeling this way. I also find myself repeating certain things over and over (like brushing my teeth) to be sure I'm actually doing them, to get myself to *remember* doing them.
I want to remain on the Paxil, as it has done wonders in the past for my depression, social anxiety, ruminating thoughts, etc., but I'm no longer sure about the Lamictal. Could the addition of Paxil somehow be affecting the Lamictal, and the combo is too activating? I'm not even sure I'm expressing this correctly. HELP! Thanks.
Posted by Ozzy on October 13, 2001, at 1:05:19
In reply to HELP! I feel HORRIBLE ..., posted by Janelle on October 12, 2001, at 23:00:05
> I want to remain on the Paxil, as it has done wonders in the past for my depression, social anxiety, ruminating thoughts, etc., but I'm no longer sure about the Lamictal. Could the addition of Paxil somehow be affecting the Lamictal, and the combo is too activating? I'm not even sure I'm expressing this correctly. HELP! Thanks.
Hi Janelle,
I understand you perfectly because i'm experiencing a similar situation. I take Effexor XR + Lamictal and God it is stimulating... As i said before on this board, Lamictal acts indirectly on dopamine and can become highly "activating" with an antidepressant. Or may be you simply experience a bad synergy from Lamictal and Paxil together? Anyway i suggest you call your pdoc for an ajustment. And it would be a very good idea to decrease your Lamictal to 50 mg a day.
My humble opinion!
Posted by jay on October 13, 2001, at 5:38:13
In reply to HELP! I feel HORRIBLE ..., posted by Janelle on October 12, 2001, at 23:00:05
Janelle:
I hate giving advise about meds..but I guess that is what this board is about. IMHO..etc..
You mentioned gradually adding small amounts of Paxil at a smaller dose before. Is it possible to go that route instead of the 20mg at first? (Which I assume you have started with.)
When adding and subtracting meds, I find only doing it in small doses helps determine better what med is doing *what*. Also, stopping any med really quickly is of course not advised.
Try your dose adjustment slowly...I know the side effects are much easier, umm, said than done, but you might get a better awareness of what is and isn't working.
BTW...can you get a benzo to help you with weaning on to the Paxil? That may help overall, too.
Hang in there...it is all not permanent. (Again..easier said then done..heh.)
Jay
> I added Paxil back to my med mix and after reading a post further above about Lamictal and Effexor, which is an SRI, I'm now wondering if Paxil (SRI) and the Lamictal I'm on (100 mg/day) is too much?
>
> I'm feeling increasingly lightheaded, spacey, cannot concentrate on even the simplest things (like TV shows!) and am very anxious about feeling this way. I also find myself repeating certain things over and over (like brushing my teeth) to be sure I'm actually doing them, to get myself to *remember* doing them.
>
> I want to remain on the Paxil, as it has done wonders in the past for my depression, social anxiety, ruminating thoughts, etc., but I'm no longer sure about the Lamictal. Could the addition of Paxil somehow be affecting the Lamictal, and the combo is too activating? I'm not even sure I'm expressing this correctly. HELP! Thanks.
Posted by Chloe on October 13, 2001, at 16:01:46
In reply to HELP! I feel HORRIBLE ..., posted by Janelle on October 12, 2001, at 23:00:05
Janelle,
Since Lamictal is working as an AD for you, it seems clear that you don't need so much Paxil. All you need is enough Paxil to hit those specific serotonin receptors that Lamictal doesn't, and to get some of the antiobsessive qualities. In order to do this, it seems like 20 mg is too large a dose.You are on a "cocktail" now. So no one agent is your antidepressant. So you might not need a full dose of any of them, or more of one, less of another. It gets tricky with cocktails, but you will find the balance.
I think you also mentioned that you take Zyprexa. That also can have antidepressant qualities, esp when mixed with an SSRI. So try to be patient, and get a hold of your pdoc. It's my impression that you need the smallest amount of Paxil, perhaps 10 mgs or less to augment your regime.
As I told you, when I reinstated my 2 mg of Celexa with the Lithium I take, I had a racy type feeling for a day or so. Then I decreased the dose to 1 mg and that seems to be a good amount for me now. And if this is totally intolerabe, Jay's idea of briefly adding a benzo might not be a bad idea. Though I think you have enough meds on board at the moment. You just haven't found the right dosages of each yet.
Try to hang in there. And give your body time to adjust. You have been off Paxil for a while...
Chloe
This is the end of the thread.
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