When Do I use Paroxetine/Paxil
Рет қаралды 3,767
2 жыл бұрынThis is the final video in the series on how to select an SSRI. In this video we will talk about paroxetine. This is not my favorite option and I will explain why this is a medication I mostly stay away from in clinical practice.
Find additional content see our other social media accounts:
www.Shrinksinsneakers.com
Facebook: @ShrinksInSneakers
Twitter: @AndPsychiatry
Instagram: @Shrinks_In_Sneakers
Disclaimer: This is not medical advice, and the information is provided for educational purposes only. Please consult your doctor for any specific medical questions.
All content is created for informational purposes only. The Content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider. If you think you have a medical emergency, call your doctor, go to the emergency department, or call 911. We do not endorse any specific treatment, tests, or procedures. Reliance on this information is solely at your own risk.
@niag7273 2 жыл бұрын
I love Paxil .. it saved my life in highschool the little time I took it. I look forward to getting back on
@ShrinksInSneakers 2 жыл бұрын
Right, this video is not to completely dismiss the value of paxil. As I said at the beginning of this series, from efficacy standpoint it's just as good as other SSRIs, but there are more side effects and downsides to paxil for the same efficacy as other medications that do not have these issues. But if it worked I will generally continue it for a patient
@nikkinghk 2 жыл бұрын
I put on 25 lbs within 5 months on Paxil for depression from chronic pain. Stopped cold turkey and was dizzy for a couple weeks. It didn't help with my depression either. Thank you so much for your informative videos.
@ShrinksInSneakers 2 жыл бұрын
sorry to hear it did not work out, it's not my favorite choice
@benjamintausheck6368 2 жыл бұрын
You had me fooled there for a second saying you loved Paxil XD. Great vid as always. I like the fade in of the text
@ShrinksInSneakers 2 жыл бұрын
appreciate the support, not too much paxil in my practice lol
@benjamintausheck6368 2 жыл бұрын
@@ShrinksInSneakers I actually just got a patient on paxil 20 mg QD for the last 6 months. Anxiety, panic with agoraphobia, and depression still not controlled. I was thinking of starting her on Lexapro or fluoxetine after labs come back and then titrate up till I get symptom control and then start weaning off paxil. Does that sound reasonable? No manic or psychotic symptoms. Past traumas but no PTSD.
@ShrinksInSneakers 2 жыл бұрын
@@benjamintausheck6368 sounds reasonable, I like lexapro in this case as clinically I think the anxiety symptoms will respond well to this medication. Maybe consider doing CBT with the patient as well if you can fit it in
@jatinsharma5024 2 ай бұрын
@@ShrinksInSneakersHi sir , I have tried many SSRI's for ocd but all of them decreases libido So is there any medicine which we can add to cancel out that side effect.
@marieb9961 6 ай бұрын
You are the best
@akimiirka 2 жыл бұрын
Hey! Thank you for the video. I Guess i've been one of luckier ones, been on paroxetine and depakote combo for bipolar for years now fairly successfully. However thank you for the info on tough withdrawals. My doc decided to do a 180 and put Me on a 600mg/day dose of Quetiapine stopping the previous meds cold turkey. So i'm searching for a second opinion and your info also assured Me that i'm correct in my worry here. Have a good day !
@ShrinksInSneakers 2 жыл бұрын
Appreciate the comment and I'm glad I could be of service
@annettediggs7130 2 жыл бұрын
Yeaaaa. I have to agree doc. It is my least likely to prescribe. Reasons I prescribe 1. Tone down sexual preoccupation 2. Sleep impairment with depression/anxiety 3. Vasomotor tx for peri menopausal women. Def don’t like it for my ADHD people. My #1 SSRI for anxiety is Prozac/not depression but anxiety for sure. I love the researched lit ….I must watch more videos
@ShrinksInSneakers 2 жыл бұрын
Agreed and I appreciate your reasoning for avoiding this medication, although I must say I recently tried it with a patient for a number of reasons but I usually avoid it. If you haven't subscribed please do and spread the word about what we are doing here .
@Viralvediosandthug Жыл бұрын
What do you think pristiq and Wellbutrin combo? My doctor suggested me to add Wellbutrin with pristiq which I have been taking since 1 year
@milanic7267 4 күн бұрын
Is it better to drink paxil at bedtime instead of during the day? thank you
@amits169 2 жыл бұрын
Two leading and experienced psychiatrists said to me that paxil is the most effective ssri for ocd in their experience (and the second most effective med for ocd after clomipramine). What do you think?
@ShrinksInSneakers 2 жыл бұрын
Every clinician will have their go to medications that they believe have demonstrated superior clinically efficacy. If we are talking about the literature, then I do not think the data from clinical trials supports this. However, clinical trials are not real life and there are many factors that determine which medication will be effective and in which patient. I do not see an issue with using either of the two medications mentioned here for OCD.
@vedatzorro 6 ай бұрын
I was taking 4 months paroxetine 20 mg but my symptoms not stopped. My doctor said go 30 mg. But after increasing dosage my anxiety increased. Is this possible and how many days continue?
@celticwarrior5646 2 жыл бұрын
Hi,would be interested in if you have any thoughts on the link between anxiety disorders and allergies,asthma,colds and flu and now Covid 19. Cheers.
@ShrinksInSneakers 2 жыл бұрын
let me do some research on the topic, with COVID-19 this is an important topic
@bluegrass571 2 жыл бұрын
Interesting video. I was on Paxil CR for years and found it helpful, but hearing about the risk of dementia is scary. I switched to Prozac to come off and that seemed fine. I guess perhaps it’s now obsolete and of course you would know more about what medications were available when, but perhaps it was useful as a more sedating alternative to Prozac early on in the SSRI era? Btw, I love your videos. I find them very interesting and I love hearing about all the latest psychiatric treatment research. Since you seem fairly early on in your career, you offer a great perspective that I haven’t heard before. Keep up the good work!
@ShrinksInSneakers 2 жыл бұрын
I appreciate it, thank you for the support and I will keep working to provide good information
@MongoJerryilluminati 2 жыл бұрын
Hi hope your keeping well do you think you can do video on mirtazapine and serteraline , mirtsetrozone I came up with that name combined together
@ShrinksInSneakers 2 жыл бұрын
From a neurotransmitter perspective the combination can make sense as sertraline targets both serotonin and dopamine believe it or not. Then you add the mirtazapine in to target norepinephrine and you have targeted all the major neurotransmitters thought to be involved in depression. There is also a theory that you target specific symptoms with different medications (e.g. sleep and appetite issues with mirtazapine) I will work on it
@MongoJerryilluminati 2 жыл бұрын
@@ShrinksInSneakers hi there thanks for the response hope you liked my name for the combustion I'm surprised to hear that seteraline effects dopamine as I thought it was just an ssri drug but I guess it makes sense, to be honest combined two with mirtazapine are great I can even have sociable drink without being hungover or feeling down, great choice of meds like you said mirtazapine effecting two chemicals instead of one. Please do a video on this I'm dying to see it thanks again for the reply
@magmasunburst9331 2 жыл бұрын
I've had a historic good response to paxil. I was off it at about 10 years and then I've been on it again and it seems to have some ability to propel me in professional activities. Can you tell me another SSRI that might be able to cover the ground paxil does in a safer way? I've tried Prozac and fluxoxamine but they don't have the same effect. I have some OCD symptoms with intrusive thoughts and can be very high level functioning but I haven't been as motivated to succeed in those areas lately. I've never been suicidal and usually don't have a kind of nihilistic depression.
@ShrinksInSneakers 2 жыл бұрын
If the goal of treatment is focus and motivation Duloxetine and vortioxetine have good evidence to support their ability to enhance cognitive function. I might place bupropion in this group as well as it has been looked at for the treatment of ADHD. With OCD SSRIs are going to be the better option and require much higher doses and longer duration of treatment. For OCD doses of 300 mg of sertraline have been used and the duration of treatment should be 12 weeks not the typical 4-6 weeks. Hope this helps, if you haven't subscribed to the channel please do, and check out instagram for additional daily content. Spread the word and help us educate and fight stigma associated with mental health treatment.
@wulfsorenson8859 2 жыл бұрын
Did u gain weight ?
@magmasunburst9331 2 жыл бұрын
@@wulfsorenson8859 I take such small doses, what many would be considered sub-therapeutic (I break the smallest size pill available in half), that I do not gain weight. I also take it with a similar sized so-called sub-therapeutic wellbutrin which is supposed to increase the longevity/impact of the paxil. I've studied psychoanalytic psychotherapy as well as work a "spiritual program" (a basic Christian faith but I've also studied a lot of awareness things that in fact were a big part of the Eastern Orthodox) and that has helped in all but the professional motivation.
@magmasunburst9331 2 жыл бұрын
@@ShrinksInSneakers Thanks. I will. You might be interested in the books published by Telical Books. They try to help resistant populations with balanced books on the combination of spirituality and psychology from a Western point of view rather than one heavy on the Eastern religion and pop awareness based psychotherapy (its more classical Western psychodynamics).
@ricdynasty Жыл бұрын
I’ve been on this medication for 13 days and I don’t like it. I initially started taking 10mg at night, per my psychiatrist recommendation. But I wasn’t sleeping well at all and would often wake up panicky with a racing heart. I switched to taking it in the morning but that makes me feel tired throughout the day. I was on 10mg for week one and 20mg for week two. I have no desire to do anything but hang out at home, and I feel like this medication has killed my appetite and libido. I asked my psychiatrist if I could switch to Sertraline but she declined and said that I should remain on this medication until our next appointment (Sept. 23rd). Today is day 14 of taking the medication and I skipped my dose this morning. I don’t want to take it another week.
@ShrinksInSneakers Жыл бұрын
I would talk with your doctor about the concerns you have. I appreciate the comment, if you haven't subscribed to the channel please do and spread the word about what we are doing here
@niag7273 2 жыл бұрын
What’s another medication that is extremely similar to Paxil? As far as helping with anxiety goes
@ShrinksInSneakers 2 жыл бұрын
Anxiety responds well to several medications, I like escitalopram and sertraline as well. I also like CBT an underutilized and highly effective way to treat anxiety
@davidsickel9531 Жыл бұрын
Dr. Rossi I have been taking paxil since 1998 for depression/anxiety. I am now looking to transition to either Viibryd or Trintellix as I am a 52 yo gay male and want the lowest side affect profile. Do you any studies that I can read that would inform me about the long term affects of taking paxil for 20 years ? Thank you David
@ShrinksInSneakers Жыл бұрын
What we know at this point is these medications are safe and there is a lot of data on them. The debate about the long term use of SSRI medications depends on the view of the doctor prescribing. Usually patients end up taking antidepressants long term after 3 more major depressive episodes as the risk for further episodes is very high. The big thing to watch out for with short half life medications such as Paxil is the withdrawal symptoms associated with stopping the medication. A cross tapering approach where you begin decreasing one medication and slowing increase the new medication might be required to avoid this problem. Check out my videos on the two medications you listed I covered them in great detail and the side effect profile is considered to be better than the SSRIs. Check out the other videos on the medication you listed and if you haven't subscribed to the channel please do and spread the word about what we are doing here.
@davidsickel9531 Жыл бұрын
@@ShrinksInSneakers I definitely watched the videos on both Viibryd and Vortioxetine and I have subscribed and shared with friends!
@ShrinksInSneakers Жыл бұрын
@@davidsickel9531 Thank you appreciate it
@davidsickel9531 Жыл бұрын
@@ShrinksInSneakers You are very welcome!
@baziniabdelfattah6423 10 ай бұрын
Depends on my experience paxil only ssri has lower sexual side effect. And helps me with erecile arousal
@Deba7777 2 жыл бұрын
Thank you for this good info, doc. My adult daughter has been on this for years & wants to get off it, but is afraid of the withdrawal effects; interested in how you would do that & over what space of time. Thank you!
@ShrinksInSneakers 2 жыл бұрын
This is not medical advice and you should always talk to your doctor before making any changes. I think the answer to your question is it depends. Some patients can tolerate a rapid taper others need to do so over a long period of time, and still others can just stop with no taper. As you can see it depends on the person. In clinical practice we always taper if someone wants to come off medication. The most basic taper would be something like a 50% reduction in dose for 3 days followed by another 50% reduction, and so on until the medication is stopped. This is a very basic example and may not work for everyone, in some cases patients require a conversion to fluoxetine which has a very long half-life and is easier to taper off. Hope this helps, if you haven't subscribed to the channel please do, and spread the word about what we are doing here. We also have daily instagram content @Shrinks_In_Sneakers
@Bomb1st78 Жыл бұрын
He’s right Prozac is the way to taper from Paxil because of its long half life.
@Torieollivette Жыл бұрын
Is it something in the pill that causes weight gain or poor diet
@ShrinksInSneakers Жыл бұрын
This is not medicinal advice; I'm not your doctor and you should talk with your doctor before making any changes. This information is for educational purposes only. Weight gain can the result of both. The medication does have some risk of weight gain which can be managed with diet and exercise in most cases. Hope this helps
@Torieollivette Жыл бұрын
@@ShrinksInSneakers ok so if I’m already naturally slim and I eat pretty clean do you think I’ll be alright
@ShrinksInSneakers Жыл бұрын
@@Torieollivette I could not say, but it sounds like you are doing all the right stuff. Best of luck and thanks for watching and commenting
@rubywolf1239 2 жыл бұрын
Video request: treating bpd with medication
@ShrinksInSneakers 2 жыл бұрын
Bipolar correct, or are we talking about borderline personality disorder?
@rubywolf1239 2 жыл бұрын
@@ShrinksInSneakers Borderline
@ShrinksInSneakers 2 жыл бұрын
@@rubywolf1239 In short mood stabilizers, antipsychotics, and antidepressants have all been used with some data to support their use. The best option is a mood stabilizer as this has the most evidence for affect regulation and reducing impulsive behavior. I still think DBT and psychotherapy are essential and should not be underestimated. I will do a video breaking down the use of the various class of medication to target specific aspects of borderline PD
@Coldlegend214 2 жыл бұрын
I'm about to start Paroxetine for my serious anxiety and panic attacks that don't let me leave the house and happen in house too. but now I'm thinking twice. any other recommendations? please 🙏
@ShrinksInSneakers 2 жыл бұрын
I like most SSRI medications with the exception of paroxetine and fluvoxamine. My go to medication are sertraline, and escitalopram for many reasons (I have a bunch of videos talking about the specifics). Hope this helps, if you haven't subscribed to the channel please do and spread the word about what we are doing here.
@Coldlegend214 2 жыл бұрын
@@ShrinksInSneakers thank you so much that helps so much you have no idea
Psychofarm
Рет қаралды 20 М.
Bob & Brad
Рет қаралды 95 М.
Heather Hirsch MD, MS, NCMP
Рет қаралды 5 М.
Shrinks In Sneakers
Рет қаралды 56 М.
Forbes Breaking News
Рет қаралды 1,3 МЛН
Alternative to Meds Center
Рет қаралды 7 М.