Hello,
Thanks for using Doctor Spring for posting your query.
Paxil is infact one of my favorite medicine to prescribe for anxiety disorder and it works wonders. It has worked with you as well. However its unfortunate that paxil being a SSRI, it has developed sexual problems in you. Restarting the same drug won't be a good option as the erectile problems may reappear. More over even effexor will have to be gradually withdrawn other wise you will have severe withdrawal symptoms like palpitation, anxiety, restlessness, headache and light headedness. It may increase the frequency of panics as well.
The effexor is definately not working for you and you need to change the medicine and in that case mirtazapine would be a good option. In my patients I start mirtazapine at 7.5mg at night and then gradually increase it to 15 mg and it is a good medication for anxiety disorder.
Also along with the medicines I request you to take cognitive behavioural therapy as well. This therapy is taken by either a psychologist or a psychiatrist in which the therapist identifies impaired cognitions (Thoughts) and try to correct them. They are 15-20 min weekly sessions and there should be around 8-10 sessions to help you with your illness.
Hope this helps,
If you have any further query, I would be more than happy to help you.
Regards
Dr. Srikanth Reddy
Patient replied :
I appreciate the advice alot! Im going to see my doctor next friday. Should i keep taking the effexor until then? Or should i stop it now? Also, i was going to ask her about Lexapro. Ive heard great things about it as well.
Hello,
You may continue to take effexor until then. Lexapro is no doubt a good drug but it is again an SSRI and will have the similar side-effects as paroxetine. Hence it may not be the best option for you.
Regards
Dr. Srikanth Reddy.