Hello
Thanks for the follow-up query.
It is very nice to know that there is an improvement in your health. I have gone through your previous posts as well and we had agreed to continue on paxil as you had mentioned that you cannot come off paxil. However now that you are considering switching paxil then I suggest the first step should be reducing paxil to 10mg and look if it is acceptable. If it is so then Bupropion 150mg and paxil can both be continued. On reduction of the dose of paxil, the side-effects of paxil will also reduce.
If at all the switch is essential then prozac (again an SSRi like paxil) may not be the good option. Yes it's true that its one of the oldest antidepressants, but it has a mechanism very similar to paxil and hence I personally feel, desvenlafaxine (pristiq) . Acting as an SSRI and NRI (serotonine and norepinephrine) it can be more effective than prozac. You may cross taper paxil and pristiq like you may reduce the paxil to 10 mg and start pristiq at 50mg. Then the paxil can come down to 5 mg and pristiq can be increased to 100mg and then in the third step paxilcan be withdrawn.
Hope this helps,
If you have any further query, dolet me know.
Kind regards
Dr. Srikanth Reddy MD
Patient replied :
Thank you very much indeed .
If we restrict the sloution between Paxil and Prozac since we do not have Pristiq in my country or not available always .
Do you think that Prozac better than Paxil about sexal side effects and weight gain ?
How can I jump from Paxil 20 mg to Prozac, and at same time keep Wellbutrin 150 mg ?
Best Regards
Hello.
Well its unfortunate that we don't have the option of Pristiq.
Now that we have to switch between Paxil and Prozac, the right way would be keeping Welbutrin at 150mg (constant). Paxil can be reduced to 10mg and Prozac can be started at 20mg. After day 7, Paxil can be stopped aburptly at 10 mg whereas Prozac can be continued thereafter.
In all probability, this cross-taper will suit you. However, I would advice you to keep your treating psychiatrist in loop while you are doing this cross-taper.
Kind regards,
Dr. Srikanth Reddy MD.
Patient replied :
Thank you again Doctor . I will follow all your advices and contact you later to check the results .
Kindly, Is it good strategy that 2.5 or 5 mg of Cialis support any sexual side effects might be consequence of Prozac, especially erection one ?
Best Regards
Hello.
Yes, Cialis may be used for the erectile dysfunction arising from the use of Prozac. I hope you don't encounter any side effects hence forth.
And yeah, you can get back to me if you have any further queries.
Kind regards,
Dr. Srikanth Reddy MD.
Patient replied :
Hello again,
In the last this time, could you tell me what the suitable to take Wallbutrin in morning or evening, and also Prozac morning or evening ?
Best Regards
Hello.
Both the medicines are activating and preferably taken in the morning.
Thanks.
Dr. Srikanth Reddy MD.