So I had been on Lexapro 20mg for 5+ years and last summer I was weened off the medication because my psychiatrist and myself thought I no longer needed it due to the lack of anxiety symptoms. Last fall the symptoms returned and were overwhelming causing me to withdraw and isolate myself in my home, I was put back onto Lexapro 20mg and eventually 30mg after little improvement for my symptoms. In the past month my anxiety symptoms returned and just last week my psychiatrist had me switch to Paxil 40mg because it looked like Lexapro was no longer working.
I have multiple questions regarding the switch. Is it normal to feel increased anxiety when starting a new SSRI? My psychiatrist had me switch from Lexapro 30mg to Paxil 40mg the day it was prescribed to me however the following morning left me extremely drowsy so I've been taking 20mg for the past few days instead to mitigate the drowsiness as recommended by my doctor. As of today I'm feeling increased anxiety and I want to know if it's from the new medication or withdrawal symptoms from stopping Lexapro and whether or not I should jump up to 40mg like my psychiatrist originally prescribed.
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Answers
WI
WildcatVet
14 May 2019
Hello! The answer is it's probably a little of both especially if you stopped the Lexapro rather abruptly. From the literature on Lexapro discontinuation: "Anxiety: Most people will experience anxiety to a significant degree when stopping Lexapro. This is a drug that inhibits the reuptake of serotonin. If you have been taking it for an extended period of time and discontinue, your serotonin levels are likely lower than average – causing severe anxiety." From the literature on Paxil: "Common (1% to 10% of users): Abnormal dreams, agitation, anxiety, depression, drugged feeling, emotional lability, nervousness" It may be a tough couple of weeks but your anxiety level should taper off fairly quickly as your metabolism adjusts to the switch and the therapeutic level of Paxil is reached. I would stay on the lower dosage of Paxil until these side effects are more under control unless your doctor says differently. Best regards and I hope you're feeling better quickly. Wildcat P.S. Paxil is approved by the FDA to treat anxiety disorders and is an excellent choice: "Paxil is used to treat depression, obsessive-compulsive disorder, anxiety disorders, post-traumatic stress disorder (PTSD), and premenstrual dysphoric disorder (PMDD)."
