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Why Am I Having A Lot Of Anxiety Again I Am Currently On 20 Mg Of Paxil For Anxiety?
Question: Hi - I am currently on 20 mg of Paxil for Anxiety, have been on Paxil for over 20 years.
I have been having a lot of anxiety again. The worst is anticipatory anxiety. It sometimes stays around as constant anxiety and I view every social or work 'event' as something anxiety provoking. Generally when I at the 'event I am not as bad as leading up.
I have xanax that I was given many years ago and take .5 mg if it gets too bad and it helps but I don't want to take it too often. I tired Valium and Klonipin as well back then but they didn't help as well as xanax.
About 7 years ago or my anxiety got bad as well and I tapered off Paxil and tried a couple other SSRI's and they didn't help and actually made it worse. I was very up and down with Lexapro especially.
I eventually went back on Paxil which took a long time to work again but the last years have been great up to about November when it started with a panic attack at a party that lasted hours. Since then it has gotten worse.
I have been on 30mg and even 40mg of paxil previously but don't feel that helped at all...and from memory made me worse for a while.
Anyway, I am wondering what I should suggest to my GP as I need to contact for a repeat prescription anyway. Do I go up in dose in Paxil or supplement with something else.? The other thing that really helped was mindfulness mediation and I let that slip a bit but have been back doing that regularly for past 3 months or so.
I have read there is less and less evidence for increasing dose working and I tired a number of other SSRIs and I believe once tried a SSNRI .
I have been having a lot of anxiety again. The worst is anticipatory anxiety. It sometimes stays around as constant anxiety and I view every social or work 'event' as something anxiety provoking. Generally when I at the 'event I am not as bad as leading up.
I have xanax that I was given many years ago and take .5 mg if it gets too bad and it helps but I don't want to take it too often. I tired Valium and Klonipin as well back then but they didn't help as well as xanax.
About 7 years ago or my anxiety got bad as well and I tapered off Paxil and tried a couple other SSRI's and they didn't help and actually made it worse. I was very up and down with Lexapro especially.
I eventually went back on Paxil which took a long time to work again but the last years have been great up to about November when it started with a panic attack at a party that lasted hours. Since then it has gotten worse.
I have been on 30mg and even 40mg of paxil previously but don't feel that helped at all...and from memory made me worse for a while.
Anyway, I am wondering what I should suggest to my GP as I need to contact for a repeat prescription anyway. Do I go up in dose in Paxil or supplement with something else.? The other thing that really helped was mindfulness mediation and I let that slip a bit but have been back doing that regularly for past 3 months or so.
I have read there is less and less evidence for increasing dose working and I tired a number of other SSRIs and I believe once tried a SSNRI .
Brief Answer:
Yes you can start SNRIs.
Detailed Answer:
Hello, thank you for your question. I have read and understood your question. For the first line anxiety treatment is SSRI and SNRIs. If you are not responding to SSRI, you can switch to serotonin-norepinephrine reuptake inhibitors (SNRIs, eg, venlafaxine extended release, starting dose 37.5mg orally once a day) are effective but typically only after being taken for at least a few weeks. Remember that it might take a little while to find the right treatment. People respond in different ways to medicines and therapy, so you might need to try a few approaches before you find the one that helps you most. The key is to not give up and to let your doctor or nurse know how you feel along the way. Psychotherapy involves meeting with a mental health counselor to talk about your feelings, relationships, and worries. Therapy can help you find new ways of thinking about your situation so that you feel less anxious.
Hope I have answered your query.
Best regards,
Dr. Heang Chan Raksmey, Family and General Physician.
Yes you can start SNRIs.
Detailed Answer:
Hello, thank you for your question. I have read and understood your question. For the first line anxiety treatment is SSRI and SNRIs. If you are not responding to SSRI, you can switch to serotonin-norepinephrine reuptake inhibitors (SNRIs, eg, venlafaxine extended release, starting dose 37.5mg orally once a day) are effective but typically only after being taken for at least a few weeks. Remember that it might take a little while to find the right treatment. People respond in different ways to medicines and therapy, so you might need to try a few approaches before you find the one that helps you most. The key is to not give up and to let your doctor or nurse know how you feel along the way. Psychotherapy involves meeting with a mental health counselor to talk about your feelings, relationships, and worries. Therapy can help you find new ways of thinking about your situation so that you feel less anxious.
Hope I have answered your query.
Best regards,
Dr. Heang Chan Raksmey, Family and General Physician.
Above answer was peer-reviewed by :
Dr. Saisudha Kotla
Hi - I may have worded my question wrong.
I tried SNRI before and it didn't work., neither did a couple other SSRI's.
I also tried Buspar a long time ago and it made me worse.
I read that increasing dose of Paxil is unlikely to help and that was my experience in the past.
What would you recommend adding to Paxil? Or it is possible switching to Paxil CR may help this poop out?
I tried SNRI before and it didn't work., neither did a couple other SSRI's.
I also tried Buspar a long time ago and it made me worse.
I read that increasing dose of Paxil is unlikely to help and that was my experience in the past.
What would you recommend adding to Paxil? Or it is possible switching to Paxil CR may help this poop out?
Please advise.
Brief Answer:
Hope you have a good health
Detailed Answer:
Hello, thank you again for your question. You already took Paxil high dose so to increase higher dose its not the recommendation. If you already use SNRI and are not effective you should try another group of anti depression drugs such as serotonin modulators, tricyclics, and monoamine oxidase inhibitors.. When you want to try the new medicine you should follow up with your doctor better. Your Doctor can see you and follow up on how the medicine works for you. It is important to follow up regularly with your Doctor.
Hope you have good health. Let me know if I can assist you further.
Best regards,
Dr. Heang Chan Raksmey, Family and General Physician.
Hope you have a good health
Detailed Answer:
Hello, thank you again for your question. You already took Paxil high dose so to increase higher dose its not the recommendation. If you already use SNRI and are not effective you should try another group of anti depression drugs such as serotonin modulators, tricyclics, and monoamine oxidase inhibitors.. When you want to try the new medicine you should follow up with your doctor better. Your Doctor can see you and follow up on how the medicine works for you. It is important to follow up regularly with your Doctor.
Hope you have good health. Let me know if I can assist you further.
Best regards,
Dr. Heang Chan Raksmey, Family and General Physician.
Note: For further guidance on mental health, Click here.
Above answer was peer-reviewed by :
Dr. Saisudha Kotla
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