These comments are made for the purpose of discussion and should NOT
be used as recommendations for or against therapies or other treatments. An indi
vidual patient is always advised to consult their own physician.
[posted 02/9/2000]
Question: I am currently taking Paxil 30mg once a day and I am interested in becoming pregnant in the next year. Is it safe to become pregnant on Paxil? Is there any higher risk of birth defects or difficulties during pregnancy? Also, is it safe to breastfeed while on Paxil?
Answer: The information on this class of drugs is relatively recent. The initial studies(published in Jama within the last year) don’t show any severe problems. But, the drugs are relatively new and there is no data on the children born to mothers on paxil and their neurologic or emotional development. This will take another 15 years to come by. Paxil is a class C pregnancy drug, certainly not the best(A or B) but not horrible. If you can not take it is probably better, but no severe consequences in most patients.
[posted 11/11/1999]
Question: I have had nightmares, disturbing, vivid dreams as long as I can remember. I feel as if I’m in REM sleep all night. I have always felt very groggy and when I get up in the mornings I feel as if I haven’t slept at all. I wake up in the night burning up. I’ve always had uncontrollable mood swings as well. Finally, at the age of 25 I have just recently went to the doctor about this. She put me on Paxil and I felt great except for a very severe case of insomnia. Do SSRI’s decrease your melatonin level? If not what would cause the insomnia? Also, is it possible for your body to overproduce melatonin? From what I’ve read about people who take it for jet lag and insomnia, they experienced vivid dreams and nightmares.
Answer: I don’t know about the melatonin, but they commonly produce insomnia-this will persist as long as you are on the medication.
[posted 11/4/1999]
Question: I have been using Paxil (for a mild panic disorder)since July 99. Beginning mid September, I have been trying to go off the meds for two reasons…the panic disorder no longer exists and I have gained 20 pounds. Since the only times I have ever gained weight have been due to pregancies, I am concerned about this excess weight. My dr suggests exercise, but I can’t add any more to my already busy schedule. Will I lose this weight when I finally come off the drug?
My other question is about the side effects of withdrawal. I am taking 5 mg every 3 days for the past 2 weeks. By the time the third day comes, I am so dizzy that I can’t function. My pharmacist recommended excessive doses of Vitamin C but that hasn’t seemed to make a difference. I want to get off this ASAP but my dr doesn’t seem to think there are really side effects. Any suggestions?
Answer: I don’t know of any way to speed the process other than just to get through it. The weight usually comes off after stopping the meds, slowly as usual with weight loss.
[posted 08/16/1999]
Question: I have taken Prozac and Paxil for depression/mood swings and am currently
on Wellbutrin SR 150mg. I have experienced a very low libido while on these
various antidepressants and would like to know if there is an alternative option
that wouldn’t carry this side effect?
Answer: I’d try Serzone or Celexa, they’re often much better.
[posted 10/3/1999]
Question: I have been taking Paxil for a severe case of Social Phobia for about 10 days. So far it has only made me sick to my stomach all the time. How long does it take for Paxil to start working for me and will this nausea go away??
Answer: The nausea usually persists, although occasionally gets better. You should be seeing some improvement now-but, three weeks is what we usually give it.
[posted 09/28/1999]
Question: My fiance (21 years old) has been taking Paxil for about 1 year now. It helped his depression for the first six months but has not been effective lately. He suffers from tension headaches and depression runs in his family (grandmother, father, mother, sister). Within the last two weeks or so his moods have been intolerable. He is gets very angry very easy. His sex drive is non-existant. His headaches are back. When he went to the doctor to discuss these problems, the doctor decided to take him off Paxil all together. I felt as though his dosage needed to be increased. He knows he needs this anti-depressant but feels like the doctor knows more than we do. What would you suggest.
Answer: I’d see a psychiatrist who specializes in drug treatment of depression. Lithium along with an antidepressant might be the answer. The younger the depression, the more likely that there is a strong family component that needs some specialized helpl
