switchingà SSRIs

[Jomaur]

I have been taking Seroxat(Paroxetine) for Anxiety for over 20 years with just a short interval when I took Venlafaxine. Up to 18 months ago I was taking 30 mg but when I told my GP that I wasn’t finding it so effective she increased it to 40 mg.This really didn’t make any difference and I have since been diagnosed with Fibromyalgia so this hasn’t helped. My GP says that in order to change to another SSRI such as Sertraline I need to taper right off the Seroxat before I can change. I am now in my 2nd week of this and am now down to 30mg but am getting withdrawl symptoms that are really unpleasant. I have read that it’s possible to do a direct switch between 2 SSRIs and another way is to cross taper. Has anyone had any experience of doing this and was it done under the direction of their GP or a Mental Health professional ?

[Mystica_viventem]

Hi Jomaur, I am taking Venlafaxine for 15 years and even though I take the smallest dosage I get whitdrawl symptoms. I've decided to change the medicine to a different one (with the doctor's approval) but I would definitely go to a Psychiatrist for that.

Is better to be safe than sorry, as many combinations (and not only) can cause serotonin syndrome.

My psychiatrist is switching it very slowly even though the new pills I take are not SSRI.

[Jomaur in reply to Mystica_viventem]

Thanks for your reply. I shall be seeing my GP in a week’s time and will explain to her that the plan she has suggested for weaning off Seroxat is not possible. I have since read that a recommended time for this is at least 3 months since Seroxat in probably the hardest SSRI to come off fro. If she is unable or unwilling to advise me how to cross taper onto Sertraline then I shall ask her to do a referral to a private psychiatrist for help with this. In the meantime I have reverted to my original dosage.

[Greenpapaya]

Hi Jomaur, I am new to this forum and I’ve seen your post and the one response. I thought I would share my information.

I have been prescribed Paroxetine for many years. Please do get a psychiatrist involved with any changes to your medication. I have a very negative experience when I was mistakenly taken off Paroxetine by a GP with a start onto Sertraline. There was no tapering down of dosage of Paroxetine . This was when I lived in New Zealand. This caused a discontinuation syndrome resulting in a brief hospital admission of 2 nights. Mental Health Services became involved and I had a psychiatrist. During the next months i reacted badly to Sertraline once my dose reached 100mg so then had cross tapering to mirtazepine. As mirtazepine did not help I then went back to Paroxetine on a high dose and have remained on this since . The psychiatrist in the UK advised if I ever wanted to reduce or change my treatment of Paroxetine to do this with psychiatric involvement. The organisation Mind also recommended this too. I would never, given my experience try , any switch of medication without the involvement of psychiatry given the experience I had. Good luck.

[Jomaur in reply to Greenpapaya]

Thank you for your reply. I am having second thoughts now about switching my medication as I wonder whether my increased anxiety is not so much due to the Paroxetine becoming less effective or whether it’s caused by the medical conditions I have. I was diagnosed with Polymyalgia Rheumatica in Jan 2021, Atrial Fibrillation in the following October and then had a fall and fractured my left humerus in three places in the November.. Following increasing severe pain in my back and legs that has restricted my mobility I was diagnosed with Fibromyalgia last November. I have also had Hypertension for about 30 years which has been quite affected by the steroid treatment I am on for the Polymyalgia. The drs at our practice have not been great at offering any treatment for my pain and pretty useless at dealing with my blood pressure and I have paid privately to see a cardiologist and for physio. I wondered if a different SSRI might be better at dealing with the anxiety and also help with my pain but now wonder if the negatives of changing are greater than the positives.Thank you for your advice. I did switch from Seroxat to Venlafaxine years ago but this was under the direction of a Psychiatrist but like you went back onto Seroxat which worked again. Good luck to you also.