Posted by Jackster on March 2, 2003, at 1:13:35
In reply to Jackster, One more time please! re: Paxil, posted by ZeeZee on March 1, 2003, at 20:56:32
Hi Zee Zee
I'm always happy to answer any of your questions!
This one's a bit of a 'chicken and egg' (i.e. which came first) situation. I remember very clearly the first time I realised the meds were actually working. It was about a month after I'd started taking them (and really wasn't sure if they would work or not). My partner and I were on holiday (always a difficult time for an agoraphobic!)and we'd stopped on the way somewhere for a toilet break. Normally I'd feel v anxious because it would mean us having to go our separate ways for a few minutes. So I was all amped up - but the weirdest thing was - once I was in the situation I felt this strange sense of calm. So the anticpatory anxiety was still there - but no panic actually happened. After that I started trying things all the time and would feel a little apprenhension - but once I was actually doing my exposure therapy - I wasn't panicking at all. From what I remember - at the beginning - I would still have the negative 'what if' thoughts - but was actually able to think - don't be ridiculous - that's completely irrational and the thoughts would go away. I think what they usually say about SSRI's is that it won't stop the anticipatory anxiety - but it will stop the panicking. So is your 'what if' thinking happening before you try something - or while you try something? If it is while you are trying something - it sounds like you need a higher dose. If it is before you try something - that is anticapatory anxiety. That will go away eventually after you get out and successfully do things a few times - you just need to 'retrain' your brain to realise that it's not a scarey situation anymore. (I hope this is making sense!)
Is there something you can try - which is just a tiny little step? I have things I can do to test out my reaction - like driving on the motorway for one exit.
When I first started Paxil I went up to 20mg. This worked great for a couple of months, and then I needed to go up to 40mg - which then worked for me for about 3 years. 40mg is the dose they recommend for panic disorder. I'm not saying you should be on this - but you may need to be on at least 20mg to get the best benefit. you've done so well to get this far - it's just a tiny little step! Well done for hanging in there! Going from 15mg to 20mg should be a lot less harder on you than previous dose increases. It's only a 33% increase compared to 5-10mg (a 100% increase) and 10-15mg (a 50% increase).Your body should adjust much quicker.
MOAI's are considered the 'gold standard' for anxiety problems - so maybe the Paxil won't be quite 'up there' with them - but it was enough for me to completely change my life.
I'm now on 40mg Paxil and 20mg of Nortiptyline. I think it might be 'muting' the panic a bit now - but it's hard to tell since I don't even know if I'm on the effective dose and won't know until I've had a blood test. I had a surprise test of it this week - I work on the 22nd floor of a building and they sent an email out advising us that the lifts weren't working properly and that we should use the stairs. This is not the sort of thing an agoraphobic on the 22nd floor likes to hear! I was feeling really anxious - but to my surprise it didn't actually tip into a panic attack - which may be a sign that the nortrip is starting to work. Keep your fingers crossed for me!
Unfortunately I can't see my PDoc until 19 March - so I won't know until then if I'm at the right dosage. So much waiting!
Anyway - hope this helps - and you should be really proud for getting as far as you have - I know how hard it's been.
take care
Jackie
poster:Jackster
thread:205154
URL: http://www.dr-bob.org/babble/20030301/msgs/205214.html