Need Advice

Hi KC and welcome. My mind is a little fuzzy and loopy right now and so if I say anything odd - please forgive me. Have you been on the Paxil all along for the past 10 years? Sometimes especially when we're on medication over an extended period of time our bodies develop tolerance to the meds and so it becomes necessary to increase the dosage. Paxil affects your serotonin levels keeping them higher which in turn elevates your mood. Over time your body says "hey, I keep getting this Paxil stuff so I guess I don't have to keep making as much of it". The problem though is that you were low on serotonin before (which is why you took the Paxil in the first place). Now that your body is so used to having Paxil, it's production of serotonin decreases and you're low again. Sometimes it helps to increase the dosage. Other times you need to try a new medication in place of or in addition to what you're currently on. Also remember that it takes these medications usually 4-8 weeks to become effective and that holds true not just when you start but also when you up the dosage.

As far as the hot flush thing... that is common with panic attacks. I get the same all the time. It starts in my abdomen and quickly shoots up enveloping my chest and rushing into my head. Once it hits my head the attack "begins". I also have found that I'm much more prone to have panic attacks when I'm hot (indoors or outdoors). When the temperature is up my odds of having an attack increase - perhaps because it reminds me of the hot flushes that usually precede my attacks. I'm not sure.

And just for the record, a hot flush as I just described is not the same as a hot flash associated with menopause; though the way they're experienced are similar. In other words, it might be hard for you to tell if you're having a flash or a flush (what's causing it). But give the new dosage of Paxil some time and if you haven't ever been in counseling it's something that you may want to consider. Counseling can help you to develop skills to use in the moment when you have a panic attack, attitudes and approaches to deal with anxiety, and can also help you to explore the origins of your anxiety and perhaps why it traces back so far in your life. I wish you well.

Hello and welcome,

It must be a coincendence that you posted today as I just saw my PCP yesterday who asked me if I had trouble with increased depression and anxiety when I went through menopause.  The funny part is I hardly noticed menopause and I was geared up to make it through with  no severe surprises.  I do agree the hot flashes and flushing can be caused by anxiety or menopause. 

When depression symptoms improve after starting an antidepressant, most people need to continue taking medication long term to prevent symptoms from returning. However, treatment may seem to stop working over time. This can happen for a number of reasons. These may be due to one of the following reasons:

It's common for depression symptoms to return or worsen at some point, despite treatment. Called breakthrough depression, symptoms may be triggered by stress or may appear with no apparent cause. The current dose of medication you're taking may not be enough to prevent your symptoms when depression gets worse.

Underlying health problems, such as hypothyroidism, can cause or worsen depression.

Some medications for unrelated conditions can interfere with the way your body breaks down and uses antidepressants, decreasing their effectiveness.

In some people, a particular antidepressant may simply stop working over time. Doctors don't fully understand what causes the so-called "poop-out" effect, or why it occurs in some people and not in others.

In most cases, depression symptoms get better with adjustments to medication. Your doctor has  recommended that you change the dose of your current antidepressant and if that does not help perhaps he will  change you  to another antidepressant or add another antidepressant or other type of medication to your existing treatment. Buspar is a good drug IMHO.  Psychological counseling (psychotherapy) may also help.

I wish you peace,

Kitt

 

Thanks spinal soldier and I have not had any blood drawn yet as I am waiting for my medical to kick in. May I ask what leads you to believe neurological symptom? I'm not sure what you mean by a CM7.

Thanks,

KC

Thanks stkitt, you seem to have a lot of medical knowledge are you in the field or just experience?

KC48

stkitt said...
...I am a CCRN, 26 years ER...

Wow, 26yrs, eh? It's reassuring to know that you've lasted 26yrs in the ER considering I'm a future health professional battling anxiety myself ^_^