Brief Answer:
Since you have been on this medicine for some time, nothing to worry.

Detailed Answer:
Hello Ms XXXX,

Thank you for posting your query here on healthcaremagic.com.

I have read your question carefully and understand your issue.

Let me first of reassure you that nothing bad is going to happen to you because of the increase in the dosage of Paxidep (paroxetine).

I say this because, you have been taking this medicine from some time already and it has reached stable levels and till now you have not had any problems with this medicine except this anxiety following the increase in dosage.

The anxiety is most likely due to the fact that the dose was increased.

However, in your case, as explained by you, your doctor has reduced the dosage before this and has now increased it. What this means is, your doctor is trying to get you on a dosage that is adequate enough and not too little or too much.

There will be some minor side-effects during that particular phase when the dose is being adjusted, but within a few weeks you should improve.

However, if you continue to have anxiety or any other symptoms you listed, then the dose must be reduced.

Based on your medicines, it seems like you are being treated by bipolar disorder. If yes, there maybe better alternatives for you, but that can only be confirmed after a complete review of your history and response to medicines by a XXXXXXX psychiatrist (preferably working in a teaching hospital).

For now, you must continue with the medicines as advised by your treating doctor and revert to him as and when he/she has asked you to follow up and discuss reducing the dosage if you continue to have the side effects.

I hope this answers your question, please feel free to write back to me if you have additional questions.

Wishing you good health.

Warm regards.

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Brief Answer:
It is impossible for me to diagnose your condition without all the info.

Detailed Answer:
Hello Ms XXXX,

Thank you for writing back to me, I am sorry for the delay in responding to your follow up.

It is not possible for me to diagnose your condition without the complete information, a detailed history from the beginning and clinical examination, but your treating psychiatrist has listened to your complete story and has examined you, so he/she has a better understanding of what is going on in your case.

I mentioned bipolar because you are being prescribed antipsychotics along with anti depressives. Which is usually done in people who have bipolar disorder.

A bipolar disorder is diagnosed based on a complete history... to say that you have bipolar disorder, you must have severe prolonged periods of depression alternating with periods of excessive elevation of mood or irritable mood.

A manic episode can be confirmed if you have profound mood disturbance which is manifest as elation, irritability and expansiveness lasting for at least 1 week and at least 3 of these symptoms..

1. Grandiosity
2. Diminished need for sleep
3. Excessive talking or pressured speech
4. Racing thoughts or flight of ideas
5. Clear evidence of distractibility
6. Increased level of goal-focused activity at home, at work, or sexually
7. Excessive pleasurable activities, often with painful consequences.

Hypomania is diagnosed if you have elevated, expansive, or irritable mood of at least 4 consecutive days’ duration and 3 of these symptoms as well...

Grandiosity or inflated self-esteem
Diminished need for sleep
Pressured speech
Racing thoughts or flight of ideas
Clear evidence of distractibility
Increased level of goal-focused activity at home, at work, or sexually
Engaging in activities with a high potential for painful consequences

Major depressive disorder is characterised by the presence of at least 5 of these symptoms (but at least one of those 5 symptoms should either be depressed mood or loss of pleasure or interest...

1. Depressed mood
2. Markedly diminished pleasure or interest in nearly all activities
3. Significant weight loss or gain or significant loss or increase in appetite
4. Hypersomnia or insomnia
5. Psychomotor retardation or agitation
6. Loss of energy or fatigue
7. Feelings of worthlessness or excessive guilt
8. Decreased concentration ability or marked indecisiveness
9. Preoccupation with death or suicide; patient has a plan or has attempted suicide.

The medicine you are taking is appropriate for your condition in my opinion, you must discuss this further with your treating psychiatrist to understand better.

It is not easy to understand this complex disorder by reading online, please discuss with your doctor soon.

I hope I have provided you with enough information.

Wishing you good health.

Best regards.

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Brief Answer:
Take the normal dose only.

Detailed Answer:
Take the normal dose only.

But remember, alcohol doesn't go well with the medicines you are on. 2 Pints of breezer isn't much but better to stay away from alcohol.

Regards.

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