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Suggest Treatment For Generalized Anxiety Disorder
Question: Dear Doctor,
Hello,
I have started to treat of GAD and social phopia before 7 years as follow : (10 mg Paxil daily as constant does daily after I reduced the heigh does in the first of treatment gradually), in addition to CTB . The results were very good and the anxiety and social phopia went away. Now I can not do without medication because the last case happened to me before 10 months when I have decided to leave the medication and I have withdrew the medication (Paxil 10 mg daily) randomly and got that relapse, so I return back to Paxil but with 20 mg daily along with Wellbutrin 150 mg and the situation come back very well again.
Right now I am on Wellbutrin 150 mg daily\morning along with 20 mg Paxil daily\evening since 7months, the role of Wellbutrin that I see and feel there is an improve and decreasing of the sexual side effects of Paxil by about 40% than before when I have used Paxil alone about 7 years without Wellbutrin .
Let me know to discuss with you the situation now and what I complain from .
I wilI keep the 150 mg of Wellbutrin daily in the morning, But I beleive that this is the time to talk about alternative of Paxil, Note that I postponed this issue many times before, but the reason that I would like to replace Paxil (although the paxil very effective for me), that :
1) I feel always that I am tired, fatigue and lazy, suffer from sleeping too much, sotimes I do not feel on myself and sleep one day and ask more...
2) and very important the side effect weight gain.. I make diet, prevent myself from many and important kind of food but no way.. the weight increase and this make me trouble..
3) In the last abnormal dreams, thats mean very intensive and long dreams with stories and adventures as I sleep many years .
4) I will get marriage soon .
I consulted the doctor here in my country about these problems and we tried to find sloutions or substitution for Paxil.. he said to me we can not try several type of medications instead of Paxil.. because every medication need a time to give the result and he fear that I fall in relapse.. his strategy is the follow :
Keeping (150 mg Wellbutrin daily) along with Prozac instead of Paxil, and this changing should be within plan and gradually until we reach to constant dose of Prozac along with 150 mg Wellbutrin .
He recommend also to support that (but on demand) with 2.5 or 5 mg Cialis to avoid and counter any side effects from Prozac (specially the erection).. he said this strategy or package would be the best (due to his long experience) and I have to be brave and try . He said that Prozac still the best medications until now among the others came recently !!!
What do you think please about the new strategy ? do you think that prozac is better than Paxil about side effects (specially sexual ones) ? Please I want your experience about that in details ? And If you agree how can I apply that transfer from Paxil to Prozac ? or If you have other sloutions about replace Paxil with others .
The steady and stable thing that I can not do without Wellbutrin 150 mg along with Paxil or alternative of Paxil ?
I hope I can find good sloution with you .
Thank you very much .
Best Regards
XXXX
Hello,
I have started to treat of GAD and social phopia before 7 years as follow : (10 mg Paxil daily as constant does daily after I reduced the heigh does in the first of treatment gradually), in addition to CTB . The results were very good and the anxiety and social phopia went away. Now I can not do without medication because the last case happened to me before 10 months when I have decided to leave the medication and I have withdrew the medication (Paxil 10 mg daily) randomly and got that relapse, so I return back to Paxil but with 20 mg daily along with Wellbutrin 150 mg and the situation come back very well again.
Right now I am on Wellbutrin 150 mg daily\morning along with 20 mg Paxil daily\evening since 7months, the role of Wellbutrin that I see and feel there is an improve and decreasing of the sexual side effects of Paxil by about 40% than before when I have used Paxil alone about 7 years without Wellbutrin .
Let me know to discuss with you the situation now and what I complain from .
I wilI keep the 150 mg of Wellbutrin daily in the morning, But I beleive that this is the time to talk about alternative of Paxil, Note that I postponed this issue many times before, but the reason that I would like to replace Paxil (although the paxil very effective for me), that :
1) I feel always that I am tired, fatigue and lazy, suffer from sleeping too much, sotimes I do not feel on myself and sleep one day and ask more...
2) and very important the side effect weight gain.. I make diet, prevent myself from many and important kind of food but no way.. the weight increase and this make me trouble..
3) In the last abnormal dreams, thats mean very intensive and long dreams with stories and adventures as I sleep many years .
4) I will get marriage soon .
I consulted the doctor here in my country about these problems and we tried to find sloutions or substitution for Paxil.. he said to me we can not try several type of medications instead of Paxil.. because every medication need a time to give the result and he fear that I fall in relapse.. his strategy is the follow :
Keeping (150 mg Wellbutrin daily) along with Prozac instead of Paxil, and this changing should be within plan and gradually until we reach to constant dose of Prozac along with 150 mg Wellbutrin .
He recommend also to support that (but on demand) with 2.5 or 5 mg Cialis to avoid and counter any side effects from Prozac (specially the erection).. he said this strategy or package would be the best (due to his long experience) and I have to be brave and try . He said that Prozac still the best medications until now among the others came recently !!!
What do you think please about the new strategy ? do you think that prozac is better than Paxil about side effects (specially sexual ones) ? Please I want your experience about that in details ? And If you agree how can I apply that transfer from Paxil to Prozac ? or If you have other sloutions about replace Paxil with others .
The steady and stable thing that I can not do without Wellbutrin 150 mg along with Paxil or alternative of Paxil ?
I hope I can find good sloution with you .
Thank you very much .
Best Regards
XXXX
Brief Answer:
consult psychiatrist
Detailed Answer:
Hi dear,
Thank you for your query.
As you are having GAD and better with Paroxetine and bupropion but you feel sexual side effects and also fear that if you discontinue drug you might have relapse.
I would suggest you that which ever medication you are on, never quit without consulting a doctor.
For alternative of paroxetine, fluoxetine is not a good option as fluoxetine also has sexual side effects specially delayed ejaculation and in rare cases erectile dysfunction.as we are using fluoxetine for treatment of patients with early ejaculation.
From my point of view you should take Desvenlaflexine which has good result in GAD and also has very less side effects.
You can quit bupropion (wellbutrin) gradually without any problem or continue as bupropion has no sexual side effects .
Discuss with treating doctor about desvenlaflexine.
Awaiting your response.
Thank you
consult psychiatrist
Detailed Answer:
Hi dear,
Thank you for your query.
As you are having GAD and better with Paroxetine and bupropion but you feel sexual side effects and also fear that if you discontinue drug you might have relapse.
I would suggest you that which ever medication you are on, never quit without consulting a doctor.
For alternative of paroxetine, fluoxetine is not a good option as fluoxetine also has sexual side effects specially delayed ejaculation and in rare cases erectile dysfunction.as we are using fluoxetine for treatment of patients with early ejaculation.
From my point of view you should take Desvenlaflexine which has good result in GAD and also has very less side effects.
You can quit bupropion (wellbutrin) gradually without any problem or continue as bupropion has no sexual side effects .
Discuss with treating doctor about desvenlaflexine.
Awaiting your response.
Thank you
Above answer was peer-reviewed by :
Dr. Vaishalee Punj
Hello Dr. XXXXXXX and nice to meet you indeed .
I think you talk about Pristiq, unfortunately this medication not available always here .
Please could you suggest other slousions ?
Best Regards
XXXX
I think you talk about Pristiq, unfortunately this medication not available always here .
Please could you suggest other slousions ?
Best Regards
XXXX
Brief Answer:
Mirtazapine
Detailed Answer:
Hi dear,
Mirtazapine is one of drug which help you but it has a sedation and weight gain is side effects.
Other options are sertraline, escitalopram, venlaflexine and newer drug agomelatine.
Discuss with treating doctor or psychiatrist.
Thank you
Mirtazapine
Detailed Answer:
Hi dear,
Mirtazapine is one of drug which help you but it has a sedation and weight gain is side effects.
Other options are sertraline, escitalopram, venlaflexine and newer drug agomelatine.
Discuss with treating doctor or psychiatrist.
Thank you
Above answer was peer-reviewed by :
Dr. Vaishalee Punj
Brief Answer:
Consult psychiatrist
Detailed Answer:
Hi dear,
yes of course Cialis 5 mg cancel the side effects of Fluoxetine specially erection problem but why we should not try the other molecule which has no sexual side effects as you are going to marry soon.
Yes there is no weight gain in Fluoxetine.
But according to me young people who is going for marriage has more concern with sexual side effects more than weight gain because weight gain can be controlled with exercise and diet control.
Discuss with your treating psychiatrist.
Thank you
Consult psychiatrist
Detailed Answer:
Hi dear,
yes of course Cialis 5 mg cancel the side effects of Fluoxetine specially erection problem but why we should not try the other molecule which has no sexual side effects as you are going to marry soon.
Yes there is no weight gain in Fluoxetine.
But according to me young people who is going for marriage has more concern with sexual side effects more than weight gain because weight gain can be controlled with exercise and diet control.
Discuss with your treating psychiatrist.
Thank you
Above answer was peer-reviewed by :
Dr. Yogesh D
Hello again My Doctor,
I will discuss that with the doctor here but I would like to get background from you before, So please since We do not have the Pristiq here, do you suggest (Escitalopram + Wellbutrin) or (Venlaflexine + Wellbutrin) ? since I want to keep the Wellbutrin 150 mg dialy and not quit it, just to combine with another, Note that The Wellbutrin I use the XL type . and the taking of Wellbutrin fit in the morning or in the evening ?
The last question : The doctor said to me that these medications will be effective in the body as long as I keep take it regulary ?? Do you agree ?
Thanks a lot .
Best Regards
XXXX
I will discuss that with the doctor here but I would like to get background from you before, So please since We do not have the Pristiq here, do you suggest (Escitalopram + Wellbutrin) or (Venlaflexine + Wellbutrin) ? since I want to keep the Wellbutrin 150 mg dialy and not quit it, just to combine with another, Note that The Wellbutrin I use the XL type . and the taking of Wellbutrin fit in the morning or in the evening ?
The last question : The doctor said to me that these medications will be effective in the body as long as I keep take it regulary ?? Do you agree ?
Thanks a lot .
Best Regards
XXXX
Brief Answer:
Consult psychiatrist
Detailed Answer:
Hi dear,
Thank you for your query.
Sorry for delay.
For you it is best to take bupropion (welbutrin) with venlaflexine rather than with escitalopram.
Because for anxiety venlaflaxine works better than escitalopram.
Bupropion xl can be taken at any time though morning time is best.
Yes for better effect you must take it regularly..
Not to worry .
discuss with treating psychiatrist.
Thank you.
Consult psychiatrist
Detailed Answer:
Hi dear,
Thank you for your query.
Sorry for delay.
For you it is best to take bupropion (welbutrin) with venlaflexine rather than with escitalopram.
Because for anxiety venlaflaxine works better than escitalopram.
Bupropion xl can be taken at any time though morning time is best.
Yes for better effect you must take it regularly..
Not to worry .
discuss with treating psychiatrist.
Thank you.
Note: For further guidance on mental health, Click here.
Above answer was peer-reviewed by :
Dr. Prasad
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