Brief Answer:
Persistent crying spells and anxiety will reduce with Paroxetine

Detailed Answer:
Hello thanks for asking from Health Care Magic

I can understand your problem. You have symptoms of crying spells and have been prescribed Paroxetine for that. This resulted in development of side effects like Suicidal thoughts. The doctor put you on Prempro thinking that it was hormonal. Now you have swelled toes, rapid heart beat and since last 2 weeks you are taking the medicines.

It is common in some females of your age to develop such symptoms like crying spells, anxiety, palpitations. In most females the reason for such symptoms is underlying anxiety and hormonal changes related to menopause. As per my opinion Prempro can control hot flashes (one of main symptoms of menopause) but in controlling anxiety and palpitations it is not much effective. Paroxetine is a SSRI drug and this drug should work in your conditions. When the drug is advised in some person it results in increase in anxiety, crying spells and suicidal ideation in individuals for some days because it causes changes at biochemical levels. These symptoms usually decrease in about a weeks and over paroxetine start showing in improvement of symptoms in about 4 weeks.

The complaints like swelling of toes and increase in anxiety are occurring due to Prempro only. Prempro consists of Estrogens and MPA which are hormones. This is known to cause swelling of toes, legs, arms and face. If the swelling don't subside in a week then I would advise you to consult your psychiatrist to stop the drug.

For your symptoms relief, if symptoms don't improve in about 4 weeks then you can discuss with your psychiatrist to change the drug. Other drugs especially of SNRI drug class like Duloxetine should help you. Duloxetine is very effective in controlling symptoms of anxiety, suicidal thoughts related to hormonal change. The drug is relatively better tolerated and also reduces anxiety. For severe palpitations you are having at this state you can take Propranolol for that. Propranolol helps to reduce the symptoms of anxiety and reduces palpitations. Both of these are prescription medicines and you can discuss with your doctor for that.

Apart from that dietary adjustments and relaxation exercises will help to reduce anxiety. For swelling in toes, for some days sleep with elevated feet (you can place two pillows below both legs), which will reduce swelling.

Thanks, hope this helps you. Please don't hesitate to ask again in follow up questions if you have more doubts.

Dr. Seikhoo Bishnoi
Consultant Psychiatrist and Psychotherapist.

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