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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Should I Be Concerned About The Drug Interaction?

I have been prescribed Paxil 40 mg at us. In addition I was placed on Cymbalta in an attempt to try to control pain from a spinal cord injury & tumor that is invading the Cord. I had to stop the Cymbalta due to the cost and was placed on Effexor ER 75 mg. if I take it in the morning as I did the Cymbalta, I am sluggish with no motivation. If I take it at night I m concerned about interaction with the Paxil. The Dr nor his FNP have been little help. I am unsure how to take the two safely. I am sorry, I was unaware there is a charge for this. I am unable to make payment due to 0 income. SSD pending. Thank you for your time
Mon, 19 Dec 2016
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Neurologist,  's  Response
Hello!

Thank you for asking on HCM!

I would explain that it is not recommended to take both Paxil and Cymbalta or Paxil and Effexor.

You should know that Paxil and Cymbalta are part of the same pharmacological class (SSRI). When combined together they increase the risk for possible serotoninergic syndrome, which is a serious medical condition.

From the other hand Effexor is a different pharmacological class, but can increase serotonin levels and when combined with Paxil, it can lead to increased risk for serotoninergic syndrome.

From the other hand both Effexor and Paxil prolong QTs interval, leading to increased risk for cardiac arrhythmia.

So, to conclude, I would not recommend taking concomitantly Effexor and Paxil.

You should discuss with your doctor on the above issues.

You can switch to an antiepilepsy drug instead like gabapentine or pregabaline to help you manage the chronic pain.

Hope you will find this answer helpful!

Greetings, Dr. Aida
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Should I Be Concerned About The Drug Interaction?

Hello! Thank you for asking on HCM! I would explain that it is not recommended to take both Paxil and Cymbalta or Paxil and Effexor. You should know that Paxil and Cymbalta are part of the same pharmacological class (SSRI). When combined together they increase the risk for possible serotoninergic syndrome, which is a serious medical condition. From the other hand Effexor is a different pharmacological class, but can increase serotonin levels and when combined with Paxil, it can lead to increased risk for serotoninergic syndrome. From the other hand both Effexor and Paxil prolong QTs interval, leading to increased risk for cardiac arrhythmia. So, to conclude, I would not recommend taking concomitantly Effexor and Paxil. You should discuss with your doctor on the above issues. You can switch to an antiepilepsy drug instead like gabapentine or pregabaline to help you manage the chronic pain. Hope you will find this answer helpful! Greetings, Dr. Aida