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Re: Paxil Augmentation

Posted by JohnL on January 12, 2000, at 2:28:58

In reply to Paxil Augmentation, posted by Rachel on January 12, 2000, at 0:50:41

> Hi,
>
> I've been on Paxil for over two months and it has helped me not much at all. My doctor has talked of augmenting it with a trycylic. Does anyone have any experience with Paxil and TCAs?
>
> Miserable in Topeka,
>
> Rachel

I'm sorry you aren't feeling better Rachel. But yes, adding a tricyclic to Paxil is fairly common. Nortriptyline or Desipramine are probably the best choices because they have the mildest side effects. Nortriptyline will improve your sleep. Desipramine might be a little more activating. Another common augmentation with Paxil is Wellbutrin. That is especially good if you are having any sexual, fatigue, or weight-gain problems. Expect a bit of a dry mouth with any of these.

If after 4 weeks of augmentation you aren't showing improvement, you would probably need to consider switching to a different med altogether rather than continue trying to bark up the wrong tree. All the SSRIs do the same thing, but they do so in quite different ways. Even though you didn't respond to one, you may respond very nicely to another. Augmenting Paxil at this point makes sense, and a TCA is a good choice. But if that doesn't help, you may need to switch. I know how you're feeling. Hang in there. JohnL


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