Hi there. I haven't posted on here in a while. Just to remind, I have Anxiety and Panic Disorder. Back last February I weaned off of Paxil because I thought it wasn't being as effective as it should have been. I was getting panic and anxiety attacks. My psychiatrist at the time weaned me off the Paxil completely before starting me on Effexor XR. The withdrawal was terrible. I started off at 37.5 Effexor XR until some of the anxiety came back and I raised the dosage to 75. Pretty soon I was on 112.5 mg. When I had a return of symptoms in July I went up to 150 mg but went back down again right away because of worry about fast heartbeat. I was fine for about two more months. Then some situations cause the anxiety to return. I tried 150 mg again for about 2 months. Didn't really work, felt just as nervous, went back down to 112.5 a couple weeks ago. I know all this really makes it sound like I was yo-yo-ing, but I feel I did give the Effexor XR a fair chance. I changed psychiatrists mid-stream too, since the previous one was impatient and petulant. Anyway, Effexor XR doesn't really seem to be keeping my nervousness and anxiety under control like the Paxil did when I used to take it for 5 years. My current psychiatrist suggested switching to Pexeva. So I have a couple of questions: 1.) How are Paxil and Pexeva different (they are both paroxetine), and why would Pexeva work if Paxil's effectiveness wore off after 5 years?
2.) My doctor wants me to start on 20 mg of Pexeva while weaning off of Effexor XR. (He says he thinks Pexeva is more effective than Effexor XR for helping anxiety.) Should I be worried about Serotonin Syndrome while doing this? Has anyone else done this? It kind of scares me to be on two of these meds at once.