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Dr. Bob is Robert Hsiung, MD,
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Posted by vincent on February 28, 2002, at 13:36:11
Hi to everybody,
i'm on paxil 20 mg/d but it is greatly sedative for me (dizzyness, drowsyness...).
My pdoc think to switch to effexor xr 75 mg/d.
Do you think effexor xr is less sedative that paxil?
I'm NOT anxious but only depressed, think 75 mg/d could be enough for depression or must increase dosage?
Thanks for your help!
Posted by JohnX2 on February 28, 2002, at 15:29:05
In reply to EFFEXOR XR or PAXIL, which is less sedative?, posted by vincent on February 28, 2002, at 13:36:11
Statistically I think that would be a good move.
I personally was wiped by Paxil but found Effexor
to be neutral.-John
> Hi to everybody,
> i'm on paxil 20 mg/d but it is greatly sedative for me (dizzyness, drowsyness...).
> My pdoc think to switch to effexor xr 75 mg/d.
> Do you think effexor xr is less sedative that paxil?
> I'm NOT anxious but only depressed, think 75 mg/d could be enough for depression or must increase dosage?
> Thanks for your help!
Posted by paulb on February 28, 2002, at 16:00:32
In reply to EFFEXOR XR or PAXIL, which is less sedative?, posted by vincent on February 28, 2002, at 13:36:11
For me Paxil was more sedative than Effexor XR but the sedation passed after a few weeks when the antidepressant started to work. I dont think this is all that uncommon and maybe you could consider sticking with it for a while. Switching from Paxil to Effexor XR also has other considerations:
-Paxil will only have a therapeutic effect via serotonin although probably does block the re-uptake of the other monoamines but not therapeutically. Effexor does big time and at high concentrations(400mg range) will enhance dopamine.
-Paxil is selective and very potent at even low doasage-20mg. The monograph for the drug shows that theres not much difference in side-effect between 40-60mg. It inhibits its own metabolism potently. Effexor XR is not selective and at low dosage will only enhance serotonin, at moderate doses norepinephrine and at v-high dosage, as I mentioned dopamine. In other words the higher the dose the more powerful and wide its effect upon neurotransmitters, presumably? Im not in a position to say for sure but evidence points to that.
But yes, I would say Effexor is less sedating than Paxil and if the dizziness/sedation does continue to be a problem it may be a very good switch.
Paulb
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