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Effexor, Paxil, or Zoloft


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Been on Effexor for 4 months. It took the edge off, still have some mild intensity and anxiousness surfacing.

I was on 37.5mg for two months, then 75mg for two months.

It doesn't seem to be "hitting". Do I just need to take it longer or take a higher dose? I'm wondering if Effexor isn't going to have the effect it did before (I took it many years ago and it quickly had a strong effect)

With that, I've heard Paxil can be strong and effective-- is that worth trying instead? Zoloft I hear is calming as well.

Edited by ChunkOfCheesecake
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On 5/4/2022 at 2:49 PM, ChunkOfCheesecake said:

Been on Effexor for 4 months. It took the edge off, still have some mild intensity and anxiousness surfacing.

I was on 37.5mg for two months, then 75mg for two months.

It doesn't seem to be "hitting". Do I just need to take it longer or take a higher dose? I'm wondering if Effexor isn't going to have the effect it did before (I took it many years ago and it quickly had a strong effect)

With that, I've heard Paxil can be strong and effective-- is that worth trying instead? Zoloft I hear is calming as well.

I’m not sure I’d give up. 75 is still pretty low id think you have lots of room

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4 hours ago, ChunkOfCheesecake said:

300mg max? I'm on 150mg now-- seems to be better.

The max of effexor seems to be based on the prescriber comfort level. The XR form is suggested to stop at 225 but many go over. I know of people who push it to 375 when the effexor is working better than anything else and they want to optimize, but not all pdocs will do that 

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On 5/6/2022 at 6:15 PM, Iceberg said:

The max of effexor seems to be based on the prescriber comfort level. The XR form is suggested to stop at 225 but many go over. I know of people who push it to 375 when the effexor is working better than anything else and they want to optimize, but not all pdocs will do that 

Yes. Exactly. When I was on it, my pdoc went up to as high as 300mg (at my request) and may have even gone up to 375mg if I asked again, but I wasn't noticing anything at 300mg and didn't see the point in going even higher. 

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  • 3 weeks later...
On 5/6/2022 at 6:15 PM, Iceberg said:

The max of effexor seems to be based on the prescriber comfort level. The XR form is suggested to stop at 225 but many go over. I know of people who push it to 375 when the effexor is working better than anything else and they want to optimize, but not all pdocs will do that 

Stepped up to 225 (and tried 259.5) -- not much of anything.

Except for one or two days I finally felt complete inner peace. Perfect. But, that went away and never came back.

Weird to say, but I think it's more effective when I'm not well rested.

 

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4 hours ago, ChunkOfCheesecake said:

Stepped up to 225 (and tried 259.5) -- not much of anything.

Except for one or two days I finally felt complete inner peace. Perfect. But, that went away and never came back.

Weird to say, but I think it's more effective when I'm not well rested.

 

I used to be on Effexor I think I took 150 mg - 225 mg for a few years, years ago. I found it helpful but I got switched to a different pdoc and this particular pdoc didn’t believe in prescribing AD’s to any bipolar type patient. Even though I had been on it for years. Anyway, he abruptly took me off of the Effexor and he took me off of it within a week or not much more I think. I felt very ill because you are supposed to slowly go off Effexor. Well my dumb dr didn’t care or know this. I just wanted to tell you that go off of it slowly if you do switch. You’ll be ok if you do it that way.

Anyway, have you ever tried Zoloft or paxil? I was wondering about these medication and if they work well. I am hoping for a calming AD with hopefully no weight gain. Is that so much to ask for? 

Good luck with your med search! Keep us updated! I hope you find your perfect match and balance!

 

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@ChunkOfCheesecake 

I should have mentioned that I have never been on Zoloft really, and as far as Paxil goes I took it at the age of 12 or 14 ish (and I’m in my 30’s now.). And I don’t remember anything really about it except my parents watching me making sure I didn’t cheek my pills. 

Edited by Wonderful.Cheese
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Yes-- Effexor is supposed to have a harsh discontinuation. Thanks for the reminder!

On 5/24/2022 at 12:00 AM, Wonderful.Cheese said:

Anyway, have you ever tried Zoloft or paxil? I was wondering about these medication and if they work well. I am hoping for a calming AD with hopefully no weight gain. Is that so much to ask for? 

I haven't yet. It seems ADs can split into two categories: calming or activating-- and Zoloft is a calming one. Paxil is supposed to be also, but it seems to put people to sleep (and causes weight gain). I get the sense that it might be strong.

I might ask to switch to Zoloft next :]

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On 5/24/2022 at 12:07 AM, Wonderful.Cheese said:

I should have mentioned that I have never been on Zoloft really, and as far as Paxil goes I took it at the age of 12 or 14 ish (and I’m in my 30’s now.). And I don’t remember anything really about it except my parents watching me making sure I didn’t cheek my pills. 

lol-- I've totally done that, cheeked or otherwise.

So I'm a little torn between the two-- with Effexor not doing much of anything, I'm wondering if Zoloft will have any effect. Paxil, seems like it might have a better chance, but I don't have any solid reasons to expect that.

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  • 1 month later...

Welp, tapered off of Effexor (I'm having some bad discontinuation).

Next Wednesday, I ask the doc for a different SSRI. My goal is to get rid of this constant intense feeling.

Should I ask for Zoloft, Paxil, Prozac, or ... ? I can ask for anything pretty much...

 

Edited by ChunkOfCheesecake
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On 5/25/2022 at 5:36 PM, ChunkOfCheesecake said:

I haven't yet. It seems ADs can split into two categories: calming or activating-- and Zoloft is a calming one. Paxil is supposed to be also, but it seems to put people to sleep (and causes weight gain). I get the sense that it might be strong.

zoloft isn't typically thought of as a 'calming' antidepressant. neither is prozac. celexa and lexapro seem to be neutral by most accounts, and paxil and luvox are the most sedating.

edit: amongst the ssris, i should say.

Edited by basuraeuropea
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14 hours ago, ChunkOfCheesecake said:

Welp, tapered off of Effexor (I'm having some bad discontinuation).

Next Wednesday, I ask the doc for a different SSRI. My goal is to get rid of this constant intense feeling.

Should I ask for Zoloft, Paxil, Prozac, or ... ? I can ask for anything pretty much...

 

Could you clarify what you mean by "constant intense feeling"?....Is it anxiety?

As far as choosing among the SSRIs, what I would suggest is letting your pdoc know what symptoms you are having, and letting pdoc decide which one might be best......That is what I would do in your situation.

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2 hours ago, CrazyRedhead said:

Could you clarify what you mean by "constant intense feeling"?....Is it anxiety?

As far as choosing among the SSRIs, what I would suggest is letting your pdoc know what symptoms you are having, and letting pdoc decide which one might be best......That is what I would do in your situation.

Sure-- sensory of sight and sound are heightened. Light is sharp and irritating, sounds are startling. It's disruptive. (It can sometimes trigger a mild bout of anxiety).

The only reason I notice it, is because I didnt have this last year.

I did let the doc know-- he now wants me to cross taper to Prozac.

Edited by ChunkOfCheesecake
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On 5/24/2022 at 12:00 AM, Wonderful.Cheese said:

I used to be on Effexor I think I took 150 mg - 225 mg for a few years, years ago. I found it helpful but I got switched to a different pdoc and this particular pdoc didn’t believe in prescribing AD’s to any bipolar type patient. Even though I had been on it for years. Anyway, he abruptly took me off of the Effexor and he took me off of it within a week or not much more I think. I felt very ill because you are supposed to slowly go off Effexor. Well my dumb dr didn’t care or know this. I just wanted to tell you that go off of it slowly if you do switch. You’ll be ok if you do it that way.

Anyway, have you ever tried Zoloft or paxil? I was wondering about these medication and if they work well. I am hoping for a calming AD with hopefully no weight gain. Is that so much to ask for? 

Good luck with your med search! Keep us updated! I hope you find your perfect match and balance!

 

I've been on Zoloft twice. I think both times up to 150mg. I found it activating. Not in a bad way per se. Hypomanic, if anything, for a couple days. No known bipolar in me or my family, so not sure what that was. Both times I had to go off of it because I found the side effects not manageable. Specifically GI upset. Was going so much at work that the 40 grit one ply was rubbing my ass raw. 

Celexa was the first AD I ever tried. That was almost twenty years ago. Honestly don't remember much about how it made me feel, good or bad. I just remember it making me feel tired. Like I'd take it at night an hour before bed. The NP at the time seemed surprised by that. Like she expected me to say it was activating. 

Then Prozac I took after the second round of Zoloft and before Effexor. Don't remember if it was sedating or activating. I just remember I've never felt more blunted emotionally in my life. And then when the psychiatrist upped the dose to 40mg, I broke out in full body hives. Was awful. Especially because Prozac has such a long half life. Took forever for them to go away. 

Edited by psychwardjesus
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On 6/30/2022 at 2:52 PM, ChunkOfCheesecake said:

Sure-- sensory of sight and sound are heightened. Light is sharp and irritating, sounds are startling. It's disruptive. (It can sometimes trigger a mild bout of anxiety).

The only reason I notice it, is because I didnt have this last year.

I did let the doc know-- he now wants me to cross taper to Prozac.

The good news is that Prozac has such a long half-life, that it is fairly easy to discontinue,  if it doesn't work out for you.

On the flip side, Prozac is considered, in general, to be a more activating SSRI: 

https://www.psychiatrictimes.com/view/psychopharmacology-anxiety

Quote from the article above:

" Fluoxetine (Prozac) is perhaps the most activating SSRI, with once-daily dosing in the morning recommended for most patients. Fluvoxamine (Luvox) is better tolerated with bedtime dosing, and citalopram (Celexa), paroxetine (Paxil) and sertraline (Zoloft) should be initiated in the morning with a change to bedtime dosing if drowsiness occurs."

Edited by CrazyRedhead
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