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Is Paxil to Strong for this cocktail?

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I take Lex now at 20mg in my cocktail. I'm BP1 w/psychotic features.

I got off of Paxil after a long withdrawl period because everyone around me was telling me it was "dangerous", and wanted me to take Lex (my pdoc didn't have an opinion one way or the other). I admit, getting samples of Lex for free from my pdoc is better than buying Paxil at the pharmacy, however I think I liked Paxil better.

Would it be too strong to keep my balance? Maybe cut the Lex and WB and readd Paxil?

What do you think I should discuss with my pdoc?

Loony as they come

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Have you tried all the non-SSRI ADs? Remeron? Strattera? Effexor? Cymbalta?

I believe they all have a better track record in terms of not agrivating mania.

You never want to take two SSRIs at once. Doing so could place you at significant risk for serotonin sydrome which can be fatal.

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Hey Loon

Not to harp on ya or anything, but a BPI who's taking high SSRI doses, Lamictal (a predominately 'activating' AC/MS), and WB looks to me like some sort of adrenaline/stimulatory junkie. Only saying this from personal experience (herrfous should really NOT be taking high-dose Provigil and 4 shots of espresso each morning with his tremor and swallowing issues!).

You know what though, if it makes you happy and doesn't hurt anybody else, then I say go for it.

Back from pharmacological ethics to your actual scenario, and sort of mirroring what Velvet Elvis said, Paxil does seem a bit harsh (even if you do come off Lex). I mean, you don't seem to be too endeared with the stuff to begin with. ;-)

The good VE also mentioned Remeron - perhaps that could supplement/replace the Lex and completely replace the Z? Just don't combine it with Z if you plan on either waking up some time this century or commuting to work by means other than rolling on your side. And if you take my apartment suggestion from last month, trust me, rolling up that divisive Hill is going to be a bitch. Remeron's a very good sedative, though it hasn't been extensively studied as an antimanic yet. I'm on it to promote deep sleep, and it's done its job handsomely.

Also, remember the differences between the tetracyclic ADs (Remeron et al) and the selective neurotransmitter RIs... the RIs have a somewhat crude method of action, flooding all of your synapses with the NTs, whereas most tetracyclics (trazodone MAYBE) actually go and block some kinds of receptors that we don't want activated...

SSRI (Skeptical of Selective Reuptake Inhibitors),


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Today I was informed that our goal is to take Lex down to 10 and raise Z up to 20 (if 15 isn't strong enough). we wish for a world of lamictal, low level of lex, Z, and inderal to keep EPS at bay.

i do so miss the paxil though. maybe it is like when people quit smoking or something and think longingly back to the substance they gave up. i'm just a junkie!

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I'm Bipoloar II or NOS and Paxil was the only SSRI to cause mania (tho I didn't know it at the time and my doc missed it too!). It seems to me Lex is the least dangerous in that regard. Did upping the Lex during your psychotic episode help?

As far as Remeron goes, for me it's mixed state land. Norepinephrine along with sedation and it seems to be made for it. That's how it was for me when it pooped out and turned on me.

I'm following your time with Z because I have a feeling I'll be on it again by end of summer.

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