Effexor and Paxil mix

[echoecho]

Does anyone have experience mixing Effexor and Paxil? 

I have tried Prozac, Zoloft, Paxil alone, Wellbutrin and Celexa, nothing worked.  I tried Effexor a few months ago and even at 37.5mg, it drove me nuts.  I had so much rage that I argued with people and wanted to "kill" them all the time.  But it pulled me out of the deep darkness. 

So now my pdoc wants to put me back on Effexor, along with Paxil (which just doesn't have any effect on me as far as I can tell). 

I'd love to hear advise/past experience from everyone.  Please help. 

[ConfusedCat]

I am but one person, however I have never heard of this combo and doubt there is one. Effexor and buspar but not effx and another ssri. Why? Because until  you get up to a very high dose on effx it is mainly only an ssri in itself. Adding another ssri would be heading into seratonin syndrome territory.

Usually if you want a combo it would be wellbutrin plus an ssri. WB starts out as an snri, no need to mega dose it to receive the boost from it, therefore it is safer as a part of a combo.

CC~

[echoecho]

I didn't respond very well to Welbutrin.  He had me on Paxil and Prozac for a week, then weened off Paxil.  I was doing badly with just Prozac, so now I am on Paxil and Effexor.  His reason is that Effexor seems to make me a bit on the psychotic side, and Paxil is a little calming.  Is it time to look for another pdoc?  I am feeling so bad, I can't make decisions anymore. 

[ConfusedCat]

I am not a Doc and would never try to second guess the reasoning of one.

What dose of each med are you taking? If you are on a high dose of the EFX, like above 250 or 300 and he thinks throwing a small dose of paxil into the mix might calm you a bit, then it *might* make sense even if not to me.

If you are at a lower dose of EFX it makes zero sense to me.

Like I said rarely would any Doc put someone on two sssri's at the same time. Usually only during a changeover from one ssri to another and even then most admit it is probably ok just to switch between most of them. (paxil, zoloft, lexapro, celexa) Although prozac is a bit different and usually done as a taper/titration.

It just doesn't compute to use two drugs hitting the same transmitters. Why were you on paxil and prozac at the same time? Was it switching over or just his reccomended combo to try? Have you ever tried paxil by itself?

Would need more info before giving an opinion on if Id dump the Doc.

I am sorry you are in this position and feeling so bad. I hope you can find better meds/help soon.

CC~

[whitenoise]

Even at lower doses, Effexor still does not function as a "pure" SSRI. As this column explains, it's basically 4 parts SSRI to 1 part NARI. So at lower doses there might still be too much NARI.

To the OP: I'd be careful about the liver interactions, because Paxil is a mild inhibitor of certain enzymes that may be used to breakdown Effexor.