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Adding Paxil to my cocktail?


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Was diagnosed with OCD last week and my psychologist is strongly recommending I go on Paxil to help manage my symptoms (I seem to be more compulsive than obsessive).

 

The thing is, I'm already on Fetzima (an antidepressant), which my neurologist prescribed a few months ago to see if it would do anything for my stubborn migraines (check out my sig for all the meds I've been on before - 99% of them are migraine-related, especially the triptans and forms of birth control to deal with menstrual migraines). It hasn't been doing anything for them, or really for my depression either (I was on 40mg 5 weeks ago so we bumped it up to 80mg, still no change).

 

Plus my gastroenterologist prescribed me trazodone (oh yay, another antidepressant) to help me sleep at night because otherwise I'll wake up 4 - 5 times every night, have trouble falling asleep, have frequent nightmares, etc. (The long story is that in Sept. I had some severe stomach pain, thought it was an ulcer, ran through a battery of tests to find I'm... perfectly fine. And he's like, "Here's something to help you sleep at night cuz you seem VERY stressed out." Hence, trazodone.)

 

My concern with adding Paxil without changing the other meds is how much likelier is this serotonin syndrome business going to rear its ugly head? And at this point I'm thinking a psychiatrist might be better suited to this type of treatment. (Nothing against my gastro, but my psychologist nearly flipped her shit when I told her he was the one who gave me trazodone and Xanax.)

 

Thoughts?

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We are a peer support site and really can't give out medical advice, and this seems like a question that requires the expertise of a doctor.

 

Does your pdoc know you are those other meds? I agree with the psychologist that it's a good idea to get your pdoc to prescribe the psych meds so he/she knows exactly what meds you are taking. Also, your pdoc should be aware of your migraine condition and the severity and what meds you take for it.

 

If your pdoc knows all this and still thinks you should take the Paxil, then you should probably follow the advice of your pdoc. Serotonin syndrome is rare, but I would also be concerned if I were in your place.

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We are a peer support site and really can't give out medical advice, and this seems like a question that requires the expertise of a doctor.

 

Does your pdoc know you are those other meds? I agree with the psychologist that it's a good idea to get your pdoc to prescribe the psych meds so he/she knows exactly what meds you are taking. Also, your pdoc should be aware of your migraine condition and the severity and what meds you take for it.

 

If your pdoc knows all this and still thinks you should take the Paxil, then you should probably follow the advice of your pdoc. Serotonin syndrome is rare, but I would also be concerned if I were in your place.

 

Urg, my bad. My purpose in asking was along the lines of, "Hey, I'm nervous about possibly taking 3 antidepressants simultaneously when two have been prescribed by doctors who aren't experts in mental health fields; has anyone else taken a butt-ton of SSRIs/SNRIs and not had bad things happen to them? Would a psychiatrist be a good idea since I'm on a lot of crap at this point?" But I realize now that I didn't word my original post very clearly to reflect my thought process; my apologies.

 

I have a primary doctor (like, general physician) but I honestly hardly ever see him. It's a good and bad thing that he's the "hands-off, I'll-never-bug-you" type because I only come in when I need to, but... I only come in when I need to, you know? And the last time I saw him was probably three years ago for what I thought might've been strep? So to answer your question, no, my pdoc doesn't know I'm on any of these meds because I change meds so frequently because of my migraines. I kind of think of my neurologist as my pdoc to be honest, since I see him once a month (he knows everything I'm on).

 

The Paxil would probably help with my OCD in all honesty. My only concern is the trazodone and Fetzima fiddling with my serotonin as well. (But really, I'd prefer to not be on Fetzima since it's freaking expensive...)

 

Nonetheless, thanks for the reply; I appreciate your input. I can always talk about it some more with my psychologist as well.

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If you're going to take a cocktail of medications, then it is definitely better to consult with psychiatrist. Sometimes there are obscure interactions between medications that you have to watch for.

 

That being said, I've personally tried trazodone for sleep. It's not really prescribed for its antidepressant qualities. It didn't do anything for me, but I've heard it's pretty effective as a sleep aid for some people. It's frequently combined with SSRI's/SNRI's. I think you have to worry about the Fetzima and Paxil combination. A good pDoc should know the proper amounts for combining the two.

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