Paxil vs Zoloft for anxiety?

March 22, 2006 2:39 PM

Paxil vs Zoloft for anxiety?

Please keep it on-topic. I was prescribed Paxil for anxiety and panic. The doctor's first choice was Zoloft but Zoloft wont be covered by my insurance until a generic is released.

posted by anonymous to health & fitness (28 comments total)

This is entirely dependent on your personal biochemistry.

Which is to say, Paxil worked perfectly for me, but your mileage will almost certainly vary.
posted by tkolar at 2:49 PM on March 22, 2006

This is impossible to answer with so little information by people who don't know anything about pharmicology or pyschiatry, and you'll find little relevant and accurate information. Anecdotes are not a good meter for your own personal choices unless conditions are perfect.
posted by cellphone at 2:55 PM on March 22, 2006

Paxil has the advantage of coming on faster.
posted by kindall at 3:30 PM on March 22, 2006

What tkolar and cellphone said - everyone's mileage varies. I use Paxil, my sister uses Zoloft. Each works fine for us.
posted by Lucinda at 3:30 PM on March 22, 2006

lexapro.
posted by radioamy at 3:42 PM on March 22, 2006

If Paxil works, then great. If not, you'll just need to try something else. Just because it's the doctor's favorite doesn't mean a damn thing -- Zoloft did not work for me, Paxil did but kept pooping out (I had to keep upping my dose over a couple of years), and now I take Effexor. Your experience will almost certainly be different.

Good luck. I know how shitty anxiety can be. Exercise does help, in addition to meds. My email's in my profile if you need to talk.
posted by sugarfish at 3:53 PM on March 22, 2006

My mother found it difficult to get off of Paxil, but it worked very well for her while she was on it. I don't believe she was ever on Zoloft.

My only experience is with Xanax, and I give it two thumbs up.
posted by kimdog at 3:55 PM on March 22, 2006

Paxil made me feel like I was on the verge of death: sweating, racing heart, anxiety, nausea, loss of appetite.

But so what. It greatly helps other people. It does nothing for others. You won't know until you try it.

So do that, and keep in close contact with your doctor to monitor its efficacy.
posted by teece at 4:05 PM on March 22, 2006

It's different for everyone.

I was on Paxil for migraines, anxiety, and depression for awhile. It worked wonderfully for my symptoms, but when my physician weaned me off of it, I ended up with a whole host of other symptoms that took a few months to go away. I had strange electric shock-like feelings all over my body and a change in my migraine symptoms. About two months after I began the weaning process, after I was totally off the Paxil for a week or so, the withdrawal symptoms went away. It was really quite freaky for awhile, and I would be hard pressed to go back on Paxil just because of those withdrawal symptoms.
posted by MeetMegan at 4:08 PM on March 22, 2006

I just saw a doctor today about anxiety attacks.

He said "stop drinking tea, and return to playing sports." He specifically recommended swimming.
posted by Mozai at 4:23 PM on March 22, 2006

It does vary, but Paxil is one of the SSRIs frequently perscribed for anxiety as well as depression, so just cause your doctor likes Zoloft better doesn't mean it would be better for you. Paxil works well for me. So don't worry about it not being your doc's first choice.
posted by Airhen at 4:27 PM on March 22, 2006

I take Zoloft and it works fine for me. It did take about a month to completely kick in (I take it for anxiety/panic attacks/depression and OCD...yeah, I was pretty messed up.) and even then it took a bit of tweaking with my doctor before we hit on a dose that worked best.

Whenever I get asked about it, I always say I consider myself incredibly lucky I managed to take a medication that worked for me the first time around. My BIL on the other hand, started out on Zoloft and is now on Paxil.

Good luck and if you'd like to talk to someone who's been there, feel free to email me at obeetaybee (at) yahoo.com.
posted by obeetaybee at 4:34 PM on March 22, 2006

MeetMegan's experience is not unusual. I'd read up on paxil withdraw before taking it. I tried searching nih.gov for articles on paxil withdraw. However, I didn't find much except for this quote:
"Some common medicines, like selective serotonin reuptake inhibitors (SSRIs, such as Paxil, Serzone, and Prozac) may make symptoms worse by increasing levels of serotonin. However, these medicines should be discontinued ONLY on the advice of a doctor, since stopping them abruptly may cause withdrawal symptoms"
posted by malp at 4:39 PM on March 22, 2006

Try paxil, if it doesn't work well for you, as your doctor for samples of Zoloft and see how that works for you. If it works well, maybe he can just keep giving you samples till your insurance covers it.

For the record, I tried Paxil. It made me want to kill myself (and I wasn't suicidal or anything to begin with).
posted by necessitas at 4:56 PM on March 22, 2006

Ditto necessitas. There's no way for your doctor to determine beforehand what effect a particular anti-depressant or anti-anxietal med will do for you, so you should be ready to try another if you either see little effect or negative side effects. Samples are your best bet here.

Also ditto necessitas on the potential effects of Paxil. Both Paxil and Zoloft significantly *increased* my anxiety when I tried them, to the point where I felt suicidal (which I wasn't to begin with) when I took them. On the other hand, Xanax, which is not an SSRI like Paxil and Zoloft and is prescribed specifically for anxiety and not depression, worked like a charm. Xanax has the added advantage of working immediately after you take your first dose, unlike the several weeks of "ramp-up" Zoloft and Paxil have.

Your mileage will vary, just be careful, and if you start to feel significantly worse on Paxil or Zoloft, talk to your doctor.
posted by I EAT TAPAS at 5:13 PM on March 22, 2006

I loved zoloft, and was mellow as heck on it. (Your insurance needs its butt kicked, but I digress.) I'm bipolar and can't take it anymore (it pooped out and gave me panic attacks later, but that was because of my underlying condition. When it worked, it was golden.
posted by konolia at 5:30 PM on March 22, 2006

It depends on each person, IMHO, as to which drug is best for them.

I started out on Lexapro which is popular these days and only lasted two days. I felt crummy from the start and on the second day I developed a blinding headache and intense pain and pressure in my head that was debilitating. I could barely make it to my bed (thank god I was home). I thought I was having a stroke or something, even though I'm only in my forties. It scared the living hell out of me. That was the end of lexapro.

I went back to the doc and we decided to try Zoloft. It also had a sample "starter pack" with scored pills, so I could easily cut the pills in half and gradually build up the dosage. This worked just fine. Thank god.

...to reiterate what some folks said, if you don't like it, don't hesitate to go back to your doc and get something else. And your doc should make you come back about 2 to 4 weeks after you start to make sure you're not going bonkers and such.

...and I saw this website mentioned in the New York Times a while back. I've only buzzed by once or twice, but their sense of humor made me laugh and it seemed pretty infomative too. The description of the OCD section of the forum is hysterical.

Obsessive-Compulsive Disorder - Click Here Repeatedly
There are six subtypes of OCD. Count them. Six. 1, 2, 3, 4, 5, 6. Thank God it's an even number.

1. Checkers worry that incorrectly performed actions will cause a bad thing to happen.
2. Washers and Cleaners worry that germs and contamination will cause bad things to happen.
3. Orderers worry that having things out of order will cause bad things to happen.
4. Pure Obsessionals just can't stop thinking about bad things happening.
5. Hoarders worry that bad things might happen if they throw something away.
6. Scrupulous OCDers worry that they are a bad thing happening or about to happen.

Six. Yep, that's six. I better count again just to make sure.
posted by bim at 5:33 PM on March 22, 2006

a generic is released.

Are you certain no generic is available? I thought I was on generic; I could be wrong.

Zoloft has worked fine on my panic attacks.
posted by docgonzo at 5:44 PM on March 22, 2006

I believe generic Zoloft is expected soon per my doctor. But there was none as of about a month ago when I refilled.
posted by bim at 6:43 PM on March 22, 2006

Personal anecdote: I took Paxil for a while a few years ago, and I went off of it the wrong way, that is, I stopped taking it without consulting my physician or attempting to taper off the dosage. For two weeks, I felt worse than I ever had before or have since, swinging between frustrated rage (I actually kicked down a door after forgetting the key in my car) and completely incapacitating weepy lethargy. I think I'm probably lucky that I didn't commit suicide or sock someone else good.
posted by pullayup at 7:47 PM on March 22, 2006

I should mention that I was really, really mellow and emotionally detached while I was taking Paxil.
posted by pullayup at 7:49 PM on March 22, 2006

My psychiatrist is head of Psychopharmacology at a big-name medical school. I asked him once if finding the right ssri is pretty much of a crap-shoot. He said yes, but with one exception: if the patient has a bias in favor of one or another, he goes with that one first.

My two sisters and I all take ssri's. We've all tried the same ones, with radically different results. Prozac made one sister sleepy, and made one sister jumpy. For me it was great. (Sorry, I know this is sounding like Goldilocks, or maybe Snow White.)

And then if one ssri disagrees with you in some way, you can't make any predictions based on that, regarding any other ssri you try next. So if you try one and hate it, don't assume a different won't work. You might have to keep trying.
posted by wryly at 9:21 PM on March 22, 2006

As mentioned above, if you get side effects do ask for samples of the other drug and see which one works best for you. Side effects should pass in 2-3 weeks. If they do not then thats not the drug you should be on, regardless of what the insurance people dictate. Every SSRI has a legion of people ready with their horror stories. Ignore them and try Paxil and if doesnt work for you try something else, even if you have to pay out of pocket.
posted by skallas at 12:19 AM on March 23, 2006

Skallas is right. Here is Wikipedia on Zoloft and Paxil. Read what it has to say about "Addictive Potential" with respect to Paxil, it's a fair summary. It may take some time for you to find the right drug, there are more options than just these two and it is worth the effort to get it right.
posted by grahamwell at 1:25 AM on March 23, 2006

I would also suggest asking about Lexapro I tried it as a remedy for anxiety and mild depression and it has literally changed my life. Side effects were very minimal and anything I noticed went away after a few days anyway.

Good luck!
posted by punkrockrat at 10:03 AM on March 23, 2006

Zoloft made me want to crawl out of my skin. Paxil turned me into a new woman. After three months I felt better and stopped taking it and was fine. (Of course I don't recommend this, but I didn't like my HMO psychiatrist and I didn't know better.) The point, as I'm sure you've figured out is that you have to try stuff until you find something that works.
posted by Kimberly at 11:13 AM on March 23, 2006

Any pharmaceuticals that deal with neurochemistry have differents effects based on a number of factors -- some known, many not. I heard about a study on the drive home the other day where patients that didn't respond to one drug were given one of three others -- one was in the same family as the first, the other two were not. There was only a vague correlation as to whether the drug in the same family would or would not help. In other words, even different drugs of the same type (like SSRIs) can have different effects. Just don't be afraid to tell the doctor exactly how you feel, any side effects, and whether you feel the prescription is working. There are likely more than just those two options.
posted by mikeh at 11:21 AM on March 23, 2006

Please be very careful and pay attention to your body. Lexapro was determined to be the reason an ex-girlfriend's father committed suicide, and Paxil has given my brother suicidal thoughts.

I'm on Zoloft, and it works wonders for my anxiety/mild depression. I barely even noticed a change, just that I was less apt to have severe anxiety attacks.

Like many people have said, it is all about how your body reacts to different medications. Make sure you pay close attention during the first few months.
posted by LouMac at 11:35 AM on March 23, 2006