New Nurse on Paxil

Trauma Columnist · Jul 17, 2015

Moved to Stress Management 101 for more answers.

OP you might find some good threads in this forum to help address your issue.

mmc51264, BSN, MSN, RN · Jul 17, 2015

I am glad that I am not the only one. We figured out one of my kids was like that, too. We would give him cold medicine and was worse. Figured it out quickly.

NursesRmofun, ASN, RN · Jul 18, 2015

I have mixed feelings, but there are times people do need the help of a medication to manage symptoms. My story (a long time ago) is, I was on it, thought it was making me gain weight (although in hindsight, I don't think it was the Paxil) and I changed to Celexa. I was on the medication too long, IMO. Also, I tried to wean off it too fast when I did decide to do without it. I strongly suggest taking your time coming off any SSRI. I had a bad rebound depression going off too fast. Anyway...good luck with it.

nursecathi · Jul 18, 2015

Have rarely met a nurse who wasn't on some sort of antidepressant/mood stabilizer. Never thought it would be me. After a horrible year of personal and professional sry backs, I joined the crowd. Don't think I could make it without them now! It's ok.

DowntheRiver · Jul 18, 2015

I didn't like Paxil. I developed anxiety during nursing school, and my PCP put me on Paxil. I took it for 6 months and then decided I wanted to try to get pregnant so I went off it. I tapered, of course, but the headaches and withdraw symptoms were the worst. I was miserable, and I did taper.

I've been off it a year and had no problems. I have a xanax Rx for "emergencies" but I literally have only used 1 of the 15 pills that were given to me.

As somebody who has been there, there are other ways to figure things out. If you think you need it, take it. If you don't, and think you only have acute anxiety, then I'd talk to your doctor about having med for instances like that. Do you work out? That really helped lessen my anxiety. I also started cooking and baking again. Taking an interested in hobbies really distracted me from being so anxious all the time.

However, what worked for me doesn't work for everyone, and there are some people who need help. Just remember, that's perfectly ok!

vintagemother, BSN, CNA, LVN, RN · Jul 18, 2015

I just want to chime in and tell you that many nurses deal with anxiety. I think it's a part of our "type A" personalities, which serve us well as nurses.

As for me, personally,I was prescribed Paxil as a young adult but fought and persevered. In those days, you'd have caught me saying God and personal perseverance could get any person deal with anxiety/ depression/ mental illness.

When I was 30/32, I suffered a big personal upheaval (divorce and homelessness while completing nursing prerequisites)

At this point, I'd tell anyone, not medical, but personal advice, to take the meds prescribed to you.

Zoloft/sertraline saved me. I feel normal. No, good when I take my meds. I started on a baby dose. I bumped it up to 100mg and feel much better.

Psych meds are prescribed for a reason. Don't feel bad about taking them.

(((Hugs and prayers))))

Dogen · Jul 18, 2015

The thing with these meds is they're fairly individual. One person will take Paxil and find it intolerable, and the next will say it's the only thing that ever worked for them. Hopefully it works great for you and you don't have to worry about it. If it doesn't, though, there are several other SSRIs that tend to work well for anxiety, so just keep at it. There's some Paxil-specific teaching you should have gotten, but I'm probably not supposed to go over it per the TOS, so I'll just ask if you're seeing a mental health professional (psychiatrist, psych NP) or if you got the script from your PCP?

Also, anyone who tells you that you shouldn't be taking a psych med is a jerk. Straight up. Only a crazy person would tell you to stop taking your coumadin, but everyone will offer you an opinion on your psych meds. So be prepared to hear a lot of inexpert opinions from anyone in your life that you tell. I don't know who writes your scripts, so I'll reiterate that if you're not seeing a psych NP or psychiatrist then I'd recommend it. You wouldn't ask your endocrinologist to manage CHF, right? Most of all, take care of yourself. :)

Ruby Vee, BSN · Jul 18, 2015

Hi allnurses!
So I've been prescribed Paxil today due to anxiety issues which I will be taking the first dose (12.5mg) tonight before I go to sleep. I've been wanting to ask allnurses, especially nurses who are or was on Paxil, what their experiences are taking it including side effects and effectiveness. I am a little nervous about taking it although my anxiety isn't severe. According to the GAD tool that my family doctor used to assess me, I have moderate anxiety. I guess I'm always a worrier and always anxious about work and what I may do wrong. I always think that it could be just a "new nurse blues" kind of anxiety. I had graduated last year and only had 5 months of LTC experience and now starting a new job in Complex Continuing Care in a hospital. I have not practiced in a hospital for 2 years now so I'm definitely very anxious to start on my first night shift (never had a night shift throughout my nursing school or the 5 months as a licensed RN). I would really to hear or read everyone's input regarding taking anti-anxiety drugs and if it's even worth taking it.

Please discuss your concerns with the provider who prescribed the Paxil. No medical advice here, but I know many nurses who have used Prozac, Welbutrin, Zoloft and Paxil to good effect. I was prescribed -- and used -- Ativan during my cancer treatment. It can make the difference between being miserable and not. Good luck!

Dogen · Jul 18, 2015

Strange but true, that was how I found out I was bipolar: I tried Wellbutrin because Paxil had pooped out on me, and that stuff sent me into the stratosphere. I was practically swinging from the chandelier and wanting to fight people at the same time, imagining that they wanted to harm me in some way. Raging? Check. Manic? Check. Delusional? Check, check, check. I will never touch it again in this lifetime. I have to avoid most antidepressants anyway because they can throw me into mania, although I do take a subtherapeutic dose of Celexa to keep depression and anxiety at bay.

Yeah, when we start someone on an antidepressant if there's any question about whether they're potentially bipolar (family hx, unknown hx) we start them on a more sedating AD like Paxil or Lexapro. There's been some really good research done in the last 6-8 years on how to use ADs in people with bipolar and a big study came out last year that really firms up the first line approach of a mood stabilizer plus an AD.

On a side note... I hate the term "pooped out." It's widely used - Stahl even mentions it in his seminal Essential Psychopharmacology as a flag to check for sx of bipolar, noncompliance, medical conditions, and substance use - but for the life of me I don't know why. Maybe because the alternative is the technical term tachyphylaxis, which sounds like a disorder of its own.

brandy1017, ASN, RN · Jul 18, 2015

I have the opposite problems with SSRI and SNRI and the docs won't believe me: I get so wired on this stuff it scares me. I just recently tried Cymbalta b/c I have a new PCP. I went to my endo appt and she was like. what the hell is wrong with your eyes? I guess they were dilated to the size of dimes. I am one of those people who can't take Nyquil. Most things that sedate people, wire me. I have no idea what PCP will do next. My old regimen is working just fine, why change it????

Serotonins are being handed out for so many conditions, like how the birth control pill is used for many off label things. Serotonins can cause migraines and even paradoxically cause anxiety and agitation so you have to see if it works for you. Benzo's are the real anti-anxiety med, but doctors are reluctant to prescribe them over the fear of dependency. Therapy can help with anxiety including cognitive behavorioral techniques and even hypnosis. There are many books that describe these techniques to treat anxiety.

Simonesays, BSN, RN · Jul 18, 2015

As others have said, only you and your MD can really decide if this is the best course of action for you. Personally, I took Effexor when I was in my late teens/early twenties for depression/anxiety. It worked well for me and at the time I definitely needed it. However, stopping this medication was horrendous. Just keep in mind that any medication that specifically targets your neurotransmitters is not to be taken lightly. Not to say don't take it, but definitely discuss any and all concerns with your MD. And because taking an anti-anxiety medication is not a solution to your problem, more of a band-aid, I would suggest adding in supplementary things that will increase your coping mechanisms and decrease your stress levels (counselling, yoga, eating well, etc.).

Also, I think it's a pretty normal reaction to be anxious about this new transition into acute care. You're definitely not alone feeling like this! Ask lots of questions at work, research things you don't understand, take your time so that you practice safely. It also helps if you can find a couple of colleagues who you connect with. Nothing like grabbing dinner or a drink with a couple of work friends after a stressful shift to help you put things in perspective.

mmc51264, BSN, MSN, RN · Jul 19, 2015

Benzo's are the real anti-anxiety med, but doctors are reluctant to prescribe them over the fear of dependency.

And my question is, how is the fact that you can't just quit an SSRI/SNRI cold turkey not a dependency???? You become dependent on the ADs too. Why is one worse than the other?? I tried to find out why some people are so much more sensitive to the SSRI/SNRI and there is some interesting theories out there (not going into it here).