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I have been on paxil for over 3 years treating social phobia. And for the past year it has not been so effective, what do you suggest upping the dosage or switching to something new. Also I do plan on having children and the paxil worries me with the latest birth defect news.

Thanks and look forward to your feedback.


Hello, Jen--

Although the SSRIs, such as Prozac and Paxil have proven valuable for treating depression, social phobia, obsessive-compulsive disorders, and various other illnesses, they do also present a variety of problems. To begin with, any one particular antidepressant drug will be effective only for between half and two thirds of those who try it. In other words, often the patient must try several antidepressants before finding one which will be effective. Then, there are the side-effects, some of them serious, which these chemicals may produce. The latest news about an enhanced risk of birth defects in regard to Paxil is an example. Finally, there is the problem you mention, which is that often a drug which has worked well for some time will begin to lose effectiveness. This usually handled by switching to a different chemical, not by upping the dosage, since upping the dosage may also up the risk of unwanted side-effects, and will probably not be as helpful as switching to a different medication.

I would suggest that you ask your doctor for help in changing to another SSRI, and I suggest that you or any woman who may become pregnant avoid using Paxil at all.

Be well.

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