I have just started taking Paxil and Klonopin. My doctor said that the Paxil is supposed to evrn out your mood,give you more energy and should eventually lessen the anxiety attacks. The jury is stil out on that as I haven't been on it long enough to determine this.
The klonopin was prescribed at the same time and is to be taken only as needed i.e when the anxiety/panic atttacs get to be too muck. The jury is still out on that as well
the following is from a wickipedia entry for paxil. Maybe this could help
Paroxetine
From Wikipedia, the free encyclopedia
Legal status ℞ Prescription only
Routes Oral
Paroxetine or paroxetine hydrochloride is a selective serotonin reuptake inhibitor (SSRI) antidepressant. It was released in 1992 by the pharmaceutical company GlaxoSmithKline and has since become one of the most prescribed antidepressants on the market due to its apparent efficacy in treating depression as well as a spectrum of anxiety disorders ranging from panic attacks to phobias. The prescription of this drug is currently controversial because of legal proceedings against the manufacturer (see controversy below).
Paroxetine is primarily used to treat the symptoms of depression, obsessive-compulsive disorder (OCD), post-traumatic stress disorder (PTSD), panic disorder, generalized anxiety disorder (GAD), social phobia/social anxiety disorder, and premenstrual dysphoric disorder (PMDD).
It was the first antidepressant formally approved in the United States for the treatment of social anxiety disorder, causing it to be sometimes referred to (although inaccurately) as an anti-shyness drug.
Pharmacology
Paroxetine is the most potent and one of the most specific selective serotonin (5-hydroxytryptamine, 5-HT) reuptake inhibitors (SSRI). This activity of the drug on brain neurons is thought to be responsible for its antidepressant effects.
Paxil controlled release (CR)
Paroxetine controlled release contains a Geomatrix™ tablet that controls the absorption of the drug. Clinical studies show that controlled release tablet provides effective symptom relief with a lower number of patients stopping their treatment due to side effects.
However, the need for an extended release form of paroxetine has not been established, as the FDA indicated that the half-life for the original Paxil was ideal for once-daily dosing, and that a CR version was not needed.
Chemistry
Paroxetine hydrochloride is an odorless, off-white powder, having a melting point range of 120° to 138°C and a solubility of 5.4 mg/mL in water.
Formulations
Paxil / Seroxat (paroxetine) is available in 10, 20, 30, and 40 mg tablets.
Paxil CR (paroxetine extended release) is available in 12.5, 25, and 37.5 mg tablets.
Paxil, Seroxat and Paxil CR are manufactured by GlaxoSmithKline, however a generic (though not yet for the extended release) is now available under the chemical name paroxetine.
Side effects
General side effects are mostly present during the first 1-4 weeks while the body adapts to the drug. Almost all SSRIs are known to cause either one or more of these symptoms. A person receiving paroxetine treatment may experience a few, all, or none of the following side-effects, and most side-effects will disappear or lessen with continued treatment, though some may last throughout the duration. Side effects are also often dose-dependent, with fewer and/or less severe symptoms being reported at lower dosages, and more and/or more severe symptoms being reported at higher dosages. Increases or changes in dosage may also cause symptoms to reappear or worsen.
Most common
Headache
Nausea
Dry mouth
Increased sweating
Drowsiness/Somnolence or Insomnia
Increased or decreased appetite
Weight loss or gain
Constipation or diarrhea
Inability to achieve orgasm
Partial or complete loss of libido (sexual desire)
Erectile dysfunction
Tremor
Vertigo/Dizziness/Motion sickness
Less common
Check with your doctor if these continue or are bothersome.
Increased feelings of depression and anxiety (initially)
Apathy
Loss of empathy
Flattening of emotional response
Nocturnal salivation
Nocturnal bruxism (teeth grinding)
Pupil dilation
Asthenia or muscle weakness
Muscle ache
Pruritis
Rash
Nightmares or change in dreams
Change in sense of taste
Rare
See your doctor if you have any of these symptoms.
Myoclonus (involuntary muscle twitching)
Sodium depletion
Severe restlessness or akathisia
Uncharacteristic levels of aggression (especially in children and teens)
Uncharacteristic risk taking
Very rare but serious
Suicidal ideation and Suicide
Serotonin syndrome
Bipolar mania or hypomania
Schizophrenia (unverified)
Jaw, neck, and back muscle spasms
Fever, chills, sore throat, or flu-like symptoms
Yellowing of the skin or eyes (Jaundice)
Black, tarry stools (this can indicate upper GI bleeding)
Other
Teratogenicity: Pregnant women are advised not to take the drug due to possible fetal heart defects.
The patient information leaflet for Paroxetine seems to differ from country to country The Tauraso Medical Clinic.
Paroxetine and other SSRIs have been shown to cause sexual side effects in most patients, both males and females. Although usually reversible, these sexual side effects can sometimes last for months, years or possibly indefinitely even after the drug has been completely withdrawn. This disorder is known as Post SSRI Sexual Dysfunction.
Withdrawal syndrome
Main article: SSRI discontinuation syndrome
Many psychoactive medications can cause withdrawal symptoms upon discontinuation from administration. Substantial evidence has shown that paroxetine has the highest incidence rate and severity of SSRI discontinuation syndrome of any medication of its class. Repeated electrical shock sensations of the brain and body (see "brain zaps"), vertigo and hot flashes being prevalent.For those experiencing extreme and unusual difficulty discontinuing paroxetine, it is recommended that an SSRI with a longer half-life, such as fluoxetine, be administered for approximately two weeks, then discontinued, to lessen symptoms
Suicidal ideation is a frequently reported experience in those withdrawing from SSRIs. Withdrawal from paroxetine or any other SSRI should be closely medically supervised by the prescribing physician.
Warning for pregnant women
Pregnant women and those who might become pregnant should avoid taking the antidepressant Paxil because of a high risk of birth defects, according to a committee of obstetricians who published their opinion in the December issue of the journal Obstetrics & Gynecology
The obstetric practice committee of the American College of Obstetricians and Gynecologists said pregnant women should not take Paxil because two previous studies found that the drug posed up to double the risk of heart defects in fetuses.
Nearly a year ago, the U.S. Food and Drug Administration (FDA) and GlaxoSmithKline -- which makes Paxil -- changed the warnings on the drug to include the results of the studies. The FDA then advised pregnant women to merely switch from Paxil to another SSRI drug, such as Prozac or Zoloft.
The FDA's enhanced warning on Paxil followed the results of a review of Sweden's birth registry that found pregnant women who took Paxil were 1.5 to 2 times more likely to give birth to a baby with heart defects than women who took other SSRIs or who did not take antidepressants at all.
Neonatal withdrawal symptoms from Paxil have also been documented from mothers taking Paxil during pregnancy
Controversy
On October 6, 2006, a US court preliminarily approved a settlement in a class action lawsuit brought on behalf of everyone in the United States who purchased Paxil(R) or Paxil CR(TM) prescribed for consumption by a minor child. The lawsuit alleges that GlaxoSmithKline promoted Paxil(R) or Paxil CR(TM) for prescription to children and adolescents while withholding and concealing material information about the medication's safety and effectiveness for minors. GSK denies all claims. If approved, the Proposed Settlement will provide $63.8 million to pay consumers, who submit valid Claim Forms, cash for the total amount they paid for Paxil(R) or Paxil CR(TM). Eligible Class Members can get up to 100% of the amount paid for Paxil(R) or Paxil CR(TM).
The Court will hold a Final Approval Hearing on March 9, 2007. At that time, the Court will consider whether to approve the Proposed Settlement and award attorneys' fees and costs.
Update to aforementioned settlement: This class action settlement (Hoormann v. SmithKline Beecham Corporation) was approved in May 2007. Although a settlement was reached in October 2006, that settlement was dramatically improved at a recent hearing (after Public Citizen Litigation Group got involved). Under the terms of the revised settlement, if you ever purchased Paxil or Paxil CR for your child or ward, you are entitled to recover up to 100% of your documented out-of-pocket expenses. If you are unable to find documentation of your Paxil purchases, you can still recover up to $100. To receive a refund for the money you spent buying Paxil or Paxil CR, you must submit a claim .the claim forms must be received by August 31, 2007.
In March 2004 the FDA placed a black box warning on SSRI and other antidepressants, warning of the risk for potential suicidal thinking in children and adolescents. ABC News reported that the prescribing of these medications to children subsequently dropped by 20 percent. According to the Center for Disease Control and Prevention's Annual Summary of Vital Statistics, the suicide rate rose more than 18 percent in those 1 to 19 years old, from 2.2 per 100,000 in 2003 to 2.6 per 100,000 in 2004. In those 15 to 19 years old, the figures reflected a more than 12 percent rise in suicide, from 7.3 per 100,000 in 2003 to 8.2 per 100,000 in 2004. This led many experts to conclude that the warning, and subsequent reduction in the use of antidepressants, led to an increased suicide rate in this age group. The finding is consistent with an earlier finding, reported to the 2003 FDA Advisory Committee by Dr David Shaffer, that suicide rates in the United States fell during the 1990s, in line with the introduction of SSRIs.
Since the FDA approved paroxetine in 1992, approximately 5,000 U.S. citizens have sued GSK. Most of these people feel they were not sufficiently warned in advance of the drug's side effects.
According to the Paxil Protest website, hundreds more lawsuits have been filed against GSK. The Paxil Protest website was launched August 8, 2005 to offer both information about the protest and information on Paxil previously unavailable to the public. Just three weeks after its launch, the site received more than a quarter of a million hits. The original Paxil Protest website was removed from the internet in 2006. It is understood that the action to remove the site from the internet was undertaken as part of a confidentiality agreement or 'gagging order' which the owner of the site entered into as part of a settlement of his action against GlaxoSmithKline. (However, in March 2007, the website Seroxat Secrets [ discovered that an archive of Paxil Protest site was still available on the internet via Archive.org) Gagging orders are common in such cases and can extend to documents that defendants wish to remain hidden from the public. However in some cases, such documents can become public at a later date, such as those made public by Dr. Peter Breggin in February of 2006.
In January 2007, according to the Seroxat Secrets website, the national group litigation in the United Kingdom, on behalf of several hundred people who allege withdrawal reactions through their use of the drug Seroxat, against GlaxoSmithKline plc, moved a step closer to the High Court in London, with the confirmation that Public Funding had been reinstated following a decision by the Public Interest Appeal Panel. The issue at the heart of this particular action claims Seroxat is a defective drug in that it has a propensity to cause a withdrawal reaction. Hugh James Solicitors have confirmed this news.
On January 29 2007, the BBC in the UK broadcast a fourth documentary in its 'Panorama' series about the drug Seroxat. This programme, entitled Secrets of the Drug Trials, focused on three GSK paediatric clinical trials on depressed children and adolescents. Data from the trials show that Seroxat could not be proven to work for teenagers. Not only that, one clinical trial indicated that they were six times more likely to become suicidal after taking it. In the programme, Panorama revealed the secret trail of internal emails which show how GlaxoSmithKline manipulated the results of the trials for its own commercial gain. Access to the documents has been gained as GlaxoSmithKline fights a fraud trial in the US.
What cannot be denied is that the release into the public domain of previously secret Glaxo documents, can only serve to stimulate discussion and debate regarding the way certain companies choose to market their products.
On the 12th Of February 2007, according to The Sun newspaper (and news organisations around the world) singer Robbie Williams checked himself into rehab to kick his addiction to Seroxat.
The following is from wickipedia for an entry about Klonopin
Clonazepam
From Wikipedia, the free encyclopedia
Routes Oral, I.M., I.V, sublingual
Clonazepam (marketed by Roche under the trade-names Klonopin in the United States and Rivotril in Europe, South America, Canada, India, and Australia) is a drug which is a benzodiazepine derivative. It is a highly potent anticonvulsant, amnestic, and anxiolytic.
Pharmacology
Like other benzodiazepines, clonazepam is believed to act by enhancing the action of GABA on the central nervous system. Because of its powerful anxiolytic properties it is said to be among the class of 'highly potent' benzodiazepines. Although benzodiazepines are valuable in the treatment of anxiety disorders, they carry a high potential for physical and psychological dependence with profound withdrawal symptoms especially if discontinued abruptly or overrapidly in certain individuals. Caution is advised when taking this or any benzodiazepine medication longer than a few weeks. One milligram of clonazepam is approximately equivalent to twenty milligrams of diazepam.Unlike most other benzodiazepines clonazepam appears to also have a secondary effect on the neurotransmitter serotonin. It has shown itself to be highly effective as a short term (3 weeks) adjunct to SSRI treatment in Obsessive Compulsive Disorder and Clinical Depression in reducing SSRI side effects with the combination being superior to SSRI treatment alone in a study funded by the manufacturers of clonazepam, Hoffman LaRoche Inc.] Similar results have been found with some other anxiety disorders, but the role of the serotonergic effects enhancing the action of the SSRI treatment remains unclear in these cases due to clonazepam's primary anxiolytic mechanism of action.
Indications
Clonazepam is sometimes used for refractory epilepsies however, long term prophylactic treatment of epilepsy has considerable limitations, most notably the loss of antiepileptic effects due to tolerance, which renders the drug useless with long term use and also side effects such as sedation, which is why clonazepam and benzodiazepines as a class should generally only be prescribed for the acute management of epilepsies. Clonazepam is less effective and potent as an anticonvulsant in bringing infantile seizures under control compared with nitrazepam in the treatment of West Syndrome which is an age dependent epilepsy, affecting the very young. However as with other epilepies treated with benzodiazepines, long term therapy becomes ineffective with prolonged therapy and the side effects of hypotonia and drowsiness are troublesome with clonazepam therapy, other antiepileptic agents are therefore recommended for long term therapy, possibly Corticotropin (ACTH) or vigabatrin. Clonazepam is therefore not recommended for wide spread use in the management of seizures related to west syndrome. Also with long term use abrupt or over-rapid withdrawal from clonazepam can precipitate withdrawal related seizures if tolerance and physical dependence has developed.
Peak blood concentrations of 6.5–13.5 ng/mL were usually reached within 1–2 hours following a single 2-mg oral dose of micronized clonazepam in healthy adults. In some individuals, however, peak blood concentrations were reached at 4–8 hours.
Clonazepam is commonly prescribed for:
Rapid eye movement behavior disorder
Epilepsy
Hyperekplexia. Clonazepam is prescribed to dampen the effects of the disorder, reducing the startle response in sufferers. Those who fall when startled are less likely to do so once treated.
Anxiety disorders. Due to the often chronic nature of some anxiety disorders, long term therapy may be advocated.
Panic attacks
Restless leg syndrome (RLS)
Initial treatment of mania, together with firstline-drugs such as lithium, haloperidol or risperidone
Hallucinogen persisting perception disorder (off-label use)
Chronic fatigue syndrome
Night terrors
Tourette Syndrome - Clonazepam has shown to be helpful in reducing and dealing with the physical motor tics associated with TS, though is still considered an off-label usage by many.
Schizophrenia - Clonazepam has been prescribed in order to alleviate the side effect of akathisia of certain antipsychotic agents used in the treatment of Schizophrenia.
Clonazepam is rarely used as a treatment for insomnia, because it has not been marketed for the treatment of insomnia and also importantly because its long half life renders it unsuitable for use for the treatment of insomnia.
Availability
Klonopin 0.5mg
Klonopin 1mg
Clonazepam 1mg (Generic) Clonazepam was approved in the United States as a generic drug in 1997 and is now manufactured and marketed by several companies.
Clonazepam is available in the U.S. as tablets (0.5, 1.0, and 2mg), orally-disintegrating tablets (wafers) (0.125, 0.25, 0.5, 1.0, and 2 mg), liquid solution (2.5mg per ml) and for injection (1mg per ml)
Like all benzodiazapines, clonazepam is a benzodiazepine receptor agonist. Long-term use (more than 2-4 weeks) can lead to a number of problems, including muscle weakness and fatigue, tolerance, physical dependence and withdrawal syndromes upon discontinuation. The benzodiazepine withdrawal syndrome which may appear during reduction or withdrawal of clonazepam treatment can be reduced in intensity with gradual reduction of dosage.
Side effects
Common:
Drowsiness
Impairment of cognition and judgment
Euphoria
Impaired motor function
Impaired coordination
Impaired balance
Dizziness
Anterograde amnesia (common with higher doses)
Rare:
Paradoxical Disinhibition. (Most frequently in children, the elderly, and in persons with developmental disabilities)
Rage
Excitement
Irritability
Impulsivity
Some users report hangover-like symptoms of being drowsy, having a headache, being sluggish, and irritable after waking up if the medication is taken before sleep. This is likely the result of the medication's long half-life which continues to affect the user after they wake up as well as its disruption of the REM cycle.
Withdrawal-related:
Anxiety, irritability, insomnia
Panic attacks, tremor
Seizures similar to delirium tremens (With long-term use of excessive doses)
100% of individuals treated on a long-term basis develop a form of dependence known as "low-dose-dependence" as was shown in one double blind placebo controlled study of 34 low dose benzodiazepine therapeutic users, physiological dependence was demonstrated via flumazenil precipitated withdrawal. Use of alcohol or other CNS depressants while taking clonazepam greatly intensifies the effects (and side effects) of the drug. Side effects of the drug itself are generally benign, but sudden withdrawal after long-term use can cause severe, even fatal symptoms.
Interactions
Similar to Diazepam.
Overdose
An individual who has consumed too much clonazepam will display one or more of the following symptoms:
Somnolence (difficulty staying awake)
Mental confusion
Hypotension
Impaired motor functions
Impaired reflexes
Impaired coordination
Impaired balance
Dizziness
Coma
Unless combined with other drugs, deep coma or other manifestations of severe central nervous system depression are rare, and the mortality rate associated with poisoning is very low. As with other benzodiazepines, overdose symptoms of clonazepam may be reversed with flumazenil (Romazicon®).
Recreational Use
Benzodiazapines such as Clonazepam are sometimes used recreationally, when used for this function they are often referred to by the slang term "Clammies", "Klonnies", "Kpins", or "Nignogs", if in Klonopin form, most commonly as a secondary drug to increase the pleasure resulting from a primary drug, or possibly to lessen or prevent some of the primary drug's negative side effects. It should be noted that relatively few cases of addiction arise from legitimate use of benzodiazepines.
I know this is a lot to read but it might give you some idea of what to expect. Only by talking with your doctor will you really know what is the best for you.
I wish you all the luck in the world on this. I am in the same boat as you. God Bless