Paroxetine to Venlafaxine

[tinx25388]

I've been meaning to ask my Pharmacist at work but things have been so busy lately, I haven't had chance!

My Dad has been taking Paroxetine 20mg for the last 15 years (alongside counselling, and is currently undertaking congnitive behvioural therapy) and under the Doctor's supervision, has made several attempts to wean himself off of it gradually, however events cause him to get too depressed and he then ends up back on the full dose. He really does want to come off medication altogether.

The GP now thinks that he has been on it too long, and may have become de-sensitised to it, so intends to change him on to Venlafaxine. I'm only concerned as I know how low he can get, and don't want this to cause more problems.

Any thoughts appreciated! Many thanks

[Nik]

The problem with long term paroxetine is the withdrawal symptoms that accompany discontinuation. It is possible if the GP wants to switch to venlafaxine to cross taper both drugs, ie start venlafaxine usually at 37.5mg whilst slowly reducing the paroxetine and slowly increasing the venlafaxine. Venlafaxine is thought to work like an SSRI at low doses, with additional "tricyclic" effects at higher doses. Venlafaxine however isn't one of the better tolerated anti-depressants.