Paxil Dosage

I am so happy for you that you are having some success with the Paxil. Guess What? I just got back from Chicago this afternoon, after spending the day yesterday in Dr. Hain’s office. Got there at 9am and left at 7pm. Turns out I not only have MAV, but have BPPV and they did every test on me, including the water in the ears . I did mention to Dr. hain about Paxil, after reading your posts about trying it and also I think it was Scott using it at 2.5mg. SO, here is what dr. Hain gave me:
( I have to use a compounding phamacist)

 2.5 mg paxil
 5 mg nori
 120 verapamil ( I am now on 210mg. ver. but he wants to lower that to 120) 
 Stop the xanax slowly ( I only take no more than .75 per day anyway) and 
 get on Lorazapam when needed.
 Do Epley manuvers and balance exercises

 I for got to ask him HOW exactly am I supposed to start all this. Do I take the paxil and the nori at the same time? I also forgot to ask if I can lower Verap. suddenly or have to wean off it. I don't really know.   The manuvers yesterday have made me soooooooo dizzy today, it's hard to type.   But, I will say that Dr. Hain is a true gentleman, brilliant, very easy going, quiet, not push and not an egomaniac, like so many Dr.'s I've seen recently. I liked and liked his whole staff of experts. I will call back there Monday to ask the questions I forgot to ask. Wow, I got nervous, evidently. I am a spinning wreck now, so again, I am happy, happy for you, Darren about the Paxil and now I have a presc. and can go as slow as I want but just don't really understand if I am supposed to do it with nori, or do one, then add the other lots later???  I think he was thinking Paxil for depression and Nori or spinnning.         It was quite the trip, very exciting to be in downtown Chicago, gorgeous hotel, Ruth's Chris steak, and would have been a dream, if I had felt normal and not so sick all the time.       spinning lady, Meredith

Wow, Meredith - so pleased your fears about Dr Hain were unfounded and that he’s such a nice guy & good doctor. We all feel we’ve hit gold dust when we find a doctor who understands MAV & has a treatment plan - it takes a weight off our shoulders to know someone to really trying to help you recover. Having BPPV as well as MAV would probably not have been diagnosed by a ‘run of the mill’ doc. Hopefully the BPPV will be fixed by the Epley moves.
Looking forward to hearing how Dr Hain suggests you take all these meds!


Im glad that Hain caught the BPPV! You will feel a LOT better soon once the BPPV settles down. Nori is usually taken at night a few hours before bed. I have been taking Paxil before bed. I think that Dr. Hain will tell you to take them both in the evening. But you could always take Nori at night, and Paxil in the morning. I dont think it really matters.

thanks to you Barb and Darren,
So comforting to have someone “out there” that understands and knows what we go through. I hope you are right, Darren, that I will start to feel better after getting the bppv under control. Started the Epley last night and I sure hope it’s normal to feel very dizzy afterwards and all night and now this morning . I will stick with it. Thank you both for encouraging words. IF I had a glass of good wine, I say “here’s to you both”, but of course, I don’t. good wishes for you, Meredith

I’m so happy that you had a good experience at Dr. Hain’s. I met with him almost 2 years ago, and really liked him. Although I have to say, between his website and this forum, I think I already knew everything we talked about. AND! He recommended Effexor, which I was totally paranoid to take.
I would think since you are taking such baby doses of these meds, that you could take them at the same time, and I believe nightime is best since they usually make people tired. Since you tried Paxil before, it shouldn’t be anything new…the Nori is pretty easy for most people, especially at such a low dose.
SInce you tried Paxil before, was it for anxiety and/or depression? I’m asking because if that’s the case, you have probably dealt with low serotonin your whole life, and as we get older, the serotonin levels drop…so it would make sense that you would be helped by these meds.
Best to you…

Hey kelley, So good to hear from you! I just thought if I started really low and went slow, that I could avoid alot of pain and heartache. I took Paxil in the 90’s when I had a very busy, stressful career selling huge houses in Orange County, Calif. Lots of very rich and pushy people, and very demanding, too. So, my Paxil just smoothed me out and eased the stress levels. I have to have these prescriptions made by a compounding pharm. for a while, until I go up highter, but I am very hopeful of Paxil for anxiety, Nori for dizzy. On another point, I found out I have bppv also. We started Epley here last night, and they did one at dr. Hain’s office, too. I am to do 3 sets of manuvers one each day for two weeks. I am hopeful about that too. Maybe that is what was causing alot of my dizziness. Yes, I really liked dr. hain but much of what he said I had read on his website, but he was wise enough to to tests on me that I had never had before, and he found the bppv himself. So, I am very happy with him and I should get a complete report in about 2 weeks. He did not mention effexor, as I had written to him and told him I tried it already and did not want to go there. So, he didn’t bring it up, except to say that 50% success rate on effexor and 75% success rate on Nori. Why does his like effexor so much??? hmmm Hope you are feeling good these days. What are you taking and how is it working? Best wishes to you, Kelley, meredith

HE said he gets 50% relief for MAV with Effexor and 75% with Nori?
Strange that his flow chart doesn’t say that…I wonder if he’s changed his tune over the years.
I think paxil comes in both regular release, and CR or SR (extended release)…with that being said, I would try to get the extended release. Paxil is known to have a short half life, so you don’t want your brain going up and down…a nice steady relese would be best, in my opinion. I also believe that Paxil comes in tablets, which come in 10mg…I know Scott from the board takes 2.5mg…I believe he cuts his in 4th’s…so it would save the expense of having a compounding pharmacy. I know my prescription for nori came in capsules, at 10mg, so you may have to have them do that one.
I don’t know anything about BPPV, so I’m hopeless at any advice there, but I’m glad you have a diagnosis.
Keep your chin up and know that good days are just around the corner!

Hi Kelley,
Yes, actually when he said effexor gets only a 50% sucess rate, my hubby looked at me like hmmmmmm,and we both were wondering what he meant, since we thought effexor was his favorite. He said 75% success for nori and that is why we decided on it. He also said that 100% of people he studied gained weight on Nori. Didn’t like that and asked him if there was anything else I could take that would be AS good for dizzy as Nori and he said NO, just watch your food portions etc. DUH!! Thanks for advice on the pills. Helps me so much. Meredith

Hi Meredith,

I am surprised at the 50% report too. But then I looked at his current treatment algorithm and he has the tris and Fex in the same box as a first line treatment. My guess is that he tries Fex first because the side effects are fewer in his opinion and 50% isn’t bad really; it’s like tossing a coin. If that fails he no doubt jumps to the tricyclics next.

S 8)

Hi Scott,
Funny that I should hear from you tonight ( but very glad!!). I just got an email from my son. He had found a post you had made and I don’t remember the date but it was on the subject of you taking paxil and benadryl (diphenhydramine) and what a scary, awful time you had. It was a few pages of posts from different people. He knew that I was going to start taking Paxil and he also knows that I take one sleep aid each night, which is diphenhydramine!!! I read your posts and of course, it scared me, so tomorrow I will look for an all natural sleep aid. Have you ever heard of Alteril? I really need a sleep aid, but am afraid to mix it with ssri’s now that I read your posts. I don’t know when that was, as I didn’t look at the date, but I sure hope you are ok , nothing too horrible happened to you and I wish you good days and nights ahead. Meredith

Paxil can make you sleep better, so you may not need an additional sleep aid. You might want to consider trazodone…it ups serotonin and is used as a sleep aid. have you considered Melatonin? I had a lot of trouble sleeping and tried many things, but I found melatonin at 3mg, and the EXTENDED release worked well. The body also makes less melatonin as we age, along with serontonin…supplemlents can be helpful. :slight_smile:

Thanks, Kelley,
Getting old is not for the faint of heart!!! Seems everything “happens” when we age. I am out the door now to the compounding pharm.and will look into getting melatonin. I guess I will be taking the paxil and the nori at night? Together? I’m so chicken, my dose of both will hardly register , as they are so low, but I will increase slowly. Off I go. xoxo meredith

Im still feeling positive effects from 10mg Paxil. Ive only been up to 10mg for 4 days now, but Im tempted to try 15mg because I have no side effects. Is this crazy?

How long do you think it takes for Paxil to kick in? As I said, I felt improvement on the first day of 10mg. But I havent made additional improvement since then, Ive just stayed at that new level. It seems that it takes an SSRI a few weeks to kick in for use with anxiety, so I should probably expect more improvements in dizziness too?

You are a gutsy guy to go up to 15mg after only 4 days at 10mg. I admire that. You want improvement and you are going to try and get it soon!!! I, on the other hand, will start out Paxil at 5mg, like you did, but go slower, maybe 2 weeks? Then titrate to 10 and stay there for 2 weeks. I hope with all my being , that paxil will help us both with dizziness as well as anxiety. Good luck, my boy!!! I’m counting on you to lead the way. BTW, I lived in calif. for 25 years, So. Calif. orange co. I see you are in Calif. My son lives in Irvine. I am in Iowa at our lake house for the whole summer. I think I told you I am in a wheelchair in stores now. I NEED to get better. This is ruining my plans for a life. So, I am thrilled that you have NO side effects at 10mg and hoping the same is true for 15mg. Good luck, Darren. I’'m hopingfor you. xoxo Meredith

I am still on 10mg and doing quite well! Ive only been on the Paxil for 8 days but I felt at least 60% better today!

However, the sexual side effects have set in… NOT happy about that. My libido is lower than usual. Do you think this will get better with time as my body adjusts to the med?

Glad you are still doing well on 10mg, darren. So glad. As far as the “other thing”, can’t help you there. I have heard that kind of thing can happen with antidepressants, so it’s probably normal and might improve, but I will be happy for you about your “dizzy” and ( smile) and (Smile) again, let you worry about the other. I started Paxil last night. A big night in our house. I took one 5 mg pill. Feel fine today. No spins. I am going to do it for a week, before I start the Nori at 5 mg. take care.
Meredith xo

That is great you are seeing improvement so quickly! Sorry about the lowered libido, and I hate to tell you but it can get worse as the dose gets higher, and typically does not go away.

With that said, I encourage you to stay at the lowest dose possible to get relief! I know you wanted to increase as quickly as possible if you were tolerating it well, but I’d suggesting hanging at 10 or 15 mg for a couple weeks and see if you can get closer to 100%. Increase only if you need to to get closer to that 100% goal.

Call me impatient, but I increased my Paxil dose to 15mg after 10 days. I still have no side effects, other than a slightly lower libido. Hopefully that will get better over time, or I may add Wellbutrin.

My dizziness has been slightly improved ever since the first day on 10mg. Sometimes I feel near 90%, and other times I feel 10%. My symptoms seem to fluctuate. It seems like it generally takes 1-2 months for an SSRI to clean up dizziness in most people, so I have to remain patient.

Good job, darren. Can’t believe you are at 15mg already on Paxil. I started 2 nights ago ( Wed. ) at 5mg and no side effects that I can tell, but I have terrible dizziness all the time. I also switched to lorazapam and weaning off Xanax as Dr. Hain asked me to do. Lorazapam is great at night to help you sleep as is Paxil, too. I need NO sleep aid. I was quite dizzy this morning and late morning I took another piece of Lorazapam. Cut .5 in half. Made me feel tired and limp all day. I am going to 10mg Paxil in two weeks. Then I have to find courage to start my Nori at 5mg. sometime in there. Just wanted to make sure I had no side effects from Paxil before I start Nori. Sorry about your libido. :frowning: meredith

That’s what’s happening to me too Darren. Some days I can feel 60% and some 0. It’s so strange. I’m upping my Cymbalta next week! Hopefully I won’t have a heart attack ;)!!!