QUESTION:
Dear Dr. Heller,
My sister is experiencing extreme anxiety bordering on paranoia all of a sudden. She has been taking Paxil for 2 ½ weeks (20 mg). The Dr also added 15 mg of Remeron for sleep which she's taken for 5 days now. All of a sudden she's very anxious, afraid she's going to overdose on her meds, and is sure she's lost her job and friends. Could this be a side effect of the Paxil? She is convinced it is. HELP.
ANSWER:
Your sister likely has the generalized anxiety disorder, which needs to be treated with BuSpar. Paxil and other SSRI's will increase the 5HT-1 receptor, which worsens anxiety. If she has the BPD, the increased anxiety often triggers dysphoria (anxiety, rage, depression and despair) - which is often accompanied by paranoia.
