QUESTION:
Dear Dr. Heller,
My 76 year old mother was put on Paxil for what her family doctor called panic attacks. She has been living alone since my father died one year ago. She has been on the Paxil drug for 4 weeks. She is a totally different person now. She comprehends about 5% of anything I try to say or do with her. Simple things she did before Paxil - she is confused about doing now. Most of everything she says now does not make any sense. I'm scared about having her live alone now.
Could this be a side effect of the Paxil? Her doctor also has her on Lorazepam which she takes "as needed". Is there another drug that could help her, or should she just tough it out with no drugs?
Signed,
Very worried daughter.
ANSWER:
The obvious first thing to do is to stop the Paxil and see how she does - although
withdrawal can be a problem. Her problem might have nothing at all to do with the Paxil,
and there could be a drug interaction.
Paxil is an excellent choice for panic attacks. It can aggravate the generalized anxiety
disorder, particularly the cognitive component - and that can be the problem here.
At her age she should have labs performed (CBC, metabolic profile, UA, B12 level, thyroid
profile), and a brain scan performed (MRI or CT).
The underlying problem needs to be addressed and diagnosed. If the studies are normal she
should be switched to another medication. I commonly prescribe Remeron in a situation like
this.
