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Is PROZAC better than PAXIL in terms of sideeffetcs?

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Please this question to Dr. Srikanth Reddy only .
Consultation ID: CS030520140095
Dear Dr. Srikanth,
Right now I am on Wellbutrin 150 mg daily\morning along with 20 mg Paxil daily\evening since 3 months, the role of Wellbutrin that I see and feel there is an improve and decreasing of the sexual side effects of Paxil by about 40% than before when I have used Paxil alone without Wellbutrin .
Dear Dr. Srikanth,
Let me know to discuss with you the situation now and what I complain from .
I wilI keep the 150 mg of Wellbutrin daily in the morning, But I beleive that this is the time to talk about alternative of Paxil, Note that I postponed this issue many times before, but the reason that I would like to replace Paxil (although the paxil very effective for me), that :
1) I feel always that I am tired, fatigue and lazy, suffer from sleeping too much, sotimes I do not feel on myself and sleep one day and ask more...
2) and very important the side effect weight gain.. I make diet, prevent myself from many and important kind of food but no way.. the weight increase and this make me trouble..
3) In the last abnormal dreams, thats mean very intensive and long dreams with stories and adventures as I sleep many years old patient.

I consulted the doctor here about these problems and we tried to find sloutions or substitution for Paxil.. he said to me we can not try several type of medications instead of Paxil.. because every medication need a time to give the result and he fear that I fall in relapse.. his strategy is the follow :
Keeping (150 mg Wellbutrin daily) along with Prozac instead of Paxil, and this changing should be within plan and gradually until we reach to constant dose of Prozac along with 150 mg Wellbutrin .
He recommend also to support that (but on demand) with 2.5 or 5 mg Cialis to avoid and counter any side effects from Prozac.. he said this strategy or package would be the best (due to his long experience) and I have to be brave and try . He said that Prozac still the best medications until now among the others came recently !!!
What do you think please about the new strategy ? do you think that prozac is better than Paxil about side effects (especially sexual side effects) ? Please I want your experience about that in details ? And If you agree how can I apply that transfer from Paxil to Prozac ? or If you have other sloutions about replace Paxil with others .
The steady and stable thing that I can not do without Wellbutrin 150 mg along with Paxil or alternative of Paxil ?
I hope I can find good sloution with you .
NB! Please I hope to review all the past Emails .
Thank you very much .

Best Regards

Category: Psychiatrist

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Thanks for the follow-up query.
It is very nice to know that there is an improvement in your health. I have gone through your previous posts as well and we had agreed to continue on paxil as you had mentioned that you cannot come off paxil. However now that you are considering switching paxil then I suggest the first step should be reducing paxil to 10mg and look if it is acceptable. If it is so then Bupropion 150mg and paxil can both be continued. On reduction of the dose of paxil, the side-effects of paxil will also reduce.
If at all the switch is essential then prozac (again an SSRi like paxil) may not be the good option. Yes it's true that its one of the oldest antidepressants, but it has a mechanism very similar to paxil and hence I personally feel, desvenlafaxine (pristiq) . Acting as an SSRI and NRI (serotonine and norepinephrine) it can be more effective than prozac. You may cross taper paxil and pristiq like you may reduce the paxil to 10 mg and start pristiq at 50mg. Then the paxil can come down to 5 mg and pristiq can be increased to 100mg and then in the third step paxilcan be withdrawn.
Hope this helps,
If you have any further query, dolet me know.
Kind regards
Dr. Srikanth Reddy MD

Patient replied :

Thank you very much indeed .
If we restrict the sloution between Paxil and Prozac since we do not have Pristiq in my country or not available always .
Do you think that Prozac better than Paxil about sexal side effects and weight gain ?
How can I jump from Paxil 20 mg to Prozac, and at same time keep Wellbutrin 150 mg ?
Best Regards


Well its unfortunate that we don't have the option of Pristiq. Now that we have to switch between Paxil and Prozac, the right way would be keeping Welbutrin at 150mg (constant). Paxil can be reduced to 10mg and Prozac can be started at 20mg. After day 7, Paxil can be stopped aburptly at 10 mg whereas Prozac can be continued thereafter.
In all probability, this cross-taper will suit you. However, I would advice you to keep your treating psychiatrist in loop while you are doing this cross-taper.

Kind regards,
Dr. Srikanth Reddy MD.

Patient replied :

Thank you again Doctor . I will follow all your advices and contact you later to check the results .
Kindly, Is it good strategy that 2.5 or 5 mg of Cialis support any sexual side effects might be consequence of Prozac, especially erection one ?
Best Regards

Yes, Cialis may be used for the erectile dysfunction arising from the use of Prozac. I hope you don't encounter any side effects hence forth. And yeah, you can get back to me if you have any further queries.
Kind regards, Dr. Srikanth Reddy MD.

Patient replied :

Hello again,
In the last this time, could you tell me what the suitable to take Wallbutrin in morning or evening, and also Prozac morning or evening ?
Best Regards

Hello. Both the medicines are activating and preferably taken in the morning. Thanks. Dr. Srikanth Reddy MD.

Dr. Srikanth Reddy
Category: Sexologist
Doctor of Medicine (MD), Psychiatry Residency Program,2001 – 2012
M.B.B.S,Mahatma Gandhi Institute Of Medical Sciences, Sevagram

Certificate Course in sex Therapy and Counselling, Sexology and Counselling, A
Sexology,Medikon Sexual Sciences, Mumbai

Training in Advanced Neurology at a leading corporate hospital (CARE hospital) in Hyderabad

Child Psychiatry Training in National Institute of Mental Health and Neuro-Sciences, Bangalore

Sex Therapy and Counsellingat MEDIKON Sexual Sciences, Mumbai.
Dr. Srikanth Reddy and 4 other Medical Specialists are ready to help you

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