Hi doctor,I am a 31-year-old male (165 cm height and 101 kg weight). I had panic attacks and permanent tension headache for the past six years (pressure on the head), unbalance, dizziness, anxiety, worrying about the future, mood swings, and chest pressure. Then my psychiatrist diagnosed me with OCD and panic attack. So, he put me on Seroxat and Lexotanil for seven years which made a huge positive impact (all the symptoms were gone approximately, but the only side effects were that I became less energetic and gained weight). Now my new doctor is telling me it is too much to take high doses (Lexotanil 3 mg three times a day) and Seroxat (20 mg three times a day) and it has been too long on them. So he wants to cut off Seroxat and Lexotanil and put me on Wellbutrin XL.So I have decreased the dosage of Seroxat gradually for 10 mg a day which caused withdrawal symptoms but now (after two weeks), it is better but I did not decrease the Lexotanil because I felt I cannot. But now the doctor said to start with Wellbutrin. He wants me to take Wellbutrin XL 150 mg the first day without Seroxat, the next day Seroxat 10 mg without Wellbutrin, (a day on day off) like that for two weeks. Then to stop Seroxat permanently and stay on Wellbutrin 150 mg daily. He preferred to decrease Lexotanil as much as I can but he wrote on the prescription 1.5 mg three times a day with the Wellbutrin XL.My questions are is there any interaction or any problem between Wellbutrin XL and Lexotanil if I take 3 mg Lexotanil three times a day with the Wellbutrin XL 150 mg? Is there any interaction between Seroxat and Wellbutrin if I took them a day on day off (as I described before)? Is the Wellbutrin XL effective for my case as my previous medication (Seroxat and Lexotanil) or not? I have started the first day of Wellbutrin XL 150 mg and I took with it, in the morning, 3 mg Lexotanil, then at the noon and night I took 1.5 mg Lexotanil, but I was surprised before sleeping at night I had a laughter attack with no reason. Is it normal?
Hello. You only want to change the drug because of feeling less energetic and for weight gain. The more important thing is that if your symptoms are under control with Seroxat (Paroxetine) 20 mg thrice daily and you have no problem other than these two symptoms as you have described, then you can continue Seroxat. For weight gain, you should start physical activity and lifestyle modification. Seroxat increases the toxicity of Wellbutrin XL (Bupropion) and can precipitate the seizure. So, if you want to switch, discontinue the drug or one day drug free method is also useful. Laxotanil is a drug of sedative category so you feel lethargic. If you stop abruptly, it creates rebound anxiety symptoms and withdrawal effects. So, reduce the dose gradually to discontinue it or set onto minimum dose. It has no as such interaction with Wellbutrin XL. Wellbutrin XL also has an effect on panic disorder but data is less than Seroxat and it also has good anti anxiety property. And for your laughter attacks, Benzodiazepines like Laxotanil may be responsible because they produce a euphoric effect.