From Joe:

I took 20mg of Paxil for three years for panic anxiety disorder. I only had a few weeks of side effects at first (nausea, vivid dreams, and then of course the sexual side effects), but then it was great. Not obsessing about things, everything was brought into a healthy perspective. However, as time went on I started not to care about anything. It went too far — a real flat effect, chronically fatigued and, of course, the worst for me, I gained 45 pounds.

I had no idea about the withdrawal. The drug company, GlaxoSmithKline, does not warn you about that. If I would miss a pill, I noticed I couldn’t even turn my head, my eyes wouldn’t follow — it was awful. I couldn’t wait until my next “hit” of the drug, and then guess what? — all the symptoms would disappear. (I should have known my body was addicted then, but on Paxil you just go through life not giving a damn about anything, so who cared?)

I think the longer you are on it, the worst these symptoms are. Coming off has been very rough. It has taken me since September to get to 3mg a day. I usually tell people who visit paxilprogress.org that at least you know somewhat ahead of time what to expect. I knew nothing but what my MD and pharmacist told me: “It’s a safe, nonaddictive drug. You won’t gain weight. It won’t effect your blood pressure.” (I’m hypertensive.) All proved not to be true.

Having said all that, however, if you are having trouble with depression, anxiety, panic etc., and it’s acute right now, paroxetine can help you to get relief from those symptoms and to lead a normal life for a time. And when it’s time to go off, just wean slowly. This gives the poor brain a better chance to adjust to “life without Paxil.” Good luck.

I have good days and bad days and some days where I don’t feel like talking to anyone. Since early July my life has been affected by this Paxil withdrawal, and it still is being affected, and most of the time nowadays I’m just sick of it. I’m tired and I want my life back.

I go for days at times not responding to emails or posting any messages. I haven’t disappeared though. Thanks for asking. I don’t want to talk about it — but thanks for asking.

If I let myself think too much about everything I have lost because of the Paxil withdrawal (my work, close relationships, so-called friends who turned out not to be friends, not being able to function like a normal human being, etc.) — I’d probably get really depressed. The level of anger and frustration and hurt is off the scale. And, still living through the withdrawal stages, I’m not in the mental condition to do anything about it — to do any thing.

I get tired of it sometimes, and I find myself sort of tuning out, because it’s all I can do to give myself a break. And it’s time like this that I’m really tempted to get high, smoke dope, find some escape.

I don’t go around sharing every single one of these bad days because I don’t want to bring everyone down. But I’m still around.

In a previous message I mentioned feeling suicidal at times. I know that’s the kind of thing that scares people off, but most people who go through this kind of thing eventually get around to feeling something like it. The problem with actually admitting it out loud is that people think you’re crazy — and nobody listens to crazy people, right? (Right.)

But the fact that I can say it out loud demonstrates, I hope, that I’m probably more healthy than the people who don’t say it out loud. And the last thing I’m going to do is smile and pretend everything is a.o.k. when it isn’t. I see people every day like that who are living in Disneyland and it’s a way of life for them. (And between you and me and that wall over there, these are the people who are nuts. Seriously.)

Despite all the depressing things I’ve experienced because of the Paxil, I am not depressed. Believe me, I know depression, and this isn’t it. This stuff is a headache, and there’s no joy to be found in any of it, but my personality is still relatively intact, and I’m not depressed.

When I’m genuinely depressed (which I don’t think I have been for a long time), I don’t want to do anything (that’s one of the things about it). What I’m experiencing from the withdrawal may be similar in that I’m not exactly animated — in the run of my day I do pretty much nothing. I try to read and I try to write as much as I can, but otherwise, I’m a walking turnip; I’m useless. (I’m also lucky to be in a position where my responsibilities are minimal. Yes, I admit it, I’ve had to move in with my parents who are nowhere close to rich but who have a big house and who feed me well and pay all the bills. I know how lucky I am to have them at this time.) But I think most of what I’m experiencing now is the withdrawal, not depression.

Unlike depression, I have the desire now to move, to do things, to live. The desire is there — underneath all the Paxil withdrawal crap, I can feel it there. But when you’re so wired up waiting for the next electrical brain zap to kick in and wipe you out (and other such wonderful conditions of the Paxil Experience), it’s hard to have enough energy to care about that desire, to give it the attention it deserves, to nurture it and to go with it. It takes energy to care, and to live and to make something substantial of that desire. And for me — stuck in the middle of Paxil withdrawal — that energy isn’t there.

I think my spirit is still intact, but everyone needs some kind of fuel to keep them going, and no matter how good-natured I’m able to be, the fact is this: I’m all out of gas. The Paxil withdrawal is using up all of my fuel. Psychic fuel, spiritual fuel, whatever you want to call it — my tank is empty, and I have Paxil to thank for it. I may be bumping around like zombie half the time running on empty, but that doesn’t mean I’m depressed.

My desire to be alive is well intact. But it’s like a car without any gas. As long as the Paxil withdrawal is burning up the fuel, I can’t expect to get any further than the end of the driveway. That’s not depression, though; it’s an empty tank. (I know, I’m repeating myself again.)

And to belabour this point even further, sometimes when I’m scrounging around for some fuel to burn — and being in the middle of Paxil withdrawal is like walking through a desert — it’s easy to feel like, “Man, I’m a goner. No water to drink to quench my thirst, and no fuel to burn so I can start up my car and get the hell out of this place. I might as well just close my eyes and die. There’s nothing here to save me. I’m already dead.” Those may seem like the words of someone who is depressed and suicidal, but that’s not necessarily so. Crawling through a desert like this, who the hell wouldn’t feel like that every now and then? That’s not crazy — that’s normal. It’s human.

And that’s the important thing to recognize. Without it, I would be depressed and I probably would be suicidal. But I know that ALL OF THIS is from the Paxil withdrawal, not necessarily from some underlying depression. (I’m just speaking for myself, remember.) That’s the knowledge that gets me through all of this crap. There’s withdrawal syndrome and there’s depression.

I’m glad I know which is which.

And just to be on the safe side, I am seeing a doctor once a week to make sure that if I do become depressed and genuinely suicidal (which, under the circumstances, would be understandable, even though I think I have a pretty good handle on it), I’ve got someone looking out for me. But so far so good.

Sorry if this turned into a rant.

First response:

Rant away! I could read your posts all day — you’re hilarious! You sound very healthy and funny. More healthy than a lot of “healthy” folk I know.

Second response:

I understand exactly what you’re saying about the suicidal thoughts not being connected to a depressive state. I went through a few weeks of that also. The scenario would go something like this: Early morning brain zaps, a little vertigo, uh-oh, no milk for coffee. Think I’ll kill myself instead of going to the store. Uh-oh, it’s snowing outside. I don’t feel like leaving the house. Think I’ll kill myself. “You’re making what for dinner? I don’t want pasta. Think I’ll kill myself.” It all seemed perfectly logical to me at the time. My husband had to hide the knives for about a week because I’d be standing at the sink doing dishes and the next thing you know I’d have a 12″ chef’s knife at my jugular and very calmly announce, “I think I’ll kill myself.” It was as though there was this little voice in my head whispering, “Okay, NOW!” It was very frightening, but I knew it was the Paxil, and it did pass — like everything else in life. I spent a lot of time in bed with the covers over my head during that period of withdrawal. I figured the worst that could happen to me is that I’d smother from the down comforter! I laugh about it now, but it wasn’t even remotely funny at the time.

Postscript – February 7th, 2001: Despite the knowledge that almost everything I was feeling was being distorted by the Paxil withdrawal — that it was the Paxil withdrawal and not me — I had moments where that thought wasn’t much of a comfort and, to quote André Gide, “Despite every resolution of optimism, melancholy occasionally wins out…” Just after my first withdrawal experience in July, there was an incident where if there hadn’t been anyone in the house at the time, I may very well have taken my life. (I know how you’re probably reacting to reading this. Note: I’m having the same reaction.) This aspect of my withdrawal experience has, I think, left the greatest impression on me. Having lived through it and survived it, it still scares the hell out of me. Despite my optimism, I probably was suicidal at times. In December 2000, near the end of the weaning process, I was feeling so beaten down by the experience that, despite everything I’d been able to deal with, I felt like I couldn’t take it anymore. A human being can only take so much. Nothing has ever pushed me so close to the edge, and it still scares me to think about it, the recognition that I have a breaking point — the ultimate breaking point where there is simply no will to live. I have survived this experience, but sometimes I have no idea how I did it.

Colin said:

I can’t believe I’m going to do this. After almost a month, I caved in and called my doctor. I get a Paxil refill this afternoon. I’m scared to go back on it but I’m also scared to be off of it. Can anyone help me?

You may have mentioned before how you went off the Paxil, but I lose track of who says what around here, so forgive me if you’ve outlined how you went about it. If I were to take a guess, though, I’d say you got off the Paxil cold turkey — and if not cold turkey then way too fast. That’s my best guess.

I went cold turkey a few months ago, lasted 6 days and on the 7th day I had go back on the Paxil. I felt suicidal a few weeks later. Losing control like that — and not having control like that — just doesn’t jive well with me. I’m much better now, but it was definitely one experience I could have done without.

I have no problem understanding how you’re feeling right now. And if you couldn’t hack it, don’t worry about it. Things will settle out and you can try again when you’re feeling up to it, if that’s what you want. That’s what I’ve done, and it’s working out okay for me.

I’ve been weaning for the past two weeks, and although I’ve gone through a rough patch these past few days, I’m getting through it — and best of all, no brain zaps. I’ve had headaches, slight dizziness, and mild fatigue. And although it hasn’t been much fun, it’s a walk in the park compared to having electrical surges in my brain.

These past few days I kind of felt the brain zaps might be creeping up on me. At first I freaked out (because I do not want to experience them again), but then I was able to calm down and decided I would stay at my present dose for a little longer before I continued to wean (I’m at 15mg, down from 20mg).

I’ve gone for at least one long walk every day, I’ve stopped drinking alcohol and caffeine, and I’ve pumped myself to the gills with vitamin supplements, ginseng tea — all that healthy crap. And it’s working. I get scared sometimes because I remember my first withdrawal experience, and I’m afraid I’d put a gun to my head if I ever found myself there again. But I’m taking it slow, I’m taking it one day at a time again, and I’m not doing anything if I don’t like the way it makes me feel. And so far so good.

I can understand you wanting to give in and take the Paxil again. And if you have you gone back on it, don’t beat yourself up over it. Enjoy the calm it’ll give you. Take a rest. You can get through it, but remember, you can’t rush this. I am in the middle of weaning right now, and I am so tempted to just get it over with. But I won’t. I’m taking it as slow as I can (and I don’t care what my doctor says). If I’m off this junk by Xmas, I’ll be happy.

If you’re back on the Paxil, I’ve been there. And so have many other people around here. Don’t worry about it. I’m sure you’ll get plenty of support whenever you feel like giving it another try.

Day 14 of my weaning off the Paxil. One week of alternating and one week of levelling off at 15mg.

I don’t have headaches, but I’m getting drowsy and slow-moving, and I’m becoming apathetic.

***king Paxil. (I’m not in the greatest mood either.)

P.S. (Sept. 2006): Covering up the f-word with italics doesn’t fool anyone. Still, this time around, I’ll try to keep most of the content of Paxil Free PG-rated.

Today is my 13th day of weaning off Paxil. One week of alternating between 20mg and 15mg, then one week of just 15mg. I’m beginning to think I should have alternated for more than a week. I was going to begin alternating between 15mg and 10mg this Wednesday, but I’m having second thoughts; I may wait a little longer.

I’ve been having headaches for the past few days, I was extremely tired one day, and when I stand up fast I get dizzy. It’s a regular dizziness that doesn’t even compare to the dizziness of cold turkey withdrawal. My spirits aren’t nearly as positive as they were during the first week of weaning.

But what I’m feeling right now feels like a precursor to more severe symptoms. It feels like the worse is about to come. And I’ve begun to feel a little uneasy again, a little worried. I have a feeling the “weepiness” is going to hit me soon. And I hate this not having control of my life. Again, what I’m experiencing now is nothing compared to my cold turkey withdrawal from a few months ago, but that doesn’t give me much comfort.

Anyhow, today I went to my new doctor, and I’m beginning to feel like I’d rather see someone who’s more sympathetic than him. Everything is too “interesting” to him, and his insights are minimal. I think he’s more experienced in treating people with more severe problems than mine, like my situation is too ordinary for him. When I asked him if there’s anything specific I can take for dizziness or headaches if they get worse, he said, “Not that I know of.” Great. Thanks for the help.

He did tell me, though, not to stand up quickly; standing up too fast is likely to cause a head-rush and dizziness. To combat dizziness, he said to make sure to drink plenty of water, which I already do anyway.

When I got back home from my appointment with him this afternoon, I laid down for a second and that second turned into two and a half hours of more-or-less unconsciousness. It’s not the first time I fell asleep during the day this past week. But now it’s becoming more pronounced. I’ve also been having difficulty going to sleep at night, so that probably doesn’t help.

I know this is nothing compared to cold turkey withdrawal, but I’m getting worried. My energy is too low. So I have to get my energy up, because I know that when my energy is low, emotionally I’m more likely to feel less in control.

Right now I’m taking B1, B2, and B6 at 50mg each, plus 50mcg of B12, and about 50mg of all the Bs. Can anyone who has taken B-complex for withdrawal tell me what dosages work for them? I’m thinking of at least doubling my dosage. I know not to exceed more than 150mg of B5, but recommended doses of B12, for instance, are 600mg daily — that’s ten times more than what I’m taking now. I’m making a few more adjustments to my diet, but I’m seriously considering upping my B-complex intake and would appreciate any suggestions.

Thanks.

Postscript (June 10, 2010): I’m not sure if I mentioned this before, but I was staying with my parents at this time at their house way out in the country. My mother had no problem letting me stay with them while I was going through my withdrawal, but my father didn’t really see what was wrong with me. So I didn’t talk to my parents much about what I was going through on a daily basis. It was a somewhat socially isolated circumstance. I’m not sure if having more sympathetic people around would have made a difference. I felt disconnected from everything anyway. Just saying hello in the morning took a lot out of me back then. So I don’t know.

I didn’t have dilated pupils when I went on Paxil. The main thing I felt was a bit of numbness is my hands and a slight lethargy, kinda dragging myself around a little. Which at the time was exactly what I needed because I was going through too much stuff at once and my nervous system was on overload. Feeling the numbing effects of the Paxil gave me something to fight against. Seeing how everything else in my life was out of control and I was beginning to lose my determination, fighting against a little pill was a synch.

I felt that I fought off the numbness of the Paxil, and getting through it, it gave me a sense of being in control. For those first few days I also felt a little punchy, if you know what I mean by that word. It’s like being pleasantly light-headed so that your overall attitude is, “Ah, what the hell,” and you find yourself with the guts to do things and say things you normally wouldn’t do. It allowed me to get through some social anxiety I was feeling, and to say and do things in social situations I normally wouldn’t have. A friendliness that I’d always known was in me was able to let loose a little, and that had nothing but a positive impact on my life.

So Paxil did work for me, and it didn’t leave me feeling sedated in any way. There were certain sexual side effects, but I was able to deal with it (it just took a bit more work). Otherwise, until the horror of my attempt at going cold turkey, Paxil seems to have been exactly what I needed at the time. Had I known of any natural remedies such as St. John’s wort, and had I known more about proper nutrition (such as the importance of Vitamins A, B-complex, C, and E, etc.), I would have taken those routes first.

Paxil would have been a last resort.

Most natural remedies (if not all of them) have no withdrawal effects (so that’s a big, big plus). It may not be as easy as taking a little pink pill every day, but it’s a hell of a lot better for you in the long run. As soon as I get off the Paxil, I will do everything I can never to go on an SSRI again.

The main benefit of proper nutrition and natural remedies is that YOU ARE IN CONTROL. Taking the Paxil, you’re handing the control of your life over to that little pill (and you know exactly what I’m talking about if you’ve experienced “withdrawal syndrome”).

Never had them dilated pupils though.

Postscript – February 4th, 2001: Eventually when I got off the Paxil, I began taking Ginko Biloba with Ginseng for about a month. It’s the only herb I tried that made a noticeable difference in my recovery, most notably in my cognitive abilities.

P.S. (Sept. 2006): I said I wouldn’t take another SSRI again, and I haven’t. There are still days even now when I think I’d love to have that little pink pill to help me along, to bring out the easy-going friendliness I wish I had on the go more often. But I’d rather live with whatever anxiety I was born with and find a way to make it work. I may not like it, but it is a part of who I am after all. I’ll never be a relaxed as I was when I was taking Paxil, and hopefully I’ll never be as stupid either. (With all due respect to those who really do need anti-depressants to live a normal life.) Oh, and I’m not sure how affective herbals are for anything. Many of the herbals I tried are now off the market (like Kava). I find mint tea relaxing, but I’m not sure any of it makes a significant difference to anyone who is severely depressed. Still, it never hurts to eat healthy.

Okay, today is my 6th day back on Paxil after my attempt going cold turkey. I still plan to wean myself off it, but not yet.

After going back on the Paxil, all the withdrawal effects disappeared — to be replaced by sleepiness. And then on the 4th day, I felt a tiny bit depressed and still sleepy. On the 5th day, I didn’t feel sleepy, but I felt definitely depressed. And today, the 6th day back on the Paxil, I just woke up and I’m not feeling the depression I felt yesterday (at least not yet; I just woke up 30 minutes ago).

So judging from the first day I went off the Paxil cold turkey (as my doctor ordered), up until today, about two weeks of my life were pretty much a write-off. That’s how much of my time this crap wasted.

But I’m trying not to dwell on that, because that’s depressing. I’m certainly not happy any of this happened.

I have noticed, though, that I feel considerably better after I’ve eaten a good meal. And I’m learning what better food to put into my body to give me more energy, which usually translates into more positive mental energy.

Postscript – February 26th, 2001: Here I am grieving over two weeks of my life which were stolen from me because of my initial withdrawal experience. Considering that the worst of the withdrawal would stay with me for about another seven months, it’s no wonder that my perception of time became distorted.

This is still my 5th day back on the Paxil after trying to cold turkey. I’m taking 20mg, my regular dose, but if you can believe it, I’m considering increasing it.

Before I went off the Paxil cold turkey as my doctor ordered, I was feeling fine. Happy, functional, smiling joe. Now my 5th day back on Paxil after my terrible cold turkey withdrawal experience, all of my withdrawal symptoms have long gone, and the headaches and the sleepiness I experienced when I first got back on the Paxil have also disappeared.

All I’m left with now is feeling depressed. My body feels fine, but emotionally I’m feeling depressed and easily saddened.

I plan to wean myself off the Paxil, but I need to feel not depressed before I do that. Right now — or at least today — I don’t have the guts to do anything. And I’m not used to feeling like this. It’s not overwhelming yet, but it is interfering with my ability to do what I want to do; that irrational, underlying fear is there. I’m fine when I do talk to people, but I’m not feeling as brave and easy-going as I was before.

I don’t want to increase my dosage. I’m trying to eat well, trying to get outside, trying to be positive, but I don’t feel like any of it. I’m hoping this will pass. I’m hoping I don’t have to increase the Paxil.

I’ll be making a doctor’s appointment today, but does anyone whose been through this having any suggestions? (I hate this shit!)

P.S. (Sept. 2006): That’s the vicious cycle of Paxil. You take it because you feel depressed or you’re axious in social situations. But once you stop taking it, whatever depression or social anxiety you experienced before doesn’t just come back — it comes back with a vengence. Some call this relapse, but how do you relapse into a condition that is worse than what you started with? This is one of the many ways paroxetine messes with your nervous system. Paroxetine may not be considered officially an addictive drug, but I’ve heard from heroin addicts who had an easier time going clean. (See also the Wikipedia entry for SSRI discontinuation syndrome and paxilprogress.org’s Published Withdrawal Studies.)

Today’s my 4th day back on the Paxil and all of my withdrawal symptoms are gone completely.

I’ve been writing a lot. I don’t know what that means, but I’m not complaining because I love writing. I’m still feeling tired like I could use a cup of coffee every half hour — but I’m not drinking any caffeine or anything at all that I could experience withdrawal from; I’ve been on that boat and I’m never jumping back on, I don’t care how big or small it is.

I feel somewhat depressed (or maybe I’m just still upset and shaken from the trauma of the withdrawal), but I’m going to get moving today regardless.

I’ve had to fight off the sleepiness I’ve experienced since going back on the Paxil (with — never forget — the intention of weaning myself off it once things have settled back to normal). I had to fight off the sleepiness during the day so I’d be tired at night and get my rhythms back on track. It seems to be working.

I’m still sleeping-in about two hours longer than I’d like, but things are getting better.

Postscript – February 3rd, 2001: I mentioned in this post and a previous post that I would never again drink coffee or anything that could cause withdrawal — and I’ve stuck to it. In December 2000, I did have one extremely bad week where I bought a pack of cigarettes and smoked them all in about two days flat, but except for that, I haven’t smoked dope or any kind of cigarette, I haven’t had coffee or tea or caffeine of any kind except for an occasional Coke, and I’ve completely lost my taste for alcohol. It was one hell of an adjustment to make, but I haven’t a doubt that I’m healthier now and better off for it.

P.S. (Sept. 2006): Well, it was nice while it lasted. I don’t smoke cigarettes anymore, but I do drink coffee every day, and I do have a beer every now and then. For a while after I got off the Paxil, I removed processed sugar, caffeine and alcohol from my diet, and I took vitamin supplements. If it’s a lifestyle you can stick with, good for you. A good deal of what makes people feel depressed is related to lifestyle — what we do every day, what we eat every day. Changing how you live life isn’t something most of us do easily. Eventually I stopped taking vitamin supplements and didn’t notice any ill-effects. I try to get 6-8 hours of sleep every night, I eat well and exercise whenever I can, and I’m feeling pretty good. After I got off the Paxil, my system was super sensitive to everything. When I ate junk food, I felt like crap. When I ate healthy food, I felt better. It was that simple.