Randy said:

I saw a psychiatrist yesterday for the first time ever. Of course he doesn’t know of Paxil withdrawal to any degree. He wanted to talk about my birth experience! He does not agree that my symptoms are due to withdrawal and wants to talk about my early childhood and relationships. F*** off! What’s the point!

My response:

Tell me about it, man. When I began weaning off Paxil, I decided to do it under the supervision of a shrink — not a psychologist, a psychiatrist. As a medical supervisor, he knows what he’s doing. He, like many psychiatrists, knows how to deal with a psychological problem with drugs. If you feel this, take that. If you feel that, take this. Utterly useless. When he actually does have an insight, it seems to be something right out Psychiatry for Dummies. Talking to my dog is more therapeutic.

This guy I’m seeing comes from an older generation of psychiatrists who seem to work under the principle, Give the patient a pill and see what happens. Don’t bother talking to him. Don’t bother really listening to him. Don’t bother trying to understand him as a person.

Our health, diseases, and reactions… can only be understood with reference to us, as expressions of our nature, our living, our being-here… in the world. Yet modern medicine, increasingly, dismisses our existence… seeing our diseases as purely alien and bad, without organic relation to the person who is ill.

The psychiatrist I’m seeing now seems to work with “the idea that one must attack the disease with all the weapons one has, and that one can launch the attack with total impunity, without a thought for the person who is ill.” (Awakenings, continued from page 228, 1990 edition.)

Whenever I show any strong emotion in front of this man, his immediate reaction is, “Perhaps you should think about trying another anti-depressant.” It’s as if he can’t deal with real people. Forget about actually listening to me. Forget about the fact that I’m an actual person and not some chemical reaction gone awry. I’m able to trust this guy (or at least give it a try) and show him my feelings, and he wants to pump me up full of pills — more pills. This was the antithesis of therapy, folks.

Therapy comes from the Greek word therapeia, which means healing. I reach out to this psychiatrist for help, and he wants to give me a bottle of pills. He’s making his hundred dollars an hour off me, but I wonder if he’s doing anything else. Trust me on this one: the ancient Greeks are turning in their graves.

I’ll continue to see him so he can medically supervise my withdrawal from the Paxil, but as soon as I’m feeling raring to go, I’m gone. This man has made a living for the past thirty years by not listening to people who need to be listened to, who are in need of that healing (paxilprogress.org is so much better). People turn to him thinking that he’s helping, but mostly he’s just make a living off them. It’s kind of hard not to think that sometimes.

I’ll be seeing him probably at least another three or four times, and who knows, maybe I’ll get something from it. Perhaps if I can package my problems in an intellectual manner which he can grasp more easily, I might actually be able to get something useful from these conversations.

So, from what I’m hearing from other people, and from my own experience, I’m inclined to believe that psychologists are the best bet, because they don’t rely on medications to solve the situation as quick and easy as possible (easy for doctors, not us). I think a psychologist is more inclined to listen whereas a psychiatrist is more inclined to prescribe. They are two completely different approaches to healing. And in my opinion, one of them works and the other one doesn’t.

You could probably have the same experience you’re talking about with a psychologist, but I think the chances are less likely. I say this from my own personal experience. My experience may be rare or it may be common, but I think it’s probably more common than not.

You said, “What’s the point?” And I say, “I know the feeling.”

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.

Doug said to a previous message:

This is an excellent response. I agree. However, I must state that I took Paxil for almost 3 years and it seemingly worked wonders for me… for a while.

The people I know personally (not through email or through paxilprogress.org) who took Paxil for extreme anxiety and panic attacks — every single one of them ended up taking on that “sedated” look I mentioned before. And there’s no way that can be good. All of them say they couldn’t live without Paxil, regardless of the weight gain and the sexual dysfunction it causes them. But neither have any of them done anything else except take Paxil to take care of themselves. They’re still living off coffee and cigarettes like they’ve always done. So, in a way, they got what they deserved. Nothing gets better in the absence of a willingness to change. Taking a little pink pill only delays the inevitable.

The calm that Paxil may provide can offer one the opportunity to work on the anxiety, but the anxiety will come back if one doesn’t actually work on it. This is something I see happening with many people, as well as having lived through it myself. It doesn’t take much to figure this one out.

I agree with you that Paxil can and often does make a difference at first. I have no doubt about it that Paxil did help me at one point; it helped me get through an extreme crisis situation, extreme stress, extreme anxiety, all during a time when my coping skills were not so good. For the duration I was on Paxil, I did everything I could to get my act together — and now, except for the anxiety related to the withdrawal, I do have it together (I hope). When I think of how I was, say two years ago, I am amazed at how far I’ve come, how effectively I deal with anxiety and stressful situations when they come up. I’m not 100% all the time, but who the hell is? (Nobody.)

I haven’t a single doubt that the makers of Paxil deliberately perpetuated a fraud by not fully informing the FDA, doctors and the public of the withdrawal effects of Paxil — to this day they clearly misinform doctors (the ones prescribing the medication) by telling them that Paxil is not an addictive drug, that there is no risk of physical and psychological dependency. Bullshit. And everyone who’s experienced Paxil withdrawal knows it. Like you said, “[It] has been an absolute nightmare getting off it (and there were side effects).”

You said:

I spent a good portion of my life avoiding most social situations, and am finding myself back there again. Only now there is the withdrawal and all of its symptoms on top of that. And I did a lot of work to get over all that when I was on Paxil. So, I’m very disappointed in the overall usefulness of the drug.

The same thing has happened to me. I find that I do experience some anxiety in social situations, or in anticipation of social situations. Not all the time, but when I do, there’s no doubt about it, it’s there. But I don’t relate this entirely to any previous condition. I think it’s due in large part to my Paxil withdrawal.

At the moment I am weaning myself off the Paxil and am down to 10mg (alternating between 5mg and 10mg). At least half of this past month I’ve been a walking zombie. Talk about being out of it; my brain has felt like mash potatoes. The last few days have been surprisingly smooth, but I’m only down to 10mg right now — that’s halfway there. My body is going through an extreme physiological adaptation now. Everything is out of whack. Experiencing some of the old anxiety doesn’t surprise me.

It’s my feeling that when I finally get the Paxil out of my system, and I’m exercising, taking my vitamin supplements and doing all kinds of other good things to keep myself healthy, the anxiety that I occasionally experience now from the Paxil withdrawal won’t be as common; it certainly won’t be debilitating. And the same may be the case for you.

Also, having taken Paxil for three years, even after you’ve taken the last pill, I’m inclined to think that it could take several more months before your body and your brain have flushed all the Paxil out of your system and have readjusted to living without it. Three years is a long time to be on Paxil (any more than 6 months is a long time if you ask me). I think the longer a person is on Paxil, the longer it will take to get over it.

Paxil can play a positive role in dealing with certain types of anxiety, but, again, it should always be a last resort. I can’t see what the good is if trying to get off the drug is worse than the problem you took the Paxil for in the first place. What a scam, ah?

Postscript – February 6th, 2001: In this post, I said, “I think the longer a person is on Paxil, the longer it will take to get over it.” This isn’t necessarily true. Everyone is different.

P.S. (Sept. 2006): Wikipedia has an entry for social anxiety. It may not be a simply a marketing slogan. However, treating social anxiety with Paxil or other SSRIs should be a last resort. Paxil is the easy fix; it requires absolutely no work or will power. So it’s very attractive. But from my experience, the risks aren’t worth it. It’s been almost 6 years since I stopped taking Paxil, and I can still feel the effects of the withdrawal. Here’s a quote from the Wikipedia article:

Research has shown cognitive behavior therapy, whether individually or in a group, to be effective in treating social phobics. The cognitve and behvioral components seek to change thinking patterns and physical reactions to anxious situations. This may be done through a technique called role playing. Prescribed medications consists of a class of antidepressants called selective serotonin reuptake inhibitors (SSRIs). Such treatment has a high response rate and low risk of dependency [sure it does] but has been criticized for its adverse side-effects and possible increase in suicide risk.

Attention given to social anxiety disorder has significantly increased since 1999 with the approval of drugs for its treatment. Marketing campaigns by pharmaceutical companies may be largely responsible for driving this.

Paxil should be an absolute last resort. Communicative therapy (a.k.a. talking) should be tried first. Then there are dietary changes that can make a difference to all kinds of anxiety. You can take vitamin supplements like B-complex to begin with. If you drink caffeine, stop now. Alcohol and cigarettes don’t help with anxiety either (but if you smoke, don’t try quitting while you’re trying to quit something else; trying to quit two things at once will wreck anyone). Making sure to get daily moderate exercise can make a difference. Try a herbal remedy. Listen to good music. Breathe fresh air. Get out in the sunshine.

Speaking from experience, these are basic things that can make a huge difference.

But it’s easier to pop a little pink pill than it is to actually make any real effort to take care of oneself (hence, we have close to two billion dollars in sales of Paxil last year).

It’s easier to take a pill than it is to actually face the fears underlying the social anxiety.

No offense to anyone suffering from panic disorder, but “social anxiety” sound like another made-up term by drug companies. I’ve been shy my whole life. I know what it’s like to be anxious around people and or large crowds. But that doesn’t mean there’s something wrong with me. I consider it a natural reaction to the madness of crowds.

Working to ease my shyness took some time, and although today I am aware that I do have this tendency to become anxious in social situation, it doesn’t bring everything I want to do with my life to a halt. I value all of my relationships and I am glad to be around the people I choose to be friends with, but I also know when I could use some time alone. I may have a certain shyness to my personality (although most people who know me socially would probably find that hard to believe), but there is nothing wrong with being this way as long as it doesn’t control my life. “Social anxiety” is a marketing slogan, a stigma that deliberately shames people into thinking they need these medications. It helps sell Paxil and other SSRIs.

If you experience “social anxiety,” it doesn’t mean you’re sick. All it means is that you’re sensitive. Big whoop. There is nothing wrong with being a sensitive person. Screw it — I’ll go as far to say it’s a good thing. My sensitivity has caused some anxiety at times, but it’s also given me a sensitivity to the feelings of other people in my friendships and close relationships which has enriched my life in ways that Paxil never has. I’m more of a one-on-one person; I’m not a group person. So what?

If Paxil is the last resort for you — I am in no way recommending Paxil — but if you decide to take the Paxil, remember that the more you take and the longer you take it, the harder it will be to get off it. If your doctor tells you something different, then your doctor can join the thousands of other doctors who are completely uninformed and misinformed as to the withdrawal effects of Paxil, and you’ll want to go see another doctor immediately. Paxil withdrawal is hell. For a substantial number of people who take it, Paxil is not an easy drug to get off of. That’s the first thing you should know.

The second thing is, if you do take the Paxil, don’t just rely on the Paxil. If it provides you with some kind of calm, take advantage of that calm and work on your anxiety. (I know plenty of people who take Paxil and then sit on their butts the whole time, never taking any action to actually deal with the anxiety or depression they had in the first place. All they do is take Paxil, and within months they begin to take on the look of a person who is medically sedated.) If you decide to take the Paxil, it would be beneficial to put yourself in situations where you can develop the coping skills (sometimes known as social skills) to ease the anxiety so that you can be relaxed and be yourself where before you used to feel anxious. If you don’t do this, and eventually you want to get off the Paxil (and seeing how hair loss and sexual dysfunction are common side effects of Paxil, you may not want to live with it forever) — when you try to get off the Paxil, all of the anxiety will come back, and on top of the effects of Paxil withdrawal, it’ll probably come back with a vengeance.

So if you do take the Paxil, do it right. And be informed.

Hope that helps.

Response:

I would like to tell a story which I think some may find more informative than your message.

While this drug may or may not help people, it does fall under a new classification of “life enhancing” drugs that has only really been around for the last 30 or so years. The aggressive marketing of this drug towards the general public is at best circumspect and possibly heinous in its design and implementation. In reading some of the legal documentation of the lawsuits currently in the courts, I noticed that Glaxo SmithKline refuses to accept the term “withdrawa” and instead uses only the term “relapse” in their dealings with plaintiffs. I know what I went through (and what most EVERYONE on this board is either going through or has been through) was a “withdrawa” from a drug.

Now the ethical question: Does the fact that a drug company knowingly refuses to use a proper term in order to protect themselves legally outweigh the use of a term of demeaning tone and inference, especially when it is used to describe the said product whose usage, after stopping, made me feel like “crap” (there are worse terms) for several months afterwards and most importantly: which use of language is more justified?

You see, it isn’t the situation that is the problem, but the language (and the fear of the language) that hides the problem.

P.S. (Sept. 2006): I seemed to have no problem giving advice in this post. I’ll be making some cuts if I find too much of that going on in future posts. I question how qualifed I am to give certain advice. Some people do have serious social disorders that require medication; otherwise, they couldn’t function. I wouldn’t want to be dismissive of that. My life is still affected by my so-called social anxiety. It does hold me back at times, and I’m not happy about it. But I’ve managed to live with it. It’s a part of who I am.

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.

Today is my 5th day back on Paxil after going through cold turkey withdrawal.

I felt tired yesterday and a little depressed, and then around 10:00pm I seemed to get a second wind (after eating a large supper). But it also left me wide awake and I couldn’t go to sleep, not until about 1:30 in the morning.

I woke up this morning feeling depressed. My dreams seem to have a strong effect on my moods. I’ve never been a morning person, but I hate waking up feeling like I don’t want to get out of bed.

I’m tried to have a good breakfast and put good things into my body (I’m learning more about proper nutrition). Before my going cold turkey, I was feeling really good. No depression at all, positive spirits, no “social anxiety,” no fear underlining my actions. Now, having gone through the hell of withdrawal and then going back on the Paxil at my regular dose, all of those things have been affected. — And I’m am dying for a coffee and a cigarette (but saying no to both).