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.

Most of the stories I’ve read on various bulletin boards are not happy stories, but nonetheless, from what I can tell there are varying degrees of the “brain zaps,” depending on how long someone was initially on the drug, how much they took, and how fast they tried to get off the Paxil. It’s easy to do the math: cold turkey will always put you through hell (not one single person said their cold turkey withdrawal wasn’t a living hell), and the more you take and the longer you’ve been on it, the worse the withdrawal (cold turkey) will be.

My withdrawal was a “horror” like Brando says at the end of Apocalypse Now. And to avoid coming anywhere close to that kind of experience again, I’ll be weaning myself off Paxil very slowly. That means, for me, lowering my dosage from 20mg to 15mg every other day, alternating between 20 and 15 until I’m feeling brave enough to lower it by another 5mg. And then I plan to keep going like that however long it takes. I don’t care about a decreased sex drive or any of the other side effects; compared to the withdrawal I experienced, it’s a walk in the park. I’m not going to try to go off the Paxil for at least another week or two, not until I start feeling completely myself again; then I’ll probably stay there for awhile before I find the guts to try to wean myself off the Paxil. But I’m guessing, for me, starting from the first day I lower the dosage by 5mg, it’ll take me at least three months to get off it.

Your weaning off it may not have to be as slow though. I think you’ll know how fast you can go by how well you’re reacting to the withdrawal. You might want to get through it as fast as you can, but don’t. Take it as slow as you can; that seems to be the least traumatic way for everybody who has successful gotten off it.

I’m not overweight (although I think I may have put on some love handles while on Paxil) and I’m in good heath and good spirits (except for the withdrawal), and my side effects were extreme dizziness and the brain zaps. Sleeping was almost impossible; my appetite was totally whacked; I had flu symptoms; my bowels weren’t very pleasant; and I kept sweating through the sheets whenever I tried to sleep or whenever I walked around for more than 15 minutes. When I wasn’t walking or sleeping, I didn’t sweat. When I did sweat, I stunk like an open sewer.

This list keeps getting better and better, doesn’t it?

The sexual dysfunction and weight gain are almost-guaranteed side effects of taking Paxil. The weight gain may be particularly worse for women, but the sexual dysfunction seems to happen with everyone right across the board. The sexual dysfunction can gradually be dealt with (details are given in several postings throughout this site), but the weight gain, or I should say losing the weight, seems to be the most trouble even after getting off Paxil; it just takes time. As for the hair loss, or thinning of the hair, this may be a result of extreme stress or it may be because of the Paxil, but it’s something I experienced myself and have read other accounts of, from women as well as men.

The good news: 1) My hair seemed to return to its normal thickness a few months after I stopped taking the Paxil. 2) For many people, their sexual function and libido also return to normal soon after they stop taking the Paxil. (Again, more details are given on this in several postings throughout this site.)

P.S. (Sept. 2006): This may not be the most informative post. I suggest going to paxilprogress.org and doing a search for “sexual side effects.” For instance, I just found this discussion thread that began with a guy asking about sexual side effects while taking Paxil. Here’s an excerpt from one of the responses:

I hear that.