It’s ‘join up the dots’ time again… more stories of extreme violence and antidepressant use

When will someone take the possible connection between extreme acts of violence and antidepressant use seriously.

I’m not saying that medication will turn every patient into a mad killer… but the connections are all too real in too many cases.

In the UK recently we read this story about a horrible murder suicide – The debt-ridden businessman who killed his family before setting fire to their £1.2million mansion lay down to die on his wife’s body, an inquest heard yesterday. Christopher Foster, 50, was first thought to have shot himself after blasting wife Jill, 49, and 15-year-old daughter, Kirstie, in the back of the head.

Foster had run into “severe financial difficulties” and was taking anti-depressants to cope with suicidal tendencies after his oil rig insulation company Ulva went into liquidation.

More recently in the US there has been this story…there was an awful murder-suicide in Middletown, Maryland last week in which a father (Christopher Wood) killed his three children and his wife before killing himself… Wood, 34, also suffered from depression and anxiety and had been prescribed four anti-depressant medications,… Because toxicology reports will not be available for several weeks, detectives do not know if he was taking his medication at the time of his death. The drugs seized were Cymbalta (duloxetine), alprazolam, paroxetine, and buspirone, officials said…

Read more at SSRI stories.

How drug companies re-engineer illness to keep making money

In this interview with Christopher Lane (from Psychology Today), David Healy outlines just a few of the ways way drug companies market their pills…

David Healy, a former secretary of the British Association for Psychopharmacology, is the author of over 120 articles and 14 books, including The Antidepressant Era, The Creation of Psychopharmacology, and Mania, a fascinating new book on the history of bipolar disorder. His criticism of drug-company practices has put him at odds with colleagues in psychiatry and pharmacology. At the same time, his undisputed expertise as a leading academic, researcher, and clinician gives him a unique perspective on patterns and problems in Anglo-American psychiatry. He recently agreed to answer a number of questions about the growing prevalence and expanded definition of bipolar disorder.

Part of what you describe in your new book Mania: A Short History of Bipolar Disorder is a fair amount of “biomythology” about the illness. What aspects in particular do you have in mind?

Biomythology links to biobabble, a term I coined in 1999 to correspond to the widely-used expression psychobabble. Biobabble refers to things like the supposed lowering of serotonin levels and the chemical imbalance that are said to lie at the heart of mood disorders, ADHD, and anxiety disorders. This is as mythical as the supposed alterations of libido that Freudian theory says are at the heart of psychodynamic disorders.

While libido and serotonin are real things, the way these terms were once used by psychoanalysts and by psychopharmacologists now—especially in the way they have seeped into popular culture—bears no relationship to any underlying serotonin level or measurable chemical imbalance or disorder of libido. What’s astonishing is how quickly these terms were taken up by popular culture, and how widely, with so many people now routinely referring their serotonin levels being out of whack when they are feeling wrong or unwell.

In the case of bipolar disorder the biomyths center on ideas of mood stabilization. But there is no evidence that the drugs stabilize moods. In fact, it is not even clear that it makes sense to talk about a mood center in the brain. A further piece of mythology aimed at keeping people on the drugs is that these are supposedly neuroprotective—but there’s no evidence that this is the case and in fact these drugs can lead to brain damage.

How does our understanding of “mania” differ today from earlier conceptions of the phenomenon?

Bipolar disorder itself is a somewhat mythical entity. As used now the term bears little relation to classic manic-depressive illness, which required people to be hospitalized with an episode of illness, either depression or mania. The problems that currently are grouped under the heading “bipolar disorder” are akin to problems that, in the 1960s and 1970s, would have been called “anxiety” and treated with tranquilizers or, during the 1990s, would have been labeled “depression” and treated with antidepressants.

How did we move so rapidly in the 1990s from a psychotherapeutic treatment model for children to a largely drug-related one?

I think a key factor in this shift has been the availability of operational criteria. These were introduced in 1980 in DSM-III, the 3rd edition of the Diagnostic and Statistical Manual of Mental Disorders. The idea was to bridge the gap between the psychotherapists, on the one hand, and the neuroscientists on the other. It was hoped that if both camps could ensure that patients met 5 of 9 criteria for depression, for instance, then at least the patient groups would be homogenous, even if the views on what had led to the problems weren’t.

It was still assumed, however, that there was a place for clinical judgment, so that a patient who met 5 of the 9 criteria for depression but had ‘flu or was pregnant would be diagnosed as being pregnant rather than depressed. But in the face of company marketing, and with the advent of the Internet, clinical judgment has been eroded. Patients going on the Internet or faced with drug company materials now all too easily find that they meet criteria for a disorder and there is often nothing or no-one to tell them this is not equivalent to having the disorder.

In the extreme, I have had patients with highly social careers come to me and say they think they have Asperger’s Syndrome because they’ve been on the Internet and find that they meet the criteria for this when, in fact, almost by definition, such a person cannot have Asperger’s Syndrome. In the absence of clinical judgment there is a default towards a biological option and a drug solution. Criteria create a problem for which a drug is all too often the answer, in just the same way that measurements of your lipid levels create a problem that a statin is the answer to.

Operational criteria are interacting here with a certain loss of medical authority. It is not possible for a doctor today to say to a patient, “Based on my 15 to 20 years experience, you do not have PTSD,” or whatever. She cannot say, “We do not need to continue this conversation; come back when you’ve had a medical training and 15 years of clinical experience.”

The doctor has to engage with the patient on the level of the material that’s out there in popular culture, and when she tries to do this she will find that she’s up against an extraordinarily skilful deployment of those materials by pharmaceutical company marketing departments who are masters at populating the wider culture to suit their interests.

In the mid-1990s, you note, roughly half of all mood disorders were redefined as bipolar disorder rather than depression. What do you think accounts for that dramatic shift in perspective?

The key event in the mid-1990s that led to the change in perspective was the marketing of Depakote by Abbott as a mood stabilizer. Before that, the concept of mood stabilization didn’t exist. And while in a popular TV series we can accept that Buffy the Vampire Slayer gets a new sister in Season Five that she had all the time but we didn’t know about, we don’t expect this to happen in academia.

The introduction of mood stabilization by Abbott and other companies who jumped on the bandwagon to market anticonvulsants and antipsychotics was in fact quite comparable to Buffy getting a new sister. Mood stabilization didn’t exist before the mid-1990s. It can’t be found in any of the earlier reference books and journals. Since then, however, we now have sections for mood stabilizers in all the books on psychotropic drugs, and over a hundred articles per year featuring mood stabilization in their titles.

In the same way, Abbott and other companies such as Lilly marketing Zyprexa for bipolar disorder have re-engineered manic-depressive illness. While the term bipolar disorder was there since 1980, manic-depression was the term that was still more commonly used until the mid-1990s when it vanishes and is replaced by bipolar disorder. Nowadays, over 500 articles per year feature bipolar disorder in their titles.

You just have to look at Lilly’s marketing of Donna from the Zyprexa documents on the Internet to see what is going on here: “Donna is a single mom, in her mid-30s, appearing in your office in drab clothing and seeming somewhat ill at ease. Her chief complaint is ‘I feel so anxious and irritable lately.’ Today she says she has been sleeping more than usual and has trouble concentrating at work and at home. However, several appointments earlier she was talkative, elated, and reported little need for sleep. You have treated her with various medications including antidepressants with little success. . . You will be able to assure Donna that Zyprexa is safe and that it will help relieve the symptoms she is struggling with.”

Donna could have featured in ads for tranquilizers from the 1960s to the 80s, or for antidepressants in the 1990s, and would have probably been more likely to respond to either of these treatment groups than to an antipsychotic, and less likely to be harmed by them than by an antipsychotic. What company marketers are so good at doing is framing the common symptoms people have—we almost all have—in a manner most likely to lead to a prescription for the remedy of the day. It flies in the face of a century of psychiatric thinking to see conditions that patients like Donna have as bipolar disorder. But while a century of psychiatric thinking used to count for something, it doesn’t any longer.

Between 1996-2001, you explain, there was a fivefold increase in the use of antipsychotics (Zyprexa, Risperdal, Abilify, Seroquel, and others) in preschoolers and preteens. What role did DSM-IV play in that, with its introduction of the still-controversial category Bipolar II disorder?

The concept of juvenile bipolar disorder flies even more in the face of traditional wisdom in psychiatry than does calling Donna bipolar. As of 2008, upwards of a million children in the United States—in many cases preschoolers—are on “mood-stabilizers” for bipolar disorder, even though the condition remains unrecognized in the rest of the world.

I am not sure how much DSM-IV played a role in this switch. I think the companies would have found a way to engineer the switch even without the introduction of Bipolar II disorder in DSM-IV.

So then how much of that shift is attributable to SSRI antidepressants coming off patent while the antipsychotics were still major revenue earners?

I think this was in fact central to what happened. The antidepressants were due to come off patent whereas the anticonvulsants were older drugs that could be repatented for this purpose, and the antipsychotics—which also could be (and were) marketed as mood stabilizers—were early in their patent life.

A related point that’s worth bringing out is that the switch happened because companies weren’t able to make new and more effective antidepressants. Had they been able to do so, I think they would have probably stuck with the depression model rather than made the switch to bipolar disorder.

In terms of what is happening in the US, I think we have to look at how skillfully the drug companies have exploited doctors. Doctors have wanted to help. While the drugs are available on prescription only, doctors tend to see giving a medicine as the way to go, where previously they had been much more skeptical about the benefits of drug treatments.

The drug companies have engineered a situation in which academics have become the primary spokespeople for the drugs. We see the sales rep in the corner and think we can easily resist his or her charms—but we still let them pick up the drinks tab. But it’s the academics who sell the drugs. Doctors who think they are uninfluenced by company marketing listen to the voices of academic psychiatrists when these, in the case of the antidepressants or antipsychotics given to children, have talked about the data from controlled trials, and by doing so have been witting or unwitting mouthpieces for company marketing departments.

In your opinion, did the FDA’s 2004 decision to add black-box warnings to SSRIs over pediatric use lead to greater off-label prescriptions and even the move toward antipsychotics, on the presumption that the latter are safer to use on children?

I think this had very little effect on the switch from depression to bipolar disorder, but what was quite striking was how quickly companies were able to use the views of the few bipolar-ologists who argued that when children become suicidal on antidepressants it’s not the fault of the drug. The problem, they said, stems from a mistaken diagnosis and if we could just get the diagnosis right and put the child on mood stabilizers then there wouldn’t be a problem.

There is no evidence for this viewpoint, but it was interesting to see how company support could put wind in the sails of such a perspective.

It was also interesting to see how close to delusional people could get about an idea like this. Faced with details such as even healthy volunteers becoming suicidal on an antidepressant, committed bipolar-ologists were quite ready to say that this just shows that these normal people are latently bipolar.

In this case, I think most people will see that “latent bipolarity,” as a concept, is functioning a little bit  like the way latent homosexuality once functioned for the Freudians. Most people will also see that the first concept is impossible. What the companies have done is hand a megaphone to the proponents of that view on bipolar disorder, which was until very recently a distinctly minority one.

And are the antipsychotics in fact safer than antidepressants?

No, they are not. The antipsychotics are as dangerous as the antidepressants. Before the introduction of the antipsychotics, the rates of suicide in schizophrenia were extremely low—they were hard to differentiate from the rest of the population. Since the introduction of the antipsychotics the rates of suicide have risen 10- or 20-fold.

Long before the antidepressants were linked with akathisia, the antipsychotics were universally recognized as causing this problem. It was also universally accepted that the akathisia they induce risked precipitating the patient into suicidality or violence.

They also cause a physical dependence. Zyprexa is among the drugs most likely to cause people to become physically dependent on it. As far as I am concerned, Zyprexa’s license for supposed maintenance treatment in bipolar disorder stems from data that is in fact excellent evidence for the physical dependence it causes and the problems that can arise when the treatment is stopped.

In addition, of course, these drugs are known to cause a range of neurological syndromes, diabetes, cardiovascular problems, and other problems. It’s hard to understand how blind clinicians can get to problems like these, especially in youngsters who grow obese and become diabetic right before their eyes.

But we have a field which, when faced with the obvious, instead chose to listen to Eli Lilly voices saying, “Oh no, there is no problem with Zyprexa. The psychosis is what causes diabetes—Henry Maudsley recognized that 130 years ago.” Well Henry Maudsley hated patients, and saw very few of them at a time when diabetes was rare. We recently looked at admissions to the North Wales Hospital from 1875-1924, years spanning his career, and among the more than 1,200 cases admitted for serious mental illness, not one had diabetes and none went on to develop it.

We also looked at admissions to the local mental-health unit between 1994 and 2007, and in over 400 first admissions none had type 2 diabetes, but the group as a whole went on to develop diabetes at twice the national rate.

This is not surprising. What is is how the entire field swallowed the Lilly line, especially when it was so implausible to begin with. We had great difficulties getting this article published—one journal refused even to have it reviewed.

One way of raising the profile of bipolar disorder in children, you note, was to argue that they’d been misdiagnosed with ADHD. What were the implications and effects of that claim?

In the case of children with ADHD, I think what one needs to appreciate is that in most of the world until very recently (and in countries like India still), ADHD is a very rare disorder where children, usually boys, are physically very overactive. This is a condition they grow out of in their teens. Treatment with a stimulant can make a difference in cases like this. Whether treatment is always called for, however, may depend on the circumstances of the child as opposed to the nature of any supposed condition.

It is only in a world where schooling or adherence to a particular set of social norms is compulsory that a condition like ADHD becomes a disorder. There was greater scope over a century ago than there is now for children to do other things in childhood and wait until they settled down in adolescence without being treated for their condition.

What we have today is not ADHD as it was classically understood, but rather a state of affairs we have had for centuries, which is “the problem child.” Today the problem child is labeled as having ADHD. But having just one label is very limiting. Child psychiatry needed another disorder—and for this reason bipolar disorder was welcome.

Not all children find stimulants suitable, and just as with the SSRIs and bipolar disorder it has become very convenient to say that the stimulants weren’t causing the problem the child was experiencing; the child in fact had a different disorder and if we could just get the diagnosis correct, then everything else would fall into place.

One fascinating phenomena at the moment is a clear looping effect with adult ADHD. Quite recently Britain’s NICE [National Institute for Health and Clinical Excellence] guidelines for ADHD came out and stated that adult ADHD is a valid clinical disorder. I am quite sure that a few years ago, 85 to 90 percent of physicians in the UK would not have thought adult ADHD was a valid clinical disorder. One might expect guidelines to be somewhat conservative, but in this case what we appear to be seeing is the guideline process getting out ahead of the field, leading clinicians in a direction that seems to be quite surprising.

Drug companies understand all too well that those constructing guidelines are supposed to be value-neutral and to follow the data. This means they can readily engineer trials that may show minimal benefit for their drug for a condition they have called “adult ADHD.” The makers of the guidelines have little option but to suspend judgment and to accept that the condition named must be real. So, for instance, as Lilly grasped, they end up endorsing the use of the agent like Strattera.

What’s astonishing about the current situation is that there seems to be almost no way to get the guideline makers—who are sitting in the middle of the road, immobilized by the oncoming headlights—out of the way of the pharmaceutical juggernaut. You can point out how they are being manipulated but they shrug and ask, “What can we do?”

We have recently begun a survey, here in North Wales, looking at aspects of this situation. In response to questions, clinicians here have indicated that three years ago they were quite certain they would not have used adult ADHD as a valid condition, but that three years from now they anticipate that they probably will. I think this shows a realistic appreciation of company abilities to change the climate in which clinical practice takes place, and the relative futility of attempting to stand up to such changes.

You have to treat real patients. What do you tell them about these conditions and their treatment options?

Many clinicians, scientists, and patients have heard about postmodernism. They might have heard company criticism of someone like me along such lines as “Pay no heed to him, he’s just a postmodernist.” The implication is that postmodernism is all-but a psychiatric disorder in its own right, in which academics like me refuse to concede that there’s any reality to human behaviors—or the physical underpinnings of disorders of human behavior. By contrast, the story goes, there are the hard scientists who work in or with drug companies who deal only with facts and hard data, and the proof is that they bring new and helpful drugs to the market.

Well, I think what Donna’s story above illustrates is that pharmaceutical marketing departments are actually the postmodernists par excellence. They treat the human body (including its disorders and complaints) as texts to be interpreted one way this year and in just the opposite way a year or two later.

In contrast, when it comes to the hazards of these drugs—just like the tobacco companies before them—the motto of Pharma has become “doubt is our product”—they simply refuse to concede that their drugs are linked to any hazard at all . . . until the drug goes off patent. You cannot get a better definition of postmodernism than “doubt is our product.”

So, to the matter of whose treatments are better: I’m quite happy that the patients coming to see me would in general get more effective and safer treatment for their problems than they’d get from physicians adhering to the latest guidelines. Trouble is, I only have to slip up once to have a big problem, whereas atrocities can be committed on the other side without anyone likely to be affected by blowback.

David Healy is the author of 14 books, including The Antidepressant Era, The Creation of Psychopharmacology, Let Them Eat Prozac: The Unhealthy Relationship between the Pharmaceutical Industry and Depression, and, most recently, Mania: A Short History of Bipolar Disorder. Christopher Lane is the author most recently of Shyness: How Normal Behavior Became a Sickness.

More on Marty Keller… “Another Shrink Bites The Dust”

This  from Evelyn Pringle:

Brown University’s Martin Keller is the latest chairman of psychiatry to be replaced since an on-going investigation led by Iowa Republican, Senator Charles Grassley, on behalf of the US Senate Finance Committee revealed the millions of dollars in undisclosed payments flowing between psychiatric drug makers and “key opinion leaders” in the field of child psychiatry.

In recent months, Charles Nemeroff at Emory University gave up a post he held for 17 years and Alan Schatzberg also stepped down at Stanford as chairs of their psychiatry departments. In December, Massachusetts General Hospital announced that Harvard’s Joseph Biederman would no longer be participating in several drug company funded clinical trials and would limit his speaking and consulting activities with drugs makers, pending the outcome of an inquiry by the hospital of his potential conflict of interests.

Fred Goodwin, the former host of a radio show called “Infinite Minds,” broadcast for years by National Pubic Radio, had his radio show thrown off the air last fall.

Keller originally gained fame as the lead author on Paxil Study 329, which claimed Paxil was “generally well tolerated and effective for major depression in adolescents.” However, a later review of the underlying data showed the drug worked no better than a placebo.  In addition, among the 93 kids taking Paxil, five suicide-related adverse events occurred compared to only one in the group of 89 kids taking a placebo.

Yet in the 2001 paper published in the Journal of the American Academy of Child and Adolescent Psychiatry, the authors reported that only one child suffered a serious adverse event, a headache, not considered to be related to treatment with Paxil.

Documents obtained in litigation have since revealed that GlaxoSmithKline knew the study was a failure when the data was reviewed in 1998, long before the paper appeared in the Journal.

Keller always gets the credit for publishing Study 329, but the fact is, not one of the authors who lent their names to this fraudulent study have come forth to explain their obvious deception. Therefore, their names deserve to be highlighted as well and include: Neil Ryan, Michael Strober, Rachel Klein, Stan Kutcher, Boris Birmaher, Owen Hagino, Harold Koplewicz, Gabrielle Carlson, Gregory Clarke, Graham Emslie, David Feinberg, Barbara Geller, Vivek Kusumakar, George Papatheodorou, William Sack, Michael Sweeney, Karen Wagner, Elizabeth Weller, Nancy Winters, Rosemary Oakes, James McCafferty, and Sally Laden.

Senator Grassley’s list thus far also includes Harvard’s Thomas Spencer and Timothy Wilens; Melissa DelBello at the University of Cincinnati; and Karen Wagner and Augustus John Rush from the University of Texas. Rush recently moved to Singapore.

The Finance Committee has jurisdiction over the Medicare and Medicaid programs and, “Actions taken by key opinion leaders often have profound impact upon the decisions made by taxpayer funded programs like Medicare and Medicaid and the way that patients are treated and funds expended,” according to the Senator.

Marty Keller… the truth about him and his ‘science’

This from the excellent Clinical Psychology and Psychiatry:

In the latest American Journal of Psychiatry appears a review of Allison Bass’s book Side Effects. As many of my readers undoubtedly recall, the book details the saga of the antidepressant drug paroxetine (Paxil) and the troubled line of “research” used to support its use in children (among other points). The reviewer clearly liked the book, which is not necessarily newsworthy. What is notable is that a book review appearing in perhaps the world’s leading psychiatry journal slams a leading member of the psychiatry profession. The reviewer, Dr. Spencer Eth, writes the following:

More recently, psychiatrists have been greeted in the morning with front-page newspaper exposés of huge sums being directed by these same drug companies to the physician leaders of our field. In Side Effects: A Prosecutor, a Whistleblower, and a Bestselling Antidepressant on Trial, journalist Alison Bass has written the powerful story of a leading medication, its manufacturer, and a favored psychiatrist, whose driving force was profit not treatment.

Ouch. Though not naming the psychiatrist directly, it is clearly a reference to Martin Keller, bigwig at Brown University, whose work on one particular study regarding Paxil was the subject of a lengthy prior post. For the collection of my posts related to Dr. Keller, please click here.

Back to the review…

This well-told cautionary lacks the excitement of a novel but instead informs the reader with an actual case study with the real names of psychiatrists we know. We can see exactly how corporate greed, drug-company-sponsored clinical research, and mental health care become a toxic mix that inevitably damages our patients’ well being, our colleagues’ reputations, and our profession’s good name.

It was a refreshing surprise to see Martin Keller’s goose get cooked in this review. I don’t mean to sound vindictive or meanspirited. Keller has done a lot of work over the course of his career, much of which likely has some redeeming value. That being said, there can be little doubt that some of his “science” is quite dubious. And for a major psychiatry journal to run anything, even a book review, that directly goes after a “key opinion leader” who appears quite culpable in performing bad science — that’s a good sign.

Seroxat and alcohol, Paxil and alcohol…

Do you know what really amazes me?… I’ll tell you then.

It is the fact that Glaxo continues to say there is nothing wrong with Paxil (Seroxat) – and that if you do suffer from withdrawal then the “discontinuation symptoms” that can occur in some people will be “generally short lived” and “mild to moderate in intensity”.

Glaxo says “We take the reporting of adverse effects very seriously, as we do with all our medications. Fortunately, with Seroxat, we have a wealth of positive experience involving thousands of physicians and millions of patients – over ten years of experience worldwide.”

Then why can Glaxo continue to IGNORE the tens of thousands of reports of “negative experience” – such as adverse drug reactions and the huge mass of anecdotal reports of severe problems while taking (and withdrawing from) Paxil?

WHY?

Below are comments posted to an article called Pax-ills – What Every Paxil User Needs to Know. It made even me sit up and take notice. (Read more comments here)

You’ll notice the dates – 2003/2004/2005… nothing new here, so Glaxo has had plenty of time to “take the reports seriously” – and yet it has done nothing:

Anonymous (March 11, 2003): Please tell me I’m not the only Paxil patient who has developed an intense craving for alcohol. I am hangover-free (which was never the case when I indulged on a weekend) and am drinking every day. It’s ruining my life but no one else seems to believe it’s the Paxil.

Amy (April 22, 2003): I just want to warn the public about the side effects from stopping the vile drug, Paxil. I have been on it for almost 3 years for GAD. When I decided to go off, my dr. gave me the instructions for “weaning” myself off the drug. I did exactly what she had told me to do, and within a week of weening, I started to get these horrible side effect. They included: Brain “zaps”, confusion, crying spells, dizziness, and a list of many other things. I called my Dr back, and let her know about this. She told me that it was just depression, and to go back on Paxil. I tried to explain to her that I was not on Paxil for depression, (This was not the original dr. that prescribe the drug to me), I was on it for GAD, and the feelings that I was having, were NOT the same feelings that I had before I started taking Paxil in the first place. I am still trying to “wean” myself off the drug, without the help of any dr., and it has been over 3 months now. I just want to stop taking it, but every time I go off, the side effects continue. No one can seem to help me.

Please, if you can help it, DO NOT go on this vile drug. While it did help me when I was on it, it is impossible to go off.

Anyone who is experiencing the same thing, there is a website called paxildatabase.com in this website, there is a petition that you can sign for the drug maker.

Nicole (May 14, 2003): Re: Paxil withdrawal–I’ve been through it, and while it isn’t my favorite experience, future withdrawal fears shouldn’t prevent anyone suffering a major depression from trying this drug or other SSRIs. I was put on Paxil for after being hospitalized for depression in 1999 and had almost three good years on it, with minimal depressive symptoms. It literally gave me my life back! Unfortunately, it seemed to be gradually losing its efficacy earlier this year (the typical poop-out thing many people experience) resulting in a second severe episode of depression. Going off the Paxil (to switch to Effexor, which I’m glad to say is working pretty well) was uncomfortable–I had “electric” “zingy” feelings in my head, muscle cramps, anxiousness for about two weeks–but not at all intolerable (certainly nothing compared to being severely depressed). More like having the flu. It’s a minor price to pay for three years of relief–Truly.

Newzmel (May 25, 2003): I am currently on Paxil and have been on and off it for about ten years. Initially, I was diagnosed as unipolar; thanks to three weeks without sleep on the new Paxil CR, I am now diagnosed as bipolar. I too get brain zaps, as well as bugs crawling in my stomach. The regular paxil made me anorexic, no appetite whatsoever. I have never had a problem getting off it, in fact, feel *great* for about two months after. Then BOOM, back to the Paxil. I have tried other antidepressants, but this one seems to work the best. I’m told it’s good for anxiety, but I notice my panic level is heightened on the drug. I’ve tried Celexa, Prozac and the most heinous of the bunch: Zoloft. I felt like my arms were on backwards. Paxil may work for some for three years Nicole, but what about these horrible side effects????

PPH (June 16, 2003): I tool Paxil from July 1996 through November 2000. Prior to taking the drug, I exhibited symptoms of depression including insomnia and frequent crying. These symptoms quickly went away when a doctor prescribed Paxil. However, there was one side effect. Prior to Paxil, I rarely drank alcohol. This changed quickly, I began drinking heavily within two months of beginning Paxil. It was something that I couldn’t control. I always thought there was a connection, but I couldn’t find any evidence to support this theory. The drinking continued with heavy consequences. Finally, after entering rehab in November 2000, I begged them to switch my medication (I had to beg because they still didn’t think it was contributing to the drinking). They did switch me to Zoloft. Today, I still don’t drink, and I lost that insane urge to drink that I had while on the Paxil.

Dolfingrl (Aug 18, 2003): Help…My husband has been on Paxil for two years and I have noticed a DRASTIC change in his personality. He has become insensitive and prone to anger…he used to be a a very caring and mild mannered person, but now is prone to violent (verbal) outbursts and is quick to lose his temper. He has difficulty controlling his anger and communicating in the normal manner. Please tell me if this is normal???

PRP (Aug 25, 2003): To all user of Paxil, my husband was on Paxil for 8 months, he was a wonder husband & father. A church member, member to masonic lodge and self-employed. Our life changed 8/21/02 when he blacked out, and got a gun and I was almost killed myself, himself, along with a family friend. The gun was fired 4-times,he then went to our couch, and his eyes where going back & forth (as I was told), I was knocked out. He then grabbed a blackjack and beat me till he came too. Then I blacked out again and I came too. I saw him with a 357 gun point to our friend’s head. He was charged with 2nd degree attempted murder and all that comes with that. To make this a shorter story, all charges were dropped because there was only Paxil in his system. He as well was a victim. We are suing GSK And we are very happy now .My husband has no memory of this event. It will live with us forever.

Luz (Sept 19, 2003): I found this thread because I was specifically searching for info on Seroxat (Paxil) and alcohol cravings. I have been on Seroxat for 5 or 6 years now, and have been drinking more with less apparent effect (until I (occasionally) black out & lose my memory) during that time. What I have noticed is that when I tried (unsuccessfully, because of withdrawal symptoms) to reduce or stop the dosage, my cravings for alcohol pretty much disappear. I am not talking about alcoholism but this level of drinking is deeply worrying to me. I understand the legal disclaimers on this thread, so I would point out that obviously this is just my particular case, but it is extremely interesting to me to see that others have had similar side effects.

Smilin’ Scott (Dec 17, 2003): I have had an increase craving for alcohol, morning hand tremors or shakes, and electric shock sensation on different parts of my body first thing in the morning. Anyone else have these things?

SSC (Dec 26, 2003): I am so glad I found this site. I, too have been searching the web for Paxil and alcohol cravings info. My cravings became so intense that it has ruined my life. I told my doctor about he cravings but he said it was not from the Paxil. I began drinking every day-large amounts. I have since lost my job, went to rehab. and am facing 2 counts of DUI and will loose my license and go to jail. I am so scared! I never had trouble with the law or drinking before. Plus, I live in a small town and everyone thinks I am the town drunk as all of this was posted in our local paper. I have been humiliated. I am also in jeopardy of loosing my current job because of my legal situation. I went off the Paxil and guess what? No cravings. If anyone has any info that might help me show a link between Paxil and alcohol, please post! I am just glad to know I am not alone.

Kit (Jan 24, 2004): After reading this article, I was relieved to find other people having the same alcohol symptoms as myself. I didn’t know why for the past two years I couldn’t stop drinking. It has been awful! I am on a small dosage of Paxil (10mg) and cut down to 5 last weekend. I still drank all week and have had some mild withdrawal- headaches, weird dreams, sleeplessness, pounding heart, but nothing I can’t handle. Last night was the first night I didn’t crave alcohol. We went out to dinner, I had one glass of wine, and didn’t want another. It is now 5:30 pm and by now I’d have had a few, but I haven’t even wanted one. I am so excited. I’ll keep you posted as I continue to cut the Paxil out of my life. Stupid drug.

Quitter (Feb 2, 2004): Hi, I have been taking Paroxetine for a bit over 2 years to combat generalized anxiety disorder. I am now 4 days into my third attempt at quitting. It is a relief to find others who know what this feels like, the “zaps”, the dissociation, dizziness, and hopelessness. I started taking this drug because it had a short half-life and would hit my system quickly, a necessity because when I went to see the doctor, my anxiety was so powerful it had consumed my life.

Surfer Girl (Feb 7, 2004): My 19 year old daughter has been on Paxil for about 8 months. Her depression is worse, she is self injurious, angry, anxiety ridden, and cannot sleep. She has nightmares, and suicidal thoughts. I recently began to taper down her dosage, after checking her into a local mental hospital. She now has to attend partial day classes every day for 3 weeks. The hospital has given her a prescription for Effexor XR, to which I say NO THANKS. I want a therapist to work with my “drug free” daughter, not a suicidal induced, stressed out maniac. Withdrawal has been a problem also. I SEE NO BENEFIT TO PAXIL CR.

Now I want off. It is terrible to be ruled by a drug. I didn’t know it would be this hard. I was so uninformed, people need to know what can happen when they quit the “miracle drug”.

Kit (Feb 8, 2004): I wrote earlier about Paxil vs alcohol. I am now down to 2.5 mg of Paxil from 10 – which I know was not a large dose to begin with – and haven’t had a drink in 11 days and haven’t wanted one either. I thank God I found this site. I knew my crazy, out of control alcohol cravings didn’t just start on their own! I’ll be off Paxil soon – probably another week. I wait until the brain zaps stop, and then I go down another few mgs. I can’t go any lower, so I’ll be off of it. After awhile, maybe in a few months, I’ll have a glass of wine. If I can’t stop drinking, I’ll know I’m a booze bag and have to quit alcohol forever. If I can drink like I used to – one glass of wine being just fine – I’ll know it was the Paxil, for sure.

Smilin’ Scott (Feb 19, 2004): Has anyone else had realistic dreams? i am having a hard time with reality and dreams. also my memory isn’t as good as it used to be. I do feel more like my old self beside the alcohol cravings, dreams and memory and the “zapping.”

Anonymous (April 2, 2004): I rarely drank much until I began Paxil but noticed a higher tolerance. I went out one night and had 19 drinks. Mixed with my Paxil, I hit a police officer and am now facing 15 yr aggravated

assault charge. I am not a violent person. I don’t even know what happened and how I was able to drink so much without passing out. No one will even listen to me about this happening due to Paxil and increased alcohol consumption. Paxil has ruined my life and my families!!! Why

aren’t there alcohol warning labels on the sides of the bottle???? Sucks to be me!!!!!

Not Myself (April 13, 2004): After one more bizarre night out, I decided to look for information on Paxil CR and alcohol. Glad to find this site.

I have been taking Paxil CR for several months. Previously took Zoloft; should NEVER have switched! I’m going back– but, here’s what I’ve noticed!

1. Paxil leaves me feeling anxious… on the verge of depression and irrational thought, but not so much that I don’t recognize that it’s happening. I feel like crying every day, but I cannot cry.

2. I have insane and crazily vivid dreams. Last night, I woke with a scream and totally freaked out my pets! What’s more, there is a finer line between my reality and dream states… it’s very confusing. Too, my memory is awful.

3. I have gone out on the town a few times; I have been out of control! Just this weekend, I was wasted after one cocktail… but, I didn’t stop… went rapidly on to a 2nd and 3rd cocktail… moving into something of a dream state. I was detached, wildly aggressive and truly out-of-control! I was fortunate to have friends with me, so I suffered only embarrassment. I slept entirely through the next day… I’ve never, ever done that before. Three days later, I still feel abnormal.

There is DEFINITELY something wrong with my reactions to Paxil CR! For me, it’s confirmed!

Anna (April 16, 2004): Hi I have been on Seroxat for 5 1/2 years i have tryed coming off before and had the side effects such as feeling down anxious head zaps which i didn’t know then where actually side effects the Doctor told me it was my anxiety coming back and i was to up my dose I know realise that to get off seroxat you have to go through the withdrawal i am now using the liquid for and have gone from 30mg to 4mg it has taken 1 + 1/2 months the side effects are not that bad I will beat this. If you really want to get off this Drug get the liquid for its much easier to cut down with.

Chris (May 9, 2004): My wife takes Paxil CR for OCD, undiagnosed before we got married, and I loved her before starting the medication, but REALLY like it that she can now go kill her own ants, spiders, and cockroaches without me rushing home from work to do it for her. There are a lot of the same side-effects involved with her that were listed in the other stories- increased tolerance/ craving for alcohol and other carbohydrates, diarrhea after eating, etc… but with the hope of eventually getting off it and keeping the OCD in check post-Paxil CR, we’re all-in-all happy with the drug. It’s not for everybody. I work in medicine and know some of those doctors talked about in the other stories- “medication is the solution to everything”. It will seriously help anyone having trouble with this medication to have a really good friend there to help, like my wife says that I am for her. Good luck to you all!

G (May 17, 2004): I have been on Seroxat for about 6 years, and found it fixed my problems, except that my craving for alcohol increased a great deal (normally drink very little). It doesn’t give you a hangover in the morning either. I have managed to keep the drinking to the evenings, but spirits taste like water, and has very little effect until I fall asleep about 11:00 pm. I started on 20mg and I am now on 10mg. Trouble is I don’t want to get of it all together, only to have my symptoms come back, which were very unpleasant. The other articles are very interesting re drinking, think they all have a common cause.

Cathy (June 5, 2004): I am about to be getting a possible Article 15 in the US Army for 2 counts of assault and drunk and disorderly behavior.

- I have NEVER gotten violent while drinking; I’m what you would call a “happy, goofy” drunk.

- Sure, I’ve gotten drunk, but I’ve never drank to where I don’t even remember drinking and become so incapacitated. In other words- I can tell you how much I drank and know that I was getting drunk!

- My blood alcohol was a .29! I only remember drinking 3 beers! My friend said I was buying one stein of beer after another- I don’t even remember this – this is for the person who said they had 19 drinks and didn’t even realize it!!!

- Maybe those of us whose lives/careers/families are being ruined because of this can support one another and assist each other in a defense.

Herein lies the problems I’m trying to deal with:

1.) Personal Responsibility-

On my prescription bottle of medication it does have a label that says “Do not drink alcohol while taking this medication” – therefore I have no defense in this matter

but pleez!!!! Are you telling me that people that take Paxil do not drink AT ALL????

It was my understanding that the main reason you shouldn’t drink alcohol is mostly that it intensifies the drowsiness and reduces the effectiveness of the drug?

I was also told that a beer or 2 is okay – but geez, if there’s a way to prove that it can cause the craving for alcohol, then maybe I can help with my defense?

I’m so frustrated. Some people say I’m trying to make up excuses and blame it on the medication. I’m struggling with this -

how do I accept personal responsibility?

I need to find medical journals/studies – is there currently research being done on SSRI’s/increasing levels of serotonin in brain and link to craving alcohol?

Also- I’ve seen where Paxil has been used to TREAT ALCOHOLISM! Could it be that for some small percentage of the population- it actually does the OPPOSITE?

Yeah, I know what you mean- the guy who said he’s labeled the “town drunk”. It’s like it’s not bad enough that we’ve done something so out of character that we’ve shocked ourselves- but that people label us. People look at me with these disapproving looks. You can’t explain that this is not normal behavior for you! It’s so devastating the humiliation. I just want to scream YOU DON’T KNOW ME, YOU DON’T UNDERSTAND!!!! But they don’t.

They’re so quick to judge you negatively.

Jill (June 18, 2004): Well thank goodness ! I thought I was the only one with these symptoms. I used to have a couple of glasses on wine on the weekends, but after being on Paxil, I can drink wine like water. One to two bottles is not unusual for me at all. And I can get up the next day feeling normal, without even a headache. Why is that ? I have the strange dreams too and sometimes feel like I haven’t slept. To make matters worse, I have gained 10 lbs (most likely because of all the wine). I really am not happy with the way this pill is working at all.

Rick (June 20, 2004): I’ve been taking Paxil for over 5 years now. I’am bipolar and have had a fair amount of success with this drug. I am 44 years of age and have been fighting this wicked disease since I was 14.Back then Doctors knew very little about this disease and how to treat it. I’ve been on just about every medication out there. Paxil is the only drug to really help me although I’m not doing very well as I write this. Drinking over the years is something I have enjoyed and for the most part was able to control it. There are plenty of times when I drank more than I should have-but I usually knew when to call it a night and always got home safely. Drinking on Paxil is a different story. I never know when to stop because you don’t feel like your getting drunk until it’s way to late and I end up blacking out.

What is so amazing is I can drink more then I ever have and wake up like nothing happened-no hangover what so ever. I also know I should not be drinking while taking Paxil but I crave it more then I ever have before. I could never understand this and now that I have discovered this web site I know i’ts not just me. As I write this I find myself in the depression stage of bipolar and although I’ve been through this so many times before I’m not sure I will be around to see what comes of this. My life has been a roller coaster and I don’t know how much more I can take.

Luz (June 25, 2004): Re. my September ‘03 post on alcohol cravings. Since that post, I have finally managed to come off Paxil completely, and have been off the drug for 6 months now. I noticed a definite ’switch point’ in the withdrawal process where my alcohol cravings disappeared entirely, and they have never returned – I am overjoyed. I wonder whether the effect some of us report is a distortion of the carbohydrate cravings the drug is said to produce (hence the weight gain), but I think there is more to it than that; I could drink and drink and drink, as if I was seeking oblivion. I am back to being an occasional drinker with normal hangovers – Hurrah! I am afraid I don’t have any good advice to offer those still suffering these cravings, but I am thinking of you.

Lisa (July 16, 2004): I was wondering if anyone else was misdiagnosed with Bi-Polar disorder while on Paxil?

I have been taking it on, and off for 11 years. Last year my ex-Dr doubled my dosage from 20 to 40mgs of Paxil, and that is when I started having bi polar signs. Not sleeping, and going like the Duracell bunny followed by being exhausted with major thoughts of suicide. My life was a living hell. I finally found a Dr that listened, and told me I was being poisoned by the Paxil, and slowly I am getting my life back.

Another thing the Paxil did was mimic Auto Immune diseases, Anyone else have this problem. Thanks!

Karen (Oct 7, 2004): Following the recent Panaroma programme on the BBC, I am absolutely disgusted at the lack of integrity by Alastair Benbow & his organisation – many people have suffered and died at the hands of these people just for the sheer end of generating profit. My faith in the medical profession at large is at an all time low. In my capacity as an advertising executive, I will NEVER work with a pharmaceutical company. They are scum.

David (Oct 12, 2004): I have been very desperate lately and it seems that everything is falling into place after reading about Paxil and alcohol. I took Paxil for 3 years and had a number of episodes like what is mentioned here,i just figured it was me and my mental decline from a 45 day coma and my brain just giving up. I have since being on Paxil become suicidal, i have mutilated myself, I have sporadic violent outbursts (at 6′3 220lbs,its not pretty), I even smell alcohol I have an uncontrollable urge to just get wasted. I to like many got a dui and I consider it to me a godsend. My demeanor is not what I mentioned above but i just assumed it was my failure to cope. I have stopped taking the Paxil cr(37.5) and realize the good it did. I don’t remember things very well like were i set my keys, money, wallet. I “space out” a lot more and almost feel as if at any time i could be sleeping but awake like on that movie Looker. My point being Paxil is an evil drug that should be limited maybe to short term use. Open your eyes see the light and get off the Paxil. Thank you for your forum, it may have well saved my life or someone else’s for that matter. If you have any advise get back to me please. Thank You again McMan

PPP (Nov 5, 2004): I TAKE PAXIL CR I WENT TO A DINNER PARTY WITH MY HUSBAND DRINKING WINE BLACK OUT ALL I CAN REMEMBER IS WAKING THE NEXT MORNING HE SAID I EMBARRASSED SO BAD THAT HE DIDN’T SHOW HIS FACE AT WORK

Kathy (Nov 11, 2004): Thank you for this website & the luck of finding it! I am finally not alone. I have been taking 20mg Paxil daily for 3 years. FOr the last 6 months I have CRAVED white wine daily & drink approximately a bottle a day every night. In the last 3 months I have had watery stool after EVERY meal, and I have gained 20 lbs. I never thought it was Paxil related, I\’ve been on it so long without these side effects I figured it was a GI problem. So I finally went to a new MD. Her suggestion was to get a colonoscopy & increase the Paxil to 30mg a day. After reading all of the above, how can I get off this horrible drug without the terrible side effecs? Please help me.

MIndy (Nov 12, 2004): Paxil side effects I too want to report an increased craving for alcohol while on Paxil. I would take the medication and a few hours later just be dying to have a drink. I was always one that drank some but never to this extent. It got to the point where I was unable to get my work done. I went to my medical DR with this and he just laughed and looked at me like I was crazy. I then went to a psychiatrist with this and she was much more receptive. I am now switching to Effexor. Today is the first day so I am hoping that it will go well. I will keep you all posted on my progress but it is so nice to know that it was not just me.

Lynda (Nov 19, 2004) My husband was put on Paxil June 2004. He ran out and didn’t refill his prescription. I found out on the 3rd day and we got it refilled on the 4th day. He planned on starting back on it the following morning. It was too late, he flipped out that night and I found him the next morning – he hung himself September 30th.

IF YOU’RE NOT TAKING PAXIL, DON’T START. IF YOU’RE ON IT, BE EXTREMELY CAREFUL ABOUT GETTING OFF IT – DON’T GO COLD TURKEY.

I would like to help get this drug off the market. Please feel free to email me at LyndaLu99999@yahoo.com

Angie (Dec 4, 2004): This site is a god send. I started taking 20mg Seroxat approximately 3years ago. Before this I rarely drank and couldn’t tolerate alcohol, my friends would tease me about my pathetic intolerance to booze, and how I could get drunk after one can of lager. I was prescribed seroxat for depression, which I have suffered with for most of my life. I never took Ad’s before and didn’t self medicate with other drugs or alcohol. Following a very stressful time in my personal life and with work, my depression worsened, and after seeing my gp, I agreed to give them a go, following many consultations over previous years where I had refused. I found they worked instantly, and for the first six months I felt fantastic, then I began to crave alcohol, and found myself coming home from work, drinking until bedtime and going to work, next day without hangover. Weekends I just wanted to stay home and drink, and i drink until I physically could take no more, but mentally still wanted more. I didn’t want to see people, didn’t want to go out, I just wanted to be at home and drink. My life stopped, and whilst functioning at work, but desperate for the end of the day, to drink I felt empty and began to think about suicide all the time. Prior to taking seroxat, whilst feeling depressed, I did sometimes wonder about suicide but always had a strong feeling that I could never ever really do it, because of loved ones. However whilst on Seroxat I lost those reasons to live. I used to sit overwhelmed by compulsions to swallow tablets and take an overdose. Sometimes I could almost taste the tablets, and had to force myself to go to sleep, to get suicide out of my head. Over the past three years I have gone through cycles. I took the tablets, felt better, then would get increased suicidal thoughts and numbness and be drinking heavily. I would stop the tablets, feel severe withdrawal symptoms, dizziness, brain shudders, sweats, emotional outbursts, feel frightened start the tablets again, feel better for a bit then go down again, and repeat the cycle. I tried withdrawing from them slowly, as recommended by GP, but I still got the side effects. In despair, I have now decided to stop them instantly and suffer the withdrawls, and just hope they don’t last, because being depressed as i was before seroxat and the brief periods of feeling better when restarting them, after a couple of days being off them, is really not worth the feelings of wanting to end my life and becoming an alcoholic.

Jim (Dec 22, 2004): Hi, I have been on paxil on and off for the last 5 years or so. I have experienced all the same horrible side affects while trying to come off the drug as well. What I was wondering is if anyone has went out and drank too much in one night while taking the paxil. I overindulged in alcohol with my buddies which i know i shouldn’t have, and now it seems like the drug just stopped working. It has been a week now since my night out drinking, and i am as anxious as ever, dizzy, and feel like the drug just stopped working. Has anyone experienced anything like this? Thanks.

Kat (Jan 11, 2005): Reading others histories and tragedies has been eye opening. After being diagnosed by by GP, three years ago, I first started a small dosage of Paxil. My child was just two, and I had a situation where I should have seen a psychiatrist immediately. My husband and I went to a counselor instead and he recommended a family doctor. The Paxil helped me to sleep, stopped my anxiety attacks, nightmares, and angry outbursts, and thoughts of death. I felt happy and relaxed for a time. The drawbacks were a fuzzy numb headed feeling, electric zaps, and the overwhelming urge to smoke cigarettes, which I had only done occasionally before. Also I let the bills go unpaid without worrying about due dates. After being on the smallest dosage for awhile, I started to feel the anxious, dark feelings again, and my GP told me to try 20mgs. I was on and off, because of my conflicting feelings about taking medication. I then became pregnant and completely stopped for some months. Until my depression was back to the point where I could not function well, I read up on paxil and side effects on the baby in womb. I stayed on through the end of my pregnancy and through nursing my daughter until she was 11 months. I have recently been very low and not able to deal with day to day life. My doctor again prescribed taking Paxil, its been 7 months since I took myself off abruptly, experiencing headaches , vivid nightmares and nausea, but I think I will not return to the comfortable numbness. It has caused memory loss, and I feel like I have empathy, affection and other good emotions erased. I am going to try herbal medicine and try to get the old me back. May God bless the families of those that have lost their lives or been killed by mental illness and perhaps these medications.

Michael (Jan 14, 2005): I don’t know about all this reaction to Paxil. I’m Bipolar and been on it 5 years at about 40 mgs. I actually quit drinking. But I have had the electic Zap thing happen once and I didn’t connect it to the Paxil.

All I know is Paxil has allowed me to live a normal life that and mood stabilizing drugs. I’m glad its there because if you knew what my life was before six years ago, well I’ll tell you.

Jon (Feb 6, 2005): I knew I wasn’t the only one! I tried doing a search on Paxil and Alcohol and only found articles about how Paxil is used to treat Alcoholism. PLEASE! That’s like giving crackers to a thirsty person. Maybe it could work, if your drinking is due solely to depression, but my experience is that Paxil hits the “drink alcohol instead of water” button. Why is there so little written on this subject? Besides the alcohol, my short term memory is not reduced, its gone. Not to mention that I’m tired of women telling me how sore I make them (laugh if you want, it really sucks). Sure would be nice to have a good orgasm again without shredding her in the process.

I’m stable enough now that I’ve gotten a good job (thanks Paxil) but I don’t get my work done, get in trouble for forgetting assignments and not completing tasks (thanks Paxil). I guess it’s time to quit this poison pill and hope the zaps aren’t too bad. I’ve tried a couple times before cold turkey and couldn’t get past the nausea and brain shutdown.

Jessie 2/11 Pax-ills I, too, developed cravings for and high tolerance of alcohol when I began Paxil. And I was somehow able to wean myself from those cravings after a few years, remaining on Paxil.

Recently I quit Paxil cold turkey. I know, I know – bad idea. But I ‘d been on the stuff since 1994 and quit twice before. Once gradually, once abruptly. And I made the conscious decision to go abrupt this time (from 20mg to 0) to avoid the long drawn-out withdrawals in favor of the more extreme but sooner done symptoms.

I regret this decision. After 4-1/2 months I am still quite sick. And my withdrawal symptoms seem to ebb and flow with hormonal fluxes, so that Day 5-Day 14 is usually pretty good. Day 14 (ovulation) brings on burning in stomach, throat and mouth, some nausea, heightened sense of smell, blurry vision, restless sleep. That lasts through menstruation. Then 5 days off until it all starts up again.

Of course, I ‘m returning to a fairly severe chronic depression and though I loathe to return to the medicine that can produce these effects, I may have to simply to survive. When I think about trying a different SSRI or another of the newer anti-depressants, I tend to think that would just add a different set of potential longterm damages.

So its not just a physiological or psychological dependency, but a depressed person ’s reasoned choice to return to the evil you know, rather than the one you don ‘t.

Is there a good argument for trying a different medication. Paxil did after all work wonders – it only made me hypo-manic, killed my sex drive, and slight twitches but it did give me a chance to live life.

JY 2/17: Effexor / Paxil were key players in my cessation of alcohol / drug use. In other words — they helped me get sober! I ‘ve been taking paxil for about 2 years, and am more productive / happy / efficient / generally pleasant than ever before. Although, i ‘ve noticed that I am prone to extreme violent outbursts (mainly verbal) which is totally not my style, and it even seems that my anxiety is worse than ever. But my depression is all gravy, which is honestly the only thing that matters to me.

Yeah, there ’s some weird side effects. I tour a lot out of the country, DJing in clubs, and after a late night, i often feel hungover (even though i don ‘t drink alcohol). I also get giant red spots on my neck and face during interpersonal interaction (especially phone calls).

Sooooo, switched to Effexor XR today, cold-turkey. Took it a few years ago and it worked like a charm. we ‘ll see what happens.

Please do not discount the fact that anti-depressants improve and even SAVE peoples ‘ lives. I for one am not sure i ‘d be alive today if it weren ‘t for them.

Also don ‘t feel guilty about taking them. I know sometimes it plays with your head, realizing that you ‘re taking a pill everyday. Sometimes society tells you that ’s weird, or not okay. But if you ‘re taking an anti-depressant, there ’s probably a good reason for that. And for some of us, we need to come to terms with the fact that we have a chemical imbalance and might need to take medication for that for the rest of our lives. And that ’s okay. If the benefits outweigh the drawbacks, it ’s probably good that you are taking it.

Stu 2/20 i also did a search looking for links about alcohol problems and paxil. i only know of three people including myself who have taken this drug, all three have had their lives destroyed due to the above mentioned alcohol cravings/tolerance. i came off cold turkey in 2001 and i,m lucky to be here. i tried reducing the dose under doctors orders but it was to painful, i wish i could have coped with the pain and done it slowly but i needed to break the addiction fast.

ArkansasChick 3/10 Being victim to the legal poison Paxil my symptoms are the same as others I’ve read about with the exception of feelings of being poisoned and losing my hair. That’s right! I looked like the crypt keeper on TV. I wonder how many years paxil can effect people. Surely the side effects aren’t forever.

Eric 3/11 Paxil and wanting to drink I took paxil for almost 2 years. In that time i became someone i didn’t even know anymore. I started drinking and even tried other drugs which i never would have even thought about untill the Paxil opened up my insides and made me aggressive and care free. I was starting to get into fights and i even got in trouble with the law fighting with them which unfortunately has cost me 16 thousand dollars. All i can say is…i was never violent or care free until i started Paxil. It was like the Paxil made me want to drink, something i hated to be around. I have been Paxil free now for 6 months and i am back to my old self. No more drinking and no more getting into trouble.

Jay 3/11: Thank goodness for all the side effects my wife and son experienced on these hellish SSRI antidepressants. After my son’s arrest after experiencing a Effexor induced psychotic break and also while in Paxil withdrawal, we found out that their depression and anxiety were simply caused by Hypoglycemia. Thank goodness for sites like http://www.alternativementalhealth.com. No more drugs of any kind in our lives. It’s all natural from here.

Pitufo 3/25: Paxil has increased my drinking as well… No Hangovers!!! It’s f@#$’d up! Now I can drink every night, ignoring my alcoholism because i have no hangover. I’ve been doing it for about 10 months and now, because of personal social problems, I am exhibiting a lot of subtle anger (towards myself and others) and it all comes out when I drink. Which is every night because I can now without the repercussions of the hangover and associated symptoms…. I would mention suicidal thoughts but that only happens when I’m really angry (livid) and besides that I am aware that it is just my current living situation…. But those thoughts (and actions) are definitely new.

Shellie 4/26: OK…I happen to LOVE Paxil. I have had social anxiety disorder for most of my life. I can honestly say that I never had a happy life until after taking the medication. I could think clearer. I was just a happier person in general. My life started to make sense in more ways that I could possibly tell you. What I believe is happening…is doctors..medical doctors..are prescribing Paxil, and do not have any knowledge of the mental disorder they are prescribing it for, or the side effects of the medications. So I believe the people who are having these problems that are so “horrible” are because they should have never taken the medication to begin with. They didn’t need it. Paxil is for people with extreme mental disorders like myself.

Dee 5/15: I started taking Paxil CR for Social Anxiety about 1 year ago. I had previously tried some other anti-anxiety and anti-depressants but my new doctor recommended Paxil CR. I have never been much or a drinker, and I have never had alcohol cravings. In fact I never tried alcohol on this med. As for me, I feel that Paxil does seem to work in treating some aspects of my social anxiety but I also am more aware of my anxiety and I don’t know if it is because I am aware of it or if I am experiencing more (whether or not Paxil related). However, I have tried to stop taking the med because I’ve felt at times a lack of motivation and loss of memory or perhaps just the ability to focus. I am 27 yrs old and I have been studying for fairly technical financial certifications and have been having trouble having the motivation or the energy to study. I’ve not had this problem before.

Julie 6/16: Wow. It isn’t “just me”. I am in the process of getting off Paxil. I had no idea that it would be so hard.

I, too, craved alcohol while taking Paxil. I would have a glass of wine and then I would not stop until the bottle was gone. I usually could care less about drinking.

And, instead of being “warm & fuzzy”, I became a violent, angry, out of control person. I would do horrible things and not remember the next morning. My husband accused me of being an alcoholic and having a personality disorder. We almost divorced and are still feeling the repercussions. I got “pushy” with my psychiatrist to switch me off of Paxil to another SSRI. Now, after doing searches on “Paxil Withdrawal”, I can understand why he was so hesitant.

My medical Dr. informed me that she does not like Paxil as the “crash” getting off it is so severe.

Where is the FDA? Peoples lives are being torn apart, ended, ruined, destroyed by this drug.

Amber 6/20: I have been on Paxil for about three years and then slowly weaned myself off of it. The withdrawal was hard but having your doctor work with you and understand the symptoms can help.I stayed Paxil free until My panic attacks started to come back last fall. My doctor asked me if I wanted to go back on Paxil and now I am doing great. I am not angry anymore and I can go anywhere without having an anxiety attack. As for drinking, I just don’t do it anymore. Drinking is said to decrease the effects of Paxil, which would be blocking the same reason I’m on it.

Jean 6/29: Been off Seroxat nearly 3 weeks now and still having symptoms dizziness, not eating etc. does it ever end

Sherrie H. 7/10: I have been on Paxil for about 8 or 9 years. i sought it out for depression. i thought it was helping me but over the years i have slipped back into the depression PLUS i used to be a shy, nice, quiet, normal person. the Paxil has made me a loud, obnoxious, mean, irritable person. i drink alcohol about once or twice a year. i thought i was having fun and seemed to have NO FEARS when drinking on Paxil. i can drink all night long and never want the party to end. before Paxil i was not like that. it has caused problems with the people i have drank with and the next day they tell me i have done and said violent things. i was mortified that THEY thought i acted like that! i remember the entire night and speaking to my family members. i remember getting mad at them BUT i do not remember the MEAN, VIOLENT, things they say i did. i have lost several family members respect and love because of Paxil. it has effected my normal every day life to the point that i feel like i am going crazy. i have had thoughts of severe anger at every thing around me to the point that i have been to the doctor having all kinds of blood work drawn up because i thought my thyroid meds where out of whack but i stumbled onto some of the many sites on the internet like this one and now know what and WHY i am so out of control and the many effects paxil has had on people just like me. i take 30 mg of Paxil and today i am going to start weaning myself off of this horrible mind altering drug. i have been taking it soooo long that i am not sure how long it will take to get out of my system. i know i can not change the things i have said and done that have hurt the people closest to me but at least i am finding out these horrible stories of anger and rage that had deadly consequences BEFORE i have gone that far. wish me luck and power on my struggle to become Paxil free and anger free again.

Skeeweeaka 7/15: I believe that the long-term affects of antidepressants are really not fully known. I also believe that our psychiatrists understate the side affects and how they drastically change the context of our lives as we are trying to fight off depression and anxiety. For me, it has meant weight gain, loss of libido, increased anxiety, social isolation, psychotic episodes, paranoia, etc. All of these hings have increased as a result of the drugs, in addition to seizures and the fact that they are only controlled with meds of which I do not want to take…

New Life 7/16: Paxil gave me my life back. I had severe panic attacks throughout my teen years but those were blamed on “being a teenager”. After my father died (whom I performed CPR on and had to inform the rest of my family that he had passed) I just shut everything out. I wasn’t sleeping for days. I would drive from point A to point B and not even remember doing it. I was beginning to lose days at a time. When I finally did sleep and could not get out the bed because I just did not want to deal, I knew I needed help. They put me on Paxil. I did so well. I did put on some weight, but I would rather be chubby than crazy! Going off of Paxil, I have tried 3 times and I was worse than before I went on it! I would lose my balance, fall down stairs, not sleep, not be able to drive, and go back on it. My doctor has given me the option to switch to Effexor, but I am afraid to go off of the Paxil. I even had to take Paxil during my pregnancy because my doctor said that electro-shock therapy would be my only recourse. When I told my OB about the ES therapy, she freaked! She said that Paxil is the only drug for depression that she gives her patients and then promptly called my doctor “a nutty quack”. As for the alcohol, one drink and I’m loopy. My husband calls me the “cheap date”. Anyway, I would love to hear from anyone who has taken both Paxil and Effexor at the same time in order to go from one to the other. I am hoping that I may get the courage to switch.

Bobby 7/17: Regarding increased alcohol consumption – I recently read this in the book “Under the Influence” (Bantam Books, 1983, page 38):

“Preference for alcohol is undoubtedly regulated by complicated activities in the brain. In a 1968 experiment, rats dramatically reduced or completely stopped drinking alcohol when given a chemical substance which depleted the brain’s supply of serotonin. (R.D. Myers and W.L. Veale,”Alcohol Preference in the Rat: Reduction Following Depletion of Brain Serotonin”, Science, Vol.160 (1968), pp.1469-71.)Serotonon, a brain amine resonsible for relaying brain messages from one brain cell to another, appears to increase the animal’s preference for alcohol. The brains of alcohol seeking mice and rats, for example, contain higher levels of serotonin than the brains of alcohol-avoiding animals. Further, drinking serotonin increases serotonin concentrations in the brains of the animals that show a preference for alcohol but not in those that avoid it.”

Lana 7/20: Yet another one – i thought i was mad. i actually have been a binge drinker for many years but could not believe the effect Paxil had on my drinking. i was a weekend drinker and have become an every day heavy drinker. and no hangover. i have tried taking up other things, but the fatigue that Paxil induces does make that difficult. I’m quite a proficient knitter now and thoroughly enjoy it. despite the knitting. i too have lost my driving license. I’ve only been on the drug for about 8 months.

I’m saving all your comments for my partner who I’m sure doesn’t believe what I have for some time, that the drug has had this effect. i’ve been much too embarrassed to say to my doctor that I’ve increased drinking – cos of the warning on the packet. but I will now – i think that there needs to be more information about this – there may only be a few of us who suffer this bizarre side effect.

We may not win a law suit and glaxo whatsit may not take responsibility, but i am convinced now that it really just one more thing that needs to be recognised as a side effect and written into the warnings.

MK 7/20: I have been on Paxil for about 2 years. Approximately a year ago, I started drinking heavily. Prior to this, I only drank once in awhile and never really enjoyed it. FOr the past year, I have been drinking almost every night. Luckily it has not destroyed my life and I am trying to get a hold on things. Last month I decided to try and quit Paxil as I didn’t feel that is was needed. When I am not on Paxil, I don’t get depressed. I am tapering myself off. I have used alcohol to help taper myself off (as sad as that sounds). Again, prior to paxil, I was a light drinker. When I did get drunk, I would get very drunk off of little alcohol. With Paxil it seems I can drink like crazy. 15 or sixteen drinks can’t put me down. Then, as I have been tapering off the Paxil, I had an experience where just two glasses of wine get me wasted to the point of almost passing out. The cravings for alcohol have suddenly subsided. Regardless of what an attorney would say about this, I believe a correlation exists for me and I would agree that the volume of postings and the amount of people that found this post by searching for “alcohol and Paxil” is pretty interesting.

Debbie 7/23: My nephew had the same thing happen to him as with PRP, except he was convicted and now is doing 40 yrs. for 1st Degree Attempted Murder.

Anthony 8/6: With regard to the various comments about Paxil and alcohol. Believe me, it’s true. Perhaps not fore everyone but I have been on Paxil for three years and I’ve had a problem with drinking, drugs and cravings the whole time. I heard whispers about there being a problem with this a few years ago but I prefer to take responsibility for my own issues. However I have seen two other people in my life go completely off the rails with substance abuse within a few months of starting on Paxil.. coincidence, perhaps. However I will leave you with this thought, I am currently weaning myself off Paxil through very gradual reduction. Bad dreams, bad moods and depression are back.. but guess what? I don’t feel like drinking.

MR 9/12: Son was on it, he tried suicide three times. Last time was a gun to his head. He was 13. He had vivid dreams, nighmares and what he reffered to as daymares (having nightmares while you are awake). He was put on Paxil because he had been bullied in school for 5 years. The school wanted him treated not rather than deal with their problems. He was not suicidal just lonly, and these drugs almost took him from us. He took to cutting himself, just to feel something, his doctor upped his dose. This was all before the FDA warnings. Stll my son was prosecuted on a gun charge, at the time he was just 5′ and 199lb. He was in one hospital center who took him off all meds, and they found out that in a safe enviroment he was a well balanced child, no need for medication, and no suicide ideation. He has been off these drugs fo 2 years now. He still has flashbacks, but deals with them with them explaining “it is just his brain rewiring itself”. He is a happy average teenage boy. He has been to the FDA hearings, and has protested against the Drug companies and FDA. He will not sit back and let someone else be harmed by these drugs.

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