ESCAPE FROM PAXHELL
The doctors in the hospital told me
heroin would have been easier to wean myself off and recover from.
[Paxil] "was devastating when I went off of it,
because I went off of it cold turkey, which was a huge mistake."
Many Paxil Protest visitors, yourself among them perhaps, are undoubtedly shocked by this site's content. To wit: You may have had no idea about the underreported and misreported dangers associated with the use of this wildly popular and overprescribed drug. Subsequently, you might be thinking about quitting GSK's "jagged little pill" if currently taking it. Or never taking it to begin with (take a hint from me.) Who could blame you?
After all, a review of the literature shows that, on average, over one-third of people taking Paxil for any extended period of time experience withdrawal symptoms. Of those, 21% experience severe withdrawal symptoms. That's translates to approximately eight out of every one hundred people who take Paxil; in terms of medical study statistics that number is huge. If Paxil's product information leaflet reflected this truth, then severe withdrawals would be listed as a common side effect. Feeling lucky?
And in the clinical trials of Paxil, a significant percentage of patients (up to 50% according to some studies) experienced withdrawal, despite the fact that a tapering regimen was utilized in those trials.
Paxil Withdrawal Victims:
From 1980-1991, approximately 5000 patients were tested on Paxil during SKB's clinical trials. Eighty-three (83) different Paxil trials were conducted.Various time periods were involved in the individual trials. Many patients were tested for only a month or 6 weeks. Some were tested longer, including approximately 400 who were in trials longer than a year. SKB pulled out all the stops to ensure the trials were successful. Only two (2) positive trials are required for FDA market approval. By any reasonable person's perspective, Paxil's track record in the clinical trials was poor. After a decade of juggling data in the 83 different trials, SKB was finally able to cite four (4) "positive" trials and three (3) "supportive" trials to justify Paxil's approval. Dropouts in most trials were rampant. Most of the dropouts occurred because Paxil caused adverse experiences, and the victims wanted nothing more to do with the drug.
If you quit Paxil it is of the utmost importance that you do not abruptly stop taking it, as this could lead to potentially life-threatening situations.
The key to getting off Paxil as safely as possible involves the use of a well thought out and carefully implemented "tapering regimen."
Discontinuation of Treatment With PAXIL: Symptoms associated with discontinuation of PAXIL have been reported (see PRECAUTIONS). Patients should be monitored for these symptoms when discontinuing treatment, regardless of the indication for which PAXIL is being prescribed. A gradual reduction in the dose rather than abrupt cessation is recommended whenever possible. If intolerable symptoms occur following a decrease in the dose or upon discontinuation of treatment, then resuming the previously prescribed dose may be considered. Subsequently, the physician may continue decreasing the dose but at a more gradual rate.
—June 2005 Paxil Prescribing Information
A tapering regimen might involve switching from the pill form of Paxil to the liquid form of the drug, so as to decrease dosage a single milligram at a time. Liquid Paxil is not a stock item in most pharmacies, but usually it can be special ordered. Just ask.
Some physicians have had some success switching Paxil users over to a comparable dose of Prozac (which has a longer "half life") and then tapering them off that drug. Regardless of the tapering regimen utilized: it should be administered under the care of a knowledgeable and informed physician.*
You are up against a nasty opponent that is not going to want to give up its home in your brain, and that will do everything in its power to stop you from quitting the drug. Imagine a chemical parasite as tenacious and hard to kill as a toenail fungus. The craving for the drug is not because it makes you feel so good, but primarily because it makes the horrible physical sensations associated with weaning off the drug go away. During past attempts at withdrawal I tried to use sheer will power to tough it out and not go back on the drug, but in the end I just lost it and gave up. The physical symptoms just got worse and worse, then worse still, then even worse yet until I had no alternative to just take the goddamned pill. My head was rapidly becoming one huge monstrous and roiling electrical storm.
— journal entry, day #89
from a Paxil withdrawal diary
The "Paxil Extremely Long Tapering" (PELT) Regimen
Individuals who suffer severe withdrawal effects when they drop even a tiny amount of Paxil should discuss with their physician the "Paxil Extremely Long Tapering" (PELT) regimen.
The PELT regimen suggests a Paxil tapering strategy that would involve a maximum one milligram drop in dosage every two, four, six (even eight or more) weeks between dosage reductions.
Individuals unable to tolerate one milligram drops would fall back to one half milligram drops — or even quarter milligram drops.
Obtain an (insulin or other) syringe from your pharmacist in order to calibrate single milligram drops; beyond that, it might be possible to "water" the dosage down into a measurable one-half to one-quarter milligram doses.
The PELT regimen is based on the premise that there are individuals who are desperate to get off Paxil regardless of how long it takes; that they do not want to resign themselves to becoming, in essence, lifetime Paxil addicts.
Persons who have become physically dependent upon Paxil must also consider the "Paxil poop out" scenario (i.e. drug tolerance) wherein Paxil simply quits working — and a user is thrown into withdrawals involuntarily. Sometimes increasing the dosage can hold withdrawal at bay, sometimes not. But even with a dosage increase: all a Paxil user is doing is delaying the inevitable — and quite possibly setting the stage for an even more severe withdrawal scenario in the future.
March 18th, 2006 update: I suggest reading through this "thread" posted at Paxil Progress dubbed "New Insight into Weaning."
Another other alternative worth exploring is to talk to your doctor about converting to a comparable dose of Prozac, and then slowly tapering off that drug using a PELT regimen. (In that case it would be a Prozac Extremely Long Taper.) Some people have reportedly had an easier time of it going this route.
(The public is demanding GlaxoSmithKline immediately rush into production Paxil tablets in 1/4, 1/2, 1, and 5 milligram tablets to give patients trying to get off the drug the tools, as it were, to optimize their chances of success.)
If you are being seen by a doctor who appears skeptical about the "phenomenon" of Paxil withdrawal there are three things you can and should do:
1) Ask him (or her) to obtain, or in the alternative you provide it, the current Prescribing Information for either Paxil or Paxil CR. Buried in the "ocean of fine print" is the critical phrase "withdrawal syndrome." You can download Paxil's prescribing information as a PDF document from the Internet; click on this link, and the first link that appears should be the document you are looking for. Or click on this link to bring Paxil's prescribing information up on your computer screen as a web page.
2) There are two books this site recommends reading prior to beginning a Paxil tapering regimen. Consider bringing these books along on your next visit to your doctor and offer to loan both to him (or her).
The Antidepressant Solution
The Paxil Withdrawal Guide (Saga Books)
The Paxil Withdrawal Guide (Free "E book" download)
3) Refer your physician to the Paxil Protest web site.
4) Find another doctor.
Paxil Withdrawal: How Easy (Or Hard) Will It Be?
Unfortunately, there's no way of knowing. While it is true many people seem to be able to stop the drug and experience withdrawal symptoms that are mild in intensity and duration, there is nonetheless a significant subpopulation of users that experience moderate to intense withdrawal symptoms lasting anywhere from a few weeks upwards of many, many months.
If your Paxil withdrawal turns out to be a severe and prolonged one here are a few words to live by:
Through endurance, we conquer.
Withdrawal Support Groups & Information
Antidepressant Facts** (Netherlands)
Antidepressant Forum (Germany)
Online Seroxat Support Group** (UK)
Seroxat User Group** (UK)
Social Audit: Antidepressant Discussion** (UK)
SSRI Withdrawal Support Site** (UK)
Footnote: On the offchance you have been surfing the Internet looking for help and have come across a drug detox program called "Narcanon": We recommend you explore Narcanon Exposed.
*Finding a knowledgeable and informed physician might be problematic: According to a survey conducted in 1997 and published in the Journal of Clinical Psychiatry, the vast majority of physicians are not aware of this problem. According to the authors, “education about discontinuation reactions … is needed for both psychiatrists and family practice physicians." These concerns were echoed in an article published in December 2000, wherein the author stated that there is widespread "misdiagnosis of antidepressant discontinuation symptoms" and "increased professional awareness of discontinuation symptoms is necessary to prevent misdiagnosis and inappropriate treatment." In recent years, the Harvard Mental Health Letter disclosed that as many as 75% of non-psychiatric physicians were unaware that Paxil can cause withdrawal reactions or how to properly diagnose the associated symptoms.
GSK's "Do More, Feel Better, Live Longer" video
(Windows Media Player or RealOne Player required to view)