It is conceivable this one web page could trigger a chain reaction which ends with a grand implosion of Paxil revenues and, more importantly, a precipitous decline in prescriptions for Paxil.

One caveat: A complete picture is not yet available. There is much more to be discovered, and the public needs independent (i.e. not GSK) psychopharmacologists to help sort the matter out. Even so, this partially assembled "piperidine puzzle" can only lead in one direction: a conclusion that "something is very wrong with this picture."

It will be interesting to watch as GSK tries to spin this data into something other than what it appears to be. Paxil's not addictive! ... don't listen to that man over there behind the curtain....

Any GSK gambit will likely begin with the revivification of language excerpted from Paxil's June, 2005 prescribing information:

Controlled Substance Class: Paxil is not a controlled substance. Physical and Psychologic Dependence: Paxil has not been systematically studied in animals or humans for its potential for abuse, tolerance or physical dependence. While the clinical trials did not reveal any tendency for any drug-seeking behavior, these observations were not systematic and it is not possible to predict on the basis of this limited experience the extent to which a CNS-active drug will be misused, diverted, and/or abused once marketed. Consequently, patients should be evaluated carefully for history of drug abuse, and such patients should be observed closely for signs of misuse or abuse of Paxil (e.g., development of tolerance, incrementations of dose, drug-seeking behavior).

A few years ago a disturbing link to a UNODC Bulletin on Narcotics — Development of Synthetic Narcotic Drugs (1956, Issue #1, pages 11-14) — began circulating on the Internet among Paxil addicts and Paxil withdrawal survivors.

According to the UNODC bulletin:

There are today a large number of compounds which have been synthesized and shown to have morphine-like activity. Up to the present about thirty have been put under international control. These compounds may be classified in five major groups, according to their different basic chemical structure.

First listed among these groups is the "pethidine group." (Click on this link to read more about pethidine.)

The word "piperidine" is peppered throughout UNODC descriptions of the pethidine group of drugs. The piperidine group is a 6 membered ring, with 5 carbons and an NH group. The addition of a phenyl group makes the "phenylpiperidine skeleton" the basis of the structure of pethidine.

Paroxetine had no chance of making it onto that 1956 UNODC for the simple reason it had yet to be discovered.

At the time the UNODC document was being bounced around through cyberspace no experts in psychopharmacology were on hand to sharpen the public's piperidine inquiry. So the world was left to wonder — paroxetine and morphine-type drugs: chemical cousins ... or blood brothers? It's 2005, and the "piperidine picture" is, at long last, coming into focus.

Why, one might wonder, is Paxil — a phenylpiperidine — not on Canada's controlled drug list? Perhaps the public missing something here.

What lies beyond this? Well, we have still more pethidine and piperidine information to upload to this site, as intensive research efforts are ongoing. Check back with this page periodically to see what else we have in store.