Paxil (paroxetine) is a common prescription anti-depressant drug; it is classed as a "selective serotonin reuptake inhibitor," or SSRI, which functionally means that it increases the levels of serotonin in the body.

This drug, as is the case with other SSRIs, can be dangerous if they're mixed with other drugs such as other antidepressants, illicit drugs (LSD, cocaine, methamphetamine), some antihistamines (Seldane, Histmanal), some antibiotics, and calcium channel blockers.

Side effects include lethargy, confusion, flushing, sweating and muscle spasms. Overdose can cause damage to red blood cells, breathing problems and kidney damage.

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From the BioTech Dictionary at http://biotech.icmb.utexas.edu/. For further information see the BioTech homenode.

Paxil is the trade name for paroxetine HCl (hydrochloride), a member of the SSRI (selective serotonin reuptake inhibitor) class of antidepressants. It's been shown in clinical trials to be effective in treating depression, OCD (obsessive compulsive disorder), panic disorder, social anxiety disorder, and GAD (generalized anxiety disorder). It is currently (2001) the only drug in the US approved for the treatment of GAD.

Paxil is available in tablets or as an orange flavoured oral suspension. The starting dose is typically 20mg/day, which can be increased as needed up to 40mg/day for elderly patients, 50mg for most adults or 60mg for OCD. (I'm told some higher doses - 80mg - are occasionally prescribed, however the Paxil monograph recommends 60 as a maximum and this has been the maximum dose tested in clinical trials.) The tablets are coated, but aren't long-acting, so they are safe to crush. (It took my doctor and a pharmacist a bit of research to determine this, since Paxil hasn't been tested on pediatric patients who are usually the folks who can't swallow pills, so I thought I'd share. Always check with your pharmacist before crushing any pills, though.) You may hear Paxil described as little pink pills - this is because the recommended starting dose, the 20mg pills, are pink. Other tablet strengths are different colours.

Paxil, like other SSRIs, is presumed to work by inhibiting the reuptake of serotonin - basically thereby increasing the amount of serotonin production in the brain. Serotonin is an important neurotransmitter.

Paxil has the same side effect profile as other SSRIs - the most common side effects are nausea, weight gain or loss, problems with ejaculation, insomnia or somnolence, and asthenia. There are a raft of much less common side effects, but most people won't experience them. Some side effects, such as nausea, may go away after a few weeks as the body adapts to them; others, such as sleep interruptions, tend not to.

The majority of patients in clinical trials benefitted at least a bit from Paxil, and the majority didn't find the side effects bothersome enough to discontinue treatment. Don't listen to random anecdotes on the internet. The plural of anecdote is not data. Listen to your doctor.

Paxil is a Selective Serotonin Reuptake Inhibitor (SSRI), a pharmaceutical drug. It works by blocking the brain from reabsorbing the chemical Serotonin, allowing more of it to remain in the area between the synapse and dendrite. Serotonin is believed to directly affect one's mood and behaviors. People with major depression, social anxiety disorder, obsessive-compulsive disorder, and other anxiety disorders are believed to have an imbalance of this chemical.

Some people have adverse effects from Paxil, including the very symptoms it is supposed to alleviate, but it is a life-saving drug for many. It can allow one to break out of the life-choking cloud of anxiety and depression and return to normal mood and feeling again.

Side effects include possible depressed mood, weight gain, dry mouth, and sexual dysfunction.

The 10mg pills are yellow, the 20mg pills are pink, the 30 mg pills are blue, and the 40mg pills are green.

Paroxetine, AKA "Paxil", AKA "Aropax", AKA "Seroxat", AKA "Aroxat".

You shouldn't go cold turkey on Paxil. The withdrawl can be quite nasty. Even slowly reducing my modest 20mg/day dose over a month I experienced what felt like birds pecking at my brain. This lasted about six months, and was accompanied by lethargy, extreme discomfort in enclosed places, and other side effects. I later found out that I had experienced the "electric shock" side effect associated with this wonderful drug.

Incredibly, Los Angeles lawyers filed a lawsuit against drug company SmithKline Beecham on behalf of 17 overmedicated narco-yuppies, which was settled in January 2002. In mid-2003 NY lawyers announced they would pick up the fight against east-coast pushers GlaxoSmithKline.

"...The Plaintiffs... continue taking the drug because they have been unable to get off the drug. Some have lost their jobs. Each has experienced similar severe withdrawal reactions and problems such as: jolting electric 'zaps', dizziness, light-headedness, vertigo, in-coordination, gait disturbances, sweating, extreme nausea, vomiting, high fever, abdominal discomfort, flu symptoms, anorexia, diarrhea, agitation, tremulousness, irritability, aggression, sleep disturbance, nightmares, tremor, confusion, memory and concentration difficulties, lethargy, malaise, weakness, fatigue, paraesthesias ataxia, and/or myalgia."

(from 2002 lawsuit press release. The NY lawsuit alleges that the drug is addictive, may induce suicidal psychosis, etc.)

dirtbag is correct.

While it may seem like the only feasible option for people looking to stop taking this shit, quitting paroxetine cold-turkey is a very, very bad idea. ESPECIALLY if you're autistic. Like listening to Yoko Ono, quitting paroxetine cold-turkey can be an express ticket to the asylum. It was for me; my folks dragged me to the Binghamton General Hospital "Emergency Mental Health" unit.

I was having an awful time in school, due to the withdrawal, and I got kicked out after being there only ten minutes. And my girlfriend dumped me the week before on the third day of withdrawal. Damn kids. Anyway, at the psych center, a little social worker came in, and he asked me the standard questions, "What's your name", "Where do you live", "When did you come here", the standard are-you-a-paranoid-schizophrenic shtick. So I spill my guts, everything that's bothering me for the last six-months. (No, my grilf breaking up with me because she "can't handle long-term relationships" has nothing to do with it.) He leaves afterwards, and orders me a lunch tray. I sat in a tiny, sterile room with sterile fluorescent lights, and a sterile desk and sterile chairs with magazines that weren't even interesting. The room was enough to drive anyone mad. I sat there alone under the 60 Hz lights for two hours. By the end, I was stimming like mad. My skin was crawling; I was curling into a ball. My mind was racing. I mutliated a styrofoam cup with a comb. I was ready to just walk out the door when the psychiatrist walked in. She was an "autism expert" of sorts, with a woman in training to become an expert in autism. Keeping in mind, I was talking about what was bothering me for an hour, because that was how long it took to say it once. So that bitch looks at me, and asks: "What's the matter? I heard you had a breakup or something."

I WAS PISSED.

I will never go there again.

In the past two weeks, after that incident, shit happened. I got all the withdrawal goodness:

• Extreme confusion during waking hours
• Intense fear of losing sanity
• Feeling of existing outside my body (like an out of body experience only not at all fun)
• Memory/concentration problems
• SEVERE MOOD SWINGS
• SEVERELY HIGHTENED IRRIBILITIY/ANGER
• Vertigo
• Unsteady gait
• Slurred speech
• Many headaches (I went through a bottle of ibuprofen alone in the past month. I told my mom it was "migraines". It sure felt like them.)
• Profuse sweating
• Muscle cramps
• Blurred vision
• Breaking out in tears
• EXTREME HYPERSENSITIVITY/SEVERE SENSORY PROBLEMS
• Hot flashes
• Chest pain
• Sore eyes
• Fatigue
• Itchiness
• Speech problems
• Severe trembling
• Involuntary muscle twitching

It sucked.

The big problem here is that paroxetine withdrawal is caused by a disruption in the production of acetylcholine due to the discontinuation of the drug. When you stop paroxetine (especially cold-turkey), your acetylcholine levels dive. This is bad in itself; however, people with autism have much lower acetylcholine levels to begin with. I can't remember the sources, but it makes complete sense. When I stopped taking paroxetine, I all the sudden felt much, much more "autistic". Like you suddenly turned into some "Low-Functioning Autistic". (A bullshit diagnosis, by the way. It's basically a bullshit name for parents of "higher-level" autistics (read: HFA and Asperger's Syndrome) to make themselves feel better about their children. You know, like "hey, at least my kid's not Rain Man". Fucking eugenicist assholes.) It sucked. It really, really sucked.

HOWEVER, I am finally getting better. In the last few days, I've been feeling GREAT. I'm starting to feel normal in a way I haven't since I was nine years old (before they put me on brain-damage in a pill). How did I get through this? I don't know. Here's some recommendations, though.

I felt much calmer sitting in my bedroom alone, listening to the Beatles. If you're around other people and it gets to you, just lie down in bed and rest. Take vitamins. Especially B vitamins. Eat eggs. They're rich in choline, which will provide your brain with more resources to make acetylcholine, and thus make your withdrawal suck less. If you get too homesick, go for a walk. If you aren't too dizzy, go for a ride in the car. And like I said, The Beatles help. So does Imagine. And above all, just hang in there! It will get better! This won't last forever!

Also visit http://www.quitpaxil.info/. It's a great site for quitting Paxil. Very informative; I learned lots there.

Good luck and Godspeed, brother.

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December 5, 2007:

I'm still cooked in the head. I've recovered most of my intellect, but I've definitely been warped by my experience quitting Paxil cold turkey. If I wasn't bipolar when I started, I am now. I do not recommend quitting Paxil cold turkey to anyone. It doesn't matter what situation you're in. Wean down slowly.

It should be obvious why I was dragged to the psych ward after reading the above. I was completely psychotic. My head did not settle down until the August after this post, when the mushroom cloud cleared. And that was, unbeknownst by me, the beginning of a very long and very strange trip.