Breakup with Paxil hard to do

Peter Katona, Columbia News Service

Tuesday, April 17, 2007

When Robert Nishiyama graduated from college in New York seven years ago, anxiety limited his ability to adjust to post-college life.

He decided to try Paxil, an antidepressant. With only little discussion with a doctor, Nishiyama got the prescription he wanted and the drug improved his life immediately.

A few years later, he felt well enough to wean himself off the drug. He consulted a doctor and cut his doses to a pill every other day. But before long, he said, "I started to feel dizzy with electrical zaps shooting through my head." He quickly returned to his original dosage and, two years later, remains resigned to relying on the antidepressant.

Nishiyama is one of many who suffer from selective serotonin reuptake inhibitors (SSRI) discontinuation syndrome, a disorder only recently acknowledged by the medical community. SSRIs help with depression and anxiety disorders and are found in prescription drugs, including Paxil and Effexor. A study published in the Journal of Informed Pharmacotherapy in 2001 found that up to 30 percent of people who try to quit the drugs experience "acute discontinuation syndrome."

Dr. Joseph Cannavo, medical director and unit chief for the chemical dependency unit at Flushing Hospital Medical Center in New York, notes that people who experience SSRI discontinuation syndrome aren't necessarily addicted to the medication. It could be a physiological dependence, in which the body adapts to a drug and the absence creates a rebound.

In 2000, Frank Streicher, then a Paxil user, started quitpaxil.org, a Web site for the millions who claim to be affected by SSRI withdrawal syndrome. The site, which includes links to medical journals and thousands of testimonials, gets 10,000 hits every month.

Some doctors have stopped prescribing Paxil. Dr. Michele Campione, a psychiatrist with the nonprofit Washington Square Institute, advises her patients to switch to liquid forms of drugs or other SSRIs.

Symptoms

Frank Streicher has collected anecdotal information on the effects of discontinuing Paxil at his Web site, quitpaxil.org.

• What it is: Paxil, also known as Paroxetine, Seroxat, Aeropax, Apo-paroxetine, Apotex, Pexeva, is a prescription antidepressant.

• Some reported withdrawal symptoms:

Intense insomnia

Extraordinarily vivid dreams

Confusion during waking hours

Panic attacks

Severe mood swings, especially heightened irritability and anger

Feelings similar to an electric shock running down the body

Unsteady gait

Slurred speech

Muscle cramps

• Duration of symptoms: Two to six weeks after the drug is discontinued