My Experience With Paroxetine (Paxil)
SSRI’s and SNRI’s
Paroxetine is part of a group of anti-depressants called SSRI’s (Selective Serotonin Reuptake Inhibitor) As the name says, these medications target serotonin, a neurotransmitter that many claim is responsible for mood balance. The body naturally lowers the serotonin levels, sometimes at a higher degree. What these medications do is slow that process down.
SNRI’s (Serotonin-Norepineprhine Reuptake Inhibitor) on the other hand, do the same thing while slowing the re-uptake of a second neurotransmitter: norepinephrine. While SNRI’s have been proven to be effective in treating a number of psychological problems, including anxiety and depression, it has been said that their side effects can be more severe than those of SSRI’s. SSRI’s have also been around longer and have a larger variety of medications that can have different effects on different people. Because of this variety, it is easier to use the trial and error method with SSRI’s.
For these reasons, I decided to give the SSRI a go.
Why I Took The Plunge
I didn’t necessarily go on Paroxetine for depression; my problems were more rooted in anxiety. I would worry about bad things happening so much that I would begin to convince myself that it was just a matter of time before they did happen. No matter how far-fetched these thoughts were, they felt real to me and would lead me to depressive episodes. These episodes could last from a couple hours to a full day. It seemed like more and more aspects of my life were being put under this ugly, negative filter. I was afraid that soon everything that I enjoyed would suffer the same fate. I was also dealing with some issues of social anxiety.
I had been dealing with my issues for a while by this time, but they seemed to get worse in the weeks after I graduated from college. I was on a job search without any success (still am actually) and had a lot more free time. Normally this would be a nice little vacation to learn new hobbies and relax, but for me it was just more time to think and dwell on the negative.
I had many discussions with my therapist about the possibility of going on a medication. While she never pushed me to the idea, she said that an SSRI would be worth a try as they are relatively easy to go on and off of; in the event that they do not work or the side effects are too much. We both knew that the decision was mine to make.
I made my decision a few days after that last conversation. I found a psychiatrist and told him about the problems I had been having. As expected, he said that I have a slight anxiety disorder. He also said that my depression symptoms were on the border of mild and moderate, which also made sense to me. With that in mind, he suggested a low dose (10mg, half the normal dose) of Paroxetine. He then asked if I would like to give that a try. I took a deep breath and said yes.
I will now give you my experience with the medication. Before I do that, I would like to ensure that the goal of this article is not to promote the use of any anti-depressant medication. My goal is to offer a first-hand experience to those who may be considering treatment with an SSRI or have just recently began treatment. Most psychiatrists and psychologist look for ways other than medication to relieve symptoms of depression and anxiety. So you should see if any of those methods work before considering medication.
One aspect of SSRI medications you should know is that they take a good while before they work. With that, there’s not much to say about my first week on Paroxetine. I was told by my doctor to take half of my dose for the first week to weave into the full dose. This meant that I had to cut my 10mg pills in half. It was a bit of a pain in the neck at first, but I got used to it.
It's funny, I experienced a heck of a placebo effect the first day I took my pill. Perhaps I was just eager and excited about getting better, but I drove to work in the best mood I had been in for months. I was blasting music to the radio and singing along like there was no care in the world. I would actually have been kind of entertained to learn that I was given sugar pills.
As far as the actual effects of the medication, the only thing that I felt from time to time was brief moments of feeling spacey. I was never dizzy or nauseas, but would feel a bit out of it. Imagine being hung over, but without the headache or nausea. These moments went away just as quickly as they had arrived.
Other than that, I did not experience any other effects. I still had my moments of anxiety that I had to escape with my own methods.
Within the second week, I noticed a few more slight changes. My negative thinking dropped a bit, but I wasn’t really dwelling on the positive either. I was kind of stuck in this neutral zone where I didn’t really care about anything. I didn’t exactly experience a lack of motivation, but it did take me a couple of moments to slap myself into doing something productive like writing or job searching.
On a social level, I did notice that I wasn’t as nervous about saying something out loud in situations that would otherwise be uncomfortable. However, I was still experiencing the occasional spacey feeling, which made me feel no need to say anything. I wasn’t over evaluating myself like I normally would, but I wasn’t necessarily taking advantage of that.
By this time, the spacey and drowsy feelings finally went away, even though I was still dealing with a cold. I did see a slight change in my mood for the better: my negative thoughts were just as severe, but less frequent. Because of this, I was having less of my depressive episodes.
Socially is where I saw a big change. I was taking more risks. I asked someone out on a date and I felt less anxious about what I should say and how I should say it. Overall, I was much more comfortable being around people.
Things continued to improve for a while from the anxiety and social point. I was still having my moments of anxiety and depression, but they were still getting less frequent.
However, after about three months, the effects began to hit a plateau. I was seeing no more improvement, when I knew there was plenty of room for so. Not long after this point, I noticed the effects wearing off. Unfortunately, this period coincided with a break up. I wasn’t necessarily heartbroken over this, but the break up did serve as ammunition for my anxiety and depression. While I tried to keep my mind off this thing, I started to once again become consumed by irrational thoughts.
I tried to stick with my dose and see if I could get through this rut that I was in, to see if any improvement would come. But it was just not happening. My anxiety and depressive episodes became more severe and frequent, almost back to where I had started.
I had a discussion with my therapist about my options: either raising the dose or trying a new medication. Once again, she gave me some insights, while still not pushing me to make a decision. She said that because the Paroxetine did have a positive effect, as brief as it was, it would make more sense to raise the dose rather than trying another medication. She suggested that perhaps it was not the medication itself that wasn’t working, rather the dose I was on.
With that in mind, I decided to increase my dose to 15mg. (still below the normal dose) It took a while to kick in, but once it did I saw a substantial change for the better. My anxiety, irrational thoughts and depression were still there (they’ll always be, I know that) but they were now much, much easier to push aside. Even better, I was catching myself in better moods more often, which wasn’t my experience when on the 10mg dose. Before, I was just feeling not as crappy, but now I was actually feeling happier.
With raising the dose, I basically went through the same phase as I did when I started the medication: very brief moments of feeling spacey, which went away quickly.
As you can imagine, like with any other pharmaceutical, Paroxetine has quite the hefty list of side effects. Most of these are very rare though. The main ones my doctor warned me about were decreased libido, weight gain and feeling drowsy. Like I mentioned before, I had my small moments of feeling drowsy which went away rather quickly. Other than that, I did not experience any other of these side effects. I was told by my psychiatrist that if the libido became a problem, Lexapro (another SSRI) could be a good substitute for Paroxetine.
Two things to keep in mind though:
1. My dose is slightly lower than normal
2. Every medication will have a different effect on each person
For curiosity's sake, here is a list of the known side effects of Paroxetine.
What About You?
If you have been taking Paroxetine (Paxil), have you experienced any side effects?
Another Success Story
Today, I am still on the 15mg dose of Paroxetine and it’s still helping considerably. I see improvements every day and hope to see those improvements for as long as I can. My anxiety and depression is still here for the ride, but I feel that I have a lot more control over the nosey little demons. My plan is to keep up with the medication until I can get into a nice, steady work schedule – basically until I have less free time on my hands – and then decrease the dose and eventually go off of it. The best-case scenario I hope for is to be able to function without the medication and know it’s there for me when I need it.
I hope that this article has helped you out in some way. I’m aware that my problems are closer to the mild side and that my dose is lower than normal, but perhaps it can help someone realize that a lower dose could have its benefits. Please take this article for what it is: a first-hand experience of an anti-depressant medication. If you are really considering it, have a productive conversation with your psychiatrist or physician. Feel free to ask me any questions via the comment section or fan mail.
Thanks for reading!