Millions of people have depression in the United States. Paxil helps many of them. And although Paxil side effects are terrible, many people think they are worth it. Depression and other mental health conditions can be crippling. Unfortunately, society mistakenly views depression as a moral failure. It’s not, however. In fact, it is a severe clinical disorder.
Additionally, depression is complex. It results from neurotransmitters changing and thought patterns. Emotional and environmental vulnerabilities lead to a clinical presentation. Once diagnosed it can and must be treated. The cause may vary. Psychiatrists and family practitioners agree that patients need treatment. The treatment choices are plenty, with psychotherapy and medication. Often, doctors prescribe a combination of both to achieve long-lasting results.
Without medical help, people can succumb to suicide, addiction, and mental and physical breakdown. Living with depression is harsh and without medical help, even more so. So, Paxil side effects don’t concern many as they battle this condition.
What is Paxil?
SSRI’s are the best medication for depression. They are Selective serotonin reuptake inhibitors. The side effect profile of SSRI’s is minimal. Paroxetine (Paxil) is an SSRI that increases serotonin levels in the brain. That, in turn, elevates a person’s mood.
The medical community hailed Paxil as a wonder drug when it first launched. That was due to its non-addictive properties. It also had a wide profile for use. The FDA approved it for the treatment of many conditions. These include depression, panic attacks, anxiety disorders, obsessive-compulsive disorder (OCD), and PTSD. It’s one of few drugs approved for the treatment of pre-menstrual symptoms.
For some of those suffering from crippling conditions, it has been a blessing. It improves mood, appetite, sleep, and energy levels. It reduces fear, anxiety, thoughts of doom, and the urge to perform compulsive actions. These habitual actions can include hand-washing, counting, and checking. They can interfere with daily life. Studies prove it reduces the number of panic attacks. The best part is that you can take it once daily in a slow release form. It’s available in a range of doses and a liquid oral solution.
Other people, however, have not been so lucky.
Paxil Side Effects
Although some people believe Paxil is a miracle drug, others experience side effects. Some of them include weakness, blurred vision, drowsiness, and lethargy. Unfortunately, dry mouth, dizziness, anxiety, increased sweating, and unexplained fever also occur. Other people have experienced digestive problems including nausea, constipation, and diarrhea. Patients reported insomnia, high blood pressure, vertigo and abnormal heartbeat.
Further, men on Paxil have had the misfortune of experiencing painful and prolonged erections. These last more than four hours. They also complained of decreased libido and the inability to ejaculate. When they do ejaculate, some have lower sperm counts.
Psychological side effects
As if this weren’t enough, there’s more. Paxil can exacerbate the very symptoms it seeks to treat. Though rare, a few psychological side effects of Paxil are:
- Memory failure
- Abnormal dreams
- Unsteady balance
- Lack of coordination
- Tingling sensations
- Suicidal thoughts
Since its part of the SSRI family, it can cause Serotonin Syndrome, though it is rare. Symptoms include swelling of the face, lips, tongue and high fever. Some may develop agitation, increased reflexes, tremors, perspiration, dilated pupils, and diarrhea.
One of the most worrying Paxil side effects is discontinuation syndrome (drug withdrawals). It’s known to be non-addicting and marketed as such. Yet, studies have shown otherwise. As many as 62 percents of the people on Paxil will experience withdrawal symptoms.
Like other antidepressants, if you suddenly stop Paxil, it can lead to withdrawal. Sweating, lethargy and uncontrollable crying characterize this. People complain of muscle pain, abnormal sensations, and fatigue. In some, electric shock shooting through the skin, depression, and suicidal thoughts are prevalent. People may also experience headaches, chills, abdominal pain, nausea, vomiting, and diarrhea.
Actually, doctors recommend a step-wise dose reduction over at least two weeks. Yet, many people often stop them without consulting their doctor. The reasons could be financial or a side effect.
One of the significant Paxil side effects is suicidal ideation which is more pronounced in adolescents. For this reason, doctors rarely administer Paxil people under the age of 18. It causes suicidal or homicidal thoughts in younger people. So, the FDA mandates the makers of Paxil to carry a “black box warning.”
In fact, a black box warning is the strictest warning by the FDA. It is put on the labels of prescription drugs or drug products. It is applied when there’s reasonable evidence of a serious hazard associated.
Paxil is not considered an addictive drug. But, it abuse takes place by crushing a tablet and inhaling the powder. Or by swallowing many pills to feel high. Since it’s prescribed heavily and is widely available, the people chasing the “serotonin high” tend to co-medicate. They abuse it with alcohol and other anti-depressants. With time, higher doses are required to achieve the same effect. Gradually, drug dependence develops.
However, one cannot disregard its addictive ability. That is because Paxil has not been sufficiently studied for its addictive potential. There is no research examining its potential for abuse, tolerance or physical dependence.
For those taking Paxil alone, the question of drug interactions doesn’t arise. But many drug combinations warrants careful use. The worst drug interaction comes with MAOI’s (Monoamine oxidase inhibitor).
When psychiatrists prescribe Paxil, they warn patients to wait. The wait time is at least two weeks if they’ve taken an MAOI. This Paxil side effect is the most important as it can cause a fatal interaction. Common FDA approved MAOIs are Phenelzine (Nardil), Selegiline ( Zelapar), Tranylcypromine (Parnate), Isocarboxazid (Marplan).
Drugs that also increase serotonin in your brain can interact with Paxil. As a result, a person may develop a condition called serotonin syndrome. Some, but not all, of these drugs include:
- SSRIs: Prozac (fluoxetine), Celexa (citalopram), Luvox (fluvoxamine), Zoloft (sertraline)
- SSNRIs: Effexor XR (venlafaxine), Pristiq (desvenlafaxine), Cymbalta (duloxetine), Effexor
- Triptans: Imitrex (sumatriptan), Amerge (naratriptan), Axert (almotriptan), Frova (frovatriptan)
- Tricyclic antidepressants: Sinequan (doxepin), Elavil (amitriptyline), Tofranil (imipramine), Anafranil (clomipramine)
- Antidepressants and psychiatric medications: Wellbutrin (bupropion), Desyrel (trazodone), BuSpar (buspirone)
- Narcotics: Tramadol, Codeine, Fentanyl
Avoid certain antibiotics with Paxil. For example, Zyvox (linezolid) and Norvir (ritonavir). Obviously, taking street drugs like cocaine, amphetamine, cocaine, and LSD is not advisable.
Additional Drugs To Avoid
You should avoid some drugs if you take Paxil. When combined with thioridazine (Mellaril) or pimozide (Orap) it can cause cardiac problems. It can affect the bleeding time, and so you cannot mix it with drugs with a similar effect. These drugs include aspirin, naproxen (Aleve), ibuprofen (Advil, Motrin), Warfarin, and Coumadin. Mixing these drugs can also result in gastrointestinal bleeding.
Anti-seizure medication like phenytoin (Dilantin) and phenobarbital reduce the effect of Paxil. Other drugs that warrant careful use with Paxil are alcohol, sedatives, and tamoxifen. Even drugs for a cough, colds or allergies are contraindicated. As far as natural supplements go, you should not use Paxil with St. John’s wort or ginseng. That is because one of many Paxil side effects is its ability to increase blood pressure.
Conditions That Contraindicate Paxil
While healthy individuals can start taking the antidepressant, it’s not for everyone. People with certain conditions cannot take Paxil, and many conditions indicate people should use extreme caution. Some medications interact with it, and Paxil side effects can worsen. Those with liver and kidney dysfunction will metabolize and eliminate Paxil far too slowly. Delayed removal from their system can develop high blood pressure with persistent use. As it affects bleeding time, those with bleeding or clotting disorders shouldn’t take this.
Additionally, people with seizures and glaucoma cannot use Paxil. Cardiac disease, low sodium levels, and bone problems also contraindicate Paxil. In 2006, the FDA warned mothers who were taking Paxil during pregnancy. They reported Paxil side effects on the fetus. Babies born to mothers on Paxil were six times likelier to have PPH. PPH is persistent pulmonary hypertension. They were also twice as likely to have serious heart defects.
People who have bipolar disorder should also not take Paxil for depression. It induces states of mania, particularly once it’s discontinued. Manic episodes in these patients lead to a complicated form of discontinuation syndrome.
Older people tend to metabolize and excrete this drug very slowly, so it’s not recommended. A life-threatening syndrome can develop in people who have low sodium counts, it’s called hyponatremia and, in these people, doctors advise extreme caution. These patients are not candidates for Paxil therapy.
Paxil side effects came to light by the class action settlement in California. The pharmaceutical company, GlaxoSmithKline agreed to pay $8.5 million to settle claims.
The first string of lawsuits related to Paxil side effects was in 2004. They were based on claims of habit forming behavior. GSK promoted the drug as non-addicting and non-habit forming. In reality, the company reportedly knew about severe withdrawal symptoms as far back as 1993. The most reported withdrawal symptoms were anxiety, insomnia, nausea, irritability, and fatigue. All the cases filed in the federal courts were consolidated, and a multi-district litigation proceeding went on in California. It resulted in a settlement for a reported $160 million in 2006.
In the US, the first suicide Paxil lawsuit to go to trial involved an adult patient. The jury awarded $8 million in favor of the family of a man on Paxil. The Paxil side effects manifested quickly, and he killed his wife, daughter, and granddaughter. He then killed himself.
In 1992, when the drug first came to market, it was classified as a drug with no risk of congenital disabilities. That classification was inaccurate. The most commonly reported congenital disability was holes in the heart wall chambers. Many lawsuits over this have brought the Paxil side effects to the fore.
The Bottom Line
Paxil is a potent antidepressant. It is effective in treating many conditions. Some of them include GAD, panic, PTSD, social phobia, premenstrual dysphoric disorder, and OCD. Doctors prescribe it for peri-menopausal or menopausal hot flashes as well. The side effects and risks associated with Paxil make it the least safe of all SSRIs and SNRIs.
That said, these conclusions should lead patients and doctors to be more cautious. Especially when compared to other antidepressants in recommending, and continuing treatment with Paxil. Do you take Paxil? Tell us about your experiences with Paxil side effects in the comment section below.