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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 7 of 7. This is the beginning of the thread.
Posted by missy on March 7, 2000, at 15:22:30
hello everyone,
i have a question concerning paxil. i was recently given
a prescription for paxil to treat my depression - i took
prozac for about a year with not too much improvement, so
i took myself off, and after a year, just decided it was
time to go back to the doctor. he thinks i should try paxil
but after reading everyone's horror stories, i'm not sure
i want to anymore. i also have had disordered eating all of
my life (not severe, anorexia or bulemia) so the weight gain
is definitely a concern to me. but i was reading other info
on paxil, and read somewhere that if you have suicidal thoughts,
you should tell your doctor immediately...i hardly ever go to
bed without wishing i wouldn't wake up the next morning, and
often contemplate taking action, but i didn't tell this to
my doctor. does anyone know of any connection between taking
paxil and being more likely to commit suicide? i haven't
started taking the med yet cause i have to get surgery in a
few days and my doctor said i should wait til i'm better - so
do you think i should take it at all??? any input would be
greatly appreciated.thanks,
missy
Posted by bob on March 7, 2000, at 18:30:21
In reply to paxil and suicide, posted by missy on March 7, 2000, at 15:22:30
Hi missy,
For anyone who is starting just about ANY antidepressant, this can be a concern. It's not so much that taking the med somehow makes you want to kill yourself, but that people who are seriously suicidal who haven't taken any steps toward doing so will get enough of a boost from the medication to finally take some action. I think this is mostly of concern for medications like SSRIs, which can take 6-8 weeks before they settle into a therapeutic effect.
The very first time I went on medication, my GP gave me zoloft. Thirty minutes after taking my first 50mg tablet, I was high as a kite and goofier than, well, Goofy. I was working as a consultant in an elementary school at the time, and it was really a struggle not to say something goofy or racy or otherwise inappropriate just to get a laugh ... I don't know how I made it thru that day without getting kicked out for good! One week later, my mood crashed right thru the floor. It was a roller coaster like that for me for the next five weeks.
Are you getting this medication from a general practitioner or from a psychiatrist? Are you in some sort of talk therapy right now? If you are feeling suicidal, you need to get more help than what a med is going to do for you. This is particularly true if you're going to have to cope with adjusting to a med at the same time as dealing with your own feelings. You need to be honest and open with your doctor/therapist about this ... quite a few of us (guilty as charged) have been where you are, and not so long ago ... some of us know we may head down that road again. Everyone I've seen write about it here talks with their therapists about it, even (or especially) if they can't mention being suicidal to anyone else. That's when they really become your lifeline ... but like I've said, you HAVE to be open and honest with that person for him or her to be of any good for you.
take care,
bob
Posted by Cam W. on March 8, 2000, at 0:25:13
In reply to Re: paxil and suicide, posted by bob on March 7, 2000, at 18:30:21
Missy - The reason that the drug companies say that you should not take Paxil (or any antidepressant) originally comes from the few deaths by suicide that were seen when Prozac was introduced in the early 1990s. Remember, the Church of Scientology played this up by exaggerating actual number of deaths and planting items in the mainstream press by experts (their "experts", not drug experts) as scare tactics. The reason that SSRIs should not be used in people with suicidal ideation is that these people, while depressed, haven't the energy to act on their impulses. The Prozac started reversing the depression, lifting the lethargy, and the people who had the suicidal ideation now had energy to act upon their impulses (as Bob has said above). Just because you think about dying while lying awake in bed (as many of us have done at one time or another) does not mean that you are planning on acting upon these thoughts (eg have formulated a suicide plan). It would be best to talk about this with your doctor and voice your concerns, and both of you can come to a consensus on your mental state (eg whether you are really suicidal or if it is the depression that is giving you these thoughts). Be up front with your doc and tell him what you have told us. Maybe it would be wise to ask what others in here think. They may have better insight or may find my logic wrong. Always get another opinion in this room; there are many knowledgeable people who have been where you are now. Bob has some good ideas. Good luck - Cam W.
Posted by missy on March 8, 2000, at 6:31:09
In reply to Re: paxil and suicide, posted by Cam W. on March 8, 2000, at 0:25:13
>
> Missy - The reason that the drug companies say that you should not take Paxil (or any antidepressant) originally comes from the few deaths by suicide that were seen when Prozac was introduced in the early 1990s. Remember, the Church of Scientology played this up by exaggerating actual number of deaths and planting items in the mainstream press by experts (their "experts", not drug experts) as scare tactics. The reason that SSRIs should not be used in people with suicidal ideation is that these people, while depressed, haven't the energy to act on their impulses. The Prozac started reversing the depression, lifting the lethargy, and the people who had the suicidal ideation now had energy to act upon their impulses (as Bob has said above). Just because you think about dying while lying awake in bed (as many of us have done at one time or another) does not mean that you are planning on acting upon these thoughts (eg have formulated a suicide plan). It would be best to talk about this with your doctor and voice your concerns, and both of you can come to a consensus on your mental state (eg whether you are really suicidal or if it is the depression that is giving you these thoughts). Be up front with your doc and tell him what you have told us. Maybe it would be wise to ask what others in here think. They may have better insight or may find my logic wrong. Always get another opinion in this room; there are many knowledgeable people who have been where you are now. Bob has some good ideas. Good luck - Cam W.thanks for your input, guys. i definitely think i need to talk to psychiatrist in the near future, but right now, i'm just so busy with the rest of my life that i don't have the time. that's why the last time i went to my gp for a check-up, i just asked him about it. since i'd been on antidepressants before, he seemed to have no problem with giving me another one to try. i realize this wasn't the best decision, but i felt so desperate at the time, i thought that if i waited any longer (like however long it would take to get an appointment with a psychiatrist), i might not make it. my mood has since lifted a little, and after reading the posts about the sie effects of paxil and other ad's, i think i'd rather try going to therapy or something. i was in therapy while i was on prozac, but it was a lot easier then because i was in college and had counseling available to me right there. so not it's a lot more work, and i'm already stressed about not having time to do anything, but i'm only 23 and don't want to be on medication the rest of my life. another thing that makes me really depressed is knowing that this is hereditary. my mother and brother have both had depression in the past (never talked about it, but it was obvious) so i'm so scared that if i have children, they'll only suffer the same way i have and i would never wish my life and the way i've felt on anyone. does anyone have any thoughts on this? thanks again for listening - i know i babble sometimes but i don't really have anyone i can talk to about this - no one takes me seriously - they think that since i'm somewhat attractive and have a good family and a good job and i'm healthy, that i couldn't possibly be depressed. they don't understand that it has nothing to do with that - but i think you guys understand. so thank you - melissa
Posted by Scott L. Schofield on March 8, 2000, at 13:50:54
In reply to Re: paxil and suicide, posted by missy on March 8, 2000, at 6:31:09
> thanks for your input, guys. i definitely think i need to talk to psychiatrist in the near future, but right now, i'm just so busy with the rest of my life that i don't have the time. that's why the last time i went to my gp for a check-up, i just asked him about it. since i'd been on antidepressants before, he seemed to have no problem with giving me another one to try. i realize this wasn't the best decision, but i felt so desperate at the time, i thought that if i waited any longer (like however long it would take to get an appointment with a psychiatrist), i might not make it. my mood has since lifted a little, and after reading the posts about the sie effects of paxil and other ad's, i think i'd rather try going to therapy or something. i was in therapy while i was on prozac, but it was a lot easier then because i was in college and had counseling available to me right there. so not it's a lot more work, and i'm already stressed about not having time to do anything, but i'm only 23 and don't want to be on medication the rest of my life. another thing that makes me really depressed is knowing that this is hereditary. my mother and brother have both had depression in the past (never talked about it, but it was obvious) so i'm so scared that if i have children, they'll only suffer the same way i have and i would never wish my life and the way i've felt on anyone. does anyone have any thoughts on this? thanks again for listening - i know i babble sometimes but i don't really have anyone i can talk to about this - no one takes me seriously - they think that since i'm somewhat attractive and have a good family and a good job and i'm healthy, that i couldn't possibly be depressed. they don't understand that it has nothing to do with that - but i think you guys understand. so thank you - melissa
--------------------------------------
Hi Melissa.
Bob is EXACTLY right.However, I don't think that this should dissuade you from continuing a treatment course of trying different antidepressants. This phenomenon can occur with any antidepressant, albeit infrequently. It seems to be limited to a breif period early in treatment - probably during the second and third week. Knowing that this is a possibility gives you the advantage. You can prepare for it. Certainly, contacting your doctor would be a first step. I think it might also be a good idea to prepare those who are close to you and allow them to observe, support and guide you through such a period, should it occur. You are at no greater risk of this happening than were any of the multitude of people who have been successfully treated and are now living rewarding lives.
Good luck.
Keep talking.
- Scott.
Posted by cynthia on March 8, 2000, at 15:34:22
In reply to Re: paxil and suicide, posted by Scott L. Schofield on March 8, 2000, at 13:50:54
Melissa- because depression is hereditary dosen't mean that any chilren you might have will automatically have depression. I have nine children. Their father had asthma and we ended up with four kids with asthma. But we treat asthma. We have also ended up with one with diabetes (so far, no family hx) and we treat diabetes. We have also ended up with one with with depression (my side of the family) and we treat the depression, with Paxil , by the way. There are ways of managing illnesses and if we are to make others believe that depression is an illness just like any other then we treat it medically just like any other.It just seems that there are many reasons to worry about should you or shouldn't you have kids.Genetics is tricky . There are no definites. Follow your heart and take care of yourself right now.-Cynthia
Posted by bob on March 8, 2000, at 20:00:09
In reply to Re: paxil and suicide, posted by cynthia on March 8, 2000, at 15:34:22
We had a discussion about the heredity issue a few months back. Facing that issue made me realize that along with my troubles come certain gifts as well ... as if the same portion of my brain is invulnerable to some things yet vulnerable to others. Two sides of the same coin. The fine line between "genius" and "insanity" ... how many of us are straddling it?
But like Cynthia said, if something goes wrong, you treat it.
As for getting meds from your GP -- go for it. I'm glad to hear that your mind is open to other avenues of treatment and that you'll use them when you can. I'm sure a lot of folk out there are helped by what their GP can do for them -- I have a brother in that group [grrrrrr ... da bum goes in to get some pills, and gets a combo, cytomel & celexa, that works for him immediately ...].
The thing that always concerns me, as a fellow Babblelander, is if things stop working. I've seen a number of folks get on here who start one med then stop, by their own choice, a few months later because they feel good or because they thought it wasn't working ... and that stopping precipitates a crisis. I was in a similar situation, and it caused a great deal of pain for me and those around me. Once I finally started seeing a psychiatrist, he told me in no uncertain terms that the reasons I had used to decide on stopping were unwarranted, and that he never would have suggested the path I took. It seems a common enough story here -- how some uninformed decisions early on can screw up things for quite some time.
That's why good information is just as important as anything else when you're just starting treatment.
Missy, I can remember staring down that "medication for life" thing, too. It's a tough pill to swallow, pardon the metaphor. Who knows? Maybe *I* won't be on meds all my life. The thing is, if I have to go back to living the way I was OFF of meds, then life on meds is more a gift than a curse. It takes some getting used to, and probably some combo that really makes you feel better, before it becomes bearable.
my two cents,
bob
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