April 21, 2008

Love Letter To Paxil

Most of you know that as critical as I am about psychopharmacology and the pharmaceutical companies that I try to occasionally tip my hat to the notion that some people--far too few, I'd argue--do benefit from anti-depressants and the like. Here's a woman from New Jersey who's so happy with her experience going on Paxil that she's written a blog entry in the form of a love letter to the drug. I pass it along because it's one of the few examples I've seen of someone praising the pill on the Net in a long while.

"Dear Paxil, Thank you. Thank you so much for the past two months. Thank you for stopping my dead in my tracks on the downward spiral of depression I was surely sinking deeper and deeper into. Thank you for giving me the clarity to consciously choose my thoughts and control my emotions. Thank you for allowing me the ability to think rationally through every situation at a slow enough pace that I can understand everything that's going on in my head. Thank you for ridding me of constant anxiety about trivial things. Thank you for chasing away the out-of-control fsense of sadness, guilt and hopelessness I've been feeling for a long, long time. Thank you for giving my tear ducts a break and for ending the scary midnight panic attacks that were depriving me of much-needed sleep."

You can read the entire post at the above link.

My primary concern for her is that she seems to be very new to the world of SSRIs and I hope she can avoid the washout phenomenon that over time can get people on a cycle of more and more meds that work less and less as time goes on.

Posted by Philip Dawdy at April 21, 2008 12:03 AM
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Comments

That was my thought too. Only two months. While it does seem to be as simple as that for some people, it's often only temporary.

The good old fashioned way of working through one's issues is not as easy but it lasts longer and the side-effects are not too bad...

Posted by: Rosie at April 20, 2008 11:14 PM

the 2 month mark is a red flag, and then [if the drug isn't working as well now]the doc will increase it, eventually patient goes off, has withdrawals, and drug will be re introduced or replaced with another due to 'return of symptoms'. it's such a common pattern.

Posted by: Stephany at April 21, 2008 01:54 AM

Oh! Of course I've been on Paxil! Changed for Effexor.
"Dear Paxil and all others,
I hate you and have nothing to thank you."

Posted by: Ana Lima at April 21, 2008 04:07 AM

Yup, even I believe in this honeymoon period and I don't think it's just a placebo effect either. Peter Kramer didn't just pull that "better than well" expression out of a hat. I'd love to know what dosage this lady is on. I'm guessing it's pretty low. All I can say is I agree with one of her commenters -- it's not going to last. And if the day ever comes when she wants to get off -- either because it's no longer working in this miraculous way or she wants to get pregnant, have kids, or she realizes she's put on rather a lot of weight -- well good luck to her because I don't think it will be pretty. If she's only on 10 mg she might be lucky. The success stories (I hesitate to call them that -- maybe the relatively "free from harm" stories) I've heard on Paxil and I have heard a few are with people on below the recommended dose who decide to get off within a year or maybe 18 months.

Posted by: Sara at April 21, 2008 07:45 AM

As a former facilitator for a local chapter of DBSA I cannot count the number of times I’ve listened to participants state, “What I wouldn’t give to feel a minute’s worth of wellness.”

I find it interesting how easily one can dismiss “only two months” of wellness.

Then again I also cannot stress, in my opinion, the importance of the individual knowing what it is to feel well so as to remember that state of wellbeing should their be a relapse and the “beast” raise it’s ugly head.

Hope and encouragement that remission is possible is what I read from that note. The individual might now be hit by a car and die but at least that person experienced “two months” of wellness.

Warmly,
Herb
VNSdepression.com


Posted by: herb at April 21, 2008 08:21 AM

My worry is more for when she tries to come off of it. I was fine on Paxil except when I came off it. Same for Effexor. I thought Effexor was the greatest thing known to man until I tapered off and had those awful side effects. No need to ruin a good thing if it's helping her right now.

Posted by: Marissa Miller at April 21, 2008 09:05 AM

I love drugs. I love seeing them work for people and I love it when they work for me. Drugs help. Drugs are fun, only Puritans don't appreciate the wonder of drugs. Doesn't mean they are not a crutch and a vice, and as agents are all iffy and potentially dangerous, and that pushing the drugs coded as "illicit" could land you in jail, while the mind-altering drugs that are advertised on TV every ten minutes are as dangerous and iffy as the naughty drugs but considered "medication" because they keep the economy booming.

Posted by: flawedplan at April 21, 2008 09:30 AM

you know what did all that for me in spades...slowed me down, made me think, stopped impulsive behavior---for 2 WEEKS before pooping out...Ritalin...I thought I'd died and gone to heaven until it proved to good to be true.

All this shit can have short term miraculous effects...I'm completely unimpressed.

Posted by: Gianna at April 21, 2008 09:33 AM

Ironically enough, I have one friend who, even though she now has diabetes, has been on Zyprexa from its Day One. Last year all heck broke loose and she was psychotic for months. Finally she upped her dose to 20 and, v iola, she was fine again. Not sure of her diagnosis, but she is actually fine. Maybe I should give her name to Lilly - they will have one poster girl. Wait, that won't work. She has diabetes. I was just thinking she's still alive after all this time.

Posted by: Sorrowful at April 21, 2008 11:32 AM

20 years ago when I started a tri-cyclic medication called Desipramine, I was told it would be temporary, and that I didn't "need" it, it would just make it easier, make me better. Up until 1 year ago, and through an advent of more and newer drugs, I still believed that this was the truth. After the temporary uplifts and the eventual downs that got lower and lower, eventually resulting in my hospitalization with electroshock, I asked my psychiatrist for a definite time-line for getting off my meds. She flatly refused, stating that I would go back to the hospital and get electroshock again if I ever went off them, and said the same thing was true for everybody she ever worked with.
I think some anti-depressants can work short-term, but they should be stopped as soon as possible, and please, help me and others find a way to work on the actual issues in our lives instead of only fixing in a short-term way!

Posted by: Sophia at April 21, 2008 02:34 PM

I wouldn't be surprised if someone could feel a moment or two of wellness from taking a drink, smoking a joint, or snorting cocaine. I don't call this remission. I call it getting high and that's exactly what's happening on an antidepressant. Let's not kid ourselves.

Posted by: Sara at April 21, 2008 04:03 PM

Sophia the problem is the psychiatric solution is always medication based. If one goes to a psychiatrist they will walk out with a script for meds. The key to therapy is to stick with a therapist and not go toward the psych office; honestly, typically it is meds from the psych and ppl see a therapist as co-treatment. It's just the way it works. Same as a psych hospital, there is not one patient who enters one who will not be placed on or sent out on drugs.

Posted by: Stephany at April 21, 2008 05:51 PM

Sara, I wish the ADs I was on caused me to get high (smile). I was flat as a pancake.

I do understand what you are saying though as I don't consider life devoid of all emotions remission. You make an excellent point.

AA

Posted by: AA at April 21, 2008 06:17 PM

Dear Stephany,

In my opinion the problem is the psychiatric disorder(s) and the infancy of the science of the brain and our lack of understanding.

It is also the caring and knowledgeable therapist, in my opinion, who accepts and recognizes that his/her knowledge and skills in some cases are beyond their professional abilities to stabilize and gain remission for the patient and acknowledge that other interventions may be necessary.

While at the same time there are also those caring and knowledgeable Psychiatrists who encounter, recognize and acknowledge patients who are not responsive to conventional treatments and are willing along with the understanding and informed consent of their patient to seek out new and innovative treatment options (non-pharmaceutical) who benefit as was our experience and that of individuals with whom I have the pleasure and good fortune to correspond with over the years.

In retrospect and reflecting upon your statement it may have been an easier course for my spouse and me to have traversed had her challenges been one of “issues” whether relating to parental nurturing, maturation, environment and/or situational stresses etc. Simply put; there is none in her case. In my spouse’s case history talk therapy was the primary and first treatment option considered and utilized without any satisfactory results and continues to this day as an adjunctive therapy simply because it causes no harm.

Warmly,
Herb
VNSdepression.com


Posted by: herb at April 21, 2008 09:08 PM

Herb,
"and me to have traversed had her challenges been one of “issues” whether relating to parental nurturing, maturation, environment and/or situational stresses etc."
I'm sorry but this is a very incomplete approach of psychoanalysis.
Unfortunately "neurosis" concept was banned from diagnosis.
Vietnam veterans were "neurotics" all of a sudden they suffer "Post-Traumatic Stress Disorder" and they are prescribed antidepressant (usually Zoloft), benzodiazepine and mood stabilizer.

Posted by: Ana Lima at April 22, 2008 03:45 AM

I am new to all this stuff and found this post and responses very interesting. I was put on celexa and the first 2 months were great! Then my psychiatrist increased the dosage, and increased it again, added another drug... needless to say I only had the 2 months before going into a weird mixed episode and I feel I lost a year of my life before I went off the meds by myself.

Posted by: Kerri at April 22, 2008 07:23 AM

AA, you're right of course about a/ds making someone flat. I was referring exclusively to that "honeymoon" window which lasts different lengths of time in different people if they get it at all. Some people get so high they get manic or psychotic and kill themselves or others but of course that's rare I know. If it works the way pharma is promising the high is more attenuated and you just feel "better than well". But you do get flat later in the process.

Posted by: Sara at April 22, 2008 08:06 AM

In response to Stephany, I did do talk therapy with psychologists for 20 years. I did not get anything positive from seeing them. They were the ones who referred me to pills, which of course had to be prescribed by psychiatrists. My last psychologist also told me to go to the hospital, and told me she thought I should get electroshock. Talking to her might have done me as much damage, and possibly less good, than these harmful and damaging treatments. When I felt shame, she made it worse. When I felt rage, she made it worse and made me feel more impotent. She had no constructive advice, and did not help me get to know myself better. I have heard of good psychologists, but I have not experienced one.

Posted by: Sophia at April 23, 2008 09:51 AM

Sophia is dead right of course. Talk therapy can do as much damage, if not more, than medication. As can "diagnosis". Yet there is no doubt that the so called "empathic alliance" if formed with the disturbed individual by whomever, if they are truly caring and supportive, can work wonders in the healing department. It's truly a shame that this can't be taught and can't be guaranteed when one seeks or enters talk therapy.

Posted by: Sara at April 23, 2008 11:06 AM

Thank you Sophia and Sara,

You’ve points both brought to my attention an omission to one of my previous sentences. I omitted the words “to her.”

The sentence read:

“In my spouse’s case history talk therapy was the primary and first treatment option considered and utilized without any satisfactory results and continues to this day as an adjunctive therapy simply because it causes no harm.”


The sentence should correctly read:

In my spouse’s case history talk therapy was the primary and first treatment option considered and utilized without any satisfactory results and continues to this day as an adjunctive therapy simply because it causes no harm to her.


And yes, I do agree that talk therapy can also be detrimental to a patient and I’d remind readers that there are psychotherapists, good psychotherapists and better psychotherapists. The same premise of utilizing vitamins, supplements, herbs and so forth considered natural substances maybe in one’s thinking be safe but upon careful reading and research there are potential dangers hereto. It is incumbent upon the patient and/or support persons to be reasonably informed.

Thanks for you’re sharing; I am agreement with your point.

Warmly,
Herb
VNSdepression.com


.

Posted by: herb at April 23, 2008 11:59 AM

wow Sophia that is awful, I'm sorry you had that experience. Thanks for sharing that.

Posted by: Stephany at April 23, 2008 03:28 PM

How much did she get paid?

Posted by: Lilly NC at April 27, 2008 03:34 PM
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