Duration of paxil side effects?

June 13, 2006 10:04 AM

So I've been on Paxil for anxiety for a few months and I'm starting to notice...

Well, the Paxil has helped the anxiety quite a bit but I'm running into a few nasty side affects that are still persisting

#1- The weight gain. I've put on about 25 pounds in 2 months. The freaky thing is that I eat right and exercise like a mother. If anything, I would expect to be losing wait or maintaining it. I've never had a problem with my weight spiraling out of control like this before. Again, I eat right and exercise like crazy. I'm addicted to activity-run/bike/hike/sports you name it.

#2-I dont seem interested in things anymore. At work I just sit unless I'm specifically asked to do something. At home, things just seem to pile up. I dont feel as passionate or concerned about things. The exception is the urgent fire that needs to be put out; its like I need some emergency to jumpstart myself.

What I'd like to know is if things will 'level' out in terms of the weight gain and the not caring, or if i can expect things to get worse. The weight gain, considering my activity level, is starting to depress me. While the anxiety was bad, these side effects are not a fair trade off.

posted by anonymous to health & fitness (21 comments total)

I tried Paxil (for depression) for about 3 months and quit it because of similar side effects. The "lack of interest" side effect was weird, because it was different from the "lack of interest" symptom of my depression, if that makes sense. I ended up on Wellbutrin for awhile, which ended the weight gain and mopey-ness, but gave me insomnia. I am glad to be off all those meds now. I think adjusting neurotransmitters is just going to have a lot of side-effects for a lot of people. Good luck.
posted by Cookiebastard at 10:14 AM on June 13, 2006

I seem to recall a leveling out reaction after about 6 months. If anything, I was able to better focus on doing the little thing that I like to do. Take a walk. Do a crossword puzzle.

Sexual side effects..now that's another story.
posted by punkfloyd at 10:18 AM on June 13, 2006

If you've been on it for a few months and are still experiencing those things then they will probably continue. You are well past the time of largest adjustment to the medication. You might want to talk with your psychiatrist about a different strategy, and if you got your meds from your GP, think about transferring your care to a psychiatrist.
posted by OmieWise at 10:20 AM on June 13, 2006

i was on paxil for a few months as well (ended up quitting because i could no longer afford to actually *pay* for it) and i was told that after two weeks my body would become acclimated to the medicine and i should start feeling "normal"

however

that side effects such as gaining weight (check), loss of libedo (never really had it so nothing to measure against...) would continue on. your general lack of interest in things - do you feel helpless or generally uninterested?

regardless, you should talk to your doctor and tell him/her about your worries. not every medication has the same effects on everyone, so there might be another prescription that you can switch to that might alleviate some of your current side effects. of course, then again, maybe your prescription is too high, or too low - do you find your anxiety manageable right now? do you feel sluggish or listless?

i hope you find a way to balance this - if the side effects aren't something you're willing to live with (which i hope they're not) you should really see about getting your dosage changed or switching out. be warned, if you try a new medication you'll likely be weened off paxil and you will likely feel worse in the hiatus.
posted by sporky at 10:21 AM on June 13, 2006

I've been on Paxil for years and have weighed in on questions here several times.

The side effects you're experiencing are normal and I have to deal with both of them. I gained weight initially, but have since been more or less steady. A little heavier than I'd like, but I haven't gotten obese or anything. I find that getting to the gym keeps me more or less stable.

The problem is that I've got to work really hard to get myself into the gym. Same goes for my own projects and research. I've always put things off to the last minute, but Paxil has made my motivation issues far more pronounced.

Paxil treats anxiety very, very well. I had debilitating panic attacks but have felt more or less normal ever since going on the medication. But I believe that the panic symptoms it mitigates sometimes make it difficult to focus on tasks. If you don't feel some anxiety about a deadline, or about taking out the trash, it's very difficult to make yourself actually do anything about it.

So I have to force myself. Sometimes I don't do a very good job of this. Still, I find that once I start, I'm generally in good shape. It's that initial hurdle that's most difficult.

My plan is to start reducing my dosage over the next few months, hopefully to get off it completely. If you decide to go this route, make sure you do so gradually. Paxil has some unpleasant withdrawal effects (if you search through AskMe you'll be able to read a lot about these).

Good luck!
posted by aladfar at 10:36 AM on June 13, 2006

Oh, and feel free to email me (in the profile) if you'd like to converse about it. I've had to deal with anxiety issue for a long time and have done lots of research into Paxil, etc.
posted by aladfar at 10:37 AM on June 13, 2006

It sounds to me like you need to see your doctor and re-evaluate your meds. I wouldn't make any changes without talking to a doctor.
posted by GIRLesq at 10:47 AM on June 13, 2006

I was prescribed Paxil about a year ago for anxiety and have taken it intermittently since. I wasn't depressed at all, just had prolonged periods of elevated anxiety disproportionate to any real stressors.

I found Paxil overwhelmingly powerful. One of the more significant side effects was your #2-- which I would characterize as 'complacency.' Complacency is very unusual for me-- I'm normally constantly motivated to do things.

I eventually discovered that I seem to be overly sensitive to SSRIs. I found that by using half the lowest prescribed dosage (5mg/day), my anxiety all but disappeared and my motivation was closer to normal. Also at this low dosage I don't seem to experience any serious discontinuation symptoms when I go off it.
posted by anonymous_k at 10:55 AM on June 13, 2006

Paxil has a terrible history at least as far as anecdotal evidence goes. On one fifteen-thousand member psychiatric support group my wife moderated for it was by far the most demonized drug - several hundred horror stories and very few words of praise. The Wikipedia article on it does a neutral-voiced version of most of the major complaints ("Citing data from the World Health Organization, 'Paxil has the highest incidence rate of withdrawal adverse experiences of any antidepressant drug in the world'."). Particularly pay attention to the withdrawl section - I have difficulty believing it's been allowed to remain on the market.

There's a billion alternatives out there with much better reputations both in terms of word of mouth and actual clinical trials. If Paxil isn't working for you then you should ask your doctor about them.
posted by Ryvar at 11:20 AM on June 13, 2006

I came off paxil after a few months solely because of the weight gain. And it took forever to get back to my normal weight. I think that the weight gain added immensely to my depression and the paxil just wasn't worth it. My dr. switched me to celexa and it has been a godsend. I lost weight on it and my depression/anxiety is in check. I subsequently added wellbutrin to the mix and it is a miracle combo for me. Good luck - I know how hard this can be.
posted by meerkatty at 11:23 AM on June 13, 2006

Paxil broke my boy parts. It didn't go away, so Paxil did.
posted by elderling at 11:28 AM on June 13, 2006 [1 favorite]

SSRIs never really helped me much. If you live somewhere where medical marijuana is available, try that. It's helped me a lot with my anxiety.
posted by Kifer85 at 12:33 PM on June 13, 2006

Ask your doctor about Zoloft....It has worked for me with very few side effects....a little complacency I agree....But like one of the other posters pointed out when I do start something, (take the initial step) the complacency all but goes away and I am into the project.

Weight Gain....Maybe that's why I've gained 15 pounds in the past 5 years and am steady at that and seem to never get below it....hmmmm....must talk to my doctor about that.

all the best, good luck
posted by jamie939 at 2:22 PM on June 13, 2006

Weight Gain....Maybe that's why I've gained 15 pounds in the past 5 years and am steady at that and seem to never get below it....hmmmm....must talk to my doctor about that.

Doubtful. Most adults gain a little bit of weight every year, 3 lbs/year is not much for an adult who lives a relatively sedentary lifestyle and eats a modern diet (aka, most Americans).

25 lbs in two months is *a lot* of weight. I guess we won't know if the OP was very thin before or what, but if it's just Paxil screwing with your metabolism that's a slowdown of around 1400 calories/day. You are probably eating more (consciously or not). Or, I suppose, you could be fidgeting much less if you were a fidgety person before.
posted by ch1x0r at 5:16 PM on June 13, 2006

You're having "flat affect." Talk to your doc to switch meds. Also perhaps combine with cognitive/behavior therapy (aka talk to a counselor).
posted by radioamy at 5:54 PM on June 13, 2006

Been on Paxil for 4+ years now -- other than the decreased sexual appetite, there are no side effects. What few there were (similar to yours) dissipated over about six months.
posted by davidmsc at 6:17 PM on June 13, 2006

I can't suggest what you should do, but I can confirm that both of these effects are extremely common with SSRIs.
posted by ikkyu2 at 6:27 PM on June 13, 2006

Just beware of abrupt discontinuation, and if you have trouble coming off don't let the doctor tell you it's, "Just the depression and/or anxiety returning." Withdrawal is hell. The drug companies will tell you that SSRIs are not "addictive" or even "habit forming".....it's parsing words and semantics because withdrawal can truly be ugly. If it wasn't for Dr. Joseph Glenmullen - and his book - I might not be alive today.
posted by Gerard Sorme at 7:46 PM on June 13, 2006

I took Paxil for a while some years ago. I gained quite a bit of weight and completely lost my libido. Needless to say, I am no longer on Paxil. (I went to my doctor and said "enough!") I'm on Wellbutrin now and it works much better for me.
posted by SisterHavana at 7:54 PM on June 13, 2006

I would definitely mention dosage to your doctor. I'm on prozac, so my side effects are different, but they used to be more significant. Then, I talked to my doctor and we lowered my dosage down to half the normal amount. That got rid of most of the side effects, and I get pretty much all of the benefit from it. Dosages are not one-size fits all, and you should definitely experiment a bit. The only annoying bit is finding pills in the right size, or remembering to take it every other day :)
posted by JZig at 9:01 PM on June 13, 2006

Oops, based on what the wikipedia article says, trying to take paxil every other day is an incredibly bad idea, because of the drug half life. Go talk to your doctor before trying any changes in dosage, as it looks like it's harder to get the dosage right for Paxil.
posted by JZig at 9:09 PM on June 13, 2006