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Be Mused by Susan M. Brackney
Be Mused : Will She be a Zombie on Paxil?

Be Mused

Will She be a Zombie on Paxil?

Dear Muse,

Could you explain how well Paxil works, and what the side effects are? My doctor prescribed it to me, and I am scared that I will lose my character or turn into a staring zombie! — Scared Little Miss

Remember that silly TV commercial with the man who says, "I'm not a doctor, but I play one on TV"? I forget who he was or even what he was selling (a headache remedy perhaps?) but that line sure has had some staying power — even if it didn't make too much sense. Along those lines, I'm not a doctor, and, worse yet, I don't even play one on TV. As a result, I'm even less qualified to discuss your general well being than he was then. But that hasn't stopped me before!

You didn't mention what condition you are being treated for, but you may be interested to know that the U.S. Food and Drug Administration has approved Paxil for the treatment of depression, generalized anxiety disorder, social anxiety disorder, panic disorder, obsessive-compulsive disorder and post-traumatic stress disorder.

SmithKline Beecham Pharmaceuticals, the maker of Paxil, claims that it and other drugs in the selective serotonin reuptake inhibitors (SSRI) class are "safe and effective with fewer side effects than other types of antidepressant medications." (But of course they're going to say that!)

Your doctor should've started you on a fairly low dose — about 10 or 20 milligrams daily — and how well any drug works really depends on the individual. Similarly, the onset of side effects from medications varies widely, too. Before they approved Paxil for general use, the Food and Drug Administration did plenty of clinical studies. In the clinical trials, 23 to 26 percent of participants reported nausea and upset stomach as the most common side effects. Drowsiness, experienced by 23 to 24 percent of people, came in second place. Eighteen percent of those studied reported headache and dry mouth, and another 15 to 22 percent mentioned feeling noticeably weak. Other side effects may include a lack or loss of strength, fatigue, sweating, dizziness, nervousness, decreased appetite and sexual dysfunction. In all, 10 percent of patients trying Paxil had to discontinue due to side effects.

As to losing your character or turning into a zombie, the closest approximation to these states that I could find amongst clinical trials were one in every 100 patients reporting "abnormal thinking" and another one in 100 claiming they felt a "lack of emotion." I have heard complaints from some artists taking antidepressant medications that the drugs affect their creative ability. Dr. Alan Swann of the University of Texas stated that this is more common for people with bipolar disorder. He explained, "Usually through the right combination of medicine and other ways to keep your sleep and activity stable, you can find a balance. It should be possible to be protected from depressions or manias that get out of hand and to keep your creativity, because reducing creativity is not a necessary effect of medicine for it to work. Luckily, there are many alternate medicines available. Combinations sometimes make it possible to avoid having to use too large a dose of a single medicine." Another bright spot: sometimes problematic side effects are merely temporary.

You may not know how well the drug works for you (or if you are rendered a zombie) for several weeks, so you may need to be patient. If you find that Paxil isn't working out, your doctor may try one or more of the many other antidepressants available. In the meantime, if you'd like more information on Paxil, you can write to SmithKline Beecham Pharmaceuticals, Medical Department; One Franklin Plaza; P.O. Box 7929; Philadelphia, PA 19101, phone (800) 366-8900. •

© 2001 Susan M. Brackney. All rights reserved.

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