Transitions

I have decided to say farewell to paroxetine (Paxil), a serotonin reuptake inhibitor (SSRI) I have been taking for a year and a half for panic disorder (anxiety). A quick search on the Internet will find you all sorts of negative rants about this drug but I am truly grateful it exists, despite my decision to wean myself off of it.

My only real complaint about Paxil is weight gain. I am a pretty active person in my late 20s and yet I have gained approximately 40 lbs since taking Paxil. Though all SSRIs affect everyone differently, Paxil is notorious for weight gain. It could be because it makes it easier to sleep a lot more. It could be because it has the tendency to increase appetite (although even with strict dieting I cannot seem to lose weight). It could even be because this medication affects how carbohydrates are metabolized. Whatever the reason, many people gain weight on this drug. Is this a reason to avoid it? No. Your psychological health should come first.

Paxil helped me through the worst time of my life when my panic disorder became so unbearable that I became incredibly agoraphobic--I could barely set foot outside my house. I'm not saying this drug will make everything better, but it definitely brought my anxiety down enough such that I could benefit from the other crucial component of recovery, therapy. It also made it possible for me to once again sleep soundly at night, something I had had a problem with since I was panicking all day and all night. It really mellowed me out during a time which I constantly felt I was coming out of my own skin.

Now, however, I feel that, although I have yet to make a full recovery (lingering agoraphobia issues when it comes to longer distance traveling out of my home city), I feel I have gained some helpful tools from therapy that will allow me to deal with this disorder without allowing it to overwhelm me entirely. I will admittedly be taking Lexapro (a similar medication) once I have weaned off of Paxil. Lexapro is a lot less likely to cause weight gain and many people who make this switch do see the weight they gained while on Paxil come off.

Weaning off Paxil can be difficult as you can experience withdrawals from this class of medication. I had been on a pretty low dosage (20mg--10mg is the smallest pill) so I am beginning by going down to 15mg (with consultation with my prescriber) for one week. Tonight is night 2. I will continue to reduce by 5mg every week. This is a pretty slow wean but I just want to ensure that I get little to no withdrawal symptoms. So far I feel fine. I will begin with 5mg of Lexapro once I am down to 10mg of Paxil. I will consult with my prescriber once I've been on 10mg of Lexapro for a month to see if that dosage is therapeutic for me.

I plan to document my experiences and any weight changes I might experience here for any others who are contemplating such a transition. Again, I am quite active (go on long distance bike rides, commute by bike, hike, jog, and participate in aerobic and strength training classes at my gym regularly) and eat healthy (lots of veggies, lean meats, beans, nuts, seeds, multigrain high fiber breads and cereals, etc). I am 5'6" and currently weigh 177lbs, when I used to weigh 137lbs. I'd be quite content to weigh 150lbs.