Our letter and reply about Paxil-- and other SSRI antidepressant therapies-- initiated so much discussion, that I opened up a new thread on my personal blog.
The comments, especially, have been eye-opening to me.
I'm the writer of the first letter. I didn't find Susie and Aretha's advice or attitudes too alarming- I guess I'm used to it, and I am kind of wary of SSRIs myself (even though for the most part, the Paxil DOES work for me). I loved reading all the comments, they're immensely helpful and supportive. I have been a lurker on here for a looong time, so it was actually really nice for me to see so much support, it definitely makes me feel more like part of the community here.
I realize I have been cavalier about taking my meds...I am also on birth control, and when I take it, I KNOW I should also be taking the Paxil too, but...I don't, not always. I guess I'm just rebelling against it now. I DID look up low cost health care centers in my area and lo, I found one in my town, and it offers behavioral and mental health services, so I am definitely checking that out tomorrow, thank you Political Party Girl.
Sometimes I almost feel kind of stupid about this problem. I know that orgasms aren't or don't have to be the primary goal of sex. Honestly I am having really good sex, the best even, and I am not coming from it at ALL. But I am in love with my new bf, and it is something I would like to experience with him. I guess I am just happy to see that no one belittled the problem (but I am on Jez, so I know those fears were kind of unfounded). I am just excited to read the support on here for topics like this =)
(As for crazy, it has been suggested before this...I don't mind)
The first question? Really. Awful answers. Fear mongering with very little information. Do not take a drug holiday. Take your meds every day, the same time every day, the same amount every day. taking them sporatically will make you moody, crazy, likely to become depressed or anxious, suicidal, and completely nonfunctional. Also, many meds don't work the same if you stop them and go back on.
Paxil is a crap drug, it should never have been approved. When you have health insurance, ask to switch to Lexapro, cymbalta, or Zoloft. they're the top sellers b/c they have the least side effects. Also ask your doc for a small number of xanax or valium to help deal with incidental anxiety.
antidepressants are dangerous in kids and young teens because they weren't tested on children and doctors used to prescribe them as if kids were miniature adults. Paxil did cause some kids to kill themselves. but you're not a child, you're 22, so that doesn't affect you. Your brain is just about done developing. You're fine.
You can find a welath of knowledge at [www.crazymeds.us] Read up on all the antidepressants and decide on, say, 5 you want to ask your doctor about.
Since you don't have health insurance, you're probably paying for meds out of pocket. You can use needymeds.org to find a program to get your meds for free or for cheap.
There might be a free or sliding scale clinic in your area. My GP helped me find mine. Or, you can apply for disability.
certainly SSRIs are serious drugs and you should be monitored closely while on them. But, I am a little offended by the way they were approached here.
Last summer my issues with depression got dramatically worse. I went on lexapro (in addition to seeing a therapist) and that worked wonders for a few months. Then, I went back to school and about 3 weeks in "broke through" the lexapro and hit an even lower low. My psychologist prescribed new meds from afar and I went through hell trying to find something that worked. Zoloft in particular made me experience what was probably the worst week of my life. Eventually I needed to take a leave of absence. I went home and my parents took me to a pharmacologist. This man really understood drugs and how they work. He was upfront and honest about side effects and the unknowns of the hows and whys of the medicine. Working with him and my therapist I was able to go back to school the very next semester.
Now, I know that I am very lucky to have parents who can afford all of these doctors for me. But I hope that this woman can find a way to get all the different kinds of help she needs. Because that is what it comes down to. Finding the right combination.
and again, I cant stress enough the importance of having someone watching over you as you go through this. Your doctor, boyfriend, parents, they all want to help, and they can.
@bellabean: I am so tired of people like our advisers (and I otherwise respect Susie) cavalierly dismissing antidepressants. No drug works for everyone. I've been on Paxil more than a decade, I've had almost no side effects, and more importantly, I have not killed myself, which would be a definite possibility without it. This is why these are PRESCRIPTION drugs: They need to be monitored by an MD.
@KillMeNow no longer has a future in journalism: I have been on Paxil for about 6 years and I am more functional and stable than ever before. However, I first tried natural remedies like St. John's Wart and L-Phenylalanine, as I was weary of prescription drugs. Neither worked for me. My doctor tried me on Prozac at a very small dosage, and I had awful mood swings, sleeplessness, etc., so I switched to Paxil.
One thing that no one has mentioned is the interraction of BC pills and SSRIs. When I started Paxil, I had zero libido and a near inability to orgasm. I poked around on the internet and found this is common in women on both BC and SSRIs. I didn't see much point in preventing pregnancy if I wasn't going to have any desire for sex anyway, so I went off the Pill and my libido and orgasm came back within a few weeks. There is a load of information about antidepressants on the internet, which isn't all legit but at least gives you ideas and questions to ask your doctor. Educate yourself, and know that not every SSRI/drug works the same for everyone, ad you have to find what works for you. While Paxil doesn't help everyone, I'm thankful that its helped me (and you).
@SheelaNaGig: Yeah, I think with sex drive I'm one of the lucky ones. But Prozac made me a jittery crazypants. With Paxil I just get dry mouth sometimes. I can live with that.
I was a virgin until oh, about a month ago. I'm 22, and a fat lady, and I don't regret it at all. (I'm also on SSRIs, partyyy.)
Personally, being in a relationship has immensely improved my body confidence! My girlfriend and I can wear each others' clothes, and I think she is completely gorgeous and sexy. If we can wear the same things, I can't exactly be the troll I thought I was.
On the SSRIs, for the love of god don't take a vacation from them without advising. I did this just last week, and my life has spiraled out of control and now I'm surrounded by a shitstorm. Yeah, the orgasms are better, but I'm depressed/anxious/fatigued as fuck. So yeah, back on those now. DON'T DO IT!
I'm 21 and I JUST had sex for the first time a couple of months ago. I always felt like a freak.... like I was so OLD. But I'm realising, that it's really not that uncommon. And when I look back now, I'm SO GLAD I waited for this guy.
gah! I came really close to sleeping with this dude in high school and that would have been a TERRIBLE mistake!!! :)
The advice to the first question wasn't bad, but the delivery was awful. And, while I don't mind being called crazy, I am guessing some do. Jussayin.....
DO NOT go off meds on your own! See a doctor before, and make sure it's a doctor qualified in the problem you are having. It's actually quite dangerous to wean yourself off drugs without medical support. While your libido, or any one part, may require specialized attention to get active while on meds, think of the overall effect. Is the embarrassment of explaining to your partner your issue, and finding ways to explore sexuality despite meds, really worse than the overall effects that weaning oneself off meds can lead to? We're talking effects like depression, severe anxiety, suicidal thoughts, serious eating and sleep disruptions, mood swings, self-medicating with other substances or behaviours. Waiting for a doctor must be incredibly hard, but toughing it out or finding alternate ways to see a qualified doctor are safer than doing it on your own and trying to self-medicate.
And a virgin at 20? Really not that unusual, and neither is it bad if a person just hasn't found the right sexual partner. There's no reason to rush. Become comfortable with yourself - and not just in a masturbating way, but in terms of what you like to do, your hobbies, your interests, your likes and dislikes, is really really important. Being a virgin not equal "alone in their room, depressed". Finding interests and people that make you happy is the way to find a good partner and sex - not the other way around. Being a virgin at 20 isn't some disease. Is delaying college while saving up money a disease? Is going to college before finding a full time job a disease? They're lifestyle choices that do not have one right answer, and vary for each individual.
And therapy, if someone is experiencing social anxiety (such as not being able to get physically close) might be a good idea for some people. Therapy isn't a bad thing, or a thing reserved for the very ill - it can be good for people who just need to talk issues out in a safe environment. Is swimming only good for people with arthritis? No? Well, same with therapy.
Also, it is COMPLETELY irresponsible of you to recommend taking a vacation from their SSRIs. Jesus Christ, the 48 hour period I went without Cymbalta (due to my own stupidity in not refilling on time) was excruciating.
@SarahMC: I'm not sure whom you're addressing, but neither woman is recommending anyone take a vacation from SSRIs. Aretha states that she's *heard* of people doing it; her mother notes that it can be problematic. Try reading closely.
I'm not on any meds, but I have many friends who are on SSRI's, and one thing I can tell you...do NOT go off them on your own. Ever.
One friend "detoxed" off of Lexapro suddenly and ended up with seizures, dizziness, and extreme anxiety. Another "detoxed" off Paxil and vomited for about 3 weeks straight, developed several ticks, and became suicidal and paranoid. These are chemicals that effect the brain, they are not to be messed around with.
Also, people need to understand neither therapy nor medication alone will "cure" a problem. They both only treat one symptom. The medication will treat the chemical imbalance, the therapy will treat the habits, thought processes, and emotional coping mechanisms. Ideally, they work in tandem.
@tiredfairy: I'm suffering going through something similar right now, trying to wean off Effexor (and go onto another SSRI), which is particularly vicious. Google "Effexor withdrawal" and you're liable to run into descriptions such as "manic episodes" "flu-like symptoms" and "crying jags." My advice to anyone thinking of getting off them is to go verrrrrry slowly. Right now I'm actually pulling my pills apart and emptying out some of t he little granules, in an attempt to lessen the side effects while still taking smaller doses.
I hate SSRIs. I hate that they're expensive, and that they're so hard to get off of, and that I've never had a decent orgasm because of them. Hate, hate, hate.
@LittleDogLaughed: I went off Effexor, at first cold-turkey, but after I started sleeping 18 hours a day, my parents sent me to my psychiatrist (and paid for it out-of-pocket, since I didn't have health insurance), so I was able to function a little better. Getting off the prozac that I had to take to get off the effexor was way easier. No side effects at all, other than depression.
Please folks, if you're having libido-crushing (or other significant) side-effects from SSRIs, find a provider who isn't afraid to perhaps radically reduce your dosage.
After years and years of having all the side effects and none of the benefits on depression and anxiety meds (and I'd been on most of them) I found a psychiatrist who saw those side effects as signs that I was being overmedicated (even on a low "normal" dose) and went so far as to prescribe liquid formulations that we could foozle with *dropwise* if necessary. It works. I have decent mental health and awesome orgasms/libido. 20mg per day of Prozac is the "normal dose". At 10mg, I was having violent, suicidial ideation to the point where they just put me on Risperdal (because "10mg of Prozac isn't a therapeutic dose"). Ultimately, I ended up doing well on 1mg of liquid Prozac every other day. (There are people at the other end of that bell curve who need many times the "normal" dosage, too.)
I'd encourage Grace to check with any medical schools in her area, as they often have teaching clinics (closely supervised). *Please* don't do anything (like the ill-advised "drug holiday") without consulting with a doctor first. Abruptly stopping or incorrectly weaning yourself off a drug can seriously fuck you up. Find a way to pay for medical supervision, advocate for yourself with your parents or your doctor, see what you can arrange. You aren't really dealing with a safe do-it-yourself situation.
@Isi: This. Don't mess with your medications without the complete assistance of your Dr.
I recently went off my Prozac for a little while (long story) which I take for both PMDD and my Fibromyalgia. It was ok for a little while, then I just started to degenerate back into my psychotic/sore state. I talked to my GYN and asked him to reduce my dosage from 20mg/day to 10mg/day, which he agreed to, because I noticed I WAS able to stay awake significantly longer when I was off the meds than on them. And it worked! YAY for me!
But ...drugs are no joke, and if you have a competent Dr (which you SHOULD and which I could write a long comment about as a different issue), you should always be talking and engaging them about your meds.
Grace, here's what I think the should have been said: The U.S. Health Resources and Services Administration has a searchable database of no-cost or low-cost health centers in your area where you can get REAL medical advice and possibly different medication. There are many alternatives to Paxil and SSRIs for anxiety and depression. Print out the list of low-cost generic prescriptions (around $4 a month/$10 for 3 months) from places like WalMart, Walgreens, and Target and ask the doctor if any of those generics could work for you. And if you're concerned about SSRIs, ask the doctor for something else, although I'd also ask if he/she thinks this reaction is to Paxil specifically or SSRIs in general, since not all SSRIs are the same.
@Political Party Girl: And Costco has some of the best prices on meds that don't fall under the $4 prescription program at Walmart and the like (and you don't have to be a Costco member to use their pharmacy).
@Political Party Girl: needymeds.org has resources to get the drugs not on the $4 or even generic list for free or low cost. This site saved my life, literally.
BTW, I need a place to jump in and add: I've heard some chatter that viagra works for women on SSRIs. The OP and anyone else who's been rendered medically frigid should ask her doctor.
I'm not on any sort of SSRI, but my favorite author was. David Foster Wallace put himself on a "drug holiday" and ended up hanging himself about a year ago.
Please, for the love of dog and all that is sparkley, do not try to manage doing something like this without the help of a professional who works with you and knows your symptoms and situation. I would cry giant salty tears if any of you ceased to exist, and the world would be worse off.
@PilgrimSoul: We're going to need a fuckload of shelves! It will be like the castle library in Beauty and the Beast. We can take turns riding around on the ladders and singing about how much we like to read.
09/25/09
The comments, especially, have been eye-opening to me.
Here's the link: [bit.ly]
If you've been affected by mental health issues and treatments in your family or personal life, you'll find a lot to chew on.
Susie
09/17/09
Also DO NOT EVER up and lower your dosage on your own, or take "drug vacations." It's really dangerous and you'll make everything worse.
09/16/09
I realize I have been cavalier about taking my meds...I am also on birth control, and when I take it, I KNOW I should also be taking the Paxil too, but...I don't, not always. I guess I'm just rebelling against it now. I DID look up low cost health care centers in my area and lo, I found one in my town, and it offers behavioral and mental health services, so I am definitely checking that out tomorrow, thank you Political Party Girl.
Sometimes I almost feel kind of stupid about this problem. I know that orgasms aren't or don't have to be the primary goal of sex. Honestly I am having really good sex, the best even, and I am not coming from it at ALL. But I am in love with my new bf, and it is something I would like to experience with him. I guess I am just happy to see that no one belittled the problem (but I am on Jez, so I know those fears were kind of unfounded). I am just excited to read the support on here for topics like this =)
(As for crazy, it has been suggested before this...I don't mind)
09/17/09
And really, If anything, you can count on us to take others problems TOO seriously.
09/16/09
Paxil is a crap drug, it should never have been approved. When you have health insurance, ask to switch to Lexapro, cymbalta, or Zoloft. they're the top sellers b/c they have the least side effects. Also ask your doc for a small number of xanax or valium to help deal with incidental anxiety.
antidepressants are dangerous in kids and young teens because they weren't tested on children and doctors used to prescribe them as if kids were miniature adults. Paxil did cause some kids to kill themselves. but you're not a child, you're 22, so that doesn't affect you. Your brain is just about done developing. You're fine.
You can find a welath of knowledge at [www.crazymeds.us] Read up on all the antidepressants and decide on, say, 5 you want to ask your doctor about.
Since you don't have health insurance, you're probably paying for meds out of pocket. You can use needymeds.org to find a program to get your meds for free or for cheap.
There might be a free or sliding scale clinic in your area. My GP helped me find mine. Or, you can apply for disability.
09/17/09
09/17/09
09/16/09
Last summer my issues with depression got dramatically worse. I went on lexapro (in addition to seeing a therapist) and that worked wonders for a few months. Then, I went back to school and about 3 weeks in "broke through" the lexapro and hit an even lower low. My psychologist prescribed new meds from afar and I went through hell trying to find something that worked. Zoloft in particular made me experience what was probably the worst week of my life. Eventually I needed to take a leave of absence. I went home and my parents took me to a pharmacologist. This man really understood drugs and how they work. He was upfront and honest about side effects and the unknowns of the hows and whys of the medicine. Working with him and my therapist I was able to go back to school the very next semester.
Now, I know that I am very lucky to have parents who can afford all of these doctors for me. But I hope that this woman can find a way to get all the different kinds of help she needs. Because that is what it comes down to. Finding the right combination.
and again, I cant stress enough the importance of having someone watching over you as you go through this. Your doctor, boyfriend, parents, they all want to help, and they can.
09/16/09
09/16/09
One thing that no one has mentioned is the interraction of BC pills and SSRIs. When I started Paxil, I had zero libido and a near inability to orgasm. I poked around on the internet and found this is common in women on both BC and SSRIs. I didn't see much point in preventing pregnancy if I wasn't going to have any desire for sex anyway, so I went off the Pill and my libido and orgasm came back within a few weeks. There is a load of information about antidepressants on the internet, which isn't all legit but at least gives you ideas and questions to ask your doctor. Educate yourself, and know that not every SSRI/drug works the same for everyone, ad you have to find what works for you. While Paxil doesn't help everyone, I'm thankful that its helped me (and you).
09/16/09
09/16/09
Personally, being in a relationship has immensely improved my body confidence! My girlfriend and I can wear each others' clothes, and I think she is completely gorgeous and sexy. If we can wear the same things, I can't exactly be the troll I thought I was.
On the SSRIs, for the love of god don't take a vacation from them without advising. I did this just last week, and my life has spiraled out of control and now I'm surrounded by a shitstorm. Yeah, the orgasms are better, but I'm depressed/anxious/fatigued as fuck. So yeah, back on those now. DON'T DO IT!
09/16/09
gah! I came really close to sleeping with this dude in high school and that would have been a TERRIBLE mistake!!! :)
09/16/09
09/16/09
09/16/09
09/16/09
And a virgin at 20? Really not that unusual, and neither is it bad if a person just hasn't found the right sexual partner. There's no reason to rush. Become comfortable with yourself - and not just in a masturbating way, but in terms of what you like to do, your hobbies, your interests, your likes and dislikes, is really really important. Being a virgin not equal "alone in their room, depressed". Finding interests and people that make you happy is the way to find a good partner and sex - not the other way around. Being a virgin at 20 isn't some disease. Is delaying college while saving up money a disease? Is going to college before finding a full time job a disease? They're lifestyle choices that do not have one right answer, and vary for each individual.
And therapy, if someone is experiencing social anxiety (such as not being able to get physically close) might be a good idea for some people. Therapy isn't a bad thing, or a thing reserved for the very ill - it can be good for people who just need to talk issues out in a safe environment. Is swimming only good for people with arthritis? No? Well, same with therapy.
09/16/09
09/16/09
09/16/09
09/16/09
09/16/09
eta: uh...joke. just in case.
09/16/09
One friend "detoxed" off of Lexapro suddenly and ended up with seizures, dizziness, and extreme anxiety. Another "detoxed" off Paxil and vomited for about 3 weeks straight, developed several ticks, and became suicidal and paranoid. These are chemicals that effect the brain, they are not to be messed around with.
Also, people need to understand neither therapy nor medication alone will "cure" a problem. They both only treat one symptom. The medication will treat the chemical imbalance, the therapy will treat the habits, thought processes, and emotional coping mechanisms. Ideally, they work in tandem.
09/16/09
I hate SSRIs. I hate that they're expensive, and that they're so hard to get off of, and that I've never had a decent orgasm because of them. Hate, hate, hate.
09/16/09
09/16/09
After years and years of having all the side effects and none of the benefits on depression and anxiety meds (and I'd been on most of them) I found a psychiatrist who saw those side effects as signs that I was being overmedicated (even on a low "normal" dose) and went so far as to prescribe liquid formulations that we could foozle with *dropwise* if necessary. It works. I have decent mental health and awesome orgasms/libido. 20mg per day of Prozac is the "normal dose". At 10mg, I was having violent, suicidial ideation to the point where they just put me on Risperdal (because "10mg of Prozac isn't a therapeutic dose"). Ultimately, I ended up doing well on 1mg of liquid Prozac every other day. (There are people at the other end of that bell curve who need many times the "normal" dosage, too.)
I'd encourage Grace to check with any medical schools in her area, as they often have teaching clinics (closely supervised). *Please* don't do anything (like the ill-advised "drug holiday") without consulting with a doctor first. Abruptly stopping or incorrectly weaning yourself off a drug can seriously fuck you up. Find a way to pay for medical supervision, advocate for yourself with your parents or your doctor, see what you can arrange. You aren't really dealing with a safe do-it-yourself situation.
Good luck. :)
09/16/09
I recently went off my Prozac for a little while (long story) which I take for both PMDD and my Fibromyalgia. It was ok for a little while, then I just started to degenerate back into my psychotic/sore state. I talked to my GYN and asked him to reduce my dosage from 20mg/day to 10mg/day, which he agreed to, because I noticed I WAS able to stay awake significantly longer when I was off the meds than on them. And it worked! YAY for me!
But ...drugs are no joke, and if you have a competent Dr (which you SHOULD and which I could write a long comment about as a different issue), you should always be talking and engaging them about your meds.
09/16/09
09/16/09
09/16/09
BTW, I need a place to jump in and add: I've heard some chatter that viagra works for women on SSRIs. The OP and anyone else who's been rendered medically frigid should ask her doctor.
09/16/09
Please, for the love of dog and all that is sparkley, do not try to manage doing something like this without the help of a professional who works with you and knows your symptoms and situation. I would cry giant salty tears if any of you ceased to exist, and the world would be worse off.
09/16/09
09/16/09