Having To Increase Or Decrease Dosage?

I've been reading many of your posts and have a question that may make us all think. For instance, I've been taking Paxil for about two years. I had found out that I had glaucoma and, misunderstanding the disease, I started having panic attacks. My goal was to get back on my feet, straaighten out my thought processes, then, to wean myself off. I had minor side affects that have baasically gone away.

Here is my question. Is it possible that some of us need to decrease rather than increase our dosage? For instance, if one does get "back on her/his feet", is it possible that she/he needs to decrease the dosage. I notice some of us who have new problems after being on medication for a while seem to increase dosage. Does it make sense to go in the other direction?

Any of your opinions or experiences would be welcome.

Vic

[safarigal]

Vic,

Think about it this way. Most of us went on Paxil because we were having problems such as anxiety and/or depression as a result of issues/stresses in our lives. For me, the major stress issue in my life is over. So there is really no need for me to be on the medication. None of the SSRIs have been studied over long term use.

Ok, so my anxiety and panic have returned. But those symptoms are manageable now since the great stressor in my life no longer exists. So I ask myself, why am I on Paxil? Its time to get off and seek counselling to battle the inner demon causing me the anxiety.

I'm Paxil free going on 2 months!!

I've read enough anecdotal stuff on Paxil experiences to believe that you're right, vic. People reacting badly to Paxil, esp. with no outer cause of more anxiety, would likely do better to decrease dosage. Happens to me that way, plus many folks whose doctors keep upping the dose do not experience relief, but often get worse. I think it's sometimes the medicine losing effectiveness over time but sometimes the body's way of saying it's trying to "deal" without, or with less, drug. Personally, I don't get doctors who just keep throwing more of the same drug at a person when the drug isn't effective for them. It's just lazy doctoring to me! The over-prescribing of Paxil is like the over-prescribing of antibiotics- the easy way out for doctors, until they realize that you can't just chuck an unnecessary, ineffective drug at people without severe repercussions. Hopefully, this overuse will start to turn around, as is the case with antibiotics.

[Cindy]

Dear Vic,

I know that in my case that when I was upped to 30 mg from 20 mg by my doctor last year was in retrospect when I started to suffer from adverse side effects. Many doctors think upping it is the answer as seemingly for "anxiety" the accepted dose is actually 60 mg...or that is what I was told by my doctor.

My doctor was terrible with me during withdrawal...totally dismissed all of my symptoms as my "panic" as simply returning...and just wanted to put me on "another flavour". I was lucky enough to find a new doctor to accept me and she is very holistic...I had actually had dealings with her prior to becoming her patient in "healing touch" sessions. She told me that if I had come in to see her in October that she would have decreased my dose to 10 mg...not upped it. She has found that often the drug needs to be reduced rather than increased in her personal dealings with patients. She actually has a patient who takes 5 mg of paxil every other day...and is thriving under that amount.

I trust this woman wholeheartedly...so in my opinion, I think decreasing rather than increasing is the way to go...if one is going to stay on the drug at all.

Cindy

[Ariella]

What I've noticed is that people mistakingly increase their Paxil dose instead of observing that it may not work for them.

I've also noticed people increase their dosage when their bodies habituate to the lower level.

And I've also noticed that the possible benefits of Paxil are observable at levels as low as 10mg, and that people that grew impatient with the 3 week wait mistakingly raised their dose.

It would seem that higher levels of Paxil don't necessarily contribute as effectively (as in, observed improvement over a few months vs. dose level) as the lower doses. I also continue to receive e-mail where people who no longer desired the negative impact of Paxil, found immediate improvement in lowering their dose level.

I can't say there's an uncontested link, but the frequency of observations is certainly worth noting.

Adding to this, people often forget to refute their belief that they are powerless without it. To stay on a medication for many years without very going through at least one full year without it to see what they are capable of on their own, would be missing an opportunity for independence and long-term growth.

When I quit Paxil, it involved great self love and internal faith. I believed myself capable of working through my anxiety/depression challenges without the full dependence of Paxil, and I stuck to it until my belief was demonstrated.

The question to ask ourselves is, "if I don't take Paxil, and I notice my life doesn't end, and if I notice I am still alive many months later, why do I think I need it?" Or better still, "why don't I believe in my own ability to explore and discover permanent solutions?"

Paxil is a product that would not have been released unless its manufacturer was certain it would generate the revenues required to make up for development costs and to build confidence in its share holders. If it's helpful or not, doesn't matter. It's a research effort that seems effective, because of statistics. When's the last time somebody defined their whole complex personality, love, passion, fears and judgments by a number? Hi, I'm a 0.3 correlation, who are you?

I hope people continue to say, "I haven't found my permanent solution yet according to who I am" instead of "I haven't found my permanent solution yet according to my dose level".