Is it too late to stop taking Paxil?

I have a question. My husband just started taking a 10mg daily dose of Paxil 4 days ago. He has been under extreme stress and we both initially thought this medication might be helpful to get him through this.

To give some background to the issues he's facing, he's a Type I (juvenile) diabetic, who is currently 18 months into remission for a very advanged stage cancer that came within a month of killing him (treated with massive chemotherapy treatments). He has also just been treated with radioactive iodine treatment for Hyperthyroidism (which may have really been the root of the depressive like symptoms but will take another 1-3 months to know for sure).

If all that weren't enough we are parents of 5 young children (including triplets) two of whom have special needs including autism and he just changed jobs less than two months ago because his previous job he'd had for 17 years was becoming very high stress demanding him to work 15-17 hour days 7 days a week. The new job isn't a lot better, some, but is only going marginally well as you can imagine. He's been the main bread-winner in the family for 10 years since most of my time is devoted to caring for the kids and his medical issues. He's also insisting on hiding all these medical ailments from his new employer for the 3 month probationary period. (Talk about elephants in the living room!)

So here is the question. After doing a great deal of reserach on Paxil, I'm having second thoughts about it. I've resisted the doctors pressure to put my child with autism on similar medications for years, so I can't believe I'm in this position. He's taken only 3 10mg tablets over the past four days (he skipped a day, I don't remember why).

I've read that not everyone experiences withdraw and he is obviously in the early stages of taking a very low dose, so I'm wondering if just stopping the medication altogether is wise in this situation. Of course this still leaves both us of with more problems on our plates than is bearable, so I don't know what to do even if he come off the Paxil with relative ease. Does anyone have any suggestions. (i.e. alternative treatments that have worked for them, that don't require medicine, since this is just so complicated for a man with this many medical problems.) He's already seeing a councelor, and that's not helping much.

Concerned and Overwhelmed Wife

It sounds to me like you really have a lot of issues on your plate!

Paxil has helped me a lot to deal with anxiety and depression. I am having a bit of trouble getting off of it though.

I can relate to the autism problem. My youngest son has asperger's syndrom. Many of his class mates are on medications. If you have a really good teacher in your school district that deals specifically with autistic kids, she would be a great resource to bounce your fears and concerns off of. My son's teacher has seen it all and is out for the better for the kids, not just the quick fix.

Good luck. This is really a great web site for getting information. I feel so much better just having these people to bounce symptoms and concerns off of.

CW, my goodness! You and your husband have so much to handle right now--I really feel for you and your family. Paxil should be the least of your worries at this point--and that is coming from a person who is pretty anti-Paxil. Frankly, 10 mg is a really low dose. (I was up to 60 mg for almost 4 yrs.) This seems to be a case where perhaps an anti-depressant is necessary to get you through. As long as he can tolerate it. My suggestion--I think Prozac might be a better choice. Paxil is a lousy drug to taper off. Prozac is apparently easier because it has a longer half life, so one's body doesn't have the extreme reactions as from Paxil. (Even if he does stay on the Paxil for whatever reason, don't let that be at the forefront of your concerns--he can get through it.)

I certainly hope that you and your husband can get some sort of counseling to bolster you at this time. Medical problems are tough. Do you have family or friends that can offer you short breaks from the kids just to have a moment to yourselves? I am sure that you both need many coping skills to handle all this. Working 17 hours a day--when does he have time to sleep and eat? No one can keep up that pace, let alone while ill. I hope you will reach out to others who might be able to lend a hand. I will be thinking of all of you and saying a little prayer that things start looking up. Hang in there.

Julie & NM,

Thanks for the replies. I was surprised that both of you would feel staying on the medication (or switching it) might be best. We're still thinking about it.

The new job is a little less unreasonable with their demands but he's still working 12 hour days 6 days a week which is hard on both of us. But we need an income, and by the time I pay childcare (If I can even get it for my oldest daughter) my potential income is pretty sad. (This is a major frustration for me, as I would love to work!) I have 5 clients I do bookkeeping and database projects for on the side so that helps, but it can't pay all the bills, especially our medical ones.

As for the child with autism, her diagnoses actually is Asperger Syndrome I just rarely refer to it that way as most people don't know what that is. Most everyone is familiar with autism though. She's a classic aspie! Almost what you would consider an autistic/savant. The child still has trouble dressing herself, but is ranked in the top 100 chess players in the country for her age group. (What a wild ride for parent!)

We've had a lot of family, friend, and even online support for all the various issues we've faced and that has helped. We don't get away from the kids often since none of our family live less than 2 hours away. It's just that when you start throwing this many issues in the bowl, even families that I've gotten very close to that have triplets with a child with autism, start having trouble offering advice to us because of my husbands medical issues. (The other special needs child in the house is one of the triplets who has some moderate learning problems, but all in all the younger 4 kids are just wonderful to parent. Even our oldest, with the Asperger Syndrome, is a fascinating person, just not always easy to live with.)

I have encouraged my husband to continue the counceling for now even though he feels it's not helping much. I think I'll have him contact his oncologist Monday to see what other medication options he might have, though we're still leaning toward him taking none. Of course the endocrinologist dealing with the diabetes and thyroid issue needs to approve whatever he takes too for obvious reasons, so it can sometimes take a week or more to make a change like this and the side effects are almost always unmangable medically for him.

We're both just very conservative when it comes to medicating for quality of life issues. It's bad enough to have to take so much medication and see so many doctors for life threatening issues, let alone add on ones for issues that are not (in his case, he is not suicidal!). We are a resourceful and committed couple, so I know we'll get through this. We aren't wealthy (there are pictures in the wallet where all the money use to be, LOL!) but we're willing to work hard and live below our means, so that gives us options as well.

Thanks for the advice. At least if he just can't cope without the Paxil, I now know that, even someone whose had trouble with this medication, still might feel it's worth the trade-off.

Thanks again,
Concerned Wife

CW, I wish you and your family the best. It sounds like you have your act together as much as is humanly possible--problem is, it's like the guy who is the one-man act blowing on the suspended harmonica, cymbals between the knees, strumming a guitar, foot on a drum pedal, etc. Just too much! Health problems are the worst. If you can get a handle on those, the rest falls into place somehow.

I would not worry excessively about taking an antidepressant. While I do not like being tied to any med, especially Paxil, you CAN get off it when necessary, and perhaps it will give him a necessary "lift" emotionally for the time being. I guess I feel that it might be called for under certain circumstances, and your husband's (and yours!) are pretty extreme right now.

I'm glad your husband's present job is at least somewhat less demanding. He doesn't need that on top of all the other health issues. I'm sure his family brings much joy to his life--you sound very supportive. I, too, am somewhat familiar with Asperger Syndrome. Yes, those children are different but have much to offer. My best to you and your family.

CW, I feel for you and yours at this trying time and I agree to a point with the other posts that are saying perhaps 10mgs of paxil are called for at this time.
However, to play devils advocate I was also only on 10mgs, but for 7 years and I got to a point recently where I was feeling withdrawal while still on it. A Dr. who is no longer in town told me that it was possible I was "burnt out" on it even at this low dose. So, now I am trying to get off it altogether. And even at 10mgs it has been a nightmare to do. I am only currently down to 2.5mgs. I think maybe the long term use is what makes it hard. If your husband decides to stay on it, I would suggest a real short term use to help get him through these hard times. They say it can take 2 to 3 weeks of taking it before you start to see the benefits. Maybe wait and see how it makes him feel after a few weeks and if it's not making a significant difference, then I would think it would be better to be off of it, because we don't know right now what kind of permanent damage it can cause. That's what scares me.
Hang in there, we're here for you!

Hey, Buzzed, I hear where you're coming from. Paxil is no friend of mine. I did read that the higher the dose and the longer you're on it have a direct bearing on the ease of withdrawal--so you're right on that one. Wow, you're having trouble coming off of 10 mg, huh? I bet it does have something to do with how long you were on it. Glad that you decided to try to quit. I have been on Celexa or Paxil for 4 yrs but my high dose was 60 mg. I wonder what's worse, brain-wise --a high dose or taking it for years upon years. Neither can be too great, huh? Glad we're both on the decline! I know only too well what withdrawal is like. Good luck! (I'm down to 5 mg--yea!!!)

Originally Posted by Buzzed

I was also only on 10mgs, but for 7 years and I got to a point recently where I was feeling withdrawal while still on it. A Dr. who is no longer in town told me that it was possible I was "burnt out" on it even at this low dose.

Buzzed, BTW, just thought I'd mention that after I finally did start to taper off the Paxil against my psych's wishes, I started to feel considerably better. I had been switched to Paxil after the Celexa stopped working. The Paxil kept being bumped up to make it "work better." I was getting increased anxiety, chest pain, and heart palpitations with greater frequency. It was only after coming down on the dose and no longer suffering those problems that the psych volunteered that after a while, the SSRI can begin to do the OPPOSITE of what its purpose is. Wonderful. I ask myself-->Why didn't the psych, a trained physician, consider that as a possibility instead of upping my dose and adding things like Buspar, Xanax, and Ambien?????? Makes me wonder.

I have read so many books, magazine articles, medical abstracts, etc. etc. on this subject now. I often feel better informed when it comes to SSRIs than the "professionals." All I can say is, thankfully, I pressed getting off this stuff rather than staying at the "maintenance dose" of 30 mg that the psych wanted for me. So, yes, "burnout" and having the drug reverse itself on you are both possible.

NM, thanks for the post. I too feel like our "trained" Dr.'s need better training on this issue. I have also been reading and researching a lot and each time I feel better informed, I'm also more scared and angry!!
Have you read " The Anti-Depressant Fact book?" I think that the permanent damage it refers to is very scary.
Congrats on your success so far!!

Yep--I've read so many books! (That's me, by nature.) That's an excellent one, as is his other book, YOUR DRUG MAY BE YOUR PROBLEM. Earlier on, I went to the library and entered the key word "antidepressants." I took out about 10 books and read them all. I have also researched on the medical sites, etc. I think these SSRIs are definitely powerful stuff, but I do believe our brains are also capable, in most instances, of bouncing back. Working your way down slowly will give your brain time to "regroup." It may take a while. I'm just glad I'm getting off this stuff now. I can't do anything about yesterday. Stay positive!

I wanted to post an update, for those that responded to my question. Despite several suggestions that my husband should consider staying on the Paxil, we both decided it wasn't worth the risk. To top that off, his blood sugar levels (is a Type 1 diabetic on an insulin pump) were all over the place on even a 10mg a day dose.

He stopped taking Paxil on a Friday and did well for two days. By Monday he was showing signs of the depression returning, but we stuck it out. Tuesday and Wednesday were the worst. To make matters worse, as if we didn't have enough problems already, Wednesday his car (baby) with 330,000 miles on it blew the timing belt and broke down on the highway with him and our daughter with Asperger Syndrome in it (not good). He missed 3 hours of work at his new job. UHHHH when will it end!

We ending up having a major fight last night at midnight. He woke up completely scattered today. My oldest daughter was attending chess camp this week (chess is her life!!!!) and we couldn't get her there and back today because we're down a car. So I've spent all day trying to deal with her tantruming over her routine being messed up. (Typical of someone with a form of autism.) Interestingly my husband sounded a little more coherant when he called from work this afternoon.

Hopefully the thyroid condition he has just been treated for is at the root of the depressive behavior and once we get it solved (may take 2-3 months) things will improve. If it's emotional problems left over from the cancer and chemo this could be a harder problem to deal with though. We've decided to keep trying with the counseling (neither of us are big fans of this). At least without the Paxil his diabetes is back under control.

At 4 days on 10mg, if he had withdrawl at all, it was mild and short lived unless his depression now is being caused by withdrawl. We just can't tell if it's that or it's just continuing from the original cause (whatever the heck that is!)

Thank you for this site! It may have prevented us another calamity in our lives six months from now when he wanted to get off Paxil, and heaven knows we don't need one more problem. We're both firm believers in mind of matter, so for now the depression (regardless of how justified it is under the circumstances) is our monster to fight and we don't want to use any weapons that ultimately may turn against us. It's like we are refusing to live by the sword, die by the sword. We may end up dying by the monster (depression) instead, but so be it!

Concerned Wife and mother of 5

CW, I hope things will mellow out. Your family has so much to handle right now. Reach down deep and pull your strength from your core. It's amazing what struggles we can fight and overcome when we have to, huh? I'll be thinking of you. (If you are offered any help, take it.)

It's been almost a month since I posted the last update. The Paxil has been gone from our life the whole time, and his depression has improved 90%! I think it's because of the thyroid treatment more than anything. All this makes me wonder why a man with so many known physical problems (cancer, Type I diabetes, and hyperthyroidism) would be prescribed Paxil before one of these other conditions are ruled out as the cause of depressive symtoms. Things still aren't stree free here, but I have to once again thank the folks who do this site. If it hadn't been for them my husband would probably now not know whether he can function without medication (he can and does) and have a tough battle to get off it ahead of him (thank goodness he won't!).

Thank you,

Concerned Wife and mom of 5

Concerned Wife,

I just wanted to let you know that after reading your posts I'd have to say that I think both you and your husband are heroes! I can only imagine what an average day must be like for you, and to overcome the odds like that is truely an inspirational thing to hear.

Thank you for sharing your story.

Emmy B