She made the appointment because she was concerned about her memory. She was able to get in the morning of Christmas Eve and I was free to go with her. In the course of the appointment I saw the name of the medication she was taking - paroxetine. I asked the doctor what it was for. He said it was for anxiety and that she had been experiencing some real anxiety when it was prescribed. I was caught by surprise. I had never noticed any anxiety beyond what is normal in life. My dad had never said anything about it.
About a week later I had an appointment with my doctor. When I asked him some questions about Paxil/paroxetine, he said he rarely prescribes it because of the side effects and that coming off of it can be difficult. That conversation led me to a Google search on Paxil side effects. Interestingly one of the side effects that kept coming up was memory loss. In posts on several sites people commented on their frustration with memory loss while on the medication. Comments responding to some of these posts tried to tell the writers that their memory loss was probably due to their depression rather than the medication. I noticed however that those who were able to stop taking the Paxil had their memory improve.
A couple months later, I took my mom to see my doctor. We decided to try weaning her off of the paroxetine. At the time she was taking 10mg a day. The doctor recommended taking 10 mg every other day for 2 weeks and then stopping. She followed the every other day regimen for about three weeks. I reminded her that she was supposed to stop taking it. She did for a short time, but went back on it after an evening of having difficulty playing a card game with friends. After learning she was taking it again, I encouraged her to stop so that we could really get a handle on whether or not her memory would improve. She did.
I was expecting and watching for withdrawal symptoms like nausea so when other problems came up I didn't make the connection. Insomnia, depression, anxiety, loss of appetite, and even more memory issues made her life unbearable. I know that many people reading this will say, "See, she did need to be on an antidepressant." But this was not a person going back to symptoms she had before being prescribed with the medication. She had never been like this before - not even close. Needless to say she had to go back on this nasty medication.
When all of this happened, it led my sister to a book, Prozac Backlash by Joseph Glenmullen, M.D., that helped us understand what was really going on. The book talked about the way SSRI (Selective Seratonin Reuptake Inhibitors) work and why so many people have difficult withdrawal when discontinuing their use. What Mom was experiencing was not a return of symptoms but terrible withdrawal.
One of the things we've learned through our expereinces is that most doctors don't understand the withdrawal that goes along with stopping SSRI medications. (There is so much information and so many new medical findings out there that they can't be expected to know everything. That's one reason I'm writing this blog. I want doctors, and maybe even more importantly lay people, to know the things we didn't know going into this.) Doctors don't understand how slowly people need to wean from these drugs. They don't know that because of the way the medications work, an every other day regimen is not the way to go.
The list of things we've learned is long.
- How drug companies get medications approved
- How drug companies market medications
- That many drugs have anticholinergic effects that cause memory loss (Paxil is one of them)
- How easily doctors prescribe anti-anxiety medications
But, these topics will have to be fodder for future posts.
