Paxil

[SHEMYAKID]

I retired in 2001 after working two years past my normal retirement age. This was because I dearly loved my job as a Project Engineer with all the interfacing with people of all disciplines, civilians, military, and representatives of foreign countries that built our aircraft under license. I had worked for 25 years for this particular company. The last two years only included about a one hour commute over two of the worst freeways in S. Calif., and that really spoiled everything for me.

I had a tough time accepting retirement, missing all the people and all aspects of my job. I went to a "Shrink", but that didn't help. Finally, my doctor put me on Paxil, and later on a generic brand of it. It did the job for me, but it also took away all of my drives; sex, creative, etc. After about a year I was able to cope with retirement, but when I tried to go off of the Paxil, my arthritis started up big time! It seems that the Paxil reduced the severe pain of my arthritis somehow. Finally, I was able to go to just half a pill (20mg) every other day, and that seems to work for me; taking care of my arthritis but allowing my drives, mostly creative, to stay with me. It's been a strange situation to be sure. SHEMYAKID

[Hercalees!Hercalees!]

Antidepressants are often used for pain management. One (Cymbalta) has an indication for diabetic peripheral neuropathic pain (DPNP) but for any other use in pain management they're being used off-label. Several have ongoing studies for additional indications for chronic pain due to different disease states and pain disorders like fibromyalgia. There are a number of theories why they work for pain. Most antidepressants act on the neurotransmitter serotonin with some lesser effect on norepinephrine. It's this effect on norepinephrine that is believed to play a role in reducing pain. Also consider that pain (all unexplained types) is a classic symptom of depression and anxiety, so by reducing depression and/ or anxiety they often reduce pain as well.

[SHEMYAKID]

Yes, that does make good sense. Thanks. SK

[foppa2142]

Did the doc ever mention Prozac? It's in the same antidepressant category as Paxil and isn't associated with any of the sexual dysfunction.

[Hercalees!Hercalees!]

Originally Posted by foppa2142

Did the doc ever mention Prozac? It's in the same antidepressant category as Paxil and isn't associated with any of the sexual dysfunction.

That's only partially true. All of the class of antidepressants that Paxil is a part of (Selective Serotonin Reuptake Inhibitors- SSRI's) are associated with some degree of sexual dysfunction. Paxil is generally considered the worst with Lexapro appearing to have the least (although a significant number of both men & women still experience it). Prozac would be somewhere between the two. It's tough to get an accurate % of people that actually suffer from sexual dysfunction as very few people will spontaneously admit it. All of these drugs work by increasing the available amount of serotonin in the brain. Serotonin appears to have a negative impact on the desire and arousal phases of the sexual response cycle, and this seems to occur through its inhibition of dopamine and norepinephrine (dopamine promotes desire and arousal, and norepinephrine promotes arousal). Serotonin also appears to exert peripheral effects on sexual functioning by decreasing sensation and by inhibiting nitric oxide. The serotonergic system may contribute to various sexual problems across the sexual response cycle. You can argue that all SSRI's (and also SNRI's) cause sexual dysfunction in all people that take them. It just may affect some more than others and many that do experience it are reluctant to admit it.

[gatorhoss]

Be very careful when you stop taking Paxil. DO NOT STOP IT SUDDENLY. There are many case reports of people having some major withdrawal symyptoms from trying to wean off of Paxil