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经常看到一些朋友问这样的问题，我现在在服米氮平想换成百忧解，或是我在服用百忧解想换成赛乐特是否可以之类问题。我自己也有
过赛乐特悲惨的停药经历，所以仔细研读了国外的一本“Paxil Withdral Guide（赛乐特停药手册（同种在不同国家有不同的英文名，
Seraxat or Paxil，中国也有乐友的等））”，我自己也才意识到原来停药还有那么多学问，而且出国处理不当会产生多种副作用，严
重的会有自杀倾向。不仅仅是盐酸帕罗西汀，其实手册中的内容对其他药物的停药也很有借鉴意义。看下来觉得对我们国内的很多患者
非常有帮助，今天我就特意找了个时间把其中比较有用的一块翻译了出来，希望能对大家有用：）
经常看到一些朋友问这样的问题，我现在在服米氮平想换成百忧解，或是我在服用百忧解想换成赛乐特是否可以之类问题。我自己也有
过赛乐特悲惨的停药经历，所以仔细研读了国外的一本“Paxil Withdral Guide（赛乐特停药手册（同种在不同国家有不同的英文名，
Seraxat or Paxil，中国也有乐友的等））”，我自己也才意识到原来停药还有那么多学问，而且出国处理不当会产生多种副作用，严
重的会有自杀倾向。不仅仅是盐酸帕罗西汀，其实手册中的内容对其他药物的停药也很有借鉴意义。看下来觉得对我们国内的很多患者
非常有帮助，今天我就特意找了个时间把其中比较有用的一块翻译了出来，希望能对大家有用：）
经常看到一些朋友问这样的问题，我现在在服米氮平想换成百忧解，或是我在服用百忧解想换成赛乐特是否可以之类问题。我自己也有
过赛乐特悲惨的停药经历，所以仔细研读了国外的一本“Paxil Withdral Guide（赛乐特停药手册（同种在不同国家有不同的英文名，
Seraxat or Paxil，中国也有乐友的等））”，我自己也才意识到原来停药还有那么多学问，而且出国处理不当会产生多种副作用，严
重的会有自杀倾向。不仅仅是盐酸帕罗西汀，其实手册中的内容对其他药物的停药也很有借鉴意义。看下来觉得对我们国内的很多患者
非常有帮助，这贴出来希望对大家有帮助！
A few questions before you
begin to withdraw
Why are you on Paxil?
To help you decide why you would stop taking Paxil, itʼs
useful to understand very clearly why you decided to use it
in the fi rst place. Any decision you make affects you intimately
and will for years.
What did your doctor say?
We usually trust our doctors and why shouldnʼt we? They
are there for us. They endeavor to not only relieve our discomforts
but lead our health in prosperous directions. At
least, thatʼs the idea. You probably went to your doctor hoping
for a solution to all your physical (body/mind) struggles.
Thatʼs not such a bad idea and youʼre not alone with these
kinds of expectations. Doctors are very frequently the only
people who can keep you alive and well. Itʼs very likely that
you fi rst heard of Paxil from one.
Nevertheless, the doctors that have prescribed Paxil have not
all said the same thing nor established the same reasons for
its use in terms of benefi ts and long-term repercussions.
Some of the things doctors have said about Paxil include
(and these are not necessarily true):
• Depression or Anxiety is a disease comparable to diabetes
and using Paxil to modify serotonin levels is like
insulin to blood-sugar levels.
• Paxil is safe and non-addictive.
• Paxil must be used for many months before the probability
of remission is diminished.
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Freedom is in you
• The possible side effects are minimal and people are generally
not bothered by them enough to stop taking Paxil.
• Paxil will cure you.
• You can withdraw from Paxil by alternating doses where
you take more one day then the next.
• You can withdraw from Paxil by halving your dose every
week.
• You can withdraw from Paxil by halving your dose every
3 days.
• You can withdraw from Paxil by halving your dose every
day until youʼre at 10 mg. and then just stop.
• You can stop taking Paxil at any time you wish without
a withdrawal plan.
• You may have a chemical imbalance that Paxil restores.
• Your dizziness is defi nitely an ear infection and not Paxil
withdrawal.
• You have the fl u, Paxil cannot make you feel that way.
The above list is not exhaustive. Take a moment to decide
if youʼre on Paxil solely because of what your doctor said.
Donʼt decide at this time if your answer is good or bad.
How much did you know about Paxil?
We donʼt always make health related decisions because of
what our doctors shared with us. Often we seek Paxil because
we heard about it from a friend or an advertisement.
Ask yourself how much you knew about Paxil before you
began taking it and entertain the possibility that you may
have made the decision unprepared or under a pretense or
expectation that experience is now revealing as false.
I had considered including a long discussion about money
and the medical industry in terms of how it motivates companies
to push unsafe/marginally tested products, how it
restricts governing agencies designed to protect consumers
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Paxil Withdrawal Guide
from achieving their mandate, how it gets a sales force to tell
doctors whatever they have to hear to grab their samples and
suggest their product, how it funds research with confl icts of
interest and more. However, the media and legal system will
reveal all of this in time and for now Iʼd like to invite you to
forget about blame, forget about suspicions, to not play the
victim and develop a new position for yourself–a position
that will empower your entire life:
You are responsible for your own life. This means it is
up to you to learn everything you can about everything
related to your existence. You MUST research every pill
you take. You MUST get second/third opinions. You
MUST realize that since you can make mistakes as a human
being, so can your doctor, or the sales agent that visited
him/her, or the pharmaceutical company that makes
a drug, or the FDA, or the share holders and so on. There
is no way you can test the integrity and honesty of all the
steps in the stairway that lifts a drug from a laboratory
to your mouth. Therefore, it is up to you to just study,
research and talk to people frequently and especially to
those who have already walked the path you are about to.
Your opinion is higher than anyone elseʼs when it comes
to managing your health. You are the one who has the
most information about you. Just knowing your blood
pressure is but a drop in the bucket of your daily experience.
You know about that crummy job that raises it in
the fi rst place. What medical test can your regular doctor
suggest that will mention your workplaceʼs street address?
What drug will write a resignation letter for you?
Now Iʼm not saying you should let your opinion overrule
professional care, although itʼs up to you to ignore
me. Take everything into consideration and slow down.
When you think youʼre depressed and seek a doctorʼs
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Freedom is in you
care and a medicine is suggested, give yourself the freedom
to think about it fi rst. Sleep on it for a few nights at
least. Taking a mind altering drug is an extremely serious
thing. You owe it to yourself to not decide in the moment
as a prescription slip is being written on.
Of course, even if you do all that, you may still get stuck
one day (or have already) on some miserable medication.
There were probably plenty of good intentions going around
and thereʼs no point in laying blame or getting upset. Just
observe closely, and choose differently and consistently to
invite a new experience. If you donʼt have the time to research
your own life and what your body ingests with great
detail (and itʼs not a good sign if you wonʼt take the time),
fi nd someone in your social circle to do it with you. And if
you know somebody who is swamped or isnʼt particularly
fond of reading, do it with them.
Either way, donʼt be hard on yourself. Youʼre here now and
empowered, hoping to create a new experience for yourself.
Weighing yourself down with self judgment like “Itʼs so
wrong to take this drug, look at where I am now” will not
help your withdrawal. Accept that you too are human and
can only learn from what you have access to, and there are
often forces that can determine (for a period of time) what
level of access you have to the truth.
Were you aware of alternative solutions?
Sometimes when youʼve been surrounded by medical counsel,
friendly advice and advertising that all say the same
thing, you can be left with the feeling that there is one and
only one solution for you. Not to discredit the benefi cial
awareness these sources can create for silent sufferers, but
sometimes the constant warning (true or not) that you may
have a problem that requires a product, helps you forget to
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Paxil Withdrawal Guide
explore all other alternatives. Some alternative solutions you
can explore are : psychotherapy, acupuncture, family support,
herbs, exercise, diet, self love, world view, emotional
preferences, personal empowerment and view of self and
spirituality. There are so many other affective parts of life
that often go unnoticed in favor of a drug solution that focuses
on but a small portion of all that you are.
Drugs are never the sole solution to mental health concerns.
In the grand scheme of things, do you see yourself as being
someone full of a potential that can only be enabled by
something you swallow? (Iʼm still trying to get chocolate to
do this.) Ask yourself at this time if you took the time to go
within for an answer instead of without.
Who are you?
One last introspection Iʼd like you to make to help you decide
if you should withdraw from Paxil (and why) involves
a look at who you believe you are as a person. Itʼs useful
for you to examine your views about yourself, expectations,
likes, dislikes, how you perceive the world and past experiences.
The time you spend looking inward will strongly
infl uence your withdrawal experience.
How do you measure success?
Examining your hopes and expectations is an important
thing for you to do. Ask yourself if youʼre withdrawing from
Paxil because youʼre tired of how it feels or is it because
you feel like giving life a go without it. Also decide what is
the perceived reward from withdrawing from this medication.
These questions are important because if you have an
uncomfortable withdrawal, your defi nition of success will be
challenged. To help with your attempt to defi ne what success
means to you, consider the following possible perspectives:
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Freedom is in you
Does success mean the reaching of one REALLY
BIG goal where you and your love/hate relationship
of the world depends on it? Differently said: The reward
is in the end result and if you donʼt get it, itʼs a
failure because without the end result, the reaching
is meaningless.
or
Does success mean a daily commitment to reach
for something better every day if you reach them or
not? Differently said: The reward is in the process
of moving towards something and there is no failure
because just by reaching for it, you are successful.
My success with withdrawing from Paxil was inspired by
perceiving #2. I really believe your success will at least partially
depend on your focus on the process too. Hereʼs why:
If you prefer to focus on the end result and not the process,
your eyes are looking outwardly and youʼll miss seeing
yourself. You could make yourself work unnecessarily and
not notice that you can torture yourself by reducing the
magnifi cence of your life to a petty game of win/lose. By
perceiving #1, your sense of purpose depends on a result
that you imagine is validating your effort. But doesnʼt the
world get in the way of reaching those big goals all the
time? Wouldnʼt that mean that adopting perspective #1
would make your whole effort meaningless if you donʼt
attain the end result? Realize that your effort is incredibly
valuable on its own, no result is necessary to prove that.
Should you adopt perspective #2, every single thing you
do, if it works to get you ʻthereʼ or not, always rewards
you because youʼre still moving forward. Trying is progress,
and any progress is a key to success. With perspective
#2, pauses and interruptions that feel like obstacles and
- 19 -
Paxil Withdrawal Guide
setbacks become new beginnings to keep moving forward
from.
“When you treat a disease, you win, you lose. But
when you treat a person, you always win. “ - From
the movie Patch Adams.
This doesnʼt mean that perspective #1 should be completely
abandoned. Itʼs still useful to hold dear to the ultimate
goal that you are moving closer to every day. Try to prefer
a particular result while remaining confi dent that you will
still grow in health and prosperity if the result happens
right away or not. You may not even be in a frame of mind
to notice your own progress while youʼre in the thick of
things.
Youʼre not only withdrawing from Paxil, but the beliefs that
fi rst chose it.
How do you make priorities?
What is most important for you? What would you like to remember
about your life and this journey later on? What you
deem most important can infl uence your progress through
withdrawal.
Admitting that kids will continue to ask for the car or cry for
food, and jobs will still take a lot of time and energy, it can
be diffi cult to know what your main focus should be. Itʼs still
a good thing to collect some life resources and spend time
loving your family, but youʼre going to have to prioritize
yourself. Possibly more than what youʼre usually comfortable
with.
- 20 -
Freedom is in you
Without you, your family or job canʼt have you. Itʼs that
simple and funny. This means that if you want to participate
in regular daily experiences, you have to promote yourself.
Itʼs time to get a little selfi sh and achieve long-term independence
so that you will be there when you want to give of
yourself. There is nothing wrong with putting yourself fi rst
during this withdrawal period, because the rewards to you,
your employer and family will be even greater. Itʼs comparable
to investing money. You give to yourself (the savings
account) now so that you can give to others later. The bulk
of withdrawal will take anywhere from a few months to a
few years. Surely you can handle a year of extra walks, more
delicious fruit and luxurious baths?
Withdrawal can be tough. It challenges your brain, body and
awareness. Withdrawal is an invitation to change a great deal
about yourself and since that process depends on you, you
need to focus on yourself as much as possible. Count the occurrence
of the word ʻyouʼ in this document and youʼll get
a feel for the importance of what Iʼm saying. You canʼt live
your life without an inner focus which helps you defi ne your
relationship to it.
Of course, focusing on yourself doesnʼt always cater to
money collecting. You may need to use your vacation time
during the tough parts of withdrawal, and yes you could lose
your job. But donʼt be immediately afraid and consider the
following:
• Money does grow on trees. Itʼs paper!
• Youʼre going to want to get this withdrawal business
over with and ignoring your personal immediate needs
will make it take longer.
• If you lose a job, it can be seen as a blessing to motivate
you to take the time to go through withdrawal with a
- 21 -
Paxil Withdrawal Guide
greater commitment.
• Life doesnʼt wait, why deny it?
• Ask yourself if you could handle losing one job and get
incredibly healthy and confi dent so that you can excel at
your next one?
• Ask yourself if you think it fair to you, or your employer,
if you gave a mediocre effort, lost your job and the time
you could have spent healing anyway?
There is a trap in all this career chess. You may start thinking,
“OK, Iʼll wait until I have more money saved up or the
kids are back in school or... .” Let me reiterate this plainly:
LIFE DOESN’T WAIT
If you donʼt choose to commit to your withdrawal now,
youʼre also choosing to repeat and strengthen a behavior/
dependence that can work even harder against you later.
Take it from a recovered procrastinator and do it now. Life
is infrequently easy, nor monochromatic enough to give you
the chance to withdraw without a single other demand begging
your full attention and energy. So admit that any time is
a good time because life and health is there for you to manage
all the time. Itʼs different if youʼre an expecting mother,
but Iʼll elaborate on that later.
What is your relationship to emotion?
Itʼs time to reach really deep inside and discover what youʼre
going to heal. I want you to know that your emotions will go
astray like a super-bouncy ball on a busy street. Your emotions
will come at you in different directions and perhaps in
fl avors youʼve never had before. This is your invitation to
prepare to become the most objective, observant, forgiving
and cognizant person youʼve ever been. You may be surprised
by the intensity of emotions youʼve been missing that
- 22 -
Freedom is in you
Paxil was helping repress.
Many people donʼt like feeling a great deal of emotion. It is
however very helpful to learn how to live with a full emotional
range. Youʼre going to have to muster the most self
love possible. You can try imagining yourself a beautiful
creature or immortal soul and the point is to view yourself as
someone given full permission to feel. Otherwise, you wonʼt
learn to master yourself and will again feel like a leaf in the
wind hoping to land on the ledge of an ingestible temporary
rescue.
Try to fi gure out what emotions mean to you and how you
prefer dealing with them so that when they come for a visit,
youʼll have a clue. I suggest you spend the most time investigating
how you handle intense frustration and anger since
they are frequent challenges during withdrawal.
Health considerations
Withdrawal can give you good or bad days, and it gets better
over time. Therefore, itʼs a good idea to keep all your
doctorʼs appointments to make sure there are no other health
issues that can be dangerously aggravated during a sleep interrupting,
high stress and fl u-like withdrawal. Some other
health challenges you may have could share symptoms with
Paxil withdrawal and itʼs wise to keep a useful amount of
comparison based knowledge to know whatʼs what. I recommend
you describe your every day. Using the public message
forum at paxilprogress.org, is a useful way to do that
since it lets others learn from your experiences too.
If youʼre pregnant, have just given birth or are nursing, itʼs
important that you work very closely with your health care
providers so that you and the baby are monitored consistently.
You will be generally told that withdrawing from
- 23 -
Paxil Withdrawal Guide
Paxil during pregnancy is a bad idea. However, there is a
growing number of research articles that mention potential
withdrawal risks to the baby if Paxil use is continued during
the later parts of pregnancy. Itʼs also useful to know that
Paxil is transmitted through breast milk.
The ethical burden of whether you should let your baby be
exposed to Paxil rests with you and your health care providers.
When in doubt, just ask what love would do.
What do you expect?
Ask yourself this: how do you expect this withdrawal will
feel and how do you expect youʼll feel a week, a month or
years later?
Now throw those expectations away. Expectations are
knives that will threaten and cut away at your sense of success.
They have no constructive use in withdrawal, so get rid
of them. Expectations can set you up to think youʼre feeling
what youʼre not, and youʼre going to need the most honest
observations possible without any mental bias. Learn to live
in the moment and not well wishing. You can expect to get
better, but you shouldnʼt guess at when in case it takes a little
longer than that.
Withdrawal requires that you live in the moment so that you
can clearly see your progress in whatever form it is at the
time, without a negative thought system like, “oh God, this
is worse than what I expected. Iʼm sunk.” It is incredibly
empowering to see new experiences for what they really
are : something you can assign new meanings to and not
premeditated ones bordering on fear controlled fi ctions. You
will feel how you will feel when you feel it. Realize that
every diffi culty experienced is a reminder that youʼre doing
it, youʼre getting there and that you have the right stuff. But,
- 24 -
Freedom is in you
if you really canʼt be who you are without an expectations
system (thereʼs nothing wrong with not liking surprises), ask
yourself if choosing to be that way really serves you. I fi nd
that when we look at our expectations, we discover that they
are blankets hiding fears. Especially when it comes to love
and relationships.
There are expectations people frequently have around this
antidepressant withdrawal experience, and some of them are
seductive traps. Donʼt worry. Iʼll give you some ideas on
how to steer clear of the worst ones while gaining an understanding
of the others. |
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雷达卡
发表于 09-5-7 17:53:52
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