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E. cut her dose from twenty milligrams to ten, then five.
Still she got zaps1 that ran from her heel to her tailbone, and up her elbow to her armpit,and alongside her spine. Turning her head made them flit across her shoulders.
Like a whack on the funny bone, she said to K.
She had nausea, at night, when she lay down and stretched her arms to still the bed.2She got up at six, when the turning of her stomach grew urgent and she bumped walls to the toilet, which she spattered with loose stool. She would scrub the bowl, but only aftera piece of toast and coffee and starting the laundry and straightening the kitchen.
Her brain took time to understand what her fingers touched or her eyes saw.
I don’t want to be on it forever, she told Dr. XXXXXXX, who agreed, but said If intolerable symptoms occur following a decrease in the dose or upon discontinuation of treatment, then resuming the previously prescribed dose may be considered (see DOSAGE AND ADMINISTRATION).
I don’t want to take it forever, E. said to K., who turned to watch a boy pause, and bend,and tie his shoe. K. thought the boy was nineteen or twenty. He was too thin. He 1 What are “The Zaps”? The zaps are little shock-like sensations, which occur during Paxil withdrawal. They can
happen with head and eye movement, or even while sitting perfectly still. After a while, you can begin to hear the
zaps happening in your head – like a ‘swoosh’ sound. <http://paxil.bizland.com/jbuzzw.htm>
2 Patients who stop taking Paxil abruptly often experience dizziness, nausea, diarrhea, and vertigo. Therefore, slowtapering is recommended. <http://www.nami.org/Template.cfm?Section=About_Medications&template=/ContentManagement/ContentDisplay.cfm&ContentID=7394 walked to the counter to order a Mocha Valencia. K. liked the hoops that ran one twothree four five up his earlobe. She thought she saw two more outlined in the fabric of hisshirt, at his nipples. She touched her hand to her nose and imagined sour sheets.
She wanted to tease him. Who orders a Mocha Valencia. Why stop, K. said. If it helps.
E. opened her mouth. She took 40 mg of Lipitor® to lower her cholesterol. She tookXanax® before meetings. She took Advil® for cramps and Tylenol® for headaches.
She carried Prevacid® in her purse—in case of red sauce. She took the pill because L.
couldn’t come in a rubber and Claritin® during ragweed months.
The long-term side effects3, she said.
Oh, K. said, who took too many pills, too. But she got up three, four times a night tocomfort T. and J. She couldn’t walk to the bathroom without kicking piles of laundry.
She hadn’t been to a movie in two years. She needed Zoloft®. Without Zoloft, she’dstab R.4 to death.5 3 It must be conceded that we do not yet know the long-term effects of Paxil or related agents (called SSRIs, andinclude Prozac® and Zoloft), if by long-term, you mean, "after 10 or more years of use." These agents are still too"new" to generate that kind of data. <http://www.mhsource.com/expert/exp1081996a.html> 4 R. took Paxil and couldn’t hold more than two things in his mind at a time_ and left details of family life to K., asif she wore curlers and spent days home folding laundry and cooking roast beef. She worked. They werevegetarian.
_ What are the possible side effects of Paxil? • Nervous System: Central Nervous System stimulation, concentration impaired.
<http://www.onlinelawyersource.com/paxil/faq.html> Question Posted By: kristine on Sunday, June 18, 2000 I have been taking 50 mg. of Zoloft for two years now to treat mild depression and social anxiety. Since I've been taking Zoloft, I don't seem to "feel"my feelings anymore. Like anger. Or if I'm experiencing a sad situation, it registers that "I am sad" or "this is sad", but I don't feel the actual sadnessthat I used to prior to Zoloft. In fact, I can't even cry (and I used to enjoy a good cry now and then). Is this normal for Zoloft?<http://www.medhelp.org/forums/mentalhealth/messages/31088a.html> E. didn’t want to forget she liked the newspaper, and that she liked chili with jalapenos and talking to her sister on the phone at night.6 She enjoyed sex once7.
What doesn’t, K. said, thinking of shrimp sopped in butter.
Nights, she crammed dinner in her mouth faster than she could chew. She snitchedmacaroni from T.’s plate. She longed for a cigarette.
I wasn’t always fat as a house, K. said.
Kids change us, K. said. Age changes us. Jobs. Friends.
6 After only a little of the Times on Sunday, E. lost focus and started thinking of mowing the lawn, and she didn’tlike kidney beans anymore. She couldn’t ever, ever stay up past ten._ _ Continue to take paroxetine and talk to your doctor if you experience decreased sex drive, impotence, or difficulty having an orgasm.
Side effects other than those listed here may also occur. <http://paxil.drugs.com/> 7 but lately her clitoris had less feeling than a pinky toe.
<http://us.gsk.com/products/assets/us_paxilcr.pdf> But those are real, E. said. I don’t know, she said, stirring her coffee, which was skin-colored and cold. It’s your brain8, she said.
Your brain, K. said. Her brain ruined her, even at 100 mg. a day.
She thought of T.’s narrow shoulder blades and the fine down of hair on his back. Shesaw him laughing as he splashed his feet in the tub. In fifteen years, he would haveearrings and long, dirty hair, and the back pocket of his jeans would fray from the wear of his wallet. He would be thin and spend mornings in a bed with sour sheets. Her son.
I’m thinking of increasing my dose, K. said Maybe I’ll go up to 150, she said. I’m not going down. She wasn’t trying to be mean.
I’m depressed, she said again, and she laughed. E. did, too.
I couldn’t stop,10 she said, before Paxil, she said, which made her sweat from her palmsand her feet and even her tongue. Her arms shook. She waded through the side effects,and they went away.
8 A psychoactive drug or psychotropic substance is a chemical that alters brain function, resulting in temporary
changes in perception, mood, consciousness, or behaviour. Extreme use can have permanent affects on the brain.
Stimulants Cocaine Amphetamine Caffeine Nicotine Psychedelics LSD Mescaline Psilocybin Cannabis PCP
MDMA ("Ecstasy") DMT Ketamine Salvinorin A Narcotics Opiates Morphine Codeine Heroin Sedatives Ethyl
alcohol Benzodiazepines Valium GHB Anti-depressants SSRIs Prozac Zoloft Paxil Antipsychotics Haloperidol
(Haldol) Aphrodisiacs PT-141 <http://en.wikipedia.org/wiki/Psychotropic_drug>
9 Like K., R. had put on weight, since the kids, but in his torso. His breasts hung. His bellybutton had sunk to acrater, and he could stick a finger in to the second knuckle, which he did. He was meaty. He had to adjust his gut toenter her. Sex felt like rolling around in sweaters.
His underwear had taken on new stains. K. suspected he wasn’t wiping.
10 BP_, everything linked. The meeting she missed meant J.’s look and W. calling her in about what wasn’t clear,but he was mad, and her job meant benefits, and she couldn’t start again looking for work. She had house payments,and she wouldn’t count on L. She took care of herself, and her sister, too, in most ways, which was fine, but sheworried, and she should have let it all go, every time, but she didn’t, and it wasn’t, and she wound tighter till herback ached and her hands shook, and she replayed events, thinking them over and over and over and over. Sherepeated sentences after she said them. To make sure they’d come out right. To make sure they had come out right.
To make sure they sounded right. People noticed. Who wouldn’t notice, and E. felt less confident, and it showed in Then she relaxed. She could take a deep breath.
She slept ten hours a night. She smiled at W., at work, when he boiled up. She feltcompassion for his position.
She stopped worrying about the traffic downtown.
She didn’t care that her clutch was starting to go, or about gas prices.
She didn’t care that she sat all day.
She didn’t care if she had the right shoes.
She didn’t care if people noticed.
She didn’t care to scrub her toilet.
She didn’t care if her evening work got done, if L. had something else to do on Friday, or She didn’t care about the neighbors’ parties.
her work, and her posture, which was rigid and hunched, her elbows glued to her sides. She stared at people, tryingto see what they really meant, and it made them nervous, which made her nervous, and powerless to change.
Impotent. She asked her primary health provider about meds, and he said The effectiveness of PAXIL in the treatment of Generalized Anxiety Disorder (GAD) was demonstrated in two 8-week, multicenter, placebo-controlled studies (Studies 1 and 2) of adult outpatients with Generalized Anxiety Disorder (DSM-IV).
She knew she should see a therapist, too, but she didn’t.
_ "It is easier to get a prescription refilled than approval for therapy. The insurance industry will not be moved, andclients think a pill is best." Dr. Gary R. Sweeten<http://www.talkingcure.com/archive/drugs.htm> Paxil was the first of two drugs I was on for depression. While I didn't have suicidal thoughts on it, I like to refer to it as the apathy drug. You cancontinue to leave the house, go to work, etc. because you just don't care. In an extreme way. So extreme that it's really not hard for me to image somepeople taking the next step and thinking hey, why bother staying alive at all?_ Oh, and this probably won't surprise you, but GlaxoSmithKline, maker ofPaxil, loves Republicans. And why not? It worked well for Enron and, to a lesser extent, Worldcom.
Posted by morgaana at June 7, 2004 05:58 AM | TrackBack But I don’t, she said. Not now. I know how to not worry.
As much as I can, she said. I mean not worry.
Sure, K. said, though she didn’t mean it, which E. knew, because she wasn’t stupid.
She wanted coffee and to talk to K, who didn’t pay attention but talked about her kidsand her kids and her kids, like she was the first fucking parent in the world.
E. listened every time and said, I know it’s hard.
K. at the center of the room, fat bitch.
Blah blah me me blah blah blah me me me blah.
E. thought about smashing K.’s face down on the cups and plates until her teeth crackedand her cheeks crumpled around her nose.
Maybe I’m feeling irritable12, she said.
<http://abracapocus.org/archives/002671.html> _ F.D.A. Toughens Warning on Antidepressant DrugsBy GARDINER HARRIS Heeding the recommendation of an advisory committee, the Food and Drug Administration ordered pharmaceuticalcompanies yesterday to add strong warnings to antidepressants, saying the drugs could cause suicidal thoughts andactions in some children and teenagers.
<http://www.nytimes.com/2004/10/16/politics/16depress.html?adxnnl=1&adxnnlx=1098111690-> 12 Think you might be experiencing paxil withdrawal?
You must be trying to discontinue paxil!_ <http://join-the-fun.com/paxil-withdrawal.html> _ Paxil WithdrawalAccording to World Health Organization ("WHO"), Paxil has the highest incidence rate of withdrawal adverseexperiences of any antidepressant drug in the world." Symptoms include severe mood swings, like extreme irritabilityand anger_. <http://www.anattorneyforyou.com/legal/px_topics130.htm> _ Subject: Paxil withdrawal (severe) and any helpful medicationTopic Area: Anxiety Question Posted By: pharmno062 on Sunday, May 16, 2004 My husband has been withdrawing from Paxil for two plus weeks now and is experiencing: disorientation, confusion, anger outbursts. He cannotsleep with regularity and rants and raves non-stop. He has a good psychiatrist and is on neurontin and i s not diganosed with any other severe DSM-IV diagnostic disorder. He is trying small amounts of xanax and very small dosages of vicodin, which gives him relief for 3 hours at a time. He doesnot want to take more drugs to complicate this situation or become addicted. He is not taking these medications in large dosages and has only beentaking them for a week. Even this does not allow him to go out in public and function without going into confusion, a rage, or nearly have drasticautomobile accidents. He also becomes combative at times.

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INSTITUTO POLITECNICO NACIONAL CIIDIR IPN UNIDAD DURANGO Resúmen Curricular 1. Nombre: Dr. en C. Ismael A. Lares Asseff 2. Puesto: Profesor Investigador Titular “C” CIIDIR IPN Unidad Durango 3. Grado Máximo: Doctor en Ciencias Médicas, UNAM 4. Miembro del Sistema Nacional de Investigadores desde 1995 con extensión al 2023: Nivel I Becas a la

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DOCUMENTO INFORMATIVO Médicos Sin Fronteras (MSF) actualmente proporciona atención a más de 100.000 personas con VIH/SIDA y terapia antirretroviral a más de 80.000 personas en sus 65 proyectos en más de 30 países. Aunque los programas de MSF reportan muy buenos resultados, los retos que Basado en datos y experiencias que se presentaron en la XVI Conferencia Internacional del SIDA

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