Late last week the New York Times published an article titled Antidepressant Paxil Is Unsafe for Teenagers, New Analysis Says. After reading it through twice, I sent the link to my friend. He messaged me back almost immediately: “I knew that shit was poison.”
We’d both known.
I was put on Paxil when I was 16. The best word to describe that time in my life is probably soggy. I cried. A lot. I cried in class, I cried between classes, and I cried after school. At night, instead of doing homework I would lie in bed and read Lucy Maud Montgomery books and cry. I got an F in math that semester, which somehow felt validating, as if it proved that I was the failure I’d always imagined myself to be.
I went to see my family doctor and after listening to me stumble through what for me was an excruciating disclosure, he looked into my eyes and said, “yeah, you do look a little blue.” He wrote me a prescription for Paxil, gave me a referral to a psychotherapist and told me to come back in six weeks.
By the time six weeks had passed I’d already quit therapy and was just as miserable as ever.
“Let’s just increase your dose,” my doctor said cheerfully.
It would turn out that this was his standard response any time I complained about antidepressant or anti-anxiety medication. No change in mood? Increase the dose. Side effects? Increase the dose. Particularly bad side effects? Add another drug to the mix and also increase the dose.
The Paxil didn’t make me less depressed, but it did give me awful insomnia. And even when I did manage to sleep, my head still felt like it was stuffed with cotton batting. Instead of going away, my thoughts about suicide got worse. I started cutting myself. When my doctor found out, he was pretty nonchalant about it. “Some kids do that,” he said. “But as long as you’re not actually trying to kill yourself…”
He let the sentence dangle there, half-finished. I wasn’t sure where telling the truth would get me at this point, so I lied. No, I told him. Of course I didn’t want to kill myself.
He seemed satisfied. Then he increased my dose again, just to be on the safe side.
Finally, after a year and half on Paxil, my doctor switched my prescription to Prozac. I was lucky enough not to experience much in the way of withdrawal, but many other people describe Paxil as being incredibly difficult to wean off of. There’s a laundry list of symptoms, including so-called “brain zaps” or “brain shivers” that are exactly what they sound like. It turns out that as miserable as being on Paxil was, coming off of it was sometimes even worse. Given all of this, why was it being given out to so many adolescents in the late 90s and early 2000s?
Part of the reason was a big push by the makers of Paxil to open up a new market for the drug. A study published by drugmaker GlaxoSmithKline in 2001 concluded that the drug was both safe and effective for teenagers, so doctors were unhesitant about doling it out to the under-18 crowd. Sure, Study 329 had followed less than 300 kids – a third of whom were taking Paxil, another third taking an older antidepressant and the rest given a placebo – but the medication was known to be fine for adults, so what was the problem?
There were lots of problems. One of the biggest was that the study didn’t show what GlaxoSmithKline said it showed.
Last week, major medical journal BMJ published a new analysis of the data from Study 329. Their conclusion?
“Contrary to the original report by Keller and colleagues, our reanalysis of Study 329 showed no advantage of paroxetine or imipramine over placebo in adolescents with symptoms of depression on any of the prespecified variables. The extent of the clinically significant increases in adverse events in the paroxetine and imipramine arms, including serious, severe, and suicide related adverse events, became apparent only when the data were made available for reanalysis. Researchers and clinicians should recognise the potential biases in published research, including the potential barriers to accurate reporting of harms that we have identified. Regulatory authorities should mandate accessibility of data and protocols.
As with most scientific papers, Keller and colleagues convey an impression that “the data have spoken.” This authoritative stance is possible only in the absence of access to the data. When the data become accessible to others, it becomes clear that scientific authorship is provisional rather than authoritative.”
This is incredibly important.
What is also important is how quickly and easily doctors dismiss complaints from adolescent patients. In my experience, my complaints about medication were either ignored or resulted in an increase in dosage – and having spoken to several other people who were struggled with mental health as teens, I’ve realized that this was true for many people. The result was both that none of us were receiving the right medication, all of us were experiencing side effects that made every day functioning difficult, and many of us now have difficulty trusting medical professionals.
Here are some of our stories:
LT: I was diagnosed with depression in my teens and was prescribed Paxil. My moods became even more extreme, I felt confused and erratic and started to experience delusions and hallucinations. I attempted suicide and was taken off Paxil when I was hospitalized. My diagnosis stayed the same and I was put on Effexor. I went home and after a few months stopped taking that because I became manic (though I didn’t know what that was at the time), thinking I could walk through walls, hallucinating, talking a mile a minute. I didn’t go on any other medication until my 20s when I was finally diagnosed with bipolar disorder. Not sure Paxil can be blamed for a misdiagnosis but it certainly was no fun to be on and I think, contributed to my attempting suicide.
LS: When I was 14, I complained about chronic worry to my doctor – I didn’t have the words or tools to understand that what I was experiencing was anxiety. She didn’t educate me on it, or suggest I seek therapy, or suggest I exercise, but she did prescribe me Paxil. The next year of my life was miserable.
I constantly thought about how better off everyone would be (including myself) if I wasn’t around. My self esteem completely disintegrated. My restricted eating ramped up into an eating disorder. I stopped being interested in almost anything, except self loathing… Finally I decided to go off it, because it obviously wasn’t helping. It took me a very long time to slowly wean off, crumbs a day basically, and I experienced those awful electric jabs in my brain the entire time.
Once I was weaned off it, I became myself again. The anxiety was back but I cared about my life again. The experience traumatized me so badly, it took 15 years of suffering through an anxiety disorder before I was finally willing to try medication again – because my new family doctor encouraged me to try lots of different things in conjunction with it – meditation, yoga, exercise, healthy diet, therapy, and tons of reading. I wish I’d had this knowledge when I was younger.
CN: Also on Paxil as a young adult. I’ve always had suicide ideation and while my sadness symptoms diminished while I was on Paxil, the suicidal thoughts remained and were devoid of emotion. They seemed more logical because they weren’t attached to an emotional breakdown.
AG: I was on Paxil in my early twenties. It led me to cutting, lack of energy, lack of hope (I lived in my apt with no power for a month…this happened several times), I self medicated with alcohol to desperately FEEL something. One time I cut myself so badly I thought I was going to die. I ran outside and flagged down a cop car who drove me to emergency. That medication nearly destroyed me. Whenever I complained, I kept being given higher doses.
MT: I was on it between ages 15-18. After being put on Paxil, I felt worse. I made 3 suicide attempts in that time that took me to the ER and some time in a psych floor for children/teens (many as young as 6 and taking liquid versions of Prozac and Praxil – I overheard the nurses handing out meds).
CD: It just made me flat. And they kept ratcheting up the dose all the time.
JT: I was on it when I was in my 20s and it was terrible for me. It made me manic, and I had never been manic and haven’t been manic since. Dangerously manic. I made poor choices and exhibited very unhealthy behaviors. Then the Paxil flu (Paxil withdrawal syndrome) nearly killed me, I swear. It’s been like 11 years and I still occasionally have brain zaps.
NS: I was given two sample packs of Paxil by someone in a walk-in clinic when I went in with mood swings when I was 22. I was on it long enough to take two doses, which left me twitching and clenching my teeth and shivering in the corner of my room like some sort of raver with too much e in their system.
CB: I too, was on in in my early 20s, and I too, felt awful on it. Manic is probably the best word to describe the feelings that came about … I was either insanely emotional and panic-attack stricken, or a complete zombie.Really didnt help control my anxiety at all…
NR: I was suicidal when I was 15 in 1995 and was first put on Paxil. I remember it made me feel extremely numb and unreal, like my brain was stuffed with cotton and the world was far away. My doc upped the dose when I complained of not feeling better and the symptoms just got worse. I remember going to my dance class and napping on the couch instead because I was just so tired. Or one time I was out with some friends and I went and lied on top of my friend’s car and stared into the sky because I was literally high from the meds.
JK: I was put on Paxil when I was 18 or 19. I was put on it by a walk in clinic doctor after I super awkwardly told him I tried to kill myself with pills. I came back a few months later, saw the same doctor, and told him I didn’t think they were helping and they seemed to be making my body feel worse (stomach aches, weird shakes) and asked shouldn’t I be referred to a psychologist or psychiatrist? He looked at me and literally said ‘ these are the only pills that will help you, and you will need them for the rest of your life’.
SG: At 17 I was prescribed with Paxil. I don’t think it was the first choice of my MD (who seemed to imply it was largely a placebo in comparison to other SSRIs) but they went with it because it had been successful (apparently) with my mother.
After two days, I got such severe dry mouth (and/or my tongue was swollen) that I couldn’t swallow, and my tongue was kind of just sticking out of my mouth at rest position.
Antidepressants have likely saved my life and they have certainly made a miserably chronic condition easier to live with. But the way they have been prescribed to me has often left me feeling confused, unheard and intensely gaslit. Because how else are you going to feel when you tell someone that a medication makes you feel awful and the only response you ever get is that you should take more of it?
For some teens, Paxil was a miracle drug. For many of us, it did little to improve how we felt and brought with it dangerous – and sometimes even life-threatening – side effects. Factors like unscrupulous drug companies, doctors eager to reach for their prescription pad and a general lack of attention to the thoughts, feelings and autonomy of teenagers all contributed to this. I have no doubt that this same story is currently playing out with different medications; I feel certain that other studies will be debunked just as thoroughly as study 329.
People need these medications; people’s lives are put in danger by these medications. There’s going to be a lot that needs to change before the latter statement stops being true.