|
 he pain and nausea
some people feel when they stop taking certain
antidepressants is spurring controversy over
whether these drugs should carry explicit warning
labels about withdrawal.
Jamé Tierney was 14 years old when she started
taking Effexor, a serotonin norepinephrine
reuptake inhibitor (SNRI), for her migraines. When
she slowly tapered off the drug, Jamé experienced
vomiting, suicidal impulses, electric shock-like
sensations and fatigue. She likened her confusion
of time and space to special effects in the movie
"The Matrix."
Such withdrawal has often been mistaken for
depression relapse. However, mounting testimony
from people like Jamé, who were prescribed SNRIs
or selective serotonin reuptake inhibitors
(SSRIs), such as Prozac or Zoloft, for
nonpsychiatric conditions could publicize what
doctors say is a phenomenon recognized since the
late 1990s. Patients using Paxil and Effexor
report the most severe problems because those
drugs have the shortest half-lives, which make
them the quickest to exit the system.
Some experts estimate 50 to 80 percent of
patients experience withdrawal from Paxil when
they go cold turkey, but this number is
controversial. Jonathan Alpert, M.D., Ph.D., an
assistant professor of psychiatry at Harvard
University, says there are no definitive
estimates, but believes that for patients who
taper off the drugs, the number could be less than
5 percent. Even for patients who stop suddenly,
scenarios like Jamé's are rare, he adds.
"The great majority of patients who stop their
antidepressants abruptly get away with it," says
Alpert.
David L. Dunner, M.D., director of the Center
for Anxiety and Depression at the University of
Washington, says studies show less than 25 percent
of patients who quit Paxil experience
symptoms.
Though Paxil and Effexor labels now warn of
"discontinuation," some say the labels aren't
adequate. Lawyer Karen Barth, who represents 35
patients in a California lawsuit, says her firm
has heard from some 10,000 Paxil patients.
Joseph Glenmullen, M.D., author of Prozac
Backlash, sees a potential crisis should
withdrawal become widely recognized.
"Thousands and thousands of people have tried
to go off SSRIs, and their doctors have mistaken
it for a relapse [into depression]," says
Glenmullen, who advocates therapy in addition to
tapering off the medication in order to
distinguish a relapse should one
occur. | 
