by Lori Dwyer on July 15, 2013 · 23 comments

If my medication isn’t addictive, why are the withdrawal symptoms so yuck?

I take sixty milligrams of Paroxetine a day, and have been doing so since a week After the sky fell in. Apparently, that’s a ‘hefty dose’ of anti–depressants– the maximum recommended dose is fifty milligrams. I think we’ll just say I’m a special (head) case and i need every damn milligram I take.

Paroxetine is an anti–anxiety medication, and its generally the first thing prescribed for PTSD. Psych meds, when used properly, are awesome. Give me all the St John’s Wort in the world, and I doubt it will have the effect that these pills do.

It’s not that they even cause me to be particularly happy. But they take the burning edge off anxiety. They regulate my over–responsiveness enough that I don’t feel as though I’m about to die from the adrenaline surge a raised voice sends through me.

Meds don’t make me happy… but it feels as though they make it possible to be happy. Like I’m starting at the some kind of even place, rather than with a sadness and worry deficit to handicap me. The meds make it possible to have a good day, if good things happen. They take away the apathetic fatigue that depression sits around your shoulders, the metaphorical cotton wool that muffles your mind somewhere between your eyes and your temples.

While I’m being metaphorical… meds don’t make the sun shine. They do, however, thin the clouds considerably. So if the sun shines hard enough it may just burn the fog away enough for it to be seen.


Just as taking my meds doesn’t make me happy, missing a dose of them (through forgetfulness or willful stupidity) doesn’t always make me sad or unsettled or anxious. If I’m having a particularly good time, I may not even notice I haven’t taken them at all.

Until the physical withdrawals kick in.

Withdrawals are never nice. A metallic thirst. A strange rushing inertia. A fast flowing pins and needles effect that shoots through your extremities every time you move. Nausea. Sleepiness. Sleeplessness.

And with that, the agitation and useless anxiety about nothing in particular. Bad dreams. Restlessness. Picking and chewing at my poor, short fingernails.

The apathy is the worst of it, though. At university I heard about what the lecturers called ‘schizophrenic logic’. “I feel okay, so I can stop taking my meds”. Not “My meds are making me feel okay, so I should keep taking them”.

It’s even stupider the way I rationalize what I don’t do. I went to Melbourne last weekend and forgot to take my medication with me. I take one dose on Saturday when I return home, then forget again on Sunday and don’t take another until Monday afternoon.

I’m an idiot, and I know I am, even while my head says to me “I feel like shit. I cannot be bothered taking my meds” instead of “My meds will make me stop feeling shit”.

Paroxetine takes two weeks to reach it’s full effect when you first start taking it. It’s got an extremely short half life, especially at such a high dose- it begins to wear off after twenty four hours, and withdrawals kick in at forty eight hours. Coming off it requires a gradual, incremental decrease.

Long post, made short; forgetting to take my medication messes with my head. I need to get my shit together.


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{ 23 comments… read them below or add one }

Sapphyre (@sapphyre_au) July 21, 2013 at 7:12 pm

We all make mistakes; hey at least this one comes with a physical reminder… some things don’t and then you can get a nasty shock.

A lot of psych meds are physically addictive, but don’t worry, if you get to the point where you don’t need them any more, you can step off them gradually (you’ve already been clever enough to figure out going cold turkey would massively suck!). Check with me if you get to that stage, I’m a massive researcher in this area and have got myself off Efexor and am stepping hubby off Benzos now in prep for stepping off anti depressants and anti psychotics. (Because he doesn’t need them anymore since he got off those nasty opiates.)


Miss Pink July 18, 2013 at 1:22 pm

Just that understanding that regardless of how you feel you have to take your medication because it is what is helping those good moments to be possible is such an amazing leap in the right direction Lori.
It is an easy connection to people when in the right frame of mind, but to have your head speak up and tell you this when you’re having a hard time, and not tell you that they aren’t working, or to tell you that you need to keep taking them when you’re having an easier time, that is so important. You are amazing xx


Lori Dwyer July 18, 2013 at 5:07 pm

Thanks Pink xx
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Drea B July 17, 2013 at 7:32 pm

My husband is on anti depressants and I’m all too familiar with the ‘I feel fine, so I wont’ take my meds’ logic. It must be hard to keep taking them though, given the side effects some of the medications can have.

<.< Hopefully you'll find it amusing.

And hopefully that one makes up for it if you don't. It's dedicated to his daughter.


Lisa@Circle of toast July 16, 2013 at 8:11 pm

Ugh, I always had a mental block about remembering to take meds, was on citalopram for a year or so. Hope they’re helping you.
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Lori Dwyer July 17, 2013 at 3:56 pm

The definitely are, Lisa :)
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Anne July 16, 2013 at 1:31 pm

oh hell… the week I go off coffee the NYT sends in the article of a lifetime telling everyone how beneficial the stuff is… prolongs life and brain cells and staves off the bad Alzheimer gig. So I sit there on that day wondering why I’m doing it but I was going to have to for a particular reason…

Now I’m thinking of going on medication the last two days and wanting to tell myself it is good and drugs will save my life and sanity. Then I read this. OMFG! I will suffer rather than deal with more hell by taking drugs.


Lori Dwyer July 18, 2013 at 5:06 pm

Oh Anne… I’m so sorry. I didn’t mean to put you off. They can do a lot of good, really- I don’t know where I’d be without them. They have their good and bad- I guess it’s just a matter of which outweighs the other xx
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Anne July 26, 2013 at 11:22 am

you really didn’t put me off… I know it’s a decision I have to make on my own and I can weight it out. Sorry for my silly outburst here. I would rather you share your best and most honest feelings than keeping it comfortable for those of us who might be in the process of freaking out about things… we need to hear the truth and we need to know we are not alone one way or the other. Thank you!


flask July 16, 2013 at 7:41 am

oh, god.

i miss being able to take meds. an unfortunate series of allergic reactions left me with nothing i can take until they invent something new and chemically unrelated.

i remember the last does i was able to take of the last med i had available. the reaction wasn’t so bad and i was able to stop it with benadryl but it was the end of life as i knew it. i went from “managed” to completely unmedicated and hitting horrible withdrawal in about twelve hours.

and i needed those meds to keep me a viable member of the workforce.

it’s a different life, and a pretty good one, but it’s not what i wanted to be when i grew up.
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Lori Dwyer July 17, 2013 at 3:53 pm

That really sucks flask :(
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Manda July 16, 2013 at 4:50 am

*hugs* I went overseas and didn’t take enough of my drugs with me, so they ran out with a week to go. It was awful. I get loss of vision, nausea, exhaustion and have trouble hearing.

I tried stopping them completely and ended up with my sister visiting on a Wednesday as I was sitting on the living room floor with my 2yr old watching tv surrounded by grocery bags.

“How long have these bags been here, hon?”
“Since I went shopping. I don’t remember. Sunday.”
“Sweetheart, I think you might have to reconsider the meds. I’m proud of you for trying, but it’s just not the right time yet.”

Really lucky I have someone who loves me enough to visit, and to talk me into seeing what’s around me so I can make a rational call about my meds. I really had hoped it would work that time, because it wasn’t that bad once the side effects wore off – it just wasn’t that good either. Not as good as I deserve to be.


Lori Dwyer July 17, 2013 at 3:52 pm

The thing with the shopping… I recognise that, too much. You’re lucky you have your sister :) xx
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Tam Triance July 16, 2013 at 2:29 am

Trying to get off meds sucks. I like Kirsty am on 60mg a day of cymbalta and recently tried to get off it by dropping to a 30mg a day twas not a pretty sight :/ hoping to try and get off them again soon tho cause its made me fat and I want to go on diet pills for awhile to shift this weight. Cant do that till I get off the cymbalta tho. I’ve tried diet and exercise and its got me nowhere. I wish you luck in getting off them and hope its not too mentally stressing for you, you have a lovely partner to support you and help you get through it so just keep battling on xo


Kirsty Forbes July 16, 2013 at 11:48 am

Oh my goodness I could cry, Tam! I am having problems with shifting my weight on the Cymbalta too! I’ve put on like 10 kilos being on them!! grrr silly drugs.


Lori Dwyer July 17, 2013 at 3:48 pm

I’ve put on a stack of weight, too. Most days I try not to mind, and I succeed… not today, though. Today I mind a lot.
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Trisha July 15, 2013 at 11:37 pm

Hi Lori,

I wonder if there is something about the planetary alignment at the moment, seeing as though last week also saw me on the adventures of being non-medicated.

Remember that you are special enough to deserve to take your meds.

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Lori Dwyer July 17, 2013 at 3:41 pm

Seems it’s not even just us Trish… must be the planetary alignment, or something.


Marianne July 15, 2013 at 11:21 pm

I was on a pretty high dose of Paroxetine (40mg) after all of the unpleasantness in April 2011…it was a life-saver in terms of treating the anxiety and PTSD. However, when my insurance changed this past January…I realized how expensive it was ($90/mo). I asked my doctor about changing to something else (also about reducing since things are so much better 2 1/2 years later). She switched me to citalpram (20mg). I find that I like it SO much better. I really didn’t have any depression, per se, to deal with…I was just a jittery, anxious mess prone to panic attacks at the drop of a hat. This new Rx seems to be even better than the Paxil…and if I miss a dose, the side effects are minimal.
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Lori Dwyer July 17, 2013 at 3:43 pm

Hey Marianne, I’m so lucky I get it on a health care card- it makes it much cheaper….


Kirsty Forbes July 15, 2013 at 9:47 pm

Dude, I am hearing you. I am so mad at the doctor that first prescribed me this shit. Why? Because it wasn’t even a discussion. No ‘you should try therapy first’ etc… So i’ve tried so many different AD’s and have come to the decision to finally come off my Cymbalta. Its taking a long time to do so because I’ve been through the withdrawals before and it sucks. I came off 150mg of Effexor xr, from the advice of a doctor. Lets just say. NOT.Pretty. So now down to 60 mg of Cymbalta.. im doing it little bit at a time. The only thing I know is that even coming off the minimalist amount of it, is going to suck. Lots of walking and lots of water is all I can suggest babe. And just ride it through till you’re clear. I wish I was warned of how hard this stuff is to get off… I swear heroin would be easier sometimes


Sally July 16, 2013 at 2:12 pm

I took 3 months to come off Effexor and I think it was possibly the WORST 3 months of my (and my family) life. The withdrawals were just horrible. Had I known I was going to go through this I never would have started on it. Too many side effects of taking it too. But then again not taking it had side effects too. It’s a vicious cycle.
What I did find useful during withdrawal was fish oil. I’d take 2 a few times a day and it seemed to make it a bit more doable.


Lori Dwyer July 17, 2013 at 3:44 pm

Yep…damned if you, damned if you don’t :(
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