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Many psychoactive medications can cause withdrawal
symptoms upon discontinuation from administration.
Evidence has shown that paroxetine has among the highest
incidence rates and severity of SSRI discontinuation
syndrome of any medication of its class. Common paroxetine
withdrawal symptoms include repeated electrical shock
sensations of the brain and body (see "brain
zaps"), vertigo and hot flashes. Suicidal ideation
is a frequently reported experience in those withdrawing
from SSRIs. For those experiencing extreme and unusual
difficulty discontinuing paroxetine, it is recommended
that an SSRI with a longer half-life, such as fluoxetine,
be administered for approximately two weeks, then
discontinued, to lessen symptoms.
For 10 years, GlaxoSmithKline's marketing of the
drug stated falsely that it was "not habit forming."
In 2002, the U.S. FDA published a new product warning
about the drug, and the International Federation of
Pharmaceutical Manufacturers Associations (IFPMA)
declared GSK guilty of misleading the public about
paroxetine on US television. The British Medical Journal
quoted Charles Medawar, head of Social Audit: "This
drug has been promoted for years as safe and easy
to discontinue.... The fact that it can cause intolerable
withdrawal symptoms of the kind that could lead to
dependence is enormously important to patients, doctors,
investors, and the company. GlaxoSmithKline has evaded
the issue since it was granted a licence for paroxetine
over 10 years ago, and the drug has become a blockbuster
for them, generating about a tenth of their entire
revenue. The company has been promoting paroxetine
directly to consumers as 'non-habit forming' for far
too long." As of 2007, GlaxoSmithKline's prescribing
information acknowledges the symptoms but eschews
the term "withdrawal" in favor of the phrases
"serious discontinuation symptoms" and "discontinuation
syndrome."
Patients considering paroxetine should be warned
in advance of these risks, and withdrawal from any
SSRI should be closely medically supervised by the
prescribing provider.
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