17 U.S. Code § 107 - Limitations on exclusive rights: Fair use
Notwithstanding the provisions of sections 106 and 106A, the fair use of a copyrighted work, including such use by reproduction in copies or phonorecords or by any other means specified by that section, for purposes such as criticism, comment, news reporting, teaching (including multiple copies for classroom use), scholarship, or research, is not an infringement of copyright. In determining whether the use made of a work in any particular case is a fair use the factors to be considered shall include—
(1) the purpose and character of the use, including whether such use is of a commercial nature or is for nonprofit educational purposes [all mirrored content falls under this clause, any ads present are mirrored from the original site, mirrored content earns me no revenue whatsoever];
(2) the nature of the copyrighted work [this is a unique resource for the mentally ill, and preservation of it can be argued to be incredibly important];
(3) the amount and substantiality of the portion used in relation to the copyrighted work as a whole; and
(4) the effect of the use upon the potential market for or value of the copyrighted work. [absolutely none whatsoever, as the original work no longer exists anywhere else (outside of whatever bits and pieces archive.org managed to capture) - the original site was intermittantly completely unavailable for a extended period of time before its SSL certificate expired (and was never renewed), and eventually the site went offline for good, then finally the DNS records were removed at some point prior to May 2018, so at this point it is well beyond the 'dead and rotting' stage]
The fact that a work is unpublished shall not itself bar a finding of fair use if such finding is made upon consideration of all the above factors.

This domain is not controlled by Jerod Poore, and I will NOT continue redirecting traffic from this domain to crazymeds.us [as I formerly did] while Jerod continues with his immature temper tantrum over adblock or continues to fail to maintain his site, fucking over his entire community and countless visitors in the process. [belated clarification: with specific regards to the adblock drama I was referring to Poore at one point replacing his entire site with a single page complaining about the amount of revenue lost to users with ad blocking active, which is something that I took extreme exception to because this affected ALL visitors to the site regardless of if or if not they were actually using ad blocking]
This mirror is unfortunately incomplete (and very slightly outdated), as /CrazyTalk/ was not included when I scraped the site (it was far too large to scrape given the site's extremely poor performance, my wish to avoid worsening the poor performance further, and other factors). If you're looking for a replacement forum, I suggest visiting https://www.crazyboards.org/forums/. There are issues with many of the mirrored pages, I am working on identifying and fixing them, but I do not have the time to address every single issue at this moment (although by now the majority of these issues have been resolved). Dynamic content is obviously completely broken (this is beyond my control), and the loss of /CrazyTalk/ is quite bad given how much good user-generated info was on there, but you have Jerod to "thank" for that. Maybe I'll bring it back online at some point, but it wouldn't be the same as before. For now, I suggest visiting CrazyBoards instead.
Note (Oct 9 2018): Infrequent additional updates regarding the status of this site will be posted on https://info.crazymeds.net


Part 2: Warnings, clinical pharmacology, interactions, additional comments and consumer experiences

> Paxil (paroxetine) Review


The Paxil (paroxetine) Overview is a briefer, more consumer-friendly version of this article. The information in this article comes from twelve separate pages, with more explanatory material, to which the overview links. The title of each section on both pages of this article is also a link to each of those pages.

Click here for 1: Indications, efficacy, dosage, titration, discontinuation, pros and cons, adverse events, availability and how supplied.

Abstract

Consumers need more information than what is provided in the patient information literature, but are intimidated by, or have no desire to read all of, the prescribing information for a drug. This review of the drug Paxil (paroxetine) provides what the educated consumer wants, highlighting its use as, and comparing it with other {{$$drugclass2}}. Also discussed are off-label uses, efficacy, adverse events and how to mitigate them, titration and discontinuation schedules, clinical pharmacology, other aspects of using Paxil (paroxetine), and consumer experiences.

Black Box and other Warnings

Any Black Box warning comes directly from the prescribing information. Comments are based on a review of the prescribing information and The Literature. Consumers have become either overly paranoid or jaded by the overwhelming amount of information presented in black box warnings, the number of drugs with them, and how no distinction made in many forms of direct-to-consumer advertising between minor side effects and adverse events serious enough to be listed in a black box. Hence the need to explain what a black box warning is (on the page at the link above) and comments about any warnings there may be for a drug.

Black Box warnings

Suicidality and Antidepressant Drugs Antidepressants increased the risk compared to placebo of suicidal thinking and behavior (suicidality) in children, adolescents, and young adults in short-term studies of major depressive disorder (MDD) and other psychiatric disorders. Anyone considering the use of PAXIL or any other antidepressant in a child, adolescent, or young adult must balance this risk with the clinical need. Short-term studies did not show an increase in the risk of suicidality with antidepressants compared to placebo in adults beyond age 24; there was a reduction in risk with antidepressants compared to placebo in adults aged 65 and older. Depression and certain other psychiatric disorders are themselves associated with increases in the risk of suicide. Patients of all ages who are started on antidepressant therapy should be monitored appropriately and observed closely for clinical worsening, suicidality, or unusual changes in behavior. Families and caregivers should be advised of the need for close observation and communication with the prescriber. PAXIL is not approved for use in pediatric patients. (See WARNINGS: Clinical Worsening and Suicide Risk, PRECAUTIONS: Information for Patients, and PRECAUTIONS: Pediatric Use.)

Black Box comments



“Noted interactions” are the really important ones and any others, especially pharmacodynamic interactions, we know of that normally don’t make it into patient information literature and online drug-drug interaction checkers.

Noted interactions

Paxil (paroxetine) + tamoxifen = that breast cancer isn’t going anywhere.

Paxil’s interference with tamoxifen’s transformation into its active metabolite is so profound, and well-known, that people taking tamoxifen are often advised to not take any SSRI, or even to not take any antidepressant. Admittedly most, but not all, SSRIs inhibit CYP2D6 to some degree, with Prozac (fluoxetine) being as bad as Paxil (paroxetine). While you’d have to be a poor metabolizer of CYP2D6 to be affected by all the rest of the SSRIs, the no-SSRI rule of thumb is a good one. But to avoid all antidepressants, even those which aren’t even metabolized by CYP2D6, is going a bit too far.



Pharmacokinetics

Most consumers are interested in two rudimentary aspects of a drug’s pharmacology: plasma clearance, which is the de facto standard for systemic elimination, and the basics of its mechanisms of action. About 2% want greater details beyond plasma half-life and any detailed mechanisms of action.

Plasma Half-Life

paroxetine has a plasma half-life of: Immediate release paroxetine HCl has a half-life of 21 hours. Paxil CR’s half-life is 15 to 20 hours. Pexeva (paraxotine mesylate) has a half-life of 33.2 hours.

Estimated Plasma Clearance

paroxetine has an estimated plasma clearance of: Plasma clearance is 4–5 days for immediate release paroxetine HCl, 4 days for controlled release paroxetine HCl, and 6–7 days for Pexeva and other paraxotine mesylate branded generics.

Elimination Method

Paraxotine is metabolized by CYP2D6.

Transformation Method

Active Metabolites

None found so far. Although there is a major metabolite that may be responsible for Paxil’s potent inhibition of CYP2D6.

Enzymes inhibited, induced, or suppressed

Paxil (paroxetine) is a potent inhibitor of CYP2D6.

And, yes, paroxetine interferes with its own metabolism, which is why its pharmacokinetics are so freaking non-linear; as well as being one part of why the discontinuation syndrome you can get from paroxetine is so much worse than any other SSRI1.

Bioavailability, bioequivalence and additional PK data

Doses/dosage affect on PK: Dosage Non-linear
Plasma elimination half-life (T1/2): Immediate release paroxetine HCl has a half-life of 21 hours. Paxil CR’s half-life is 15 to 20 hours. Pexeva (paraxotine mesylate) has a half-life of 33.2 hours.
Estimated plasma clearance (CL/F): Plasma clearance is 4–5 days for immediate release paroxetine HCl, 4 days for controlled release paroxetine HCl, and 6–7 days for Pexeva and other paraxotine mesylate branded generics.
Time to reach steady state & conc. (Css) in ng/ml: Steady state: 10 days
Time of maximum plasma concentration (Tmax): 5 hours Range 2–12
Peak plasma concentration (Cmax) in ng/ml: 60 ng/ml Range 30–140
Area under the curve (AUC0–24), as ng.hr/ml: 1500 ng.hr/ml Range 510–2827 Aggregated data for 10, 20 & 30mg a day.
Overall bioavailability (F)%: 99%
Protein binding%: 95%

Comments and Miscellaneous PK Data:

The PK data for paroxetine are all over the map. Nailing them down is difficult, especially when the PK are non-linear and no two studies used the same dosages over the same period of time. So those are very round numbers in a big range.

What we have above are based on 30mg a day of the immediate release form, when available, and are from the PI sheet and two additional studies. A third was a single-dose study using 40mg, which I didn’t use because the other studies didn’t use more than 30mg and everyone took their Paxil for a minimum of 10 days.
Here are the numbers I have for Paxil CR (single dose data from the PI sheet):
Steady State: 13 days
Half-life: 15–20 hours
Tmax: 6–10 hours

DosageCmax ng/ml
12.5 mg2
25 mg5.5
37.5 mg9
50 mg12.5

And for Pexeva (paroxetine mesylate), based on 30mg a day taken for 24 days. From Mosby’s drug consult:
Steady State: 13 days
Half-life: 33.2 hours
Tmax: 8.1 hours
Cmax: 81.3 ng/ml



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Pharmacodynamics

The Essentially what is often in the current prescribing information. Although we need to go to the original prescribing information or old papers for this. This is useful because the originally theorized mechanism(s) of action is frequently how many consumers think a drug works, regardless of how long after it was disproved. A review of the literature of new theories regarding paroxetine’s mechanism(s) of action. If possible we’ll pick at least one that we think is the most likely.

Original Theoretical Mechanism of Action

Pharmacodynamics: The efficacy of paroxetine in the treatment of major depressive disorder, social anxiety disorder, obsessive compulsive disorder (OCD), panic disorder (PD), generalized anxiety disorder (GAD), and posttraumatic stress disorder (PTSD) is presumed to be linked to potentiation of serotonergic activity in the central nervous system resulting from inhibition of neuronal reuptake of serotonin (5-hydroxy-tryptamine, 5-HT). Studies at clinically relevant doses in humans have demonstrated that paroxetine blocks the uptake of serotonin into human platelets. In vitro studies in animals also suggest that paroxetine is a potent and highly selective inhibitor of neuronal serotonin reuptake and has only very weak effects on norepinephrine and dopamine neuronal reuptake. In vitro radioligand binding studies indicate that paroxetine has little affinity for muscarinic, alpha1-, alpha2-, beta-adrenergic-, dopamine (D2)-, 5-HT1-, 5-HT2-, and histamine (H1)-receptors; antagonism of muscarinic, histaminergic, and alpha1-adrenergic receptors has been associated with various anticholinergic, sedative, and cardiovascular effects for other psychotropic drugs.

Because the relative potencies of paroxetine’s major metabolites are at most 1/50 of the parent compound, they are essentially inactive.--Paxil PI sheet

Current theoretical mechanism of action

  • Paroxetine is a potent serotonin reuptake inhibitor, the most potent SSRI on the US market. Potency isn’t everything. As Dr. Preskorn wrote:

There is a frequent misconception that potency refers to the dose of a drug needed to produce an effect. That is wrong. Instead, it refers to the concentration of a drug needed to produce an effect. Two drugs may be able to produce exactly the same effect, but the concentration needed of each drug may be quite different. The drug that requires a lower concentration to achieve the same magnitude of effect is the more potent drug regardless of the dose needed to achieve that concentration.--Clinical Pharmacology of SSRIs

  • After pure paroxetine gets spiced up with various salts and is converted to paroxetine hydrochloride - Paxil and most generics - or paroxetine mesylate - Pexeva and a few overseas versions - it’s no longer 28 times as potent as fluoxetine. Nevertheless, it still practically floods your brain with serotonin. In some places that’s good, in other places that’s not so good.
    • Flooding your brain at the 5-HT1A receptors is good, because too little serotonin there is responsible for things like anxiety, depression, and assorted cognitive problems.
    • A little more serotonin at the 5-HT2A if you don’t have enough is good, because that helps regulate sleep. Too much is bad, and when excessive sleep becomes a problem. Too much serotonin at 5-HT2A can also lead to hallucinations and problems caused by too little dopamine.
    • A little more serotonin at the 5-HT2C if you don’t have enough is also good for depression and thinking clearly, but too much leads to muddled thinking and weight gain. As with 5-HT2A, you can wind up with even less dopamine, as well as less norepinephrine, which means more cognitive problems, more sleep problems of one kind or another, and more depression.
    • And those are just the best-known / most-studied 5-HT receptors, and the ones we know are affected to some degree by serotonergic medications. Extra serotonin at 5-HT1B may be great for aggression and alcoholism, but it’s also another factor in sexual dysfunction2.
  • Like Lexapro and Zoloft, Paxil desensitizes 5-HT1A autoreceptors, which is good3.
  • Paroxetine is also has a moderate norepinephrine reuptake inhibitor, maybe enough to enhance its antidepressant properties and offset potential side effects, but it’s probably just enough to make the discontinuation syndrome even more hellish.
  • Paroxetine is a mild antagonist at some muscarinic receptors. Probably just enough for the anticholinergic side effects that are also side effects of norepinephrine reuptake inhibitors (dry mouth, constipation, urinary retention) to be more likely and worse.
    • Which is a feature, not a bug, as far as anyone with IBS is concerned.
    • And it might be enough to keep the movement- and hormone-related side effects problems caused by too little dopamine from being worse.
  • Finally (they think, so far) paroxetine is a nitric oxide synthase inhibitor, which also contributes to sexual side effects. As if getting too much serotonin at 5-HT1B and messing around with your dopamine weren’t enough to ensure that Paxil will be effective for chemical castration.

Drugs with similar methods of action

Most people think all SSRIs are interchangeable. With a dosage adjustment they are to some degree. As far as total mechanisms of action are concerned it depends on why you’re taking it. For anxiety disorders you want Lexapro. For everything else Prozac and moderate dosages of the SNRI Effexor come the closest; which is funny, since fluoxetine and venlafaxine have the weakest of all the serotonin reuptake inhibition of SSRIs and SNRIs available on the US market.



Discussion Board, Official Sites, PI Sheets, and other Useful Links

Discussion Board

Crazymeds’ Paxil discussion board

Official US website

GSK’s Paxil page is just the PI sheets for Paxil and Paxil CR

Other official websites

GSK’s Official Japanese パキシル Site

PI:Paxil|Paxil’s Full US Prescribing Information]]

PI Sheets for other forms

Paxil CR (Controlled Release) Full US PI sheet

Non-US SPCs, PILs, etc.

Other sites of interest

DrugsDB.com’s Paxil Page

Comments and Consumer Experiences

Author’s Comments on and Experiences with Paxil (paroxetine)




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Online consumer ratings & reviews don’t skew as negatively as once thought.4 While more people have negative experiences with medications than big pharma would otherwise have one believe, the drugs are rarely painted as badly as Internet fearmongers would like them to be. As mentioned in the Efficacy section of part 1 of this review, I also use anecdotal data gathered from non-medical social media sites with a consistent overlap of demographic sets (e.g. women with bipolar 2 and/or migraines and scrapbooking). Those sites won’t be listed because I won’t give the drug companies free information since they refuse to buy ads on this site.

Consumer Rating/Review Sites Used for Anecdotal Data

Consumers’ Rating of Paxil (paroxetine)

3.154 out of 5 on a scale of 0 to 5.

Consumer Experiences from Crazymeds’ Members

There are 5 reviews of Paxil (paroxetine).

08 April 2011 - 17:11  

06 February 2013 - 18:47  

It’s Me reviewing/commenting on their experiences with Paxil (paroxetine)   wrote:

Maybe if you are Mary-Kate Olsen, this is fun..

Seriously, what the hell is this stuff. Yeah… take it if you feel like being a dopped up zombie all the time. One point I felt like I was levitating out of my seat in class and I didn’t even pick up my feet when I walked. You aren’t sad or happy or angry or anything, you are just like “oh I should do this now cause it keeps me busy doing something and it seems productive and good for me,” yeah peeling 13 pomegranates for “fun” at your Grandma’s cause you have nothing else to do sounds like loads of fun (like seriously this is the type of fucked-up weird unexplainable shit it does to you). Oh and stopping it….. hahahahaha talk about your whole body experiencing RLS (if that even makes sense) and feeling like you’ve been hit by a freight train or stuck in a room for hours with nothing but Lady Gaga fans, yeah, it makes your life suck if you want to quit it. I relate it to the movie limitless, except it doesn’t do cool stuff like that while your on it, you just shop a lot and drink alot (I guess cause those are things that make you happy), build up a high alcohol tolerance cause your Brain is taken over by Seratonin. Honestly, here is what I think you should be put on if you have depression, an exhausting workload and social life, and you have no time for yourself and find that you are up at like 3 in the morning after homework/studying cause that’s your only weekly free time.

I would say take Lexapro, its amazingggg and makes life fun and easy, except for it can make you sleepy, take probably like 10 mg if your not super sad all the time. Take about 10–20mg of adderall or something to help you with becoming distracted, take seroqel or trazodone, to help with the insomnia and anxiety problems, small dosages though of either, due to the ADD med. take zyprexa if you are kinda happy-sad (Manic) with your depression or may have SAD alongside MDD, it comes in very small dosages and if you can, but its hard to get perscribed to (just cause when people hear the word Xanax they think mega druggies and whitney houston in a bathtub, so it’s understandable) the small Xanax tablets to have just incase the lexapro and trazodone can’t help with those large scale “OH SHIT FUCK I’M HAVING A MIDLIFE CRISIS AT TWENTY” moments, also, Provigil is apparently a good drug to take, its a smart pill and helps actually kind of repair the brain in a way cause it was used for patients with alcoholism in some studies, and it regulates biorhythms. If you took this you could take a small dosage of this and lower your adderall dosage ( having less crystal meth related products in your system is always good) or just have a bigger dosage of this and no adderall. btw, I’m not majoring in the medical field, so my recommendations are to be taken lighthearted, but in a perfect world, thats how I would prescribe it for the mentally worn, tired, but unrelenting and ambitious worker (who is sensitive and gets easily distracted.) pretty much 1/4 of college students.

12 September 2013 - 00:36  

CrazyPiller reviewing/commenting on their experiences with Paxil (paroxetine)   wrote:

BEST for Anxiety. but I am sorry….WORST SIDE EFFECTS EVER

I went on Paxil after other failed SSRI’s because my panic disorder had gotten so bad, and because my dad has been on it like 20 years, and it’s been his saving grace.

   Paxil worked. It controlled ALL of my panic! I wasn’t afraid anymore. I could even go out without carrying that emergency xanax *just in case* It was that good. It also kept my depression at bay. It was MARVELOUS and I could finally live my life!

  Until I got pregnant and had to have my child scanned for heart defects. Then I would miss a dose, and I would get these “brain shocks” which I guess is some sort of withdrawal, but they were AWFUL. It was as if sometimes I would turn my head, but my vision couldn’t catch up, and it would get all choppy until I stopped moving my head. but those BRAIN ZAPS!! my gosh!! I thought, if it can do this to my brain, I am not comfortable with this. this can’t be safe… and I talked to my doctor about going off of it before I became pregnant with my next child.

  Now, I will admit, NOTHING has controlled my panic disorder like Paxil. But I was having children, and Paxil had been providing babies with heart defects… I couldn’t chance it, and I didn’t trust it once the brain shocks got really bad.

  It was also the WORST for a lively libido, and it made me fat. quickly.

  But, to others, if your panic disorder is crippling you, the benefits will outweigh the risks, in my opinion.

29 October 2013 - 01:20  

g-spin reviewing/commenting on their experiences with Paxil (paroxetine)   wrote:

Paxil,weird at first, don’t be freaked out, just take it.

I havent been on this forum in a long while…because i havent had too!! I just wanted to get on here and write a note to someone else like me up at 3 in the morning shaking uncontrollably in a non stop panic attack. My little adventure started while in the military in the desert of the middle east while taking Lariam (anti-malaria drug) in 2005. Later I found out the drug cause neurlogical damage and has an FDA warning…now. I spent the next 7 years in therapy, CBT, trimeridian therapy, talk therapy, herbal medicine diets, and countless hours in hospitals fighting chronic attacks of crippling panic. On Nov 1 2012 I began another attack that lasted for over a month that put me in the emergency room, the most undescribable nightmare short of the war-zone itself. I finally asked the counsellor I was seeing if there was any medication that could help me, he refered me to a local rehab center where i started on Depakote and slowly mixed in Paxil. OK this was a bumpy ride. I read many reviews of Paxil about the wierd things it does to you…KEEP TAKING IT! My opinion of meds before i was on them was that they were reserved for those insane assylum people and the meds were nothing more than hallucinagens that kept people in some sort of trance. WRONG! I’m currently taking 1250 Depakote, 30 paxil and 40 buspar. Life saving. Because of the meds I kept by career in the military, can function like a normal person, go to work, just regular old everyday life. Here’s a cry out to the person suffering like I was a year ago. If you are on this forum and find yourself relating to peoples symptoms and descriptions you probably need something yourself. Its not a big deal. There is a video on youtube by Dr Robert Sapolsky of Stanford university, he describes the chemical imbalance that many people suffer with and compares it to diabetes and the insulin that a person has to take. THERE ISNT ANY TALK THERAPY THAT IS GOING TO SOLVE YOUR CONDITION, YOU CANT TALK YOUR WAY OUT OF DIABETES!! It angers me because I suffered for so long and the stigma of medication is overwhelming. I was headed next to the pyshiatric ward, terror and nighmares and hiding in closets, unable to go to work!!! The meds are not a perfect utopia that solve all lifes problems, other than the begining they dont change you or distort you, Its like taking asprin for a headache, the pain mostly goes away. Thats all this stuff is like, like taking some asprin. Now yes its true the side effects can be annoying, but they dont hold a candle to the bat-shit crazy, rip my ears off my head, paranoid, heart racing, suicidal panic that was destroying me!! I just want to tell you that Paxil worked for me in wonderful ways. It hasnt been some spooky rollercoaster ride, the beginning was very hard about 2 months. This has been a fast year, time is moving quickly again for this I thank God, cause I was praying my little butt off!

2013-11-22  

mamazcrazee’s experiences with Paxil (paroxetine)

Side effects are so worth the benefits!

I see so many negative reviews about paxil. For me it is the only med that has ever worked. I do have the sexual side effects. I have gained weight but I have always struggled with that so I doubt if paxil had anything to do with that. In fact, by doing low carb and using a fiber supplement, I am down 57 lbs while taking paxil. I have horrible depression and anxiety where I had to force myself to go anywhere or be around anyone. Paxil takes the edge off of my anxiety/depression so I can function normally. Without it, I have two emotions, rage and extreme depression. I would get so irritable, yell at my kids and husband, then bawl for no reason. When I am on paxil, I can control those emotions and am so much happier. Just wanted to let everyone know that this med has helped some people. I don’t plan on ever going off of it so the discontinuation problems do not concern me. Good luck in your journey!



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Rate this article

If you feel like it, you may rate this article on a scale of 0 (worst) to 5 (best). The more value-judgments the better, even if you can criticize each only once.

Please rate Paxil (paroxetine): a review of the literature and consumer experience.

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References

  1. Paxil’s Full US Prescribing Information
  2. Hughes, Shannon, and David Cohen. “Can online consumers contribute to drug knowledge? A mixed-methods comparison of consumer-generated and professionally controlled psychotropic medication information on the internet.” Journal of medical Internet research 13.3 (2011).

{{$$bigbiblio}}


1 Effexor, Cymbalta and Pristiq aren't SSRIs.

2 A deficiency of serotonin at 5-HT1B could be responsible for traits commonly associated with members of college fraternities. That condition makes people prone to aggressive behavior, alcoholism, and, in men, premature ejaculation.

3 Apparently researchers endeavor to obfuscate meaning - with a methodology not dissimilar to medieval guilds - in order to maintain exclusive access to the knowledge within their treatises residing in the public domain.

4 I feel so…Fox News skewered by The Daily Show, as the study by Hughes and Cohen uses my own website to contradict what I originally thought to be the case.


If you have any questions not answered here, please see the Crazymeds Paxil discussion board. We welcome criticisms of the articles, notifications of bad links, site problems, consumer experiences with medications, etc. I’m not always able to write back. Hence I never answer questions about meds via e-mail that are answered by this or other articles. Especially if they have been repeatedly asked on the forum. That’s why we write these damn things. Questions about which meds are best for your condition should also be asked on the forum; because this is a free site, so the price of admission is making things easier for somebody else searching for the same answer. We don’t deal with children on the forum or in private because after doing this for ten years I don’t have the emotional stamina to deal with kids who have brain cooties. How to contact Crazymeds. — Jerod Poore, CME, Publisher Crazymeds (crazymeds.net)


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Paxil, and all other drug names on this page and used throughout the site, are a trademark of someone else. Paxil’s PI Sheet will probably have the name of the manufacturer and trademark owner (they’re not always the same company) at or near the very bottom. Or ask Google who the owner is. The way pharmaceutical companies buy each other and swap products like Monopoly™ real estate, the ownership of the trademark may have changed without my noticing. It may of changed hands by the time you finished reading this article.




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Almost all of the material on this site is by Jerod Poore and is copyright © 2003, 2004, 2005, 2006, 2007, 2008, 2009, 2010, 2011, 2012, 2013, 2014, and 2015 Jerod Poore. Except, of course, the PI sheets - those are the property of the drug companies who developed the drugs the sheets are about - and any documents that are written by other people which may be posted to this site will remain the property of the original authors. You cannot reproduce this page or any other material on this site outside of the boundaries of fair use copying without the express permission of the copyright holder. That’s usually me, so just ask first. That means if want to print out a few pages to take to your doctor, therapist, counselor, support group, non-understanding family members or something like that - then that’s OK to just do. Go for it! Please. As long as you include this copyright notice and something along the lines of following disclaimer, I’m usually cool with it.



All rights reserved. No warranty is expressed or implied in this information. Consult one or more doctors and/or pharmacists before taking, or changing how you take any neurological and/or psychiatric medication. Your mileage may vary. What happened to us won’t necessarily happen to you. If you still have questions about a medication or condition that were not answered on any of the pages you read, please ask them on Crazy Talk: the Crazymeds Forum.
The information on Crazymeds pertains to and is intended for adults. While some information about children and adolescents is occasionally presented (e.g. US FDA approvals), pediatric-specific data such as dosages, side effects, off-label applications, etc. are rarely included in the articles on drugs or discussed on the forum. If you are looking for information regarding meds for children you’ll have to go somewhere else. Plus we are big pottymouths and talk about S-E-X a lot.
Know your sources!
Nobody on this site is a doctor, a therapist, or a pharmacist. We don’t portray them either here or on TV. Only doctors can diagnose and treat an illness. While it’s not as bad as it used to be, some doctors still get pissed off by patients who know too much about medications, so tread lightly when and where appropriate. Diagnosing yourself from a website is like defending yourself in court, you suddenly have a fool for a doctor. Don’t be a cyberchondriac, thinking you have every disease you see a website about, or that you’ll get every side effect from every medication1. Self-prescribing is as dangerous as buying meds from fraudulent online pharmacies that promise you medications without prescriptions.
All information on this site has been obtained from the medications’ product information / summary of product characteristic (PI/SPC) sheets and/or medication guides - which is all you get from sites like WebMD, RxList, NAMBLA NAMI, etc., the sources that are referenced throughout the site, our personal experience and the experiences family, friends, and what people have reported on various reputable sites all over teh intergoogles. As such the information presented here is not intended as a substitute for real medical advice from your real doctor, just a compliment to it. You should never, ever, replace what a real doctor tells you with something from a website on the Internet. The farthest you should ever take it is getting a second opinion from another real doctor. Educate yourself - always read the PI/SPC sheet or medication guide/patient information leaflet (PIL) that comes with your medications and never ever throw them away. OK, you can throw away duplicate copies, but keep at least one, as that’s your proof of purchase of having taken a med in case a doctor doubts your medical history. Plus they take up less space than a bottle, although keeping one inside of a pill bottle is even better.
Crazymeds is not responsible for the content of sites we provide links to. We like them, or they’re paid advertisements, or they’re something else we think you should read to help you make an informed decision about a particular med. Sometimes they’re more than one of those things. But what’s on those sites is their business, not ours.
Very little information about visitors to this site is collected or saved. From time to time I look at search terms used and which pages they bring up in an effort to make the information I present more relevant. And the country of origin, just because I’m geeky like that. That’s about it. Depending on how you feel about Schrodinger, our privacy policy should either assuage or exacerbate your paranoia.
Crazymeds is optimized for ridiculously large screens and browsers that don’t block ads. I use Firefox and Chrome, running under Windows 72. On a computer that sits on top of my desk. With a 23 inch monitor. Hey, at least you can make the text larger or smaller by clicking on the + or - buttons in the upper right hand corner. If you have Java enabled. Like 99% of the websites on the planet, Crazymeds is hosted on domain running an open source operating system with a variety of open source applications, including the software used to display what you’ve been reading. As such Crazymeds is not responsible for whatever weird shit your browser does or does not do when you read this site3.
No neurologists, psychiatrists, therapists or pharmacists were harmed in the production of this website. Use only as directed. Void where prohibited. Contains nuts. Certain restrictions may apply. All data are subject to availability. Not available on all mobile devices, in the 12 Galaxies Guiltied to a Zegnatronic Rocket Society, or in all dimensions of reality. Hail Xenu!

‘Everything is true, nothing is permitted.’ - Jerod Poore


1 While there are plenty of books to help you with hypochondria, for some reason there’s not much in the way of websites. Then again, staying off of the Internet is a large part of curing/managing the disorder.

2 Remember kids, Microsloth operating systems are like TOS Star Trek movies with in that every other one sucks way, way more. With TOS Star Trek movies you don’t want to bother watching the odd-numbered ones. With Microsloth OS you don’t want to buy and install the even-numbered ones. Anyone who remembers ME and Vista knows what I mean.

3 Have I mentioned how open source operating systems for commercial applications is one of the dumbest ideas in the history of dumb ideas?* I don’t even need my big-ass rant any more. Heartbleed has made my case for me. And that’s just the one that got all the media attention. The very nature of an open source operating system makes security as much of an illusion as anonymity on teh Intergoogles. Before you flip out too much: the domain Crazymeds is hosted on uses a version of SSL that is not affected by the Heartbleed bug. That’s one of the many reasons why I pay a lot of money and keep this site on Lunarpages.

* Yes, I know I’m using open source browsers. I also test the site using the now-defunct IE and Safari browsers. Their popularity - and superiority - killed IE and Safari, so that’s why I rely on the open source browsers. It’s like brand vs. generic meds. Sometimes the generic is better than the brand.

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