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thedrifter
12-13-05, 08:08 AM
Paxil Americana
By James G. Poulos
Published 12/13/2005 12:06:15 AM

THERE IS ALREADY no shortage of reasons to join the tens of millions of Americans taking Paxil or its generic counterpart, paroxetine. As we shall see, side effects range from the hapless hiccups to grand mal seizure. But we're now told that the hit anti-uncomfortableness drug raises the risk of harm to others beside ourselves, in the form of birth defects: "Pregnant Women Warned By FDA to Avoid Paxil." Specifically, your Paxilated baby is overly likely to develop like a diseased clump of swiss cheese, with "holes and malformations in the chambers of the heart."

Of course, as the Washington Post takes pains to point out, "the defects often heal on their own, and more severe cases can be surgically repaired." Well. Goodness knows we wouldn't want the fetal needs of our children to get in the way of -- what? What does Paxil treat? Oh, a whole host of things: really, everything -- Depression, Generalized Anxiety Disorder (GAD), Social Anxiety Disorder (they won't allow the acronym SAD), Panic Disorder, Obsessive Compulsive Disorder (OCD), and Posttraumatic Stress Disorder (PTSD). GlaxoSmithKline, well aware that what they're selling is simply a seratonin bomb, suggests that the hydra of neurosis Paxil treats exceeds"everyday shyness" or "the normal worry and anxiety we all face."

But then GSK reveals the full scale of our national spaz-out pandemic -- Depression: 16 million sufferers yearly; GAD, 5 million a year; SAD, 12 million; Panic, 3 million annual victims; OCD, up to 5 million over their lifetimes, and PTSD, up to 16 million at some point before they die. Fortunately for our mental census, GSK assures us that "many people have an overlap of these conditions." But even subtracting out a million sufferers from each disease to ensure nobody's counted twice, the figure reaches over 50 million. That's one of four Americans between the ages of 15 and 64, and the reader knows as well as this writer does that the kids and the elderly are often not exempt from pharmacotropic manipulation. Indeed, rarely have they the freedom to opt themselves out.

LET'S CIRCLE BACK to the side effects -- on what exactly 1 of 4 Americans (a conservative estimate) ought to roll the dice in exchange for the benefits of Paxil (yet to be described). The list, for those courageous enough to slog through it, is massive, appearing to embrace the known universe of ailments. But let's enjoy a few representative highlights:

Asthma
Pneumonia
Acne
Urinary urgency
Abnormal gait
Lack of emotion
Ear pain
Eye pain
Breast pain
Deafness

There is no predicting, and no shortage of guesses. The libido could increase. The libido could decrease. The vagina could hemorrhage (basic vaginitis is more common). Beware skin discoloration, stupor, alcohol abuse; but also more horrible things you might not have heard of but understand (generalized spasm, weight gain) as well as things "only your doctor" can understand: arthralgia, choreoathetosis, fasciculations and nystagmus.

THIS WOULD BE FUN if it weren't so blanket and Boschean a throwing of caution to the wind. One of the "infrequent" side effects of Paxil, though it could be fairly applied to its use and creation, is listed as "abnormal thinking."

From kidney calculus to taste loss, visual field defect to maculopapular rash, Paxil provides a worrying palette of collateral damages. Yet this is understood not to trouble the patient -- so long as the pill can be safely delivered into the stomach before, worse than secondary effects, second thoughts begin to set in. And what does our patient receive in exchange? The relief of biochemical calm, in brief, but rather than offering a laundry list of supposed cures it services our inquiry to concentrate on the pains meant to be eased for the SAD -- sufferers of Social Anxiety Disorder.

As "diagnosed" by GSK, the afflicted "often" gets "physical symptoms such as blushing, sweating, shaking, trembling, tense muscles, shaky voice, dry mouth or a pounding heart. When you have social anxiety disorder you can feel very anxious in the presence of others. You might think other people are very confident in public and you are not. Just blushing can feel horribly embarrassing to you, and you might feel like everyone's eyes are always on you. You might feel anxious about giving a speech, talking to a boss, or dating. Some people with social anxiety disorder are afraid of public speaking or parties."

In translation, someone with SAD is (at least sometimes) (a) intimidated around strangers, (b) embarrassed to be caught being embarrassed, (c) self-conscious at parties, (d) uncomfortable delivering a speech, (e) nervous on a date, and (f) a human being, just like everyone else.

Res ipsa loquitur. Now the coup de grace (as I steer around risks of gingivitis, bloody diarrhea, malaise, and pallor): the side effects of Paxil also include dehydration, hostility, hysteria, and paranoid reaction: extreme versions of the very symptoms the drug is meant to prevent. (Strangely, decreased sweating -- something any habitue of nervousness would appreciate -- is listed as a side effect, along with the other undesirables.)

THE PERSON AT THE PARTY staggering around hiccuping -- the one with the discolored skin, enlarged breasts, and the demented gait -- isn't likely to attract the kind of public attention we all enjoy. The great unanswered question of Paxil -- though I have my suspicions -- is whether our poor distorted victim will be too high on seratonin to realize that the smiles on the faces of his fellow partygoers are actually grimaces of queasy horror.

Would that they, too, had a Paxil each -- and all chilled out together, a roomful -- a planetful -- of jabbering, malfunctioning zombies.

James G. Poulos is a writer and attorney living in Washington, D.C. His commentaries are found at Postmodern Conservative.

Ellie