I’m just wondering if anybody has any experience, or second hand knowledge, of an SSRI being effectively phased out by incorporating exercise into one’s lifestyle. I’ve a friend who has been taking Paxil for several years, and a year or so ago tried to go off it by cutting her dosage in half every couple weeks per her doctors advice, but found it much much too difficult. She’s mentioned again she wants to be free of the meds (not so much because meds are bad, but because it dampens her artistic urge, sex drive, and overall vitality), but it’s just such a bitch to do so, like quitting smoking, that she isn’t too confident in how to effectively to do so. I figure that I get depressed when I don’t exercise, so maybe it’s a more natural alternative solution? Enlighten me all ye depressed/formerly depressed ST’ers 
I will preface my comments by saying that I work for a pharmaceutical company that sells an SSRI. (not Paxil) Depression is a chemical imbalance in the brain and what SSRI’s due is attempt to restore that balance by increasing a neurotransmitter called serotonin. Thay are all a little different in how they interact with the body in terms of side effects and withdraw effects (the side effects when you are trying to stop treatment). Many patients try several before they find the one that works best for them. I do not think there is any scientific proof that excercise can increase serotonin in the brain but I personally beleive that for many of us excercise is mentally therapeutic. The first thing I would suggest is to discuss with her doctor some alternatives to Paxil and at the same time begin to improve her fitness. She may find that throught experimentation with other agents she may feel more like herself and even stop treatment altogether over time but she does not have to suffer through her current treatment if it is not working for her and giving her the quality of life she deserves.
As opposed to her past, her current treatment is definitely “working” for her in her opinion. She says she’ll take the side effects just about any day, listed in my previous post, over being emotionally unstable. I think she just wants the emotional stability along with the vitality and creativity, and I can’t blame her for that.
after sustaining a head injury, depression is a common consequence. I was on Effexor (I believe it’s an SSRI) for a while. I ramped up the riding (couldn’t run just then), and eventually weaned off the Effexor. after a subsequent operation, I had another bout of depression, and started taking Wellbutrin (and am still). Wellbutrin acts as a stimulant as well as an antidepressant. obviously what meds your friend responds to will depend on her own brain chemistry, but I’d get on the exercise program before weaning off the SSRI. starting off may be rocky, I slept 12+ hours a day the first week I took Effexor. my energy levels took a while to return to normal.
Better than happy pills.
.
There is ongoing scientific research investigating the effects of endurance sports in treating depression. From what little I understand of the research, there appears to be a link between long duration exercise/sports and overcoming depression. When I last heard, one of the challenges the researchers were having was separating the physological benefits from the chemical/physical benefits. That endurance training provided an anti-depression benefit was taken for granted.
Paxil is extremely difficult to quit for some folks myself included. My doctor didn’t give me the entire story when I tried to quit. For alot of people it take months a slightly reducing the dose to avoid withdrawal effects. This site is pretty informative and was helpful in my case but it doesn’t have anything to say about exercise. http://paxil.bizland.com/jbuzzw.htm
Following on to what others have said, yes, the exercise will stimulate the release of serotonin and endorphins, but that release is not as sustained as with meds, sort of like a half-life. The med stays in your system for a period of time even after stopping taking it. So do the chemical reactions from exercise. However, this half-life from exercise is maybe a few hours, not long enough to rely on a sustained higher level of functioning throughout the day, on a daily basis. Short version: exercise will definitely help, but is not the end-all.
Wellbutrin has come out with a sustained release SSRI that appears to specifically address the sexual and flattened affect/emotional response side effects. I have a male client who switched from Prozac to Wellbutrin and much prefers it. Anecdotally, two friends used it for combination of depression/stop smoking and are now not depressed, not smoking, and bonking their brains out.
She should talk to her doc about switching so she can make an informed decision.
PS - Paxil is sometimes prescribed for depression with a significant element of anxiety/OCD. If this matches your friend’s symptoms, has she thought about perhaps adding talk therapy to address the anxiety? She might benefit from a structured system of cognitive restructuring for the anxiety as an adjunct with another SSRI.
If I stop working out for more than 3-5 days, I can feel the blues creeping in.
Buy a guitar.