Symptoms include balance problems, nausea, flu-like symptoms, tingling and electric shock sensations, vivid dreams, nervousness and melancholy. The problem, doctors now are saying, is that patients and even other doctors may not be aware that stopping these drugs, which are among the top 10 best-selling pills in the United States, may be causing the symptoms. Many doctors and patients also may not know that to end treatment, levels of the drug should be tapered off while under a doctor's care. According to recent research in the Journal of Clinical Psychiatry, as many as 70 percent of general practitioners and 30 percent of psychiatrists do not know about the side effects of ending serotonin-boosting drugs. Of those who do know, only 20 percent of psychiatrists and 17 percent of general practitioners caution their patients about the proper way to slowly lower the levels of these drugs to come off them.
Pharmaceutical companies place the responsibility of proper prescribing on the doctor.
The numbers tell the story. Pa. Zoloft, made by Pfizer Inc., of New York City, was introduced in 1992 and is seventh. Paxil, available since 1993, is ninth. Glenmullen says today the serotonin boosters are being prescribed for more and more moderate conditions, but that they should be reserved for people who are truly debilitated by their mental illness. And once on a drug, Glenmullen says, many people who don't really need it for the long haul have trouble getting off.