Dr. Richard Naimark, a psychiatrist in private practice at Chestnut Hill Counseling in Dover, New Hampshire, relates a tidbit that tempers TCR’s fairly lukewarm review of Paxil CR.

“I’ve treated a woman for depression for a few years who had done quite well on Paxil but complained of dizziness as a side effect. I tried her on other SSRIs as well as Effexor and Wellbutrin, but nothing helped as much as Paxil. One day as I was listening to her, it dawned on me that her dizziness followed a predictable pattern of having its onset about 6 hours after her dose. This was consistent with a mild SSRI discontinuation syndrome. I switched her to paxil CR, and the dizziness completely disappeared, presumably because of the lack of discontinuation side effects.” We protested to Dr. Naimark that paxil CR has the same discontinuation half-life as the original. “I realize that,” he said, “but my thought is that the longer transit time in the gut smoothed out blood levels enough to effectively lengthen the half life.”