Cary,

I'm not quibbling with the gist of your advice, but it's important to note that the majority of people who are receiving antidepressants are doing so from their general practitioner, internist, family practice doc, etc.

And sadly, it's very likely that the doctor who prescribed the medication may not have much expertise or knowledge about mental health issues, or know what, if anything, to do about a patient acting as this LW's mother is acting.

These days, you go in and say you're blue, down in the dumps, sleeping a lot, can't deal with winter, lonely, gaining weight, losing weight, sleeping too little, and so on, and they whip out the scrip pad, and you're walking out with Prozac, or Paxil or Xanax or Klonopin -- oh, and some Ambien to help you sleep of course.

Many people who have more serious mental health problems than mild depression or mild anxiety -- problems like borderline personality, bipolar disease, major depression, schizophrenia -- are being rushed out with a garden-variety antidepressant or antianxiety scrip...

Just so the LW knows what might be in store...

Many regular old family physicians prescribe these SSRIs..so I would not assume LW's mother was seing a psychiatrist. Paxil is the hardest of the SSRIs to come off of. Google "Paxil withdrawl" to read many horror stories. For some people Paxil withdrawl can cause all kinds of craziness...it needs to be discontinued VERY slowly and under supervision. She probably needs to be remedicated for awhile...and yes it sounds like she has gone off the deep end...reminds me of the sad story of the crazy astronaut..sad... Do you know what other medications she is taking now? Some people get strange reactions from medications they are taking as well as from those they are withdrawing.

...instead of immediately calling the police and/or your state's mental health services and discussed having her involuntarily committed. She is a danger to everyone around her, including herself. She needs to be under immediate and constant supervision of a mental health professional.

Needless to say you need to get your mother to a doctor. Be prepared to go to court to gain control if she is resistent. Do not screw around with this. We needed to do with with my brother. Sucks but needs to be done. Get sister on the phone in the morning, get to Mom's house and just do what needs to be done.

Call Mental Health services in your area. Also try local Crises Lines, i.e. suicide hotlines. I used to volunteer for one we not only talked to people in immediate need but passed out phone numbers to call for anyone who needed help. Call the local hospital and explain the situation they may refer you somewhere. There are resources out there for situations just like this. (I am also anonymous below. You will be OK.)

You don't need to be under the care of a psychiatrist to get Paxil. You can get it from any MD. Good luck, you will need it, and I am very sorry for you, LW.

It's not easy to have an adult involuntarily committed. We are going through this at the moment with my older half-sister, whose mother had to be committed for the last half of her life. My sister believes there are people living in her attic, she has already set fire to her neighbor's house, and we're all terrified that she will shift her attention to us next. For a while it looked as if there was hope because of the arson, but she has told her lawyer she doesn't want to plead insanity and wants to fight being committed. My other half-sister, who mainly remembers that her own mother was very unhappy being institutionalized, is backing her up, and it's a mess.

Good luck. If you run into unhelpful individuals or agencies, don't stop trying. You're not being disloyal to your mother by taking steps to combat her illness. And try to remember, she isn't pure evil, she's just a prisoner in a machine that isn't working properly.

1) As others have said, SSRIs

are frequently prescribed by

primary care docs.

2) I, too, am surprised the letter

writer has not done more than

write to an advice columnist

(even a top notch columnist like

you, Cary.)

3) Is there any possibility that

mom is suffering from early Alzheimers?

4) Coming off of an SSRI sucks.

Try suffering with electronic

"head zaps." Those alone might

be making mom crazy.

Good luck - tough situation.

If she stopped taking Paxil suddenly she very well could have psychotic episodes. That's the dirty little secret of psychiatric medications - if you don't come off of them right you can have a reaction that's worse than what made you start taking them in the first place.

You are going to find it's nearly impossible to have her treated against her will because of gross abuses that patients were subject to in the not-so-distant past.

So what's a concerned (and frightened) daughter to do? I like the root of Cary's idea - find the doc who prescribed it and see what s/he can do. Maybe if nothing else he can get her back on it and wean her off properly.

Good luck. What a hard situation.

I've been diagnosed as bipolar, and several other diagnosis depending on whatever was the shrink's pet specialty at the time I was seeing him/her. I don't deny that my brain chemistry is a tad out of whack and I need meds, maybe even every day of my life. However, psychiatric meds can cause symptoms that mimic the disease they are supposed to treat, and withdrawal symptoms can be hell.

Even psychiatrists will downplay withdrawal symptoms or be ignorant of certain ones. It's hard to go into detail if you're only seeing patients for ten minutes at a time. I agree that you shouldn't stage an intervention for your mother alone.

Commitment laws vary. You might want to seek legal advice, too, if you can.