QUESTION:
Dear Dr. Heller,
My boyfriend has been taking Seroxat (Paxil) for 6 months as he is suffering from depression (due to family tragedy). I have a few questions to ask about the drug. Since being on the drug he seems to have bad mood swings and easily starts arguments with people over insignificant details. Also when we go out in the evening he will drink and I'm not sure what this does to the drug's effect. He will become happy and very energetic but gets to a certain point where he totally changes and gets very aggressive and abusive. He will start fights and behave stupidly but he will not remember a thing about it the next day. His GP has suggested increasing the dose but I'm not sure that this is going to help. He used to be a lively outgoing person who would never dream of starting trouble or being aggressive towards me. I really want to help him so please can you give me some advice.
ANSWER:
The likely explanations are bipolar disorder, which can be caused by antidepressants,
and the BPD with the GAD (generalized anxiety disorder).
If he has the GAD with the BPD, Paxil will increase his anxiety, triggering dysphoria
(anxiety, rage, depression and despair). If he doesn't, bipolar III is the likely
diagnosis.
