Astral Codex Ten

Paxil

4 min read

Paxil

Article

Paxil is a recurring brand in the Astral Codex Ten archive, appearing 2 times across 2 issues between March 31, 2021 and July 15, 2021. The archive places it in contexts such as “20 mg of paroxetine (Paxil)”; “The most effective dose of every SSRI would be: Paxil: 30 mg”; “their effort to market the antidepressant Paxil”. It most often appears alongside SSRIs, 1902, 1903.

Metadata

  • Category: Brands
  • Mention count: 2
  • Issue count: 2
  • First seen: March 31, 2021
  • Last seen: July 15, 2021

Appears In

Source Context

Recovered passages from the original issue text. When the raw archive preserved outbound links inside the source passage, they are listed directly under the quote.

Oh, The Places You'll Go When Trying To Figure Out The Right Dose Of Escitalopram
March 31, 2021 · Original source
16.7 mg Lexapro equals 20 mg of paroxetine (Paxil) or fluoxetine (Prozac). But the maximum approved doses of those medications are 60 mg and 80 mg, respectively. If we convert these to mg imipramine equivalents like the study above uses, Prozac maxes out at 400, Paxil at 300, and Lexapro at 120. So Lexapro has a very low maximum dose compared to other similar antidepressants. Why?
Prozac: 30 mg Paxil: 30 mg Zoloft: 75 mg Celexa: 30 mg Lexapro: 15 mg
Book Review: Crazy Like Us
July 15, 2021 · Original source
The frame story here is about a top anthropologist invited by GlaxoSmithKline to a lavish conference at a five-star resort in Japan. They asked him a bunch of questions about the cultural construction of mental illness. He pressed deeper and learned they were trying to “raise awareness of” depression in Japan as part of their effort to market the antidepressant Paxil there. This had, Watters thinks, much the same effect as “raising awareness of” anorexia in Hong Kong.
As part of GlaxoSmithKline’s marketing work, they replaced utsubyo with a new idea, kokoro no kaze, “cold of the soul”. This was supposed to mean that depression was a minor illness (like a cold), something everyone got occasionally (like a cold), and something that was purely biological and could/should be controlled with medication (like a cold). Japanese people were extremely excited about this and bought Paxil by the bushel, and now they use SSRIs at a rate close to Americans.
I was kind of unimpressed with this chapter. It seems pretty obvious that Japanese people got depressed before Paxil’s marketing campaign, including depressed to the point of suicide. GlaxoSmithKline comes off looking a bit manipulative, but it does kind of seem like the rush to get Paxil after their advertising campaign was less “sinister pharma company invents a new disease” and more “oh my god, there’s a name for this thing that I’m suffering from and maybe someone can help me!” There’s certainly a philosophical issue here - do you shrug off depression as just a part of life, or medicalize it? - but it’s not obvious that there’s anything different or uniquely Japanese about this question, or that Westerners made anything worse by exposing Japan to our solution.