Paxil - Weight GAIN - Sex LOSS - Alternatives

Here is my story...I am a recent stay at home mom.  Worked until I had my third child and then decided what was more important to us for me to be home.  The first year off work was VERY hard for me, the adjusting to not working, which I have done my whole life (I'm 40 years old) depression crept into my life.  I started on Paxil a year ago and the results were life altering...WONDERFUL..I had my soul back.  It was the best thing that ever happened to me and my family.  I have been tolerating the side effects, the weight gain...over 20 lbs in 1 year..and the loss of feeling during intercourse.  I MISS IT!!!!  I want it all.  Mental well being, a trimmer me and orgasm with my spouse.  So here is the question..How do I get off the Paxil without serious side effects, can I substitute St. John's Wort or another natural substance WHILE I wean myself AND afterwards? Can I be subscribed a diet aid to help with my weight?(That in of itself can be very depressing) What about sexual creams to enhance arousal?  I guess that was more than one question.  I have a doctors appointment next week and would like to have some information to help me discuss my options with her.  I have been reading other people's stories about withdrawing from this medication and quite frankly, it's freaking me out. Please help me put things into perspective.  Thanks.

[HFHS MD - RG]

Paxil is meant for use as an antidepressant. Oftentimes, people recover from this illness and find that the side effects of the medications are not tolerable anymore.

One question that needs to be answered by you and your psychiatrist is DO YOU STILL NEED PAXIL? You stated that you have been on it for a year and have been feeling wonderful. Depending on your previous history of depression if any, you may discuss with your psychiatrist regarding weaning off Paxil slowly, depending on your dosage, this may take months to avoid any sudden withdrawal effects. If at some point of your being weaned off, you feEl tHat there is a recurrence of your symptoms, this means that your depression is not completely treated yet.
At this point, discuss with your doctor being started on an antidepressant which has no or lower incidence of sexual dysfunction like wellbutrin.

Being on psychiatric medications may result in weight gain. An advise is to watch your diet. I am not too fond of diet pills as most of them are not FDA regulated and I am cautious about potential side effects. A consult with a dietician may help.

St john's Wort is widely used in Europe but here in the united States, it is a non-regulated drug that means that one   st john's wort brand is different from another st john's wort brand because some of them add other ingredients which may also be harmful.

Regarding the creams, currently you have not indicated for its contraindication.