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Paxil

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The drugs industry didn't get to the top of the commercial tree by being anything other than resilient - as well as creative problem-solvers

The drugs industry didn't get to the top of the commercial tree by being anything other than resilient - as well as creative problem-solvers.

One recent problem has been the trashing of hormone replacement therapy (HRT) by the influential Women's Health Initiative trial.

Menopausal women constitute a very big market, and HRT drugs have made sizeable contributions to the pharmaceutical companies' bottom line.

So the industry isn't about to give up easily on such bounty, and the first attempt to recapture it has already been made. It comes in the unlikely form of Paxil (paroxetine), an SSRI antidepressant.

The drug was tested on 165 menopausal women who'd been complaining of hot flashes - and, compared with a placebo, it seems to be effective over a six-week period. In fact, the researchers concluded, Paxil could well be a good alternative therapy to HRT. Paxil is already one of the world's best-selling drugs, so such a revelation can only add to the coffers, it seems.

This breakthrough discovery may lose its edge on considering three facts: Fact 1: Paxil is manufactured by GlaxoSmithKline; Fact 2: three of the four researchers are full-time employees of GlaxoSmithKline, and the fourth is a consultant to the company; Fact 3: GlaxoSmithKline paid for the research.

The researchers didn't touch on the adverse reactions either - which is a pity because Paxil is not well tolerated and around 16 per cent of users discontinue treatment for this reason. The more common reactions include sweating, tremor, dizziness, insomnia, headache, sleepiness, constipation and female genital disorders. More serious reactions have included high blood pressure, a too-rapid heartbeat, pain, ulcers, arthritis, osteoporosis, delirium, hallucinations, grand mal seizures, asthma, conjunctivitis, eye haemorrhage, breast atrophy and kidney dysfunction.

Still, compared with hot flashes, this has got to be a winner (JAMA, 2003; 289: 2827-34).


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