MENOPAUSE: Well, can I interest you in a powerful antidepressant? (Or:

Readers of last week’s E-news will know that the pharmaceutical industry has lost one of its best money-spinners after HRT therapy was so thoroughly trashed by the influential Women’s Health Initiative trial.

But the pharmaceuticals didn’t get where they are today by being anything other than resilient (and creative). They are already suggesting that a powerful antidepressant could be a suitable replacement for HRT.

Specifically they have been testing paroxetine (Paxil), a selective serotonin reuptake inhibitor. They tested it on 165 menopausal women who had been complaining of hot flashes-and, compared with a placebo, it seems to be effective over a six-week period. In fact, the researchers conclude, Paxil could well be a good alternative therapy to HRT.

This breakthrough discovery may lose its edge a little if we now reveal 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 employees (sorry, researchers) may also have been diffident to talk about adverse reactions to the drug. That’s a pity because Paxil is not well tolerated, with around 16 per cent of users having to discontinue treatment. The more common reactions include sweating, tremor, dizziness and insomnia (Aren’t they supposed to be menopausal symptoms? – Ed), headache, sleepiness, constipation, and female genital disorders. Serious reactions have included hypertension, tachycardia, pain, ulcers, arthritis, osteoporosis, delirium, hallucinations, grand mal seizures, asthma, conjunctivitis, eye haemorrhage, breast atrophy and kidney malfunctioning.

Still, compared with hot flashes, it’s got to be a winner.

(Source: Journal of the American Medical Association, 2003; 289: 2827-2834).

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Written by What Doctors Don't Tell You

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