Guest guest Posted June 9, 2003 Report Share Posted June 9, 2003 Mon, 9 Jun 2003 13:59:03 -0500 HSI - Jenny Thompson Jumpin' Pax Flash Jumpin' Pax Flash Health Sciences Institute e-Alert June 9, 2003 ************************************************************** Dear Reader, I was torn. I didn't know whether to laugh or scream. (I guess I did both because a couple of people stopped by my office to see if I was okay.) That was my reaction last week when I read this " good news " for menopausal women who suffer from hot flashes: A new study concludes that the selective serotonin reuptake inhibitor called paroxetine (better known as Paxil) can reduce the frequency and severity of hot flashes. This is WONDERFUL news...if you happen to be on the board of directors of GlaxoSmithKline, the makers of Paxil. But if you're among the many women who will hear about this and ask their doctors for a Paxil prescription, you might eventually find yourself wishing you could trade the Paxil for the hot flashes. The problem is, by then you might not be able to. ----------------------------- 3 out of 4 doctors recommend... ----------------------------- There's no need to spend a lot of time with the details of this study, so here are the bare bones: Researchers randomly selected a group of 165 menopausal women who experienced hot flashes and who were not taking a hormone replacement therapy. Roughly one-third of the group received 25 mg of Paxil daily, one-third received 12.5 mg daily, and one-third received a placebo. The frequency and severity of hot flashes were approximately reduced (on average) 65 percent in the first group, 62 percent in the second group, and 38 percent in the placebo group. The researchers concluded that Paxil may be " an effective and acceptable " therapy for treating hot flashes. Going just by the numbers of this study, it appears that Paxil does relieve hot flashes. So I'll let them have " effective. " But the word I have trouble with is " acceptable. " Because given the wide variety of problems that Paxil users have reported over the past decade, it would be stretching the point to call this drug acceptable. And the researchers are certainly well aware of the whole Paxil package because three of the four members of the research team are employees of GlaxoSmithKline. Nice. I think it was right there I might have screamed. ----------------------------- A good trade off? ----------------------------- Because this study was conducted at Johns Hopkins Medical School, and because it was published in the Journal of the American Medical Association (JAMA), there's no doubt that doctors all over the country will be intoning these prestigious names when assuring their menopausal patients that Paxil is an " effective and acceptable " treatment for their hot flashes. Acceptable? Here are some of Paxil's side effects described as " frequent " : hypertension, impaired concentration, nausea, vomiting, emotional instability, vertigo, inflammation of the mucus membrane, rapid heart beat, weight gain, and temporary suspension of consciousness. And here's my favorite frequent side effect: depression. That's right - the very thing that Paxil is designed to relieve. What's worse is that some patients report even worse side effects when they try to discontinue their Paxil use. For many years GlaxoSmithKline assured consumers that Paxil was non-habit forming and easy to discontinue. Meanwhile, case after case reported that patients coming off the drug experienced nightmares, dizziness, burning and itching of the skin, agitation, sweating and nausea. And for many of those patients, the only way to treat the side effects was to begin taking Paxil again! And then, just to make it official, last year the FDA issued a warning that withdrawal symptoms from Paxil may be severe. All of these things are well known about Paxil. So who (other than GlaxoSmithKline employees) could possibly characterize Paxil as an acceptable trade off for hot flashes? ----------------------------- A little spin on the side ----------------------------- ABC television coverage about the JAMA study reported that the researchers " believe " that Paxil is " more promising " than alternative therapies such as vitamin E and black cohosh. Their study had nothing whatsoever to do with any alternative therapies, but ABC kindly helped them create the impression that Paxil trumps natural methods of coping with hot flashes. Of course, ABC didn't mention the GSK connection to the study. They wouldn't want to offend a drug manufacturer that buys plenty of TV advertising for its other products, including Gaviscon, Contac, Tums, Tagament, Flonase, Zantac, Nicorette, and Aquafresh toothpaste. In an e-Alert I sent you last month ( " Spin This " 5/29/03), I told you about a number of alternative therapies that have relieved menopause symptoms for HSI members. Contrary to what the Johns Hopkins researchers would have ABC believe, many women find black cohosh to be very effective in controlling hot flashes. And if black cohosh doesn't work, there are other safe and natural methods to try, including red clover, wild yam progesterone cream, indium sulfate, and vitamin E. (One member wrote to tell us that daily doses of 2000 mg of vitamin C and 400 IU of vitamin E reduced her frequency of hot flashes from 10 each day, to only one. Side effects: none.) ----------------------------- The larger picture ----------------------------- I think that one of the primary reasons why women ultimately won't be happy using Paxil is that there's much more to menopause symptoms than just hot flashes. In other words, Paxil can't address menopause as a whole. Some time ago I told you about a special report titled " Look and Feel Your Best, " written by HSI Panelist Linda Page, N.D., Ph.D. - a noted author and a doctor of holistic medicine. In " Look and Feel Your Best " Dr. Page shows women how to make their way through menopause naturally, without using hormone replacement therapy. She emphasizes that menopause is actually nature's way of protecting women from breast and uterine cancer by rebalancing hormone production - a process that no one should try to defeat with pharmaceuticals. Read more at http://www.agora-inc.com/reports/610SHORM/W610D611/home.cfm to find out about how Dr. Page's techniques can make the difference between just surviving menopause, and emerging from it happier and healthier. Best of all, this report is guaranteed NOT to cause hypertension, impaired concentration, nausea, vomiting, emotional instability, vertigo, inflammation of the mucus membrane, rapid heart beat, weight gain, and temporary suspension of consciousness. But if you're feeling blue due to menopause symptoms, it just might help lift you out of depression. ************************************************************** ...and another thing You may have heard how the Atkins diet succeeded in two " controlled " trials, as reported last month in the New England Journal of Medicine (NEJM). An HSI member named Adam heard, and sent these comments: " It is a shame that the results of the study shows no weight change after a year. There are too many drop outs for the statistics to be non biased. Would like to see your comments. " While the results of these studies had their drawbacks, the details are not as negative as Adam seems to think. Both studies (from the University of Pennsylvania) compared the Atkins high-protein diet to a high-carbohydrate/low-fat diet in obese subjects. In both trials (one lasted 6 months, and the other a year) the Atkins groups lost more weight than the high-carb groups. In the year-long study, participants of both groups gained back some of their initial weight loss. The authors of the study called the differences between the final net weight losses of the two groups " statistically insignificant. " And that's true. But in the end, the Atkins group lost more than the high-carb group. This may not sound like a resounding success, but it's a success just the same. Because until just recently very few mainstream nutrition or dietary experts would have ever imagined that in a one-year controlled trial a high-protein diet could succeed over a low-fat diet. " Low fat equals good health " has been the mainstream mantra for more than 20 years, but with these studies and others, that mantra is being challenged like never before. And while it's true that there were dropouts in each of the groups in both studies (as there are in virtually all long- term dietary trials - especially with obese subjects), the dropouts were not so many that the test results were invalidated. Beyond the fact that the Atkins diet clearly bested the high- carb diet, these equally important results stand out as well: In the one-year trial, the Atkins group had a significantly greater increase in HDL cholesterol, and their triglyceride levels decreased more than in the high-carb group. Similar results occurred in the 6-month trial, with the Atkins group showing greater triglyceride reduction and increased insulin sensitivity compared to the other group. I think we're so used to seeing wild claims on TV ads ( " I lost 50 pound in two days! " ) that the results of a controlled, year-long trial like this may not seem impressive. In fact, these are very important mainstream successes for a diet that was almost universally dismissed by the nutritional establishment for 30 years. Somewhere Dr. Atkins is smiling. To Your Good Health, Jenny Thompson Health Sciences Institute ************************************************************** Sources: " Paroxetine Controlled Release in the Treatment of Menopausal Hot Flashes " Journal of the American Medical Association, 2003;289;2827-2834, jama.ama-assn.org " Frequent Paxil (Paroxetine) Side Effects " Prozac Truth, prozactruth.com " Withdrawal From Paroxetine Can Be Severe, Warns FDA " Alison Tonks, British Medical Journal, 2002;324:260, 2/2/02, bmj.com " Halting Hot Flashes - Researchers Say Antidepressants May Help Menopausal Women " ABC News, John McKenzie, 6/3/03, abcnews.com " A Randomized Trial of a Low-Carbohydrate Diet for Obesity " New England Journal of Medicine, 348:2082-2090, No. 21, 5/22/03, content.nejm.org " Atkins Diet Bolstered by Two New Studies " Janet McConnaughey, Associated Press, 5/21/02 " Atkin's Gains Upper Hand in 'Controlled' Trial " NaturalIngredients.com, 5/22/03, naturalingredients.com Copyright ©1997-2003 by www.hsibaltimore.com, L.L.C. 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