Paxil Reduces Benefits of Cancer Treating Drugs

A study in the British Medical Journal found that paroxetine, better known as paxil, decreases the benefits of the cancer treating drug tamoxifen. In addition, they found an increased risk of death in breast cancer patients the longer both drugs were taken concurrently.

Tamoxifen is a popular breast cancer treatment that can be taken for up to five years to prevent a recurrence. Conversely, paroxetine is a selective serotonin reuptake inhibitor (SSRI) antidepressant that is typically used to treat major depression, obsessive-compulsive, panic,social anxiety, and generalized anxiety.

Paroxetine has revealed promise for easing the hot flashes that can occur after cancer treatment. However, this anti-depressant has been known to have side effects such as nausea, somnolence, and sexual problems. This medication is also associated with significant weight gain and adult suicide.

Researchers studied the health records of 2,430 women taking tamoxifen between the years 1993 and 2005. They discovered that roughly 25% or 630 of these women were also taking paroxetine. Of the 1,074 women that died during this period, 374 of them died from breast cancer according to Ontario's cancer registry.

“Tamoxifen is an extremely important drug for breast cancer," said Dr. David Juurlink, a co-author of the study and a scientist at the Institute for Clinical Evaluative Sciences in Toronto. Paroxetine "takes that benefit away by interfering with the body's normal handling of tamoxifen. Specifically, researchers concluded that paroxetine blocks or inhibits an enzyme called cytochrome P450 2D6, which is needed to metabolize tamoxifen into its active form.

Although the evidence suggests that this anti-depressant must be stopped, researchers caution against abruptly ceasing treatment with paroxetine because of withdrawal effects and worsening of depressive symptoms.

Interestingly, the study did not find any increased risk of death among the smaller sample of women taking tamoxifen combined with some other SSRI, such as fluoxetine (Prozac), sertraline (Zoloft), citalopram (Celexa) and venlafaxine (Effexor). However, this smaller sample size may confound the study’s conclusiveness; however it does suggest that attractive alternatives exist.

Furthermore, there are always unanswered questions when it comes to research that focus on health records as several variables are unknown and uncontrolled. That being said, the slightest risk identified should be enough to stop using this medication, especially when there are equally effective substitutes.

Also, in recent news…

“In the first Paxil birth defect trial that resulted in a $2.5 million verdict against GlaxoSmithKline in October 2009, the infant, Lyam Kilker, was born with three heart defects; an atrial septal defect, a ventricular septal defect, and an interrupted aortic arch, after his mother took Paxil while pregnant.”

Antidepressant interferes with breast-cancer drug
Paroxetine
Paxil Birth Defect Trial - Battle of the Experts

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Virtual Reality Therapy Could Benefit Victims of Haiti Earthquake

Cyberpsychology is the study of the human mind and behavior in the context of human-technology interaction. Computer-mediated forms of counseling include e-mails or chats online with a therapist; however cyberpsychology is not limited to the use of internet technology as it also includes cyborgs, artificial intelligence, and virtual reality. This type of therapy can be used to treat various types of mental illness including Post Traumatic Stress Disorder.

PTSD is common in soldiers returning from combat duty, victims of sexual or physical assault and survivors of imprisonment or hostage situations. It is also common among individual that have experienced acts of terrorism, accidents or natural disasters and those diagnosed with a life-threatening illness. Conventional approaches to treat PTSD include antidepressant medication and psychotherapy; however recovery rates are far from acceptable.

“Exposure therapy has been recognized as a highly promising method for treating patients with PTSD. Rather than relying on patients' visualization skills to ‘relive’ the traumatic experience, technological strategies such as virtual reality (VR) provide a controlled environment in which patients can experience a situation or scenario while learning to cope with their emotional responses.”

When natural disasters occur relief efforts typically focus on immediate needs, such food, clothing, shelter, first aid, emotional support and family reunification. Treatment of ongoing mental health should play a vital role in the response. The implementation of this type of tool could have major benefits for mass casualty survivors.

In Haiti, for instance, individuals are experiencing major losses that will affect them for years to come. The loss of loved ones, displacement, medical injuries and material loss are all psychologically devastating. In addition, the victims of this tragedy are likely to be disturbed by memories of the trauma and experience flashbacks of mass graves and friends, neighbours and even family members burned or trapped under collapsed buildings. Furthermore, the destroyed buildings and homes, and the absence of family members will continue to serve as traumatic reminders.

“‘Empty situations’ posed by the sense of an absence of personal location, deprives the victim of a safe ‘holding environment’ so necessary for the recovery process. These secondary adversities caused by displacement function as a barrier to the effort required in ‘processing’ the trauma of personal loss.” Rebuilding the lost structure in their lives is necessary for recovery, however efforts cannot end there. Extended treatment is essential to full or near full recovery, therefore, funding should be applied to ongoing mental health treatment. Virtual reality treatment in safe clinical settings could be part of that effort.

Virtual reality treatment is not a quick fix. It consists of many sessions of gradual exposure and it is most often combined with cognitive behavioral therapy and anxiety management in order to cope with the recreation of the traumatic events. It is important to note that the virtual recreation consists only of certain aspects of the event and not the exact recreation of the event itself.

Evidently, time, money and effort of this type of approach far exceeds the efforts of distributing supplies, however success rates are far more important than quick and easy methods. Moreover, this type of therapy should really be considered for relief personnel as their mental health is also at risk from their experiences. Recovering from the effects of a natural disaster is a lengthy process and the treatment for its effects on mental health is an even lengthier one.

Posttraumatic Stress Disorder: Virtual Reality and Other Technologies Offer Hope
Cyberpsychology
The risk of PTSD following the earthquake in Haiti

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