I was kind of outraged to read that Doug seemed to support the study that claims that Paxil improves memory - not in my case, it actually has left me with short term memory loss, though I guess I would need a barrel of dollars/pounds and a top notch lawyer to prove that in a court of law [Holds out begging bowl to Nemeroff]. In any case, I'm a patient, and it really doesn't matter what patients have to say does it!
Okay, let's grab the bull by the horns here and try and ascertain where Doug, Emory Uni and Nemeroff stand regarding the use of Paxil.
We pretty much know Nemeroff's stance, in fact his stance has made him a bucket full of money, ironically Nemeroff's payee, GlaxoSmithKline, have also made a lot of money on the back of Nemeroff's 'talks'.
I'm not entirely sure where Doug stands. He has stood against Pharma before, quite why he or Emory refuse to make a stance against Paxil is abundantly obvious... well it is to me anyhow.
Doug responded on his blog to my post Nemeroff Defender Salutes Paxil, which was basically yet another 'study' to find out what Paxil was supposedly good for rather than what it was not good for.
I went on record by saying: "For the record Doug. You are talking complete and utter bollocks!". This was in response to Doug's comments regarding a study he directed and concluded the following: "The findings of this study indicate that Paxil may help reverse memory loss and increase hippocampal volume, leading to clinically significant improvements in memory and concentration that will improve their work and social function. It may also be true that improved memory will help trauma survivors re-integrate and work through memories of their own traumatic events."
I wrote an email to Doug and copied in interested parties. It's the only way to respond on Doug's blog as long comments are not allowed.
----- Original Message -----
Sent: Tuesday, October 14, 2008 5:57 PM
Subject: Re: You are joking Doug?
Why do you wish the brand name to be removed from the title?
Do you or your research team honestly believe that Paxil/Seroxat/paroxetine, call it what you will, actually help reverse memory loss?
Are you aware of the official and 'non-official' adverse reports of this particular drug?
Jesus Doug, when will someone from Emory come out and speak out against Paxil?
I think maybe you/Emory or GSK should research why so many people are having trouble with this drug rather than carry out studies trying to find yet another illness/ailment it can supposedly cure!
Who came up with the idea anyway?
Were scholars all sitting around one day drinking coffee and discussing Paxil then out of the blue did one suggest that you should do a study regarding Paxil and memory loss? Did GlaxoSmithKline approach you or did Charles Nemeroff suggest it to you?
Emory already has tarnished its image with the way it closed its eyes whilst Nemeroff was raking in the dollars - Did it do so because GlaxoSmithKline were kind enough to fund research such as Paxil improving memory?
I will ask you this Doug, seeing as you seem to be learned in Paxil and its effects:
Patient comes to you and it is deemed by both you and he/she that they are ready to taper off 40mgs of Paxil that they have been on for approx 6 years. How long will/should it take that person to taper off 40mgs? What regime would you recommend for the tapering Doug?
I would be interested to know your position on this.
How long would/should it take a patient to taper off 40mg of Paxil?
What tapering system would you recommend?
*Interested partied blind copied
Doug has chosen to respond via his blog, which kind of makes sense albeit time consuming.
I think the brand name should not be used because that is tantamount to advertising. The press likes to use the brand name (i.e. Paxil in this case) as opposed to the generic name (paroxetine) because it is easier for the public to remember, which is why whoever wrote this press release (not me) probably did that. Thank you for bringing this to my attention.
As for whether I think it helps memory, in our studies of PTSD diagnosed individuals (who have problems with memory) 9 months of treatment does seem to help memory measured on neuropsychological tests of memory. The 2003 was done while I was at Yale and Dr. Nemeroff was not part of the study. I came up with the idea for the study after seeing Ron Duman, PhD, present his research that SSRIs promote hippocampal nerve growth (hippocampus is a brain area involved in memory). I submitted funding requests to several makers of SSRIs and GSK was the only company interested in funding. [Bob asked why this was: answer, only Paxil and Zoloft are approved in the US for PTSD, and GSK probably was most excited about the drug.] We currently don't have funding from GSK but we do do research on the effects of medication on the brain (including paroxetine) funded by governmental agencies. We currently use generic paroxetine for our research (not Paxil).[question about that from Bob, a generic company may make their own paroxetine, it is the same active ingredient, yes, but since it is a different actualy plant it may not be identical].
As for the implication that universities may be biased toward not closely policing personal income gained by physicians from pharmaceutical companies because of funding received from pharmaceutical companies, my answer is (as I wrote in my book) I think that the medical industry in general is influenzed by pharma and the reasons are numerous, but include payments to Key Opinion Leaders (KOLs) who then sit on the advisory panels for drug approval, funding of community medical education, etc. etc. I myself don't give a lot of industry funded talks, as I said before.
Bob, As for your particular situation, it looks like you took Seroxat which my understanding is not identical to Paxil [different manufacturing in UK but not sure]. In any case Kimberly [Kimberly also left a comment on Doug's blog]complains of memory problems. I had heard that as well for Lisa Van S who comments on pharmalot.com but her child was a teen. And Truthman30 [Truthman also left a comment on Doug's blog], I don't know your history, or your name for that matter. I don't treat teens, only adults with PTSD involved in research studies of the brain. I haven't seen in my own practice people complaining of memory problems, usually memory gets better, but I couldn't exclude the fact that it happens in some people. I am always open to new information from people who are actually taking the medication. Since there isn't any evidence that doses of more than 20 mg are more effective we don't go above that, and we don't treat for more than nine months. And we always taper for at least a month and work with the individual if they have side effects. However if you were on 40 you might try two months, going down 10 mg every two weeks.
And no, Kimberly, I have not taken paroxetine/Paxil.
This is for educational purposes, please don't take it as medical advice.
This obviously prompted a response from myself and this is the reason why I write this post now.
Personally, I think Doug is being evasive here. He and I [and millions of others] know that Paxil can be one hell of a drug to taper from. His advice at the end of his comment is typical of the ignorance that surrounds ALL SSRi's but in this instance, Paxil/Seroxat. He suggested "...we always taper for at least a month and work with the individual if they have side effects. However if you were on 40 you might try two months, going down 10 mg every two weeks."
Doug, it took me 18 months to taper from 40mg to 22mg. The breaking of a 20mg tablet [to 10mg] was way too drastic. I had to use the oral suspension form of Seroxat, a sickly orange liquid administered by a syringe. I'm not the only one, there are literally thousands of people who have had to do this. May I suggest you ask GlaxoSmithKline to fund a study as to why people are having to do this? I'm not a betting man Doug but in this case I would bet you a meal at a swanky restaurant that they would probably tell you to go forth and multiply.
Do your research Doug, check out Paxil Progress, a forum set up by patients for patients. A forum that highlights just how difficult the withdrawal process is - you will even find many stories of memory loss on there.
I've been fortunate enough to hold talks with the MHRA in the UK Doug. We discussed the withdrawal problem for ALL SSRis. They listened and agreed to sit down and talk with David Healy [Nemeroff won't like that will he?]. The whole point of my discussions with the MHRA has clearly been demonstrated by your lack of knowledge regarding tapering Doug. What you suggest could tip people over the edge.
Paxil/Seroxat is addictive Doug [for some people], make no bones about it. Emory, Nemeroff and yourself need to go back to the drawing board and start listening to patients - Like I stated above, Check out Paxil Progress, as I understand, GlaxoSmithKline check it out daily as they do my blog.
There is a real problem with withdrawal Doug on ALL SSRis, as far as I'm aware Paxil/Seroxat tops the list of adverse reactions [see meeting minutes with MHRA]
If any study needs to be done, it's the withdrawal issue one Doug. GlaxoSmithKline won't fund you because they have been paying Nemeroff thousands of dollars for years to 'big up' this particular SSRi. Quite why you wish to bury your head in the sand over this issue is why there are bloggers such as myself trying to raise awareness.
Paxil/Seroxat has had its day Doug, it has caused human suffering and in cases death yet YOU, Emory and Nemeroff promote it with studies [and I will state it again] that are complete bollocks!
You may wish to gloss over the current Online Paxil Petition, read some of the comments left by people that have signed it then ask yourself why patients are making a stand against shoddy withdrawal advice handed out by MD's such as yourself... because the advice you gave [above] was shoddy Doug!
I'm passionate about this particular issue because I experienced it. I was not depressed when tapering Doug so please don't go down that avenue with me. I was merely trying to get my life back on track. Unfortunately, GlaxoSmithKline's, Seroxat, was stopping me from doing so... and I'm not alone in that particular nightmare Doug.
Read the new book, The Evidence, However, Is Clear...The Seroxat Scandal
By Bob Fiddaman
AVAILABLE FOR DOWNLOAD HERE
PAPERBACK COMING SOON