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Thursday, February 11, 2010

Paxil/Seroxat "...the only SSRi that exhibits mechanism based (“suicide”) inhibition", says study.


Image: pharmj.com


The recent press coverage regarding Seroxat and breast cancer link has showed that women taking Seroxat at the same time as tamoxifen, a drug used to stop cancer recurring, are more likely to die from the disease.

The paper, Kelly, Juurlink et al, Selective serotonin reuptake inhibitors and breast cancer mortality in women receiving tamoxifen: a population based cohort study; BMJ 2010;340:c693, has recently been sent to me and one very interesting paragraph jumped out at me, a paragraph that none of the mainstream press seemed to have picked up on.

The paragraph at the end of the first page of the paper says:

“For example, paroxetine is an exceptionally potent CYP2D6 inhibitor, and is the only SSRI that exhibits mechanism based (“suicide”) inhibition, resulting in irreversible loss of enzyme function until new CYP2D6 is synthesized.”


The use of the word “suicide” is interesting to say the least – to describe Seroxat as the only SSRi that is self inhibiting. This is a problem with this drug being a substrate of 2D6 as well as a potent inhibitor of 2D6. At higher doses it shuts down the very enzyme it itself needs for proper phase I metabolism. When you factor in the fact that about 10% of the Caucasian population are genetically poor metabolizers at 2D6 to begin with it becomes abundantly clear that the problems with Seroxat are huge.

Is Paxil/Seroxat the only SSRi that has been alleged to cause suicide of the 2D6 enzyme? [irreversible loss of enzyme function]. No other SSRi was linked with regard to this in the study. *Update

The study/paper can be downloaded from the BMJ website

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