Paroxetine (Molecule of the Month for January 2007)
Seroxat, Aropax, Paxil, Deroxat, Motivan
Paroxetine is a selective serotonin reuptake inhibitor (SSRI) antidepressant and is one of the most prescribed antidepressants on the market due to its efficacy in treating depression as well as a spectrum of anxiety disorders ranging from panic attacks to phobias. Paroxetine is made by GSK, who have approx. $1/2 billion worth of sales per quarter, due to this drug. Paroxetine is primarily used to treat the symptoms of depression, obsessive-compulsive disorder (OCD), post-traumatic stress disorder (PTSD), panic disorder, generalized anxiety disorder (GAD), social phobia/social anxiety disorder, and premenstrual dysphoric disorder (PMDD).
Paroxetine is the most potent selective serotonin (5-hydroxytryptamine, 5-HT) reuptake inhibitor (SSRI). This activity of the drug on brain neurons is thought to be responsible for its antidepressant effects. Strangely, clinical trials for Paxil have not lasted more than twelve months. The effectiveness of Paxil in major depressive disorders has been proven by two twelve week clinical trials in which the patients either had flexible doses or a placebo. Both of the studies concluded that Paxil is significantly more effective than the placebo control group. For another disorder, three 10-week studies were conducted to prove the effectiveness of Paxil on panic disorders. In the first and second studies, Paxil proved consistently better than the placebo. But the third trial Paxil failed to have any significant difference to the placebo.
GSK has recently lost a lawsuit concerning paroxetine, on Dec 22, 2006, a US court decided that individuals who purchased paroxetine for children may be eligible for benefits under a $63.8 million Proposed Settlement. Since the FDA approved paroxetine in 1992, approximately 5,000 U.S. citizens have sued GSK. Most of these people feel they were not sufficiently warned in advance of the drug's side effects. On January 29 2007, the BBC in the UK will air a fourth documentary in its 'Panorama' series about the controversial drug Seroxat. This programme, entitled Secrets of the Drug Trials, focuses on on three GSK paediatric clinical trials on depressed children and adolescents. Data from the trials show that Seroxat could not be proven to work for teenagers. Not only that, one clinical trial indicated that they were six times more likely to become suicidal after taking it. In the programme, Panorama reveals the secret trail of internal emails which show how GlaxoSmithKline manipulated the results of the trials for its own commercial gain. Seroxat in the UK is now banned for its use with under 18 year olds.
Formal Chemical Name (IUPAC)
Update by Karl Harrison
(Molecule of the Month for January 2007 )