December 14, 2012

Antidepressant to Protect against Diabetes Vascular Complications


Researchers at the University of Texas Medical Branch at Galveston discovered that the commonly used antidepressant drug Paxil could also become a therapy for the vascular complications of diabetes.

Vascular complications  are responsible for most of the complications due to diabetes. Blood vessels, large and small, are abnormal in diabetic patients with long standing disease. This discovery may offer a treatment option for preventative and therapeutic use.

The study was published online on the journal Diabetes. The current work suggests paroxetine as a novel drug intervention for diabetic vascular complications. Researchers believe that the drug could also be used as a potential treatment for cardiovascular complications of diabetes.

Unlike most anti-depressant drugs, paroxetine (brand name Paxil), offers a protective benefit from elevated glucose that can inflict injury to the micro and macro vessels of the body. The byproduct of high blood glucose produces reactive oxygen species (ROS), which destroy blood-vessel linings and lead to diabetic complications such as heart attacks, strokes, retinopathy, nephropathy and neuropathy.

The novel protective benefits of Paxil act in a two-fold approach. First, it directly reduces concentrations of superoxide, a powerful ROS. Second, it suppresses the production of ROS. When excess sugar is available in the cells environment, ROS is manufactured in excess.  Paxil (paroxetine) protects against ROS under hyperglycemic conditions.

The researchers wanted to see what kind of effect paroxetine would have on diabetes-induced rats. For this arm of the study, researchers injected rats with streptozotocin, a chemical that induces diabetes. The  rats developed hypoglycemia, but their arteries retained the ability to dilate. This reaction contradicts the conditions diabetes imposes on the body in compromising the circulation.

The word of the week is repurpose. Whether you’re talking about metformin extending the survival rate for women diagnosed with ovarian cancer or Paxil to ward-off the development of diabetic vascular complications, this is adopting the use of an antidepressant for a different purpose.

Paxil received a black-eye when the story broke that the use of Paxil must be closely monitored because of the withdrawal symptoms patients could experience.  The risk of vascular complications is an everyday threat you live with diabetes. I don’t think that “discontinuation” is a big concern if the risk-reward is becoming addicted to a drug that can protect against irreparable damages from a chronic disease.

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