taken in combination, two drugs commonly prescribed antidepressant Paxil and the cholesterol-lowering Pravachol drugs seem increases significantly the blood glucose, a new study concludes.
The increase is more apparent - and for - in the diabetic whose blood sugar is already too high, the researchers noted.
"This interaction may affect up to 1 million Americans who would be on these two drugs and who get a bump in their blood glucose may be unnecessary," said researcher principal Dr. Russ Altman, Professor of biological, genetic engineering and medicine at Stanford University.
It is possible that the blood sugar spike triggered a diagnosis of diabetes type 2 patients, Altman said, "and we could avoid this diagnosis if they had not been on these drugs", he said. "This is speculative, but it is possible."
No single drug raises sugar in the blood and the researchers said they cannot yet explain the effect of the combination. Also, combinations of other antidepressants and cholesterol not stimulate glucose levels. "This is not what we would call a"class"effect", Altman explained.
Paxil (paroxetine) is in a class of drugs known as inhibitors of the reuptake of serotonin (SSRIS) and Pravachol (Pravastatin) belongs to a group of drugs called statins. "We looked at all the other pairs of SSRIS and Statins and there were a couple who has shown a small bump in glucose, but there is nothing to do with the humpback seen Paxil and Pravachol," Altman said.
For the study, published online may 25 in clinical and therapeutic Pharmacology, researchers have used a technique called data mining, analysis of large databases in the hope of finding information which, although not immediately obviousis gleaned by combining the data in a new way.
In this case, team Altman used the data from the U.S. Food and Drug Administration Adverse Event Reporting System, more data from the universities of Harvard, Stanford and Vanderbilt to identify the associations would not apparent doctors dealing with individual patients.
Using this method, researchers have identified 135 non-diabetic patients taking both drugs whose blood sugar increased of 19 milligrams per deciliter after the start of treatment. They have also identified 104 diabetic whose blood sugar increased an average of 48 mg/dl while taking the two drugs.
With levels of sugar in the blood of 126 mg/dl or two tests are considered diabetic. Levels of 100 mg/dl to 125 mg/dl are considered prédiabétiques.
By extrapolating these results to the whole of the population of the United States, the Altman team believes that of 33 million people taking Paxil or Pravachol, 500 000 to 1 million hold together.
To verify whether their conclusions were simply associations which could be explained by other factors, researchers have experimented with drugs in mice.
The mice were exposed to two drugs after receiving a diet rich in fat, high calorie to pre-diabetic. No single drug has increased sugar in the blood, together they have increased sugar in the blood of about 128 mg/dl to 193 mg/dl, the researchers found.
"It was just like humans in our data base, said Altman." So, this seems to be a real biological effect. "This could give us an overview of the mechanisms of diabetes."
Altman warns that people taking this drug combination should not respond.
He has said "people on an antidepressant should not mess with because depression is a very serious illness". It would be reasonable to see a doctor and see if your blood glucose have been difficult to control, he said. He said "if it was, then I think the thing to change would be the Statin,".
Dr. Ronald b. Goldberg, Professor of medicine at the Institute for research of diabetes at the University of Miami Miller School of Medicine, said that it was "" an interesting conclusion and could be clinically important. ""
"People with diabetes have an increased risk of depression." they are all recommended to be on Statins, "said Goldberg. "Then, it can worsen glycemic control in diabetic people."
But Goldberg thinks that it is too early to change clinical practice based on this study only. "This must be confirmed in a clinical trial," he said.
No comments:
Post a Comment