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A 22-year-old cancer patient battling for her life after contracting H1N1 swine flu recovered fully after doctors took the unorthodox approach of giving her the antiviral drug Relenza intravenously.

The British physicians who treated the woman said this last-resort approach may need to be considered for others as swine flu sweeps the globe. Relenza is licensed in pill form and as an inhaled powder, but not as an intravenous medication.

In this woman’s case, neither Relenza nor a similar H1N1-fighting drug, Tamiflu, could reach her severely affected lungs when taken orally or inhaled, the physicians report in the Sept. 4 online issue of The Lancet.

“There were clinical signs that the patient was not able to absorb the Tamiflu because of a problem with the digestive system; and in the case of Relenza, the lungs were very inflamed with a lot of fluid leakage, and we considered it likely that the powdered form of the drug was not able to penetrate far enough to be effective,” explained study co-author Dr. Michael Kidd of University College London Hospitals.

The woman’s situation was dire. She had been hospitalized in an intensive care unit for 16 days and was breathing through a respirator after her lungs filled with fluid. Also, her immune system had been badly weakened by the chemotherapy she was taking to help fight her cancer.

Since oral or inhaled medicines had failed to reach the woman’s lungs, Kidd and his colleague, Dr. Mervyn Singer, turned to an unlicensed form of intravenous Relenza after consultations with the hospital and next-of-kin. “Giving the antiviral drug into the bloodstream would get round these obstacles, and we anticipated it would reach the lungs rapidly and effectively,” Kidd said.

The treatment worked. After receiving the IV Relenza, the woman began to recover speedily, greatly reducing the amount of H1N1 virus in her system. Five days later, she breathed on her own, and in a little more than a week she left the intensive-care unit.

Singer and Kidd also gave the patient corticosteroids at the same time that she received the intravenous Relenza. “We reasoned that the steroids might help by damping down the inflammation once the viral replication was under control,” Kidd said. “We have no evidence that this was the case in our patient, but we would like to see this possibility addressed in future clinical trials.”

Their success in bringing this very sick patient back from the brink augurs for the wider acceptance of intravenous Relenza for patients seriously affected by the swine flu this fall and winter, Kidd said. “We consider it very important to further investigate this approach as soon as possible, since apart from the obvious individual patient benefit, it could help relieve the pressure on beds that is likely to occur in critical care facilities during the colder seasons,” he said.

One U.S expert agreed. “The patient was deathly ill and [the doctor] got permission to use it on this patient, and then it seemed to have helped, and I think that’s great,” said Dr. Peter Gross, chief medical officer at Hackensack University Medical Center in New Jersey.

“The individual involved was at very high risk of having very serious complications of the novel H1N1 because the person was very immunocompromised,” Gross pointed out.

The U.S. Centers for Disease Control and Prevention has placed people with chronic underlying illnesses, such as asthma, diabetes or cancer, and those with compromised immune systems high on the list of those at risk for severe or life-threatening H1N1 infections. Many of the 477 Americans who have died have had some sort of underlying medical condition, CDC officials noted Thursday in their journal, Morbidity and Mortality Weekly Report.

According to Kidd, the woman he treated exhibited no side effects from the strategy. “IV Relenza is well-tolerated in adults at quite high doses, previously shown in clinical trials, and it can be used in children from 6 months of age,” he said. There are certain “contraindications” for its use — doses may need to be adjusted if the patient has kidney disease, for example, and its safety during pregnancy “has not been established,” Kidd said.

But even for pregnant women (another H1N1 high-risk group, according to the CDC), “in severe swine flu respiratory disease, the expected benefit to the mother is likely to outweigh any possible risk to the fetus,” Kidd said.

While alcohol may be considered a depressant, teetotalers as well as heavy drinkers are more likely to suffer from depression and anxiety than moderate tipplers, a new study has found.

Norwegian and British researchers also found that people who don’t drink report having fewer friends than drinkers do, a possible reason for their increased likelihood of being depressed.

“We see that this group is less socially well-adjusted than other groups,” study co-author Dr. Eystein Stordal, an adjunct professor in the Norwegian University of Science and Technology’s neuroscience department, said in a university news release. “Generally when people are with friends, it is more acceptable in Western societies to drink than not to drink. While the questionnaire recorded non-drinkers’ subjective perception of the situation, a number of other studies also confirm that teetotalers experience some level of social exclusion.”

Another possible explanation, the researchers said, had to do with general health of the teetotalers.

“We found on average that there were more people with physical complaints among the non-drinkers than in the other groups,” Stordal said. “These individuals are more likely to use medicines that mean they shouldn’t drink. But it may also be true that having such an illness increases a person’s tendency to be anxious or depressed.”

The study, based on a survey of 38,000 Norwegians and published in the August online edition of the journal Addiction, found high levels of depression and anxiety even when it factored out people who abstained from drinking because of previous problems with alcohol. In all, roughly 17 percent of abstainers reported having anxiety and nearly 16 percent reported having depression.

The researchers also found that people who averaged only two drinks per week reported the fewest bouts with depression or anxiety.