Breast Cancer Surviviors Taking Tamoxifen Have Been Asked to Avoid Certain Anti-depressants
Anti-depressants are the most prescribed medication in the United States. So whenever there is new information about anti-depressants and drug reactions I like to get the word out to as many people as possible.
There are many different types anti-depressants and the information released at the 45th Annual Meeting of the American Society of Clinical Oncology specifically mentions one type SSRI, Selective Serotonin Reuptake Inhibitors. It is important to note that some SSRIs are also used to reduce hot flashes in who are not diagnosed with depression. Examples of SSRI that were mentioned are Prozac, Paxil, and Zoloft. These medications should be avoided in breast cancer survivors who are currently taking Tamoxifen.
Tamoxifen is used in premenopausal and some postmenopausal women, to reduce the re-occurrence of breast cancer by interfering with the activity of estrogen in the body. When these two types of drugs are taken together the SSRIs reduce the effectiveness of the Tamoxifen. The SSRI drugs affect the liver’s ability to correctly break down the Tamoxifen into the active metabolite, endoxifen.
What does this mean for women that are being asked to change their anti-depressants?
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Hi Dr. Dae:
Thanks for helping spread the word about tamoxifen drug interactions. As a prodrug requiring CYP2D6 conversion to be effective, tamoxifen should not be taken with any potent CYP2D6 inhibitor as some SSRIs are. Here is a list of common CYP2D6 inhibitors from http://www.healthanddna.com/Druglist.pdf:
amiodarone
{amitriptyline}
bupropion
celecoxib
chlorpheniramine
chlorpromazine
cimetidine
cinacalcet
{citalopram}
chlorpheniramine
clomipramine
{desipramine}
diphenhydramine
doxepin
duloxetine
{fluvoxamine}
fluoxetine
goldenseal
halofantrine
haloperidol
{hydroxyzine}
imipramine
methadone
metoclopramide
moclobemide
paroxetine
pimozide
propafenone
quinidine/quinine
ritonavir
{sertraline}
terbinafine
thioridazine
ticlopidine
You may be interested in Tamoxitest, a combined Tamoxifen resistance test and software that scans for drug-drug, drug-herbal, and drug-gene interactions that can reduce tamoxifen efficacy. More information is at www.Tamoxitest.com