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Author: Admin | 2025-04-28
Skip to content Results for {phrase} ({results_count} of {results_count_total})Displaying {results_count} results of {results_count_total} Combining Tamoxifen with Antidepressants: What You Need to Know Combining Tamoxifen with Antidepressants: What You Need to Know View Larger Image An updated version of this post can be found HERE.Two thirds of all breast cancer tumors are known to have receptors that respond to hormones; that is they can grow in response to estrogen. Tamoxifen is a medication which selectively blocks estrogen receptors on breast cancer tumors and, in this fashion, reduces the risk of recurrence by half in women with estrogen receptor-positive breast cancer (1). Tamoxifen, however, is a “prodrug”. That means that after it is taken, it needs to be “activated” or converted into its active form, endoxifen (most prevalent active form), by a liver enzyme called CYP2D6.Treatment of Depression in Women with Breast CancerRoughly half of women diagnosed with breast cancer report symptoms of depression, anxiety or both during the first year of receiving the diagnosis (1). It is estimated that one in four women taking tamoxifen are also taking an antidepressant, most commonly serotonin reuptake inhibitors (SRIs). Given that so many women with breast cancer take antidepressants, studying the interaction between medications used to treat either of these disorders is of importance, as they are often prescribed together. The major concern is that some antidepressants inhibit the function of the CYP2D6 enzyme (described above) which is required for the conversion of tamoxifen to its active form. Examples of strong CYP2D6 inhibitors are bupropion (Wellbutrin), fluoxetine (Prozac), and paroxetine (Paxil). Other SSRI medications, such as citalopram (Celexa), escitalopram (Lexapro), venlafaxine (Effexor) and sertraline (Zoloft) are considered to be less potent inhibitors of CYP2D6. If taken with tamoxifen, these CYP2D6 inhibitors could possibly decrease the available amount of the active metabolite (endoxifen).Naturally, the following question arises: does taking CYP2D6-inhibiting antidepressants along with tamoxifen decrease the effectiveness of tamoxifen?Measuring the Interaction Between Tamoxifen and AntidepressantsThere have been many studies on interaction between antidepressants which have yielded conflicting results. In an article published in the September 2016 issue of BMJ, Donneyong et al. set out to compare differences in mortality (risk of death) in women who were treated with the combination of tamoxifen and strong CYP2D6 inhibitors (fluoxetine or paroxetine) vs. women who were treated with tamoxifen and weaker CYP2D6 inhibitors (citalopram, escitalopram, fluvoxamine, sertraline). This study used data collected from health insurance programs from 1995
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