Increased risk of death for women taking paroxetine and tamoxifen
Women with breast cancer who take the antidepressant paroxetine at the same time as tamoxifen are at an increased risk of death, a new Canadian study has found.
Antidepressants are of particular importance because they are commonly used in women with breast cancer, often for long periods of time.
Although many antidepressants have little or no impact on tamoxifen’s metabolism, paroxetine – a selective serotonin reuptake inhibitor (SSRI) – is a potent inhibitor of the metabolic step that converts tamoxifen to endoxifen.
Against that background, doctors at the Institute for Clinical Evaluative Sciences in Toronto set out to investigate whether SSRIs can reduce tamoxifen’s effectiveness in practice.
They examined the healthcare records of 2,430 women aged 66 years or older with breast cancer who received tamoxifen between 1993 and 2005. About 30 per cent of these women also received an antidepressant at some time during their treatment with tamoxifen, and paroxetine was the most commonly used agent.
The results show that use of paroxetine, but not other SSRIs, in combination with tamoxifen, was associated with an increased long-term risk of breast cancer death, in a fashion that correlated with the extent of drug overlap.
This supports the theory that paroxetine can reduce or abolish the benefit of tamoxifen in women with breast cancer.
The researchers estimate this treatment with paroxetine will result in one additional death at five years for every 20 women treated. The risk with more extensive overlap is greater.
(Source: IMT)
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Help. I am currently taking Zoloft but have been diagnosed with breast ca. I will be put in Tamoxifin but what about the Zoloft? My Dr. told me I must take another antidepresent not one in the Zoloft family? I am worried that I will go downhill without my Zoloft.
cindy
29 Mar 10 at 6:53 pm