Managing menopausal symptoms and depression in tamoxifen users: Implications of drug and medicinal interactions

Desmarais, Julie Eve; Looper, Karl

doi:10.1016/j.maturitas.2010.08.005

Cited by 39 publications

(40 citation statements)

References 80 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Antidepressants and anxiolytics can be effective in this situation, but monitoring for potential drug interactions is essential. However, if possible, women taking tamoxifen for breast cancer should avoid taking cytochrome P450 (CYP450) 2D6 strong inhibitors such as fluoxetine, paroxetine, and bupropion [35] because data show that the concurrent use of medications that inhibit CYP2D6 reduces the diseasefree survival interval [36 -39], although this is somewhat controversial [40]. Psychosocial support, whether oneto-one or group counseling, and cognitive behavioral therapy may also be useful.…”

Section: Depression and Anxietymentioning

confidence: 99%

Symptom Management in Metastatic Breast Cancer

2011

View full text Add to dashboard Cite

Approximately 40,000 women die as a result of breast cancer each year and many more live with advanced disease. When breast cancer recurs, the goals of treatment often shift from one of cure to controlling the disease for as long as possible while palliating symptoms interfering with the patient's functional status and quality of life. This requires ongoing discussions with the patient and family about the goals of care. Many symptoms depend on the site of metastasis, with bone being the most frequent, and commonly occur with fatigue, depression, insomnia, and pain. The purpose of this paper is to identify and provide an overview of the management of the most common symptoms in patients with breast cancer metastases.

show abstract

Section: Depression and Anxietymentioning

confidence: 99%

Symptom Management in Metastatic Breast Cancer

2011

View full text Add to dashboard Cite

show abstract

“…paroxetine, fluoxetine) have been used to alleviate the flushing, but some of these agents inhibit CYP2D6 and may decrease the levels of endoxifen, the active metabolite of tamoxifen, and reduce the adherence to tamoxifen (discussed in ''Factors affecting adherence to oral endocrine treatments'' section). Venlafaxine and gabapentin do not interact with the CYP system, and are useful in the treatment of tamoxifen-induced flashes [38], but it is not known whether the use of these agents to prevent flushing improves adherence to the oral adjuvant therapy for breast cancer. It is known that about 30% of subjects with breast cancer given venlafaxine to counter hot flashes, discontinue venlafaxine treatment due to toxicity [39], and this may limit any improvement in adherence to the oral endocrine agents observed with venlafaxine.…”

Section: Interventions To Minimise Adverse Effectsmentioning

confidence: 99%

Adherence to oral endocrine treatments in women with breast cancer: can it be improved?

Doggrell

2011

Breast Cancer Res Treat

View full text Add to dashboard Cite

There is a perception that women on oral endocrine treatments for oestrogen receptor-positive breast cancer will be adherent to these medicines, as they are facing a serious life-threatening disease, and the oral endocrine treatments are effective, easy to use and generally well tolerated. This is not in fact the case, and this is the basis of the first half of this review. The second half is of whether the changes/interventions to 'improve' adherence do actually increase adherence to the oral endocrine medicines. The review shows that better outcomes are achieved with good adherence to endocrine treatments in breast cancer. The rates of adherence to endocrine treatments range between 15 and 50%, and are influenced by a large number of factors (e.g. adverse effects, lack of belief in treatment, psychological problems and poor patient-health care provider relationship). Interventions to minimise the adverse effects have been used in an attempt to improve the adherence to the endocrine treatment therapies, but it is not known whether these do actually improve adherence. Similar, it has been assumed that interventions by health professionals (doctors, nurses and pharmacists) will improve the adherence, but this has not been tested. In conclusion, in women with breast cancer, we know there is a problem with adherence. There are also many approaches and suggestions about how to improve adherence to the oral endocrine treatments, but none of these approaches/suggestions have been scientifically tested, and they need to be.

show abstract

“…Antidepressants such as paroxetine, fluoxetine and bupropion are strong inhibitors of CYP2D6, and their use must be avoided in patients taking tamoxifen. Both fluvoxamine and nefazodone inhibit CYP3A, which might have the potential to affect the tamoxifen metabolism [14]. Sertraline and duloxetine are moderate inhibitors of CYP2D6 [15].…”

Section: Tamoxifen Metabolismmentioning

confidence: 99%

Treatment of Depression in Patients under Breast Cancer Therapy: Antidepressant-Tamoxifen Drug Interactions

Aguiar¹,

Aguiar²,

Rocha³

2017

J Drug Metab Toxicol

View full text Add to dashboard Cite

The hormone therapy with tamoxifen is used in patients with breast cancer. The tamoxifen mechanism of action is based on the antagonist action of selective estrogen receptors. Depression and anxiety are psychiatric disorders which frequently coexist in patients with breast cancer. In the last decades, there has been an increase in the use of antidepressants. This literature review aims to provide a general view of pharmacokinetic knowledge of drug interactions between tamoxifen and antidepressants. Since tamoxifen is metabolized by CYP2D6, the use of antidepressants that are inhibitors of this is enzyme, such as paroxetine, fluoxetine and bupropion must be avoided. Based on cytochrome p450 drug interactions, it can be concluded that the use of citalopram, escitalopram, desvenlafaxine and venlafaxine are safe and effective treatment unlikely to alter tamoxifen efficacy.

show abstract

Managing menopausal symptoms and depression in tamoxifen users: Implications of drug and medicinal interactions

Cited by 39 publications

References 80 publications

Symptom Management in Metastatic Breast Cancer

Symptom Management in Metastatic Breast Cancer

Adherence to oral endocrine treatments in women with breast cancer: can it be improved?

Treatment of Depression in Patients under Breast Cancer Therapy: Antidepressant-Tamoxifen Drug Interactions

Contact Info

Product

Resources

About