Prescribing Tamoxifen in Patients With Mood Disorders

Carmassi, Claudia; Cordone, Annalisa; Dell’Oste, Valerio; Pedrinelli, Virginia; Pardini, F.; Simoncini, Marly; Dell’Osso, Liliana

doi:10.1097/jcp.0000000000001412

Cited by 7 publications

(3 citation statements)

References 93 publications

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“…ERβ seems to be more involved in mood regulation [ 264 ]. Also, tamoxifen has been suggested as a potential treatment for episodes of mania, but more studies are needed [ 265 , 266 ]. The GPER1 has also been recently involved in stress response and anxiety in male and female mice 267 , 268 ], as well as in depression in men and women [ 269 ].…”

Section: Sex Differences In Drug Responsementioning

confidence: 99%

Sex Differences in Stress Response: Classical Mechanisms and Beyond

Hodes,

Bangasser,

Sotiropoulos

et al. 2024

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Neuropsychiatric disorders, which are associated with stress hormone dysregulation, occur at different rates in men and women. Moreover, nowadays, preclinical and clinical evidence demon- strates that sex and gender can lead to differences in stress responses that predispose males and females to different expressions of similar pathologies. In this curated review, we focus on what is known about sex differences in classic mechanisms of stress response, such as glucocorticoid hor- mones and corticotrophin-releasing factor (CRF), which are components of the hypothalamic- pituitary-adrenal (HPA) axis. Then, we present sex differences in neurotransmitter levels, such as ser- otonin, dopamine, glutamate and GABA, as well as indices of neurodegeneration, such as amyloid β and Tau. Gonadal hormone effects, such as estrogens and testosterone, are also discussed throughout the review. We also review in detail preclinical data investigating sex differences caused by recently- recognized regulators of stress and disease, such as the immune system, genetic and epigenetic mech- anisms, as well neurosteroids. Finally, we discuss how understanding sex differences in stress re- sponses, as well as in pharmacology, can be leveraged into novel, more efficacious therapeutics for all. Based on the supporting evidence, it is obvious that incorporating sex as a biological variable into preclinical research is imperative for the understanding and treatment of stress-related neuropsychiat- ric disorders, such as depression, anxiety and Alzheimer’s disease.

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Section: Sex Differences In Drug Responsementioning

confidence: 99%

Sex Differences in Stress Response: Classical Mechanisms and Beyond

Hodes,

Bangasser,

Sotiropoulos

et al. 2024

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“…Other complications include congestion and sexual dysfunction [ 135 ]. In addition, gastrointestinal cancers [ 136 ] were also mentioned.…”

Section: Side Effects Of Tamoxifenmentioning

confidence: 99%

An Update on Tamoxifen and the Chemo-Preventive Potential of Vitamin E in Breast Cancer Management

Khallouki

Hajji

Saber

et al. 2023

JPM

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Breast cancer (BC) is the most common female cancer in terms of incidence and mortality worldwide. Tamoxifen (Nolvadex) is a widely prescribed, oral anti-estrogen drug for the hormonal treatment of estrogen-receptor-positive BC, which represents 70% of all BC subtypes. This review assesses the current knowledge on the molecular pharmacology of tamoxifen in terms of its anticancer and chemo-preventive actions. Due to the importance of vitamin E compounds, which are widely taken as a supplementary dietary component, the review focuses only on the potential importance of vitamin E in BC chemo-prevention. The chemo-preventive and onco-protective effects of tamoxifen combined with the potential effects of vitamin E can alter the anticancer actions of tamoxifen. Therefore, methods involving an individually designed, nutritional intervention for patients with BC warrant further consideration. These data are of great importance for tamoxifen chemo-prevention strategies in future epidemiological studies.

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“…Tamoxifen, a non‐steroidal selective estrogen receptor modulator, with mixed anti‐estrogen and estrogen mimetic activity, primarily used in hormone‐sensitive breast cancer treatment, exhibits anti‐PKC activity at adequate doses, and studies indicate its efficacy in treating manic episodes (Palacios et al., 2019). The antimanic effect of tamoxifen is attributed to PKC inhibition and its downstream effects, with estrogen modulation potentially contributing to its efficacy (Bagdadi et al., 2021; Carmassi et al., 2021; Sabioni et al., 2008). The CANMAT BD guidelines suggest tamoxifen as a third‐line treatment for acute mania (Yatham et al., 2018).…”

Section: Introductionmentioning

confidence: 99%

Efficacy and safety of endoxifen in bipolar disorder: A systematic review

Joseph,

Vishwanath,

Praharaj

2024

Human Psychopharmacology

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BackgroundEndoxifen, a protein kinase C inhibitor and selective estrogen receptor modulator, primarily used in breast cancer treatment, has recently emerged as a potential therapeutic option for managing manic episodes associated with bipolar disorder (BD). This review aims to assess the existing evidence base for endoxifen in BD treatment and evaluate the strengths and limitations of current research findings.MethodsA systematic search was conducted on Medline, Embase, and Web of Science databases. We included studies published in English that used endoxifen in BD, alongside any relevant studies identified through manual searching and conference papers with full‐text availability. Information pertaining to dose, duration, clinical effects, and safety profiles was extracted from the included studies. The Cochrane Risk of Bias 2 tool was used to assess the risk of bias in clinical trials.ResultsThe final review included seven case reports (including two conference presentations), two clinical trials, and one prospective study. Most studies administered endoxifen 8 mg and reported an improvement in manic symptoms. Several case reports included patients with comorbid substance use, and most patients received mood stabilizers concurrently. Few reports lacked any structured outcome measures. The clinical trials used divalproex 1000 mg as an active comparator, which was deemed sub‐therapeutic. Despite being multicentric, the first trial lacked data on center‐wise recruitment, and certain methodological concerns were observed across the included trials. There were no serious adverse effects noted, except for a significant elevation in lipid profile within a 3‐week period. Limited data were available regarding endoxifen efficacy and safety in mixed episodes, depressive episodes, and maintenance treatment.ConclusionThere is a paucity of research on the efficacy and safety of endoxifen in BD. While existing evidence suggests short‐term efficacy in manic episodes, significant limitations were identified in most of the included studies. Further research is imperative to establish the efficacy and safety of endoxifen in BD before considering its recommendation as a viable treatment option.

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Prescribing Tamoxifen in Patients With Mood Disorders

Cited by 7 publications

References 93 publications

Sex Differences in Stress Response: Classical Mechanisms and Beyond

Sex Differences in Stress Response: Classical Mechanisms and Beyond

An Update on Tamoxifen and the Chemo-Preventive Potential of Vitamin E in Breast Cancer Management

Efficacy and safety of endoxifen in bipolar disorder: A systematic review

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