Tamoxifen use for the management of mania: a review of current preclinical evidence

Armani, Fernanda; Andersen, Mônica Levy; Galduróz, José Carlos Fernandes

doi:10.1007/s00213-013-3397-x

Cited by 27 publications

(14 citation statements)

References 137 publications

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“…Interestingly and also paradoxically, tamoxifen is currently under investigation for its anti-manic properties. 6 Our patient had also a history of antidepressants use for obsessive-compulsive symptoms without any history of manic/hypomanic shift. Trastuzumab, another agent in which she is on treatment for a few months seems to be less likely to be responsible for the manic episode, mainly because of lack of a temporal correlation.…”

Section: Discussionmentioning

confidence: 83%

Tamoxifen-induced acute mania: A case report

Duman

Kuşman

Çolak

et al. 2020

J Oncol Pharm Pract

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Introduction: Tamoxifen is widely used for the treatment of hormone-responsive breast cancer, osteoporosis, and post-menopausal symptoms. Also, tamoxifen is currently under investigation for its anti-manic properties. In this article, we report a case who developed manic episode following the initiation of tamoxifen and remitted with discontinuation of the medication. Case Report: A 58-year-old woman was diagnosed with breast cancer. Pathologic diagnosis was invasive ductal carcinoma. Following bilateral total mastectomy operation, trastuzumab was initiated with intervals of 21 days. Five days before the fourth application of trastuzumab, tamoxifen was added. On the sixth day following the initiation of tamoxifen, manic symptoms were developed and she was diagnosed as acute mania. Management and Outcome: The oncology department suggested withdrawing tamoxifen due to a possible association between tamoxifen initiation and behavioral symptoms. Manic symptoms were rapidly (approximately 24 h) improved following cessation of tamoxifen. Psychiatric evaluation on the fifth day following cessation of tamoxifen revealed no manic symptoms. An aromatase inhibitor-exemestane was initiated and she showed no side effects with this medication since then. Discussion: To our knowledge, this is the first case report of probable tamoxifen-induced mania. Our case report at least indicates that there were possibly some patients who were sensitive to the tamoxifen's nervous system effects, mainly to manic effects. In conclusion, clinicians should be aware of these rare behavioral adverse effects of tamoxifen.

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Section: Discussionmentioning

confidence: 83%

Tamoxifen-induced acute mania: A case report

Duman

Kuşman

Çolak

et al. 2020

J Oncol Pharm Pract

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“…Likewise, animal models for mania are considered a valuable tool for the screening of new agents with mood stabilizing properties (Armani et al, 2014). Even though stimulant-induced animal models of mania has allowed progress in this field, there are several limitations associated with such approaches.…”

Section: Discussionmentioning

confidence: 99%

Modeling mania in preclinical settings: A comprehensive review

Sharma

Fries

Gálvez

et al. 2016

Progress in Neuro-Psychopharmacology and Biological Psychiatry

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The current pathophysiological understanding of mechanisms leading to onset and progression of bipolar manic episodes remains limited. At the same time, available animal models for mania have limited face, construct, and predictive validities. Additionally, these models fail to encompass recent pathophysiological frameworks of bipolar disorder (BD), e.g. neuroprogression. Therefore, there is a need to search for novel preclinical models for mania that could comprehensively address these limitations. Herein we review the history, validity, and caveats of currently available animal models for mania. We also review new genetic models for mania, namely knockout mice for genes involved in neurotransmission, synapse formation, and intracellular signaling pathways. Furthermore, we review recent trends in preclinical models for mania that may aid in the comprehension of mechanisms underlying the neuroprogressive and recurring nature of BD. In conclusion, the validity of animal models for mania remains limited. Nevertheless, novel (e.g. genetic) animal models as well as adaptation of existing paradigms hold promise.

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“…[21] Randomized controlled trials have provided increasing evidence on the antimanic properties of tamoxifen, the only known centrally active protein kinase C (PKC) inhibitor available for use, encouraging further research on the role of PKC in the pathophysiology and therapeutics of BD. [22] Results about the possible antimanic effect of memantine and the COX-2 selective nonsteroidal anti-inflammatory drug, celecoxib, are expected. Two melatonin agonists, agomelatin and ramelteon, are expected to proceed to late trial evaluation as adjunctive treatment for bipolar depression.…”

Section: Current Limitations and Future Perspectives In Drug Developmmentioning

confidence: 98%