Time to Update Evidence-Based Guideline Recommendations About Concurrent Tamoxifen and Antidepressant Use? A Systematic Review

Integrating Systematic Reviews into Supportive Care Trial Design: The Rethinking Clinical Trials (REaCT) Program

“…Out of 28 areas of clinical equipoise identified from surveys of patients and healthcare providers [ 7 ], 22 systemic reviews have been performed and published [ 16 , 17 , 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 ]. Of these, 18 were new reviews, while 4 were updated reviews of previously published reviews.…”

“…The reviews were related to areas of clinical equipoise in: breast cancer ( n = 15), all tumour sites ( n = 4), breast and prostate cancers ( n = 2), and prostate cancer ( n = 1) management. These reviews covered topics regarding; adjuvant therapy [ 28 , 36 ], adjuvant supportive care [ 17 , 21 , 26 , 27 , 29 ], metastatic [ 21 ], palliative supportive care [ 16 , 18 , 25 , 30 , 34 ], both adjuvant and palliative supportive care [ 19 , 22 , 23 , 24 , 31 ], and survivorship [ 20 , 32 , 33 , 35 , 37 ]. The details of each review are shown in Table 1 , and where each question lay in the cancer journey is shown in Figure 2 .…”

A systematic review of pharmacologic treatment efficacy for depression in older patients with cancer

“…Metabolically, antidepressants have the potential to interact with chemotherapies among other cancer treatments ( Caraci et al., 2011 ). For example, paroxetine, fluoxetine, venlafaxine, and bupropion have been implicated to decrease the active metabolite of tamoxifen, but the long-term impact of this treatment remains controversial and more research is needed ( Grassi et al., 2018 ; Bradbury et al., 2021 ; Nevels et al., 2016 ; Del Re et al., 2016 ).…”

Management of Breast Cancer Survivors by Gynecologists

“…It should be noted that there has been some concern about the use of tamoxifen and antidepressants because of drug interaction and metabolism with CYP2D6 inhibition, but larger studies have not seen evidence for negative effects on breast cancer-related outcomes. 29 Trazadone is often used in cancer patients for insomnia which can also be beneficial for the sleep disturbances created by vasomotor symptoms. HRT is generally avoided in breast cancer patients, although there is debate in the safety of HRT in the triple negative breast cancer population.…”

“…In a review of breast cancer survivors, Abel et al28 provides a large review table on potential medications and dosages for the treatment of vasomotor symptoms. It should be noted that there has been some concern about the use of tamoxifen and antidepressants because of drug interaction and metabolism with CYP2D6 inhibition, but larger studies have not seen evidence for negative effects on breast cancer-related outcomes 29. Trazadone is often used in cancer patients for insomnia which can also be beneficial for the sleep disturbances created by vasomotor symptoms.…”