Tamoxifen effects may be wiped out by Paxil, Prozac, or Zoloft~ so reports a new cancer study!!!!!

chenheart
chenheart Member Posts: 5,159
edited March 2014 in Breast Cancer #1
Cutting right to the chase, and please do not shoot the messenger~ the results of an extensive cancer study was reported upon at a cancer conference in Florida yesterday. It concluded that women taking Tamoxifen along with Paxil, Prozac, and to a lesser degree Zoloft, may be virtually wiping out the effects of the Tamoxifen!!!!

After 2 years, 7% of women on Tamoxifen alone had a recurrance~ combined with the above mentioned antidepressants, the recurrances jumped to 14%!!!!!

Other antidepressants seem NOT to have this cancelling-out effect. Drs. have known of this risk for years, but evidently not to this extent until now.

Though they will no doubt be inudated with calls, I strongly suggest, if you are one of the women with this particular combo~ CALL YOUR DR! We are talking about our lives here! Perhaps a different anti-depressant is in order.

Wish I were relating the study had found a cure~ Sigh!!!

Hugs,
Claudia
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Comments

  • austingrl
    austingrl Member Posts: 45
    I saw that article
    Hey, Chen;

    I saw that article, and it really got my head spinning with all kinds of questions. Such as, if they cancel out tamoxifen, does this mean they convert to estrogen in the body somehow? Why does this happen? And, if so, is there a link between estrogen levels and serotonin(sp?) levels? Man, it could go on and on. I sure hope they're wrong!!
  • 1surfermom
    1surfermom Member Posts: 396 Member
    austingrl said:

    I saw that article
    Hey, Chen;

    I saw that article, and it really got my head spinning with all kinds of questions. Such as, if they cancel out tamoxifen, does this mean they convert to estrogen in the body somehow? Why does this happen? And, if so, is there a link between estrogen levels and serotonin(sp?) levels? Man, it could go on and on. I sure hope they're wrong!!

    tamoxifen
    Claudia,
    Thank you for posting this. I was reading my local Sunday paper and there was a small article about this. Can you believe it? The article was about the size of a paragraph. It is very disturbing that there isn't very much coverage about this. Surf
  • chenheart
    chenheart Member Posts: 5,159
    austingrl said:

    I saw that article
    Hey, Chen;

    I saw that article, and it really got my head spinning with all kinds of questions. Such as, if they cancel out tamoxifen, does this mean they convert to estrogen in the body somehow? Why does this happen? And, if so, is there a link between estrogen levels and serotonin(sp?) levels? Man, it could go on and on. I sure hope they're wrong!!

    I hope they are wrong too!
    I hope they are wrong too! From what I read, it seems that there are other antidepressants which do NOT react adversely with Tamoxifen. So hopefully, our sisters on Tamoxifen who need other meds as well can switch to something which will not pose a recurrance risk.

    Hugs,
    Claudia
  • Jeanne D
    Jeanne D Member Posts: 1,867
    chenheart said:

    I hope they are wrong too!
    I hope they are wrong too! From what I read, it seems that there are other antidepressants which do NOT react adversely with Tamoxifen. So hopefully, our sisters on Tamoxifen who need other meds as well can switch to something which will not pose a recurrance risk.

    Hugs,
    Claudia

    Thanks Claudia!
    I have read that before. I think Phoenixrising posted a website to go to that told you what messed with the effectiveness of Tamoxifen and a lot of antidepressants were on there. But, not for sure it was her, but, someone on here did awhile back. My oncologist had also mentioned this to me when I first met her, but, I wasn't on antidepressants and wasn't considering Tamoxifen, so, I didn't pay much attention to what she said about it. This is important information! Thanks again Claudia!

    p.s. There is an article on cancer.org about this and it was dated back in 2005. Just type in Tamoxifen and antidepressants and a lot of info pops up if anyone is interested.
  • tasha_111
    tasha_111 Member Posts: 2,072
    Jeanne D said:

    Thanks Claudia!
    I have read that before. I think Phoenixrising posted a website to go to that told you what messed with the effectiveness of Tamoxifen and a lot of antidepressants were on there. But, not for sure it was her, but, someone on here did awhile back. My oncologist had also mentioned this to me when I first met her, but, I wasn't on antidepressants and wasn't considering Tamoxifen, so, I didn't pay much attention to what she said about it. This is important information! Thanks again Claudia!

    p.s. There is an article on cancer.org about this and it was dated back in 2005. Just type in Tamoxifen and antidepressants and a lot of info pops up if anyone is interested.

    Claudia thanks
    I'm on zoloft and tamoxifen...I'll ask my doc tomorrow. Huge hugs Jxxxxxxxxx
  • phoenixrising
    phoenixrising Member Posts: 1,508
    cyp2d6
    Thank you for bringing this up Claudia, it's a topic that is near and dear to my heart. I got about 5 alerts concerning this study this morning and if I could just mention a few things....

    This study was also being done in the Netherlands and they showed that recurrences with the SSRIs also was at 14% but they also showed that those not taking SSRIs had a recurrence rate of ~13% while the U.S. study had ~7%. So according to the article the conclusions are conflicting. This is one of the articles I received:

    ASCO:ConflictingDataonBreast Cancer,Tamoxifen,SSRIs

    This all has to do with the gene responsible for metabolizing Tamoxifen to Endoxifen which is the one responsible for tumour reduction/prevention. Many women have a defective gene and are poor or intermediate metabolizers and so will not get the most out of Tamoxifen. The SSRIs can inhibit the production of the enzyme needed to transform Tamoxifen into Endoxifen.
    Some are strong inhibitors and others are moderate to weak.

    Here is a well known chart that is used to see what is what:

    P450DrugInteractionTable

    I was tested and found I was an intermediate metabolizer which is the same as taking 2 strong inhibitors (according to the testing company) therefore if I had to take tamoxifen I would not take anything at all remotely inhibiting the 2d6 gene. No matter how weak the inhibitor was. Although some oncs do not believe in testing for this, the Mayo clinic recommends all women be tested before taking Tamoxifen.

    There is a school of thought that if you are having se, then it must be working. That would certainly make sense however there are many women who are poor or intermediate metabolizers that have horrific se and normal metabolizers that have virtually few. So I don't think I would count on it. Besides, I had more hot flashes before dx than I do on Aromasin.

    For more information on past discussions concerning this, just do a csn search at the top of the page for CYP2D6. There have also been many discussions on breastcancer.org.

    Thanks again Claudia and I hope this clarifies the issue for those interested.
    jan
  • Christmas Girl
    Christmas Girl Member Posts: 3,682 Member

    cyp2d6
    Thank you for bringing this up Claudia, it's a topic that is near and dear to my heart. I got about 5 alerts concerning this study this morning and if I could just mention a few things....

    This study was also being done in the Netherlands and they showed that recurrences with the SSRIs also was at 14% but they also showed that those not taking SSRIs had a recurrence rate of ~13% while the U.S. study had ~7%. So according to the article the conclusions are conflicting. This is one of the articles I received:

    ASCO:ConflictingDataonBreast Cancer,Tamoxifen,SSRIs

    This all has to do with the gene responsible for metabolizing Tamoxifen to Endoxifen which is the one responsible for tumour reduction/prevention. Many women have a defective gene and are poor or intermediate metabolizers and so will not get the most out of Tamoxifen. The SSRIs can inhibit the production of the enzyme needed to transform Tamoxifen into Endoxifen.
    Some are strong inhibitors and others are moderate to weak.

    Here is a well known chart that is used to see what is what:

    P450DrugInteractionTable

    I was tested and found I was an intermediate metabolizer which is the same as taking 2 strong inhibitors (according to the testing company) therefore if I had to take tamoxifen I would not take anything at all remotely inhibiting the 2d6 gene. No matter how weak the inhibitor was. Although some oncs do not believe in testing for this, the Mayo clinic recommends all women be tested before taking Tamoxifen.

    There is a school of thought that if you are having se, then it must be working. That would certainly make sense however there are many women who are poor or intermediate metabolizers that have horrific se and normal metabolizers that have virtually few. So I don't think I would count on it. Besides, I had more hot flashes before dx than I do on Aromasin.

    For more information on past discussions concerning this, just do a csn search at the top of the page for CYP2D6. There have also been many discussions on breastcancer.org.

    Thanks again Claudia and I hope this clarifies the issue for those interested.
    jan

    Thank you, both Kindred Spirit (a/k/a Claudia) and Jan...
    This is extremely important information for the entire group to consider. So, thank you, both.

    Jan - regarding studies: My onc has always assured me that he accesses all pertinent BC studies. As you point out, and as he has previously explained, identical clinical trials in different locations can have varying results (possibly due to "environmental" differences?). My onc claims his favored studies are regional. We happen to live in an area where BC statistics are much higher than the national averages.

    Claudia - regarding anti-depressants, etc.: My onc, in fact my entire oncology team of doctors, would not provide me with ANY of them, not in the earliest days nor even now, almost six years since diagnosis. Nor sleeping pills, nor prescription pain meds. Even when I practically begged for them. I was also forbidden to seek these types of medications from other (non-oncology) doctors. I simply trusted them. Now I have a much better understanding of their cautions, and am grateful for it.

    Kind regards, 12/25
    (a/k/a Susan)
  • Noel
    Noel Member Posts: 3,095 Member

    Thank you, both Kindred Spirit (a/k/a Claudia) and Jan...
    This is extremely important information for the entire group to consider. So, thank you, both.

    Jan - regarding studies: My onc has always assured me that he accesses all pertinent BC studies. As you point out, and as he has previously explained, identical clinical trials in different locations can have varying results (possibly due to "environmental" differences?). My onc claims his favored studies are regional. We happen to live in an area where BC statistics are much higher than the national averages.

    Claudia - regarding anti-depressants, etc.: My onc, in fact my entire oncology team of doctors, would not provide me with ANY of them, not in the earliest days nor even now, almost six years since diagnosis. Nor sleeping pills, nor prescription pain meds. Even when I practically begged for them. I was also forbidden to seek these types of medications from other (non-oncology) doctors. I simply trusted them. Now I have a much better understanding of their cautions, and am grateful for it.

    Kind regards, 12/25
    (a/k/a Susan)

    Very good information
    Very good information Claudia and Jan! I don't take antidepressants and I am not on Tamoxifen yet, but, I think I will read more about it now and talk to my oncologist. Thanks!
  • Kat11
    Kat11 Member Posts: 1,931 Member

    Thank you, both Kindred Spirit (a/k/a Claudia) and Jan...
    This is extremely important information for the entire group to consider. So, thank you, both.

    Jan - regarding studies: My onc has always assured me that he accesses all pertinent BC studies. As you point out, and as he has previously explained, identical clinical trials in different locations can have varying results (possibly due to "environmental" differences?). My onc claims his favored studies are regional. We happen to live in an area where BC statistics are much higher than the national averages.

    Claudia - regarding anti-depressants, etc.: My onc, in fact my entire oncology team of doctors, would not provide me with ANY of them, not in the earliest days nor even now, almost six years since diagnosis. Nor sleeping pills, nor prescription pain meds. Even when I practically begged for them. I was also forbidden to seek these types of medications from other (non-oncology) doctors. I simply trusted them. Now I have a much better understanding of their cautions, and am grateful for it.

    Kind regards, 12/25
    (a/k/a Susan)

    Were there other drugs
    Were there other drugs mentioned in the study?
  • phoenixrising
    phoenixrising Member Posts: 1,508
    Kat11 said:

    Were there other drugs
    Were there other drugs mentioned in the study?

    I think those were the main
    I think those were the main ones that people are using today. Bupropion (Zyban)is a strong inhibitor according to the chart but I think it's out of favour for depression. The chart can tell which ones are included and how strong they are. Hope this helps.
    jan
  • tjhay
    tjhay Member Posts: 655
    Tamoxifen and anti-depressants
    Thanks for the info, I am going to my psychologist this week do to depression from lack of hormones brought on by tamoxifen ( i am sure there are other reasons for the depression as well)but this will be good if she decides to put me on yet another med.
    Smiles
    Tjhay
  • Alexis F
    Alexis F Member Posts: 3,598
    Thanks for this info
    Thanks for this info Claudia. I have read something about this before.
  • Kristin N
    Kristin N Member Posts: 1,968 Member
    Hey Claudia
    Interesting article and I would imagine, will induce a lot of calls to bc survivors doctors tomorrow. I have never been on antidepressants, but, I know some women that are. I will certainly pass this info on to them. Thank you!
  • Kylez
    Kylez Member Posts: 3,761 Member
    There is another posting on
    There is another posting on here from that doctor. It is about the same thing Claudia. Scary stuff.
  • jnl
    jnl Member Posts: 3,869 Member
    Kristin N said:

    Hey Claudia
    Interesting article and I would imagine, will induce a lot of calls to bc survivors doctors tomorrow. I have never been on antidepressants, but, I know some women that are. I will certainly pass this info on to them. Thank you!

    This is very interesting. I
    This is very interesting. I have read about this before. Thanks for bringing it to my attention again.
  • jnl
    jnl Member Posts: 3,869 Member
    Kylez said:

    There is another posting on
    There is another posting on here from that doctor. It is about the same thing Claudia. Scary stuff.

    Did you see the other posting Chenheart?
    It is about this same thing, from a Doctor.
  • chenheart
    chenheart Member Posts: 5,159
    jnl said:

    Did you see the other posting Chenheart?
    It is about this same thing, from a Doctor.

    Guess not!
    Nope...didn't see anything from a Dr! LOL I read the newspaper, and wrote down what I gleaned from the article! Evidently, the info can't be posted too many times! It's important to many of the sisters here...so Drs, RNs and Aliens ( I am included in that group) are welcome to post here! :-)

    Hugs,
    Claudia
  • Jeanne D
    Jeanne D Member Posts: 1,867
    chenheart said:

    Guess not!
    Nope...didn't see anything from a Dr! LOL I read the newspaper, and wrote down what I gleaned from the article! Evidently, the info can't be posted too many times! It's important to many of the sisters here...so Drs, RNs and Aliens ( I am included in that group) are welcome to post here! :-)

    Hugs,
    Claudia

    Thanks again for this
    Thanks again for this Claudia! It was on the news the other day too. I think it is stirring up quite a controversy.
  • cats_toy
    cats_toy Member Posts: 1,462 Member
    chenheart said:

    Guess not!
    Nope...didn't see anything from a Dr! LOL I read the newspaper, and wrote down what I gleaned from the article! Evidently, the info can't be posted too many times! It's important to many of the sisters here...so Drs, RNs and Aliens ( I am included in that group) are welcome to post here! :-)

    Hugs,
    Claudia

    Claudia
    you posted yesterday, she posted today. You wouldn't have seen hers when you posted yours.
    Yes, always good to spread this kind of info, luckily I am taking neither.
    Thanks again Ms 50footer!
    Photobucket

    Cat
  • Noel
    Noel Member Posts: 3,095 Member
    cats_toy said:

    Claudia
    you posted yesterday, she posted today. You wouldn't have seen hers when you posted yours.
    Yes, always good to spread this kind of info, luckily I am taking neither.
    Thanks again Ms 50footer!
    Photobucket

    Cat

    Curious
    Is it better, so to speak, to be er pr neg or er pr post? I thought someone said that the negative was a more aggressive cancer. Is that true? Anyone know?