Tamoxifen is a popular breast cancer treatment that can be taken for up to five years to prevent a recurrence. Conversely, paroxetine is a selective serotonin reuptake inhibitor (SSRI) antidepressant that is typically used to treat major depression, obsessive-compulsive, panic,social anxiety, and generalized anxiety.
Paroxetine has revealed promise for easing the hot flashes that can occur after cancer treatment. However, this anti-depressant has been known to have side effects such as nausea, somnolence, and sexual problems. This medication is also associated with significant weight gain and adult suicide.
Researchers studied the health records of 2,430 women taking tamoxifen between the years 1993 and 2005. They discovered that roughly 25% or 630 of these women were also taking paroxetine. Of the 1,074 women that died during this period, 374 of them died from breast cancer according to Ontario's cancer registry.
“Tamoxifen is an extremely important drug for breast cancer," said Dr. David Juurlink, a co-author of the study and a scientist at the Institute for Clinical Evaluative Sciences in Toronto. Paroxetine "takes that benefit away by interfering with the body's normal handling of tamoxifen. Specifically, researchers concluded that paroxetine blocks or inhibits an enzyme called cytochrome P450 2D6, which is needed to metabolize tamoxifen into its active form.Although the evidence suggests that this anti-depressant must be stopped, researchers caution against abruptly ceasing treatment with paroxetine because of withdrawal effects and worsening of depressive symptoms.
Interestingly, the study did not find any increased risk of death among the smaller sample of women taking tamoxifen combined with some other SSRI, such as fluoxetine (Prozac), sertraline (Zoloft), citalopram (Celexa) and venlafaxine (Effexor). However, this smaller sample size may confound the study’s conclusiveness; however it does suggest that attractive alternatives exist.
Furthermore, there are always unanswered questions when it comes to research that focus on health records as several variables are unknown and uncontrolled. That being said, the slightest risk identified should be enough to stop using this medication, especially when there are equally effective substitutes.
Also, in recent news…
“In the first Paxil birth defect trial that resulted in a $2.5 million verdict against GlaxoSmithKline in October 2009, the infant, Lyam Kilker, was born with three heart defects; an atrial septal defect, a ventricular septal defect, and an interrupted aortic arch, after his mother took Paxil while pregnant.”Antidepressant interferes with breast-cancer drug
Paxil Birth Defect Trial - Battle of the Experts
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