Antidepressants-Paxil, Prozac, Zoloft Increase Risk of Breast Cancer

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Antidepressants-Paxil, Prozac, Zoloft Increase Risk of Breast Cancer

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Sunday, 31 May 2009

 

 

Inexplicably, the FDA has dragged its feet about adding a warning label to

both tamoxefin and the antidepressants, Paxil, Prozac and

Zoloft--despitethe unanimous recommendation of its own advisory panel in 2006.

 

 

An independent large study conducted by MEDCO Health Solutions Inc. found

that women treated with tamoxifen for breast cancer doubled the risk of the

disease returning if they used antidepressants--in particular, Paxil and

Prozac.

 

 

The researchers used medical records to identify 353 women taking

tamoxifen plus other drugs that might interfere with it, and 945 women taking

tamoxifen alone. Those taking a drug combo did so for about a year on average.

 

 

Next, researchers checked to see how many were treated for second cancers

in the following two years. **Breast cancer recurred in about 7 percent of

women on tamoxifen alone, and in 14 percent of women also taking the

antidepressants Paxil and Prozac, and, to a lesser extent, Zoloft.**

 

Medco*s chief medical officer, Dr. Robert Epstein, said: If women want to

take an antidepressant, **you probably want to stay away from those

three.**

 

 

Inexplicably, the FDA has dragged its feet about adding a warning label to

both tamoxefin and the antidepressants, Paxil, Prozac and Zoloft--despite

the unanimous recommendation of its own advisory panel in 2006.

 

 

Posted by Vera Hassner Sharav

 

 

ASSOCIATED PRESS

May 31, 2009

Study: Drug combos may raise breast cancer risk

By MARILYNN MARCHIONE

 

 

ORLANDO, Fla. (AP) -- Breast cancer survivors risk having their disease

come back if they use certain antidepressants while also taking the cancer

prevention drug tamoxifen, worrisome new research shows.

 

About 500,000 women in the United States take tamoxifen, which cuts in

half the chances of a breast cancer recurrence. Many of them also take

antidepressants for hot flashes, because hormone pills aren't considered safe

after breast cancer.

 

 

Doctors have long known that some antidepressants and other medicines can

lower the amount of tamoxifen's active form in the bloodstream. But whether

this affects cancer risk is unknown.

 

 

The new study, reported Saturday at a cancer conference in Florida, is the

largest to look at the issue. It found that using these interfering drugs

- including Prozac, Paxil or Zoloft - can virtually wipe out the benefit

tamoxifen provides.

 

 

Many doctors question the magnitude of harm from combining these

medicines, and a second, smaller study suggests it may not be very large.

 

 

But the bottom line is the same: Not all antidepressants pose this

problem, and women should talk to their doctors about which ones are best.

 

 

**There are other alternatives we can consider** that are safer, said Dr.

Eric Winer, breast cancer chief at the Dana-Farber Cancer Center in Boston.

 

 

He had no role in the study, which was done by Medco Health Solutions

Inc., a large insurance benefits manager. Researchers used members' medical

records to identify 353 women taking tamoxifen plus other drugs that might

interfere with it, and 945 women taking tamoxifen alone. Those taking a drug

combo did so for about a year on average.

 

 

Next, researchers checked to see how many were treated for second cancers

in the following two years. Breast cancer recurred in about 7 percent of

women on tamoxifen alone, and in 14 percent of women also taking other drugs

that could interfere - mainly the antidepressants Paxil and Prozac, and, to

a lesser extent, Zoloft.

 

 

If women want to take an antidepressant, **you probably want to stay away

from those three,** said Medco's chief medical officer, Dr. Robert Epstein.

 

 

No greater breast cancer risk was seen in women taking the antidepressants

Celexa, Lexapro or Luvox with tamoxifen, and there are reasons to think

that other antidepressants may be safe as well, Epstein said.

 

 

A second study led by Dr. Vincent Dezentje of Leiden University Medical

Center in the Netherlands found little risk from combining tamoxifen and

popular antidepressants. However, only 150 women in the study took such combos

for more than two months, and they were compared to women taking combos for

a shorter time - not to women using tamoxifen alone.

 

 

The Dutch and Medco studies were presented at a meeting of the American

Society of Clinical Oncology.

 

 

The federal Food and Drug Administration has been considering a change to

tamoxifen's label to warn about the antidepressants drugs and a gene

variation some women have that can make tamoxifen less effective. An advisory

panel unanimously recommended a change in 2006, but the agency is still

considering it.

 

 

**This is a very controversial area,** said Dr. Claudine Isaacs, a breast

specialist at Georgetown University's Lombardi Comprehensive Cancer Center.

**Until these data are absolutely clear, I would avoid drugs that impact

on tamoxifen metabolism.**

 

 

Breast cancer is the most common major cancer in American women. More than

182,000 new cases were diagnosed last year, and it caused nearly 41,000

deaths.