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Antidepressant can interfere with tamoxifen – A study
Tamoxifen news:
Breast cancer is the most commonly known cancer diagnosed in women and drug tamoxifen significantly helps in curing this disease. In the latest study, researchers have found that patients taking tamoxifen for the treatment of breast cancer may not get the full advantage of this medicine if taken along with some anti depressants. The researchers have stated that enzyme CYP2D6 is of prime importance to activate tamoxifen up to its optimum level. Antidepressants medicines like fluoxetine and paroxetine taken together with tamoxifen can restrict this important enzyme.
There were 2,430 women under taken for the study. Their respective health care record was studied by the researchers. About 30% of women were using antidepressant like fluoxetine, paroxetine and bupropion along with the treatment of tamoxifen. The result showed that women taking such anti depressant and tamoxifen were on higher risk of death and shows a drug interaction which is highly unwanted and is potentially life threatening. Dr. David Juurlink, one of the study’s author said that findings of study indicates the proper usage of anti depressants along with tamoxifen.
In another study 463 patients were used for the study. The researchers found that out of the total patients seven of them were receiving tamoxifen and sixteen were receiving an aromatase inhibitor along with strong CYP2D6 inhibitor which includes fluoxetine, paroxetine and bupropion. They also found that one patient on tamoxifen along with six other on aromatase inhibitor were receiving moderate CYPD6 inhibitor. Subjects on weak and moderate inhibitors were under gone test for metabolic activities before the start of tamoxifen treatment. All the seven patients receiving heavy dose of inhibitors were advised to alter the medication with equal amount of impact as that of tamoxifen.
The researchers stressed that patients should not stop taking tamoxifen but should understand that it is a situation where anti depressants inhibits the effect of the medicine.
Calorie restriction and exercise prevents breast cancer in postmenopausal women – A research
Cancer news:
Scientists at the University of Texas at Austin have identified pathways by which a reduced calorie diet and exercise can modify a postmenopausal woman's risk of breast cancer. The mTOR pathway is known to induce cancer. Caloric restriction and exercise have beneficial effects in disrupting pathways that lead to mTOR activation. Caloric restriction affects upstream pathway as compared to exercise and has more beneficial effect.
The increase in fat tissue alters adipokines which promote the risk of cancer. Out of three adipokines, two adipokines leptin and hepatocyte growth factor(HGF) increase the risk of breast cancer while adiponectin, a endogenous insulin sensitizer, decreases the risk of breast cancer.
In the experiment, 45 mice had their ovaries removed to simulate post menopausal state and then fed with high fat diet for 8 weeks. Then the mice were divided in four groups, a control group, one with caloric restriction of 30 percent, one permitted to eat at will and the other too permitted to eat at will but exercised for 45 minutes daily for five days a week. After the end of 8th week, the weight of calorie restricted mice was on average of 19.9 grams, that of control mice was 28.8 grams and of exercised mice was 26 grams. The tissues were put on histochemical analysis. The fat content of caloric restricted mice and the exercised mice were almost same and fat content was highest for that fed at will. The leptin levels were significantly less in caloric restricted mice and exercised mice as compared to control while adiponectin levels were highest in caloric restricted mice. The downstream proteins for mTOR activation were less in caloric restricted mice and exercised mice. The experiment shows the risks associated with obesity and the benefits of caloric restriction and exercise on prevention of cancer while caloric restriction has more pronounced anticancer effect.
Tamoxifen notes:
Tamoxifen (generic name tamoxifen) is used to treat and prevent some types of breast cancer. It is used in women who are at high risk for breast cancer and in women with DCIS (after surgery and radiation). It blocks female hormone called estrogen there by preventing the growth of tumours that are activated by estrogen.
Hormones that cause breast cancer growth may also be blocked by ovarian function suppression using drugs, surgery or radiation to the ovaries. It is not yet known whether giving ovarian function suppression together with either tamoxifen citrate or exemestane is more effective than giving tamoxifen citrate alone in treating breast cancer.
Tamoxifen side effects includes sudden numbness, chest pain, shortness of breath, unusual vaginal bleeding or discharge, irregular menstrual periods, pale skin, new breast lumps, hot flashes, swelling in hands or feet, depressed mood, weakness, decreased sex drive or thinning hair. Weight gain can be a side effect of tamoxifen and this is sometimes due to water retention but at other times a consequence of a eating more either due to a increased appetite or mild nausea.
Generic Nolvadex is an orally active selective estrogen receptor modulator that is used in the treatment of breast cancer and is currently the world's largest selling drug for that purpose. It is also used to treat infertility in women with anovulatory disorders.
It is recommended to buy Nolvadex under doctor’s supervision and have blood levels checked regularly.
Other names of nolvadex includes zitazonium, Dignatomoxi, Emblon, Noltam, Novofen.
Store tamoxifen at room temperature away from moisture and heat.
2007 Dec;14 Suppl 1:S20-40.
Derzko C, Elliott S, Lam W.
Obstetrics and Gynecology and Reproductive Endocrinology, St. Michael's Hospital, and University of Toronto, Toronto, Ontario.
Management of sexual dysfunction in postmenopausal breast cancer patients taking adjuvant aromatase inhibitor therapy.
2007 Dec;14 Suppl 1:S11-9.
Thorne C.
Management of arthralgias associated with aromatase inhibitor therapy.
J Pediatr. 2004 Jul;145(1):71-6.
Lawrence SE, Faught KA, Vethamuthu J, Lawson ML.
Department of Pediatrics, University of Ottawa, Ontario, Canada.
Beneficial effects of raloxifene and tamoxifen in the treatment of pubertal gynecomastia.
Cochrane Database Syst Rev. 2004;(3):CD001024.
Nowak A, Findlay M, Culjak G, Stockler M.
Tamoxifen for hepatocellular carcinoma.
Anticancer Drugs. 2004 Aug;15(7):707-714.
Zeisig R, Ruckerl D, Fichtner I.
Max-Delbruck-Center for Molecular Medicine, Department of Experimental Pharmacology, Berlin, Germany; Technical University of Berlin, Faculty III, Institute of Biotechnology, Berlin, Germany.
Reduction of tamoxifen resistance in human breast carcinomas by tamoxifen-containing liposomes in vivo.
Chem Biol Interact. 2004 Jul 20;148(3):149-61.
Cardoso CM, Almeida LM, Custodio JB.
Laboratorio de Bioquimica, Faculdade de Farmacia and Centro de Neurociencias de Coimbra, Universidade de Coimbra, Couraca dos Apostolos, 51, R/C, 3000-295 Coimbra, Portugal.
Protection of tamoxifen against oxidation of mitochondrial thiols and NAD(P)H underlying the permeability transition induced by prooxidants.
Eur J Cancer. 2005 Mar;41(4):647-54. Epub 2005 Jan 18.
Constantinou AI, White BE, Tonetti D, Yang Y, Liang W, Li W, van Breemen RB.
Department of Surgical Oncology, University of Illinois at Chicago, 840 South Wood Street, Chicago, IL 60612, USA.
The soy isoflavone daidzein improves the capacity of tamoxifen to prevent mammary tumours.
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