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New Study: Antidepressants Commonly Prescribed with Tamoxifen Put Women at Much Higher Risk for Recurrent Breast Cancer
Date:5/30/2009

," said Dr. Robert Epstein, Medco's chief medical officer and one of the study researchers. "It's also the first time that a comparative analysis has been done looking at various SSRIs and what's clear is that several of these drugs are extremely risky for women to take with tamoxifen, while others don't present a problem."

This study advances prior research which has shown that the active form of tamoxifen, called endoxifen, is found in far lower levels in the blood stream when CYP2D6 inhibitor drugs are present, and it is the first study to show the comparative impact of various antidepressants on breast cancer recurrence.

"While we expected to see some impact on the disease recurrence rate based on already existing evidence, what is remarkable is that the effect is consistent with the pharmacologic potency of these antidepressants as CYP2D6 inhibitors. This lends biological plausibility to the data," added Dr. David Flockhart, chief of clinical pharmacology at Indiana University School of Medicine and a member of the research team.

Study Details

The study was a retrospective analysis of almost 1,300 women who were newly prescribed tamoxifen to treat breast cancer between 2003 and 2005 and were monitored for at least two years, with the average being 2.7 years. All study patients had to be at least 70 percent compliant with their tamoxifen therapy and on average, compliance was 90 percent throughout the study period. The average duration that patients used tamoxifen and a CYP2D6 inhibitor concurrently was 340 days.

The analysis first looked at two different cohorts, one with 353 women, about 27 percent of the study sample, who were taking a moderate to potent CYP2D6 inhibitor in conjunction with tamoxifen which included but was not limited to antidepressants, and a group of 945 women on tamoxifen who were not taking any CYP2D6 inhibitor. The patients' phar
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SOURCE Medco Health Solutions, Inc.
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