The FDA has considered a change to the label for tamoxifen, a common drug used in breast cancer prevention, to warn about combining this drug with antidepressants. Medico Health Solutions, a large insurance benefits manager, released a study in May reporting that antidepressants including Prozac, Paxil, and Zoloft interfere with the preventative effects of tamoxifen. Researchers compared medical records of 353 women taking tamoxifen combined with other drugs to the records of 945 women taking tamoxifen alone. Breast cancer recurrence within 2 years of treatment was found in 7% of the women on tamoxifen alone and 14% of women taking tamoxifen with other drugs, especially antidepressants. Dr. Robert Epstein, Medico's chief medical officer suggests that women who have experienced breast and need to take an antidepressant should "Iprobably want to stay away from those three" - Prozac, Paxil, and Zoloft. Other antidepressants such as Celexa, Lexapro, and Luvox showed no correlation with recurring breast cancer.

Contrasting results were obtained from a study carried out by Dr. Vincent Dezantjie of Leiden University Medical Center in the Netherlands. This group examined 150 women taking tamoxifen and antidepressants for more than 2 months, and compared their status to those taking the drug combination for less than 2 months. Results from this study revealed little risk from the drug combination. Physicians have long known that various medications lower the amount of active tamoxifen. Whether or not this interaction directly impacts cancer is uncertain. Dr. Claudine Isaacs, a breast specialist at Georgetown University's Lombardi Comprehensive Cancer Center, does note that "This is a very controversial area. Until these data are absolutely clear, I would avoid drugs that impact on tamoxifen metabolism". This information is pertinent to us and our students. Nursing graduates need to be prepared to provide patients with up-to-date information and advise them as to drug interactions, risks and possible untoward effects.

Source: Marchione M. Some antidepressants may risk breast cancer return. Yahoo! NEWS, May 31, 2009. Available athttp:news.yahoo.com/s/ap/20090531/ap_on_he_me/us_med_breast_cancer;_ylt=AnusQihi. Accessed on June 1, 2009.