Do Selective Serotonin Reuptake Inhibitors Attenuate Tamoxifen's Benefits in Breast Cancer Survivors?

Paroxetine was associated with excess mortality in breast cancer survivors who were receiving tamoxifen as adjuvant therapy.

Tamoxifen is converted by the hepatic isoenzyme CYP2D6 to metabolites that have much higher affinity for estrogen receptors than does the parent prodrug. Selective serotonin reuptake inhibitors (SSRIs) inhibit CYP2D6 to varying degrees, and paroxetine is the most potent inhibitor. In a retrospective cohort study, Canadian investigators assessed survival times in 2430 breast cancer survivors (age, ≥66) who were treated contemporaneously with tamoxifen (median duration, 4 years) and a single SSRI or venlafaxine. Paroxetine was the most commonly prescribed SSRI (26%). At a mean follow-up of 2.4 years, 1074 women (44%) in the cohort had died; 374 deaths were attributed to breast cancer.

Concomitant use of paroxetine and tamoxifen was associated …

Reviewing Author

Andrew M. Kaunitz, MD

Disclosures

RoyaltiesUpToDate

Grant/Research SupportMerck, Mithra, Medicines360

Editorial BoardsContraception; Menopause; Contraceptive Technology Update; OBG Management; Medscape OB/GYN & Women’s Health

Andrew M. Kaunitz, MD

Disclosures

RoyaltiesUpToDate

Grant/Research SupportMerck, Mithra, Medicines360

Editorial BoardsContraception; Menopause; Contraceptive Technology Update; OBG Management; Medscape OB/GYN & Women’s Health

Do Selective Serotonin Reuptake Inhibitors Attenuate Tamoxifen's Benefits in Breast Cancer Survivors?

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Reviewing Author