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Antidepressants are commonly used for depression and vasomotor symptoms in breast cancer patients treated with tamoxifen. However, many antidepressants inhibit the cytochrome P450 (CYP) 2D6 enzymes required to convert tamoxifen to its active form, which has led to an FDA black box warning that antidepressant use in tamoxifen-treated breast cancer patients could retard tamoxifen's therapeutic effect and increase risk for cancer recurrence. To learn more, researchers used pharmacy and electronic medical records to prospectively follow 16,867 women with early-stage breast cancer (TNM stages, 0–II); follow-up lasted a median of 6 years.
In the cohort, 8099 patients used antidepressants — most commonly, fluoxetine (20%) and paroxetine (11%). Medi…