Treatment of Depression in Patients under Breast Cancer Therapy: Antidepressant-Tamoxifen Drug Interactions

Abstract

The hormone therapy with tamoxifen is used in patients with breast cancer. The tamoxifen mechanism of action is based on the antagonist action of selective estrogen receptors. Depression and anxiety are psychiatric disorders which frequently coexist in patients with breast cancer. In the last decades, there has been an increase in the use of antidepressants. This literature review aims to provide a general view of pharmacokinetic knowledge of drug interactions between tamoxifen and antidepressants. Since tamoxifen is metabolized by CYP2D6, the use of antidepressants that are inhibitors of this is enzyme, such as paroxetine, fluoxetine and bupropion must be avoided. Based on cytochrome p450 drug interactions, it can be concluded that the use of citalopram, escitalopram, desvenlafaxine and venlafaxine are safe and effective treatment unlikely to alter tamoxifen efficacy.