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drug interaction(s) of tamoxifen with SSRI

Drug interactions: - CYP2D6-mediated conversion of tamoxifen is inhibited by CYP2D6 inhibitors, including SSRIs paroxetine, fluoxetine, & sertraline - apparently, citalopram, escitalopram, & fluvoxamine are weaker CYP2D6 inhibitors & their interactions may not be clinically significant - paroxetine does inhibit benefit of tamoxifen in women with breast cancer - increased mortality from breast cancer in women taking both tamoxifen & paroxetine relative to tamoxifen alone [2] - fluoxetine was not found to be associated with an increase in mortality, possibly because the number of women taking both fluoxetine & tamoxifen was low [2]

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DRUGS: tamoxifen serotonin reuptake inhibitor

References

  1. Prescriber's Letter 16(7): 2009 COMMENTARY: Tamoxifen and SSRIs: Is There An Interaction? COMMENTARY: How to Switch Antidepressants CHART: Cytochrome P450 Drug Interactions Detail-Document#: 250702 (subscription needed) http://www.prescribersletter.com
  2. Kelly CM et al Selective serotonin reuptake inhibitors and breast cancer mortality in women receiving tamoxifen: a population based cohort study BMJ 2010;340:c693 PMID: 20142325 http://www.bmj.com/cgi/content/full/340/feb08_1/c693