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SSRIs impact on tamoxifen efficacy?

Page last modified on: September 9, 2009
Question from Linda: Good evening, doctors. Would you please share the latest info on the impact of SSRIs (specifically Zoloft) on tamoxifen efficacy? Is there a test that will show how well a person is metabolizing tamoxifen? This information does not seem to be widely circulated.
Answer —Nicholas Robert, M.D.: This question raises a very important aspect of treatment, which is how different people metabolize the same drug differently. There is now an understanding that tamoxifen can be metabolized different ways, depending on what enzymes people have. In addition, there are certain drugs that can inhibit enzymes and will also affect the metabolism. At this point, everyone is trying to figure out how to use this information in recommending drugs like tamoxifen. There is now an understanding that SSRIs do affect tamoxifen and should be avoided if tamoxifen is to be used. There is also the ability to do a blood test to determine how well tamoxifen is metabolized, but it remains unclear how to use this test when recommending tamoxifen. This area will need to be studied in greater detail before we can make firm recommendations.

Editor's Note: If you are taking tamoxifen, talk to your doctor about which antidepressants are safe for you to take. Some antidepressants -- including Paxil (chemical name: paroxetine), Wellbutrin (chemical name: bupropion), Prozac (chemical name: fluoxetine), Cymbalta (chemical name: duloxetine), and Zoloft (chemical name: sertraline) -- interfere with the body's ability to convert tamoxifen into its active form, preventing you from getting the full benefit of tamoxifen. For more information, please visit the Tamoxifen page.

On Wednesday, June 20, 2007, the Ask-the-Expert Online Conference was called Updates from the 2008 ASCO Annual Meeting. Generosa Grana, M.D., F.A.C.P. and moderator Nicholas Robert, M.D. answered your questions about the latest news on breast cancer screening, treatment, and side effects reported at the annual meeting of the American Society of Clinical Oncology (ASCO) in Chicago.

The materials presented in these conferences do not necessarily reflect the views of breastcancer.org. A qualified healthcare professional should be consulted before using any therapeutic product or regimen discussed. All readers should verify all information and data before employing any therapies described here.

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Meet the Experts

Generosa Grana, M.D., F.A.C.PGenerosa Grana, M.D., F.A.C.P. is the director of the Cooper Cancer Institute and heads the division of hematology/medical oncology at Cooper University Hospital.

Nicholas Robert, M.D.Nicholas Robert, M.D. is a co-chair of the Breast Committee of the U.S. Oncology Research Network and also chairs the Cancer Committee and Research Committee of the Inova Fairfax Hospital's Cancer Center. 

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