Clinical Update 2024: Recommendations on the Use of Antidepressants in Women Taking Tamoxifen
While some antidepressants may affect the metabolism and efficacy of tamoxifen, many antidepressants can be used safely in this population.
While some antidepressants may affect the metabolism and efficacy of tamoxifen, many antidepressants can be used safely in this population.
Bupropion is commonly used to treat depression, and is also prescribed to support smoking cessation. Early data on bupropion-exposure during pregnancy raised concern for a possible increase in risk of malformations of the heart and large blood vessels in bupropion-exposed infants. Subsequent data from bupropion pregnancy registries has been reassuring, however, and do not demonstrate an overall increase in risk of cardiac defects following first trimester bupropion exposure. Although the overall risk of cardiac defects was not increased, the distribution of specific defects in these registries was unexpected in some ways. For example, the GlaxoSmithKline Bupropion Pregnancy Registry included two cases of coarctation of the aorta out of the 675 bupropion-exposed infants, compared to the rate of 6 cases per 10,000 births in the general population.
Women receiving tamoxifen for the treatment or prevention of breast cancer should be aware of possible drug-drug interactions between tamoxifen and specific antidepressant medications. Antidepressants are used widely to treat depression and anxiety disorders in [...]
About half of women smokers stop smoking during pregnancy, and that means about 13% of women in the United States continue to smoke while pregnant. In addition, about half of the women who manage to [...]
An updated version of this post can be found HERE. Two thirds of all breast cancer tumors are known to have receptors that respond to hormones; that is they can grow in response to estrogen. [...]
Bupropion is commonly used to treat depression, and is also prescribed to support smoking cessation. Early data on bupropion-exposure during pregnancy raised concern for a possible increase in risk of malformations of the heart and large blood vessels in bupropion-exposed infants. Subsequent data from bupropion pregnancy registries has been reassuring, however, and do not demonstrate an overall increase in risk of cardiac defects following first trimester bupropion exposure. Although the overall risk of cardiac defects was not increased, the distribution of specific defects in these registries was unexpected in some ways. For example, the GlaxoSmithKline Bupropion Pregnancy Registry included two cases of coarctation of the aorta out of the 675 bupropion-exposed infants, compared to the rate of 6 cases per 10,000 births in the general population.
Many women are understandably concerned about the risk of weight gain associated with antidepressants. It is difficult to advise them as to which antidepressants are less or more likely to cause weight gain, as there [...]
For women with mild to moderate attention-deficit/hyperactivity disorder (ADHD) symptoms, we frequently recommend discontinuing medication and switching to a non-pharmacologic intervention. Although these women might experience some decrease in their level of functioning, they typically [...]
Approximately 4% of the adult population suffers from ADHD. Attention and executive functioning difficulties also occur in those with mood and psychotic disorders and require treatment strategies similar to those used to address ADHD symptoms. First line medications most often used to treat ADHD in adults are Dextroamphetamine (Dexedrine, Adderall) and Methylphenidate (Concerta, Ritalin, Metadate).
There are data to support the use of certain antidepressants during pregnancy. Most of the research over the last decade has focused on the selective serotonin reuptake inhibitors (SSRIs) like fluoxetine (Prozac) and the older tricyclic antidepressants, but there is some new data supporting the use of bupropion during pregnancy.