Women face difficult choices when deciding whether or not to continue psychiatric medications during pregnancy. For many years, we have typically recommended the older antidepressants, including the selective serotonin reuptake inhibitors or SSRIs such as [...]
It has been a few months since Zulresso (brexanolone), the new FDA-approved treatment for postpartum depression, has been available. At our clinic, we have had multiple queries regarding how to obtain treatment with Zulresso. One [...]
Every day, we see women in our clinic who are deciding whether to continue a selective serotonin reuptake inhibitor (SSRI) for management of depression or anxiety during pregnancy. As a class, SSRI use during [...]
Serotonin reuptake inhibitor (SRI) antidepressants may affect platelet aggregation and thus may increase the risk of bleeding. Over the last few years, we have seen several studies which have sought to determine if exposure [...]
January was Birth Defects Prevention Month, and MotherToBaby launched a free app designed to provide evidence-based information to pregnant and breastfeeding women. There is Information on a broad range of medications, some herbal remedies, [...]
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. [...]
An updated version of this post can be found HERE. Tamoxifen is a selective estrogen receptor modulator (or SERM) which is used for the treatment and prevention of breast cancer. Tamoxifen’s effects in the breast [...]
Tamoxifen is a SERM (selective estrogen receptor modulator) used in women with breast cancer; it reduces the risk of relapse and improves overall survival. Tamoxifen may also be used to reduce the risk of breast cancer in women at high risk for the disease. In order to be fully effective, tamoxifen must be metabolized to an active metabolite, endoxifen, by the liver enzyme CYP2D6. Consequently, any co-administered agent that inhibits this enzyme will reduce the conversion of tamoxifen to endoxifen, thereby potentially reducing the efficacy of tamoxifen as a breast cancer therapy.
Women receiving tamoxifen for the treatment or prevention of breast cancer should be aware of possible drug-drug interactions with specific antidepressant medications (e.g., SSRI). These antidepressants are used widely to treat depression and anxiety disorders. In addition, multiple studies have shown that these antidepressants are an effective non-hormonal treatment for hot flashes; over 25% of women who are experiencing hot flashes related to tamoxifen therapy are now prescribed antidepressants to manage their symptoms.