Were you on antidepressants BEFORE diagnosis?

Jacquio

Back in December when I met my med. onc. to discuss my upcoming chemo treatment, I asked him if I could get a higher dose of my antidepressant to help me get through everything. Without a second to spare, he said, "NO." I've been thinking about that quick response ever since (never brought it up to him again), and decided that now that I'm thinking clearly post-treatments, I would do a little research. I recently googled "antidepressants and breast cancer" and have found references to studies where they are associating antidepressants (specifically Paxil) to a future breast cancer diagnosis. Has anyone heard of this, asked their docs about it, been taken off of antidepressants? I wonder if this is something that needs more study or attention. So many people have taken antidepressants, it makes me wonder...

NarberthMom

Jacquio -

If you are at a Comprehensive Cancer Center, they should have a social work/therapist/or psychiatrist on staff. Ask to meet with one of them, and they will do an assessment about whether you need anti-depressants. It's important to work with pyschiatrists who specialize in cancer patients, because they know what drugs "play" well with chemo and post-chemo treatments

In a pinch, you could also try your PCP and see if you could something.

I'm sad that your onc so quickly dismissed your depression without more fully exploring whether you were having real depressive symptoms. 

Jacquio

Actually, I'm doing well, thanks, however what I am wondering about is the studies I am finding out where they are finding a link between Paxil and a future diagnosis of breast cancer.

Thanks for you caring post!

FloridaLady

I can't imagine short to use of antidepressant will cause you any harm.  I have not see any of this research yet.  But quality of life is very important while in treatment. With so many of us on them does make me wonder why if this is a issue not been brought up to us.

Flalady

NarberthMom

Flalady - I totally agree with you!

LUVmy2girlZ

Keep us posted!  I have NEVER been on anxiety pills until I was dx'd and my PCP said he would prescribe something mild but only gave me a 30 day prescription.  There are times I think I should get it filled as the anxiety can quickly pop up anytime...but if there are "risks" I think we should be informed prior.

Anyway, I have known people to be on it for YEARS!!!  Are you referring to the ingredient ?  Or antidepressants in general...like xanax etc.

I started walking...and it works WONDERS...I never took the time and now I believe it has helped immensely w/ my nerves!

Much LUV

bunnyrabbit

I have also been on a antidepressant for about 3years...interesting.  But I to believe the quality of life is important while on treatment.  I will talk with my Onc on Monday about this...thanks.

Jacquio

If you google anitdepressants and breast cancer, you'll see references to Paxil in particular. Some of the studies show a link between being on it for a while, and then a diagnosis of breast cancer. It made me think, I wonder how many of us have been on antidepressants for years, and now have a BC issue...  Me for one.  I am bringing it up to my onc when I see him next week to see what he says about the research. 

LUVmy2girlZ

WebMD Medical News

June 16, 2000 -- Ever since some studies in animals showed that antidepressants might increase the risk of breast tumors, researchers have been looking for a similar link in humans. Now a group of Canadian researchers reports that its study of more than 5,000 women found that those who had taken the drugs for at least two months had a greater probability of having breast cancer than those who had not.

This finding, which the researchers discussed at a meeting of the Society for Epidemiologic Research in Seattle, adds support to a study done by the same researchers published this spring in the American Journal of Epidemiology. That study looked at a much smaller number of women. In it, researcher Nancy Kreiger and her colleagues at the University of Toronto reported that women who took an older class of drugs, called tricyclic antidepressants, for two years had twice the risk of breast cancer. And those taking Paxil, one of a class of drugs called serotonin reuptake inhibitors (SSRIs), had seven times the risk. But because of the small number of patients in that study, the true effect of the drugs couldn't be confirmed.

In the more recent study, a substantially smaller link was seen between antidepressants and breast cancer.

"The reason we looked at this is that a psychiatrist, who is also one of the co-investigators, noticed that in mouse studies, antidepressants may cause mammary tumors," one of the researchers, Michelle Cotterchio, PhD., tells WebMD.

"The results could be the result of chance alone. That's why future studies need to be done. It takes five to 10 studies in different subgroups before people start believing the findings."

Indeed, several critics have pointed out what they consider to be shortcomings in the studies, or problems in the interpretation of the results.

The animal studies were prompted by the recognition that the antidepressant drug molecule is similar to that of other chemicals that are known to cause cancer. These agents appear to inhibit an enzyme associated with cancer, explains Judith Parsells Kelly, PhD. The next step was to do so-called epidemiologic studies, in which the incidence of cancer in women who had used antidepressants was compared with that in those who hadn't used the medications.

"Epidemiology is really a rather crude tool, and it's effective for identifying increases in risk when the magnitude of the risk is quite high," Kelly says. But that is not the case with antidepressants and breast cancer. Kelly was not involved in the Canadian study, but she has studied links between drugs such as SSRIs, tricyclic antidepressants, and antihistamines and cancer.

Several physicians who spoke to WebMD raised the question of whether depression alone could have been responsible for the increased risk Krieger and colleagues found.

"There's a general theory that depression may make people susceptible to cancers in general, because it can decrease immune function. There has not been any strong data to support that. On the other hand, it hasn't been looked at in a well-designed study," says Bruce Trock, PhD, associate professor of medicine and oncology at Georgetown University School of Medicine in Washington.

Krieger's findings raise other several questions, Trock says, such as: How does the number of women who took antidepressants and didn't get cancer compare to the general population? Were the researchers able to eliminate the impact of known breast-cancer risk factors?

For these reasons, more studies need to be done. At this point, Kelly says, "Women should not avoid taking antidepressants because they're afraid of developing breast cancer. The evidence is not strong enough to justify that type of action."

Says Charles Loprinzi, MD, an oncologist at the Mayo Clinic in Rochester, Minn., who has studied the use of Prozac to relieve hot flashes in breast cancer survivors: "The bottom line must be that you can't put much credence in [these findings]. The numbers are small and consistent with what might have occurred by chance. This is the same sort of risk that people have talked about with alcohol use. It's very, very small indeed."

Shirlann

Well, sisters, this is just ducky!!

I started on Paxil one year before my diagnosis.  DARN!!  But I am 10 years post treatment with no new cancers (that I know of).  

But I sure would not have wanted this one Anti-dep, if I had known this, I am still on it too.  There are many others now, so it probably would be a good idea to try another one.

I would not have survived without the anti-deps, being a life-long anxiety/ depressive, I would have died from fright.  But if I wasn't on Paxil, maybe I would not have gotten BC.  Sheeesh,

Oh well, Hugs, Shirlann

Jacquio

Shirlann, I'm right here with you, I need them to get through this new territory for me - 'after treatments what now." I will be asking my onc about this when I see him. He is from a very highly regarded group in the Chicagoland area, and goes to all the conferences. When he flat out told me NO CHANGE to my current prescription, I knew there was a reason behind it. And it's the one time I didn't ask "WHY."  I'll let y'all know what he says. They say wine is a risk, fat is a risk, cell phones are a risk...how about all of us who sit in front of computers all day long...  Who knows, but if we can find out WHY we got it to begin with someday, then my daughter, your daughter, granddaughter, neice, nephew may be spared what we are going through. So, we may not be able to do anything about our past, but we can certainly contribute to the future. 

Jacquio

Just found this. They'll never give 100% conclusions, but this sounds encouraging. 

Does Paxil cause breast cancer?

(This article was first printed in the March 2006 issue of the Harvard Women's Health Watch. For more information or to order, please go to http://www.health.harvard.edu/newsletters/Harvard_Womens_Health_Watch.htm.)

Q. I heard there's a relationship between Paxil and breast cancer risk. Is this true?

A. The short answer to your question is no: The available research does not show that Paxil (paroxetine) raises the risk of breast cancer. The story of how researchers have addressed this question illustrates how medical knowledge advances.

Paxil is one of a class of antidepressant drugs called selective serotonin reuptake inhibitors (SSRIs), the best known of which is fluoxetine (Prozac). Some SSRIs have also been shown to reduce hot flashes, and are an alternative for postmenopausal women who would like to avoid hormone therapy, which increases breast cancer risk. But they can also increase levels of prolactin, a hormone that stimulates the growth of certain breast cells, so there's been some concern they might increase breast cancer risk.

A 1992 laboratory study showed that Paxil accelerated the growth of mammary tumors in rodents. Later research did not replicate these findings in various human cells, including a human breast cancer cell line. But the rat study had spurred further research on the issue. In 2000, researchers reported a sevenfold increase in breast cancer risk among Paxil users compared with nonusers. And a 2003 study concluded that breast cancer risk doubled among women who had used SSRIs for three years or more. But both investigations were very small, and the results could have been due to chance.

In 2005, several large studies analyzing data from thousands rather than dozens of women all concluded that antidepressant use did not raise breast cancer risk. The largest study analyzed the medical records of 109,004 women who had used antidepressants for five years. It showed no increase in breast cancer risk overall, and no greater risk for women taking Paxil than for those taking other antidepressants.

The most recent study, conducted at the University of Seattle and published in December 2005 reported similar results.

There has been no randomized, controlled clinical trial - the scientific gold standard - to resolve this question definitively. But the latest group of studies is very reassuring. A woman who's getting relief from depression by taking an SSRI should not be concerned that it will increase her risk of breast cancer. 

- Celeste Robb-Nicholson, M.D.
Editor in Chief, Harvard Women's Health Watch

(This article was first printed in the March 2006 issue of the Harvard Women's Health Watch. For more information or to order, please go to http://www.health.harvard.edu/newsletters/Harvard_Womens_Health_Watch.htm.)

KPolasek

Noritrptylene (not sure about the spelling) ... it is an anti-depressant but it was given to me for pain.  I also went on Paxial about a year or so before I was diagnosed.

 Blessings,

K