I read with sadness today that Jennifer Saunders, the British comedienne and writer, has been having treatment for breast cancer.
As a man I will never quite understand the range of emotions a woman must go through whilst receiving treatment for this illness.
What concerned me about her Harley Street treatment was the use of two drugs.
Tamoxifen and citalopram.
According to The Daily Mail the side-effects of Tamoxifen pushed Jennifer into menopause, which she likened to ‘jumping off a cliff’.
The Daily Mail writes:
She will continue to take tamoxifen, which works by blocking the female hormone oestrogen, for five years but admitted it had left her feeling depressed and unable to get out of bed.
The mother-of-three, who was diagnosed last year, said: ‘You are pushed into menopause like jumping off a cliff… bang!’
She also revealed she was put on anti-depressants after chemotherapy.
Jennifer was given a course of the SSRi citalopram [Cipramil] - I find this astounding.
Back in 2009, at the American Society of Clinical Oncology (ASCO) 45th Annual Meeting, it was revealed that patients who are taking tamoxifen to reduce their risk for breast cancer recurrence should avoid concomitant use of selective serotonin reuptake inhibitors, of which citalopram is one.
SSRi's are potent inhibitors of the cytochrome P450 2D6 enzyme that converts tamoxifen to its active metabolite, endoxifen. By inhibiting the enzyme, these drugs reduce the blood levels of this active metabolite, and so reduce the efficacy of tamoxifen in protecting against breast cancer recurrence.
I'm a big fan of Saunders and her husband Ade Edmonson, I grew up with them. I hope that, at some point, the Harley Street specialists who prescribed Jennifer citalopram can refer to the studies out there that suggest that SSRi's and Taoxifen should not be mixed.
Daily Mail article HERE
**British drug regulators, the MHRA, post drug safety warning regarding Tamoxifen and SSRi medication  HERE
** Listen to the audio recording of when two Irish parents met citalopram manufacturer Lundbeck to pose questions about the safety and efficacy of their product HERE