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Acute Tamoxifen-Induced Depression and Its Prevention With Venlafaxine

Received October 2, 2007; accepted November 28, 2007. From the Dept. of Psychiatry, McGill University, Montreal, Quebec, Canada; the Consultation–Liaison Service, Dept. of Psychiatry, Sir Mortimer B. Davis Jewish General Hospital, Montreal, Quebec; and the Dept. of Oncology, Sir Mortimer B. Davis Jewish General Hospital, McGill University, Montreal, Quebec, Canada. Send correspondence and reprint requests to Karl Looper, M.D, Sir Mortimer B. Davis Jewish General Hospital, Office A-540, 3755 Chemin de la Côte-Ste-Catherine, Montreal, Quebec, H3T 1E2, Canada. e-mail: karl.looper{at}mcgill.ca
© 2009 The Academy of Psychosomatic Medicine

BACKGROUND: Tamoxifen is a first-generation selective estrogen-receptor modulator that has been shown to decrease recurrence and prolong survival among premenopausal women with breast cancer; however, it also results in estrogen-insufficiency symptoms, the most common being hot flushes. OBJECTIVE: The authors present a case in which tamoxifen apparently produced acute depression symptoms in a 34-year-old breast cancer patient. METHOD: After two aborted periods of tamoxifen treatment, the patient was started on venlafaxine as a preventive measure before tamoxifen treatment was begun again. RESULTS: After 2 months of treatment with venlafaxine, tamoxifen was initiated for a third time, with no recurrence of her previous mood symptoms. CONCLUSION: Treatment of depression may result in better compliance with tamoxifen regimens and, thus, more favorable outcomes.

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