title: Successful use of agomelatine in the treatment of major depression in a woman taking tamoxifen: a case report.
abstract: The selective estrogen receptor modulator, tamoxifen, is extensively used for the endocrine treatment of all stages of hormone receptor-positive breast cancer. Tamoxifen is a mainly inactive prodrug, necessitating metabolism by the cytochrome P450 (CYP450) pathway, predominantly the Cytochrome P450 2D6 (CYP2D6), into the active metabolites 4-hydroxytamoxifen and, in particular, endoxifen to achieve its therapeutic effect. As several women treated with tamoxifen may experience depressive symptoms or may have a previous or actual major depressive episode with ongoing antidepressant treatment or need for a new-onset therapy, the coprescription of an antidepressant drug may be particularly problematic as several antidepressants are potent CYP2D6-inhibiting drugs. We herein report a case of a patient with major depression and concurrent tamoxifen therapy successfully treated with agomelatine monotherapy.
authors.affiliation: *National Health Service, Department of Mental Health, Psychiatric Service of Diagnosis and Treatment, Hospital "G. Mazzini," Teramo; †Department of Neuroscience and Imaging, University "G. D'Annunzio," Chieti; ‡National Health Service, U. O. S. D. Senology, Hospital "G. Mazzini," Teramo; §Hermanas Hospitalarias, FoRiPsi, Villa S. Giuseppe Hospital, Ascoli Piceno; ∥Department of "Scienze della Formazione," University of Catania, Catania; and ¶Department of Health Science, University of L'Aquila, L'Aquila, Italy.
authors.forename: Domenico
authors.initials: D
authors.lastname: De Berardis
authors.forename: Maurizio
authors.initials: M
authors.lastname: Brucchi
authors.forename: Nicola
authors.initials: N
authors.lastname: Serroni
authors.forename: Alessandro
authors.initials: A
authors.lastname: Valchera
authors.forename: Michele
authors.initials: M
authors.lastname: Fornaro
authors.forename: Monica
authors.initials: M
authors.lastname: Mazza
authors.forename: Giovanni
authors.initials: G
authors.lastname: Martinotti
authors.forename: Massimo
authors.initials: M
authors.lastname: Di Giannantonio
mesh_terms: D000081:Acetamides / Q000627:therapeutic use*; D000328:Adult; D000928:Antidepressive Agents / Q000627:therapeutic use*; D002277:Carcinoma / Q000188:drug therapy; D003865:Major Depressive Disorder / Q000139:chemically induced* / Q000188:drug therapy*; D004965:Estrogen Antagonists / Q000009:adverse effects*; D005260:Female; D006801:Humans; D013629:Tamoxifen / Q000009:adverse effects*; D009281:Naphthalenes
chemical_list: D000081:Acetamides; D000928:Antidepressive Agents; D004965:Estrogen Antagonists; D013629:Tamoxifen; C084711:agomelatine; D009281:Naphthalenes