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    It had all the elements of the kind of fraud we are n the lookout for today, but back then were essentially unheard of – ghostwriting [Sally Laden], corrupt KOLs [Charles Nemeroff], flooding of the literature, etc. The discontinuation symptoms [withdrawal] was first reported in 1994, and in a wave of articles in 1995, but didn’t really get appropriate attention until the 2001 report by Haddad: Discontinuation symptoms are recognised with tricyclic antidepressants, monoamine oxidase inhibitors, selective serotonin reuptake inhibitors (SSRIs) and miscellaneous antidepressants. A wide variety of symptoms have been described, differing somewhat between antidepressant classes, and several symptom clusters or discontinuation syndromes appear to exist. A common feature is onset within a few days of stopping the antidepressant or, less commonly, reducing the dosage. Discontinuation syndromes are clinically relevant as they are common, can cause significant morbidity, can be misdiagnosed leading to inappropriate treatment and can adversely effect future antidepressant compliance. Preventative strategies include tapering antidepressants prior to stoppage and educating patients and healthcare professionals to ensure that antidepressants are taken consistently and not stopped abruptly. Most reactions are mild and short-lived and require no treatment other than patient reassurance. pid=20601103&sid=ac VRDi Rc YWz Q&refer=news Antidepressants Cut Effectiveness of Tamoxifen in Breast Cancer By Lisa Rapaport May 30 (Bloomberg) — Tamoxifen, a breast cancer medicine used by millions of women, doesnt work when taken with antidepressants like Eli Lilly & Co.s Prozac, Pfizer Inc.s Zoloft and Glaxo Smith Kline Plcs Paxil, a study says. Tumors were more than twice as likely to return after two years in women taking the antidepressants while on the cancer drug, compared with those taking tamoxifen alone, the study showed. The research, by Medco Health Solutions Inc., was presented today at a meeting of the American Society of Clinical Oncology in Orlando. Doctors began treating hot flashes with antidepressants, an unapproved use, after a U. study seven years ago linked the former standard remedy, hormone replacement therapy, to an increased risk of breast cancer and heart attacks. Other types of antidepressants, such as Wyeths Effexor, may be safer for women on tamoxifen than Paxil or Prozac, said Powel Brown, director of cancer prevention at the Lester and Sue Smith Breast Cancer Center at Baylor College of Medicine in Houston. Effexor doesnt interfere with tamoxifen so that is the preferred drug for oncologists to treat hot flashes, said Brown, who wasnt involved in the study. We need to get that message out to primary care doctors and psychiatrists and gynecologists so they will be aware that antidepressants like Paxil have a risk of inhibiting tamoxifen. Hot flashes are a side effect of tamoxifen. About 187,000 women were diagnosed with breast cancer and 41,000 women died from it in 2005, the most recent year for which CDC data are available.

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