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Re: caution....

Posted by linkadge on July 13, 2008, at 12:20:46

In reply to Re: caution.... » Jay_Bravest_Face, posted by SLS on July 13, 2008, at 5:09:16

>Results using mice and fruit flies are >preliminary, and I don't know if there is a >statistical correlation between these drugs and >cancer in humans.

Iforgotmypasword hinted at a bone marrow genotoxicity study. I'd be interested in reading that.

>You would think it would have shown up in the >human population by now.

I'd say no! The thing that *can* separate genotoxicity from cancer is time. Its a very difficult thing to study. If you take a substance that might initiate tumor growth, you might not detect cancer till decades later. One study associated use of the genotoxic TCA's with a higher incidence of breast cancer in women. I am *very* hesitent when people say, "we'd know by now", because I don't think thats true. Unless you directly look for an association, it can be very difficult to detect. People get cancer, its not something one immediately blames on the use of an antidepresant, especially before the knowledge of the genotoxicity of these substances was available.

>Genotoxicity is a scary proposition, though. I >am glad that nortriptyline works better for me >than desipramine. I would like nothing better >than to be able to use desipramine were I to >need it.

I'd keep my eye on all relavant research. In some of the studies, certain TCA's displayed mixed results (ie genotoxic one study, then not in the next study). The issue of drug safety is a dynamic process. We learn more each day.

>I guess when it comes to risk versus benefit, >there has not been enough of a quantification to >make an informed decision.

Still, its about potential risk. If a genotoxic TCA were the *only* available antidepressant that was capable of sufficiantly elevating depression, then it could possibly be justified. But for those in whom a nongenotoxic alternitive is close in efficacy, then it would just make sense to make the switch.

>What are you basing your caution on?

Common sense. Choose the path with the least potential risk.


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