Posted by linkadge on July 13, 2008, at 13:03:50
In reply to Re: caution.... » linkadge, posted by SLS on July 13, 2008, at 5:17:08
>If there is no need to panic or jump to >conclusions, why do you recommend not taking >these genotoxic drugs based upon the facts you >found?
To panic would be to assume that one is going to get cancer due to past or current exposure to a genotoxic TCA. On the other hand, I would not consider it to be foolish to want to make a change to a potentially safer agent.
The drug is already approved. It takes a lot more health risk for a drug to be unaproved then it does for the drug not to be approved in the first place.
Secondly, exactly who is working on the patient's behalf to assure that the genotoxicity is an acceptable risk?
>Can you convey the magnitude of your concern >about genotoxic antidepressants and why?
To me its not so much about concern than it is about common sense. The genotoxic TCA's have fairly consistenly displayed the ability to damage genetic material. Many of the tests for geneotoxicity appear to be highly predictive of the carcinogenic potential of many environmental toxins. I would consider it to be common sense to switch to a nongenotoxic alternative if it is as effective.
It is easy for somebody (who isn't taking the drug) to tell you not to be alarmed. If you were currently taking desipramine, you might think of the issue in a different light.
No, nobody has proven that the genotoxic TCA's cause cancer, but there is a possability. Desipramine/clomipramine seems to be the most reliably genotoxic and I would have a very hard time feeling comfortable ingesting a theraputic dose (for me 150mg clomipramine) day after day. There has been cancer in my family and a higher risk of cancer in this geographical region (for one reason or another). It would make sense (in my mind) for me to reduce any controllable potential risk factors.
>I sway back and forth on the issue and would >like more facts or description of your >perspectives on the risk factors.
If you want me to prove an association I obviously can't do that. I am also not capable of
conveying any idea of any true risk as there is an unacceptable paucity of followup studies.The TCA's are very effective antidepressants. The side effect profile is of course a concern for certain conditions. Some research, for instance, directly contraindicates the use of TCA's in patients with heart disease. There seems to be an attempt to phase the TCA's out. What I mean, is that there seems to be a push to discribe the TCA's as dirty and a move to advise against their general use.
Because of this, I don't think there is adequate concern over just how much of a risk the TCA's might pose in terms of cancer. If half of the SSRI's were discovered to be genotoxic, there would be more drive to clarify the issue. As for TCA's I don't think anyone cares, they're old and 'we don't use them anymore'.
Most doctors will take the preliminary findings as further justification for avoiding their use, but will probably have no further concern or motivation to follow up.
I would personally think that because genotoxicity does seem to present itself as a risk factor for cancer and because of the lack of likelyhood of prompt followup studies, one would be best advised to err on the side of caution and switch to a safer option if at all medically feasable.
Linkadge
poster:linkadge
thread:839295
URL: http://www.dr-bob.org/babble/20080706/msgs/839562.html