Neuropsychiatric effects of tamoxifen: Challenges and opportunities

Front Neuroendocrinol. 2020 Oct:59:100869. doi: 10.1016/j.yfrne.2020.100869. Epub 2020 Aug 18.

Abstract

Epidemiological, clinical, and basic research over the past thirty years have described the benefits of estrogen on cognition, mood, and brain health. Less is known about tamoxifen, a selective estrogen receptor modifier (SERM) commonly used in breast cancer which is able to cross the blood-brain barrier. In this article, we review the basic pharmacology of tamoxifenas well as its effects on cognition and mood. The literature reveals an overall impairing effect of tamoxifen on cognition in breast cancer patients, hinting at central antiestrogen activity. On the other hand, tamoxifen demonstrates promising effects in psychiatric disorders, like bipolar disorder, where its therapeutic action may be independent of interaction with estrogen receptors. Understanding the neuropsychiatric properties of SERMs like tamoxifen can guide future research to ameliorate unwanted side-effects and provide novel options for difficult to treat disorders.

Keywords: Breast cancer; Estrogen; SERM; Tamoxifen.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Affect / drug effects*
  • Animals
  • Antineoplastic Agents, Hormonal / pharmacology*
  • Cognition / drug effects*
  • Estrogen Antagonists / pharmacology*
  • Humans
  • Tamoxifen / pharmacology*

Substances

  • Antineoplastic Agents, Hormonal
  • Estrogen Antagonists
  • Tamoxifen