Tamoxifen Abuse

Sometimes, when I write about new psychotropic medication coming to
market, I include a comment on the abuse potential.  For
example, I've commented before on the relative lack of abuse potential
for  href="http://en.wikipedia.org/wiki/Rozerem" rel="tag">ramelteon
( href="http://www.rozerem.com/home_c.aspx" rel="tag">Rozerem)
and href="http://en.wikipedia.org/wiki/Modafinil" rel="tag">modafinil
( href="http://www.provigil.com/" rel="tag">Provigil).
 Usually, I end with a disclaimer: "but some people will abuse
anything."



Despite that universal disclaimer, I really never thought I would hear
of anyone abusing tamoxifen.   href="http://en.wikipedia.org/wiki/Tamoxifen" rel="tag">Tamoxifen
( href="http://www.tamoxifen.com/consumer/home.asp" rel="tag">Nolvadex)
is a selective estrogen receptor modulator.
 It blocks estrogen receptors.  Its main use
is in the prevention of recurrence of estrogen-receptor-positive breast
cancer.  It is difficult to imaging anyone abusing such a
thing.



Now, however, there is a report of people abusing tamoxifen:

href="http://www.guardian.co.uk/medicine/story/0,,1798339,00.html">Gymgoers
'are abusing tamoxifen'

Guardian Unlimited

David Batty

Thursday June 15, 2006



UK gym users are increasingly abusing prescription medicines including
breast cancer drugs in order to build up muscle definition, researchers
said today.



A survey of male and female gym attendees found not only growing rates
of steroid abuse but also greater misuse of prescription drugs.



Prescription drugs used included the breast cancer treatment tamoxifen
and the diabetes medication insulin, the study - published in the
Journal of the Royal Society of Medicine - said.



The survey of 200 gymgoers in south Wales found 95% were taking a
combination of prescription drugs as well as steroids.



Researchers from the University of Glamorgan found a 14% rise in the
number of gymgoers using insulin - taken to increase body mass -
between 2000 and 2005.



Some of those using the medication suffered abnormally low blood sugar
levels, and one fell into a coma.



The study also found a 22% rise in the numbers using tamoxifen, and the
chief researcher, Professor Bruce Davis, discovered that male
bodybuilders were using the breast cancer drug to counteract the
adverse side effects of steroids.



"When men take testosterone in large doses, it changes into oestrogen
and they can develop a condition known as gynaecomastia, which causes
them to grow breasts. Some even produce milk," he said...

This is a fairly sophisticated form of abuse, in that it seems unlikely
that it would occur to the average body-builder to do this.
 Probably, someone with medical training thought of it.
 Possibly, it was someone involved in the illicit supply of
the anabolic steroids.  



It is a saddening commentary on the desperation of these persons, who
would abuse a second prescription drug in order to counteract the
adverse effects of the first abused drug.  From the
manufacturer's site:

In clinical trials it has been shown that
cancer of the uterus, stroke, and blood clots can occur approximately 2
to 4 times more frequently with NOLVADEX than placebo, but each
occurred in less than 1% of women. Some of these strokes, blood clots,
and uterine cancers were fatal.

I'm assuming that whoever first came up with the idea of abusing
tamoxifen would have known about these risks, but went ahead with it
anyway.