BRIGHTON, England--Tamoxifen taken by healthy women to prevent breast cancer seems to produce minimal psychological and sexual side effects.

So concluded a British team that found little difference in anxiety, mood swings, or sexual functioning between 254 high-risk women randomized to 20 mg/day of tamoxifen for four years and 234 placebo controls, also at high risk. Both groups' self-reported scores, recorded every six months, remained similar to baseline, though there was wide individual variation at times, particularly with anxiety.

After 48 months of treatment, 26% of those taking tamoxifen reported mood swings as did 22% of those in the placebo group, Dr. Lesley Fallowfield of the University of Sussex and colleagues reported in the April 1 Journal of Clinical Oncology.

Some 23% of the tamoxifen group reported anxiety, compared with 25% of the controls, and 80% of the tamoxifen women reported they were sexually active, compared with 75% of the controls.

Tamoxifen users reported more hot flashes (42% vs. 29%), night sweats (43% vs. 29%), and cold sweats (10% vs. 3%) than the controls.

The women in the study were participants in two ongoing randomized breast-cancer prevention trials. Questionnaires were completed at trial entry and every six months during treatment.

The British psychosocial findings were comparable to those of a National Surgical Adjuvant Breast and Bowel Project study in 1999. However, that study found more vasomotor and gynecologic symptoms and some extra problems in sexual functioning--possibly the result of chance--among those taking tamoxifen.

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