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Tamoxifen Safer in Smaller Doses

October 12, 1998

Dangerous side effects of tamoxifen, a cancer drug that scientists think can also be used to prevent breast cancer, might be reduced by cutting the dose of the drug, Italian researchers reported Tuesday in the Journal of the National Cancer Institute. The researchers said they found tamoxifen seems to work well in much smaller doses than usually given.

"Up to a 75% reduction in the conventional dose of tamoxifen does not affect the activity of the drug," Andrea Decensi and colleagues at the European Institute of Oncology in Milan, Italy, wrote. Tamoxifen, sold under the name Nolvadex, is already the most commonly used drug against breast cancer. The Food and Drug Administration is considering whether to approve it for preventing breast cancer in women considered at high risk.

This consideration is based on a study, initially reported in April, that found healthy women at the highest risk of developing breast cancer had their risk cut in half by taking tamoxifen every day. There are side-effects from tamoxifen, such as an increased risk of blood clots and a higher incidence of cancer of the uterus. Women who are obese, smoke or have diabetes have an increased risk of developing blood clots, so tamoxifen may not be a good option for them.

Decensi's study gave 127 healthy women aged 35 to 70 either 20 milligrams of tamoxifen a day, 10 milligrams a day, 10 milligrams every other day or a sugar pill.

Drug Shows Promise in Cases of Head Trauma

A synthetic marijuana analog called dexanabinol may improve the treatment of the 375,000 Americans who suffer head trauma each year. Such trauma causes brain swelling that pinches the sensitive tissue against the skull. There is currently no effective treatment for such trauma.

Israeli physicians tested dexanabinol on 67 brain trauma patients at six trauma centers in Israel. They reported last week at the Congress of Neurological Surgeons in Seattle that the drug produced a 26% reduction in deaths. Three months after the injury, 42% of patients who received the drug had a "good" outcome on a conventional scale, compared to only 17% of the group who received a placebo.

Fetal Cocaine Exposure Related to Child Behavior

Children born to women who used cocaine during pregnancy run a higher risk of developing long-term behavior problems, a study of first-graders suggests. Teachers who were asked to rate classroom behavior reported that cocaine-exposed children showed more problems in 11 of 14 areas, including distractibility, social skills, hyperactivity and disorganization.

"Clearly, children exposed to cocaine were at risk for behavioral problems," said the researchers, led by Dr. Virginia Delaney-Black of Wayne State University's School of Medicine. However, the researchers cautioned that the study did not take into account other factors that could have caused the problems. The study of 102 youngsters appears in the October issue of Pediatrics, published by the American Academy of Pediatrics.

--COMPILED BY THOMAS H. MAUGH II

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