Atomoxetine and modafinil both had evidence of low carcinogenic and low genotoxic potential.
Little troubling data exist to suggest that methylphenidate might be carcinogenic over the long-term, but the Tufts group rated it as “intermediate” in terms of potential risk because of the sparsity of data.
Amphetamines were categorized by the group as having high carcinogenic potential. Among antipsychotics, clozapine and mesoridazine demonstrated a low carcinogenicity risk in preclinical studies, while risperidone, olanzapine, quetiapine, aripiprazole, and to a slightly lesser degree, ziprasidone demonstrated a high risk.
Haloperidol, chlorpromazine, trifluoperazine, pimozide, and fluphenazine all were categorized as “intermediate” in carcinogenic potential based on available preclinical data. In seven epidemiologic studies of carcinogenicity of antipsychotics, five found positive evidence of carcinogenicity and two were negative, Dr. Gálvez-Flórez reported. Many benzodiazepines, on the other hand, showed little evidence of carcinogenicity in preclinical studies.
Among mood stabilizers, carbamazepine and oxcarbazepine showed a high risk of carcinogenicity, lamotrigine and lithium showed a low risk, and other agents were deemed to be of intermediate risk in preclinical studies.
“In terms of consistent results, it seems that almost all atypical neuroleptics showed a high potential risk,” Dr. Ghaemi said. “This is one class that clearly needs to be studied.”
The Pharmaceutical Research and Manufacturers of America declined to comment on this story.
Dr. Gálvez-Flórez has served on the speakers bureau, advisory board, or as a consultant to Eli Lilly, GSK, Pfizer-Wyeth, and AstraZeneca, and has received educational support from numerous pharmaceutical companies. Dr. Ghaemi has received a research grant from Pfizer.
By Betsy Bates. Send your thoughts to cpnews@elsevier.com