citalopram and tamoxifen - anyone ?

Is anyone taking citalopram as well as Tamoxifen - Is it safe to do so and have you found it helped with anxiety/depression. I was prescribed venlafaxine but after reading up about it i am going to see if i can swop it for citalopram.
Thanks Melx

I am. All’s good.

Me too it’s amazing xx

Recent research suggests that neither Citalopram which is a SSRI or Venlafaxine which is a SNRI inhibit the effects of Tamoxifen.

Venlafaxine is generally used at a dose of 37.5mg for hot flushes but this dose is sub-optimal for Depression (75-150mg is the usual dose for depression). Citalopram is generally given at 10mg for anxiety and 20-40mg for depression.

If you decide to go for Citalopram, evidence suggests that there is not much difference in the reduction of hot flushes dependent on the dose so if you need it as an anti-depressant, I’d suggest you discuss a dose of around 20mg with your GP or onc.

Thank you ladies xx


BTW, love your collie! So cute.

Yes and yes. And works wonders with tam flushes. Fab stuff. Was on Venlafaxine but had a weekend when I forgot my script and the se s withdrawal stuff was dreadful. so went back to citalopram .

Doesn’t solve everything though but that’s for a different thread…

I haven’t taken Citalopram but have been taking 37.5mg of Venlafaxine to help with the hot flushes that I have been getting with Herceptin. Works like a treat. The first couple of days I had to take some of my chemo anti-sickness drugs with it as it did cause nausea feelings but after that it has been fine.

I know what you mean about the leaflet being scary but then if you read the leaflet inside a packet of Nurofen you wouldn’t take any!!!

I have read that up to 50% of BC patients end up suffering from depression. Does anyone think that it could be as a direct side-effect of Tamoxifen, rather than an indirect effect because of the whole cancer thing?

I don’t think I’ve ever felt this low, and I’ve had some pretty dark stuff to deal with in my life, and it started a couple of months after starting Tam. I know there has been lots of other stuff that has contributed to it, but could the tamoxifen be causing it?


I definitely think it is directly linked to Tamoxifen. I have never had a depressed bone in my body, not even when I was diagnosed with BC and not throughout all my treatment. Like you I have also had some dark stuff to deal with over the years, including watching my mum die of stomach cancer in a matter of weeks, but as soon as I started taking Tamoxifen within a couple of weeks I felt it, like a great big weight on my head (amongst other horrific side effects).

I struggled on for a couple of months by which time I was truly suicidal, even wondering what it would be like to jump out of my office window 27 floors up in the City of London. Just before Christmas I stopped taking it and within a week felt back to my old self - well almost (am still having side effects from Herceptin, hence the Venlafaxine) but do not have the depressed heaviness at all.

I am due to have my last Herceptin next week along with an appointment with my onc, don’t know what she is going to say about my stopping taking it, but at the moment don’t feel inclined to start again, as for me there has to be some quality alongside potential quantity of life.

I read somewhere that overall approx 50% of women stop taking Tamoxifen due to side effects before the 5 years. I wonder if it is the remaining 50% that suffer from depression.


i am not tnbc but i have been taking citalopram for years for depression, noq a
i am on 40mg since being dx with breast cancer in 2010, could not do without it.

I’m on Tamoxifen and have been taking 10mg of citalopram for 6 weeks now for the hot flushes. The flushes have gone and been replaced with a weird prickly feeling. On the whole feeling much less tired as getting better night’s sleep. Was a total mess. Had to have time off work to recover from acheyness and generally feeling yuk. Now feeling bit brighter and more positive. This Tamoxifen is serious stuff and it seems some of us need help with it. Don’t suffer in silence and think this has to be the new normal. My GP has been great in “sorting” me out:)

Spoke to my GP today and asked her what she thought, and she said it’s very possible that the removal of oestrogen could contribute to a bad depression. So at least I’m not going mad. (Or better to say, at least I know WHY I’ve gone mad…)

Dose upped to 40mg, and I haven’t had a hot flush for a while, which is a good thing, but still feeling totally horrible. So much so that I’m considering just jacking in the Tam. Haven’t done so yet, but it’s very tempting.


I have an appt. with my onc next week and I know she is going to blast me for stopping tamoxifen. I have seen that the tablets also come in 10mg as well as the usual 20mg.

Am thinking of suggesting to her that I try this dosage to see hownI get on. Surely some Tam would be better than none???

If not, have decided for definite that not going to got back on full dose, as have to live a normal life.


I’ve completely forgotten what a “normal life” is…

I saw my onc just last week and didn’t think to mention the depression, or about five other questions I had for him. Damn shame as it was the actual onc I saw and not one of the millions of registrars that drift through the onc dept. But I am very tempted to just jack in the Tam (and citalopram because I won’t need it then) and see what happens. I can’t bear feeling like this, it’s left me a gibbering wreck and wrecked my family life, which is not fair on them either.


I can’t tell you whether it is right or wrong for you to carry on taking Tam or not. From what it sounds like you would be so much better without. BUT there is the little voice that say ‘what if’ all the time in your head.

I know my onc will give me a blasting next week as she is one of these ‘do as I say’ people and her usual ‘you do want to be cured don’t you’, but am feeling strong enough now to not be bullied by her.

Interestingly I put my stats in the NHS Predict website which shows survival and recurrence. In my case, taking into account tumours size, grade, nodes, and ER, PR and Her 2, Tam adds 5% to the overall survival.

Personally I can live with losing that 5%, what I can’t live with is feeling suicidal all the time, that’s a long time of misery.

Try having a break from it for a while and see how you go before you make a final decision.

And remember even if you decide to stop even for a short time, you are not a bad person or failure, don’t let anyone tell you otherwise or tell you that you are putting your health at risk, its a proven fact that chemo, rads, Herceptin and surgery add to survival more than Tam. Yes, its better to be able to take Tam as well, but at what cost???


Sam, I’ve been feeling so flipping low that I’ve been praying for really aggressive secondaries so I can just lie down and die… Tell me that’s normal and I won’t wait for secondaries, I’ll just throw myself from the top of the car park roof.

I know I’ve got lots of other crap going on in my life that’s extremely stressful, but I am NOT stronger, and I am NOT able to cope with it all, but I used to be able to deal with anything life could throw at me and come out the other side smiling. A bit battered, but still human. Right now, I’m slightly higher up the evolutionary scale than a slug, but not much further.

Citalopram has knocked the hot flushes on the head (well down to bearable levels and not too intrusive most of the time though my thermostat’s broken and I can be hot one minute and frozen the next) but the inside of my head is a total mess, hence my permanent residence on the crazy sobbing lady bench. My poor kids have had to see their mother going completely mad, and I do feel as if I should be locked up in the looney bin sometimes.

There, that feels SO much better.


You sound perfectly normal to me, that’s exactly how I felt when I was taking Tam. No word of a lie I would rather be back having chemo than taking it, I felt strong then than I did when on it.

I went back to work in August last year and just couldn’t get through the day. My head was full of mush and I couldn’t concentrate. I used to look at people’s mouths talking to me but didn’t compute with what they were saying. Makes me sound not quite right, doesn’t it.

I know I am not a medical person but it really sounds to me like you need to take a break from the Tam. What’s the worst that can happen if you stop for a few weeks - nothing is going to come back that quickly. And then if you start to feel better you will be able to rationalise it more. And you will be in a better frame of mind to make a more long term decision.

That’s my plan, whilst I am still on Herception - one more to go next week - I work on the basis that I have stuff going round my body so its not completly on its own and then I can make the decision later. And the Venlafaxine keep the hot flushes from Herceptin more or less under control.

I don’t know how old you are, I am 43, but I assume you have a long life ahead of you, and you can’t live it like you are at the moment. You need to take back control.

Sorry, I got on my rant horse then…

I’m a little bit older than you but was happily pre-menopausal before all this. I’m also doing the Herceptin thing, I’ve had 11 or 12 (see, can’t even remember that!) so it’s definitely something I will have to discuss with my onc or my GP.


If your periods have stopped through chemo, why not get your GP to do a blood test to see if it has pushed you through the menopause. If so, you could try swapping from Tam to an AI. Just a thought.

Oh - and big hugs too.