I am yet again at the end of my tether with the hot flushes, with another 17 months of tamoxifen to go. I think I have tried everything apart from low dose anti-depressants which I have been very reluctant to try, but now feel it is maybe the time to give them a try as I don’t see how else I am going to make the full five years on tamoxifen. I don’t want to give up on the tamoxifen, as I want to know that I have done everything possible to prevent this cancer coming back, but at the moment I am really not coping with the hot flushes.
So for anyone who has taken low dose anti-depressants for hot flushes, I would appreciate knowing what you took, whether it worked, and what side effects (if any) there were.
Thank you
If she doesn’t see this thread, Lost in France might help if you message her
I believe that some folk have been given a low dose of amitriptyline. I was given that for chronic pain in 2004 and it make my brain disappear; I struggled to put 2 words together in a sentence.
My GP gave me some vasodilator tablets - can’t 'member what they were; and they were fantastic - only needed a short course and it fixed the night sweats and the more severe hot flushes permanently. Still had years of medium/mild flushes but they were bearable.
I was on tamoxifen in a trial from late 2000 - 2005, and I menopaused in 2007/8. At the time fluoxtetine was not known as being problematic with taoxifen, but I can honestly say I had no menopausal symptoms during either experience, which I pput down to the SSRI.
Ha…well dunno about it stopping hot flushes as taking it for past 3 weeks has not made any difference to being hot or cold BUT…having reluctantly given in and gone to docs against my better judgement I have to admit the amytriptiline 10mg dose has worked wonders for me being able to sleep. I am not zombie like during the day, in fact i do lots of stuff and my head is not fluffy…well certainly no worse than on chemo and I would say a darn site better than my OH…and he has not had either!
All I can say is give it a go as 10mg is not addictive as its a very very small dose.
Hi,
I’m a year into tamox and have had bloody awful hot flushes since chemo. I’ve tried loads of things - all the stuff you can buy over the counter including magnets in knickers - all useless and all expensive. I’ve also tried the following drugs - these are my comments about them:
Night nurse - really helps with sleep but not a long term prospect
venlafaxine - supposed to be the best anti-depressant for flushes but didn’t work at all for me. Also made me nauseous and have a dry mouth.
gabapentin 900mg - supposed to reduce intensity and number of flushes and it seemed to have this effect on me, certainly when I stopped it after 6 months I noticed the flushes got worse. Made sleep a lot better and didn’t seem to have any other effects although might have made it hard to lose any weight.
citalopram - I’ve been on this for 6 weeks and it seems to be working. (hooray). I’m on 10mg and can go up to 20mg if necessary. Had no obvious side effects and hot flushes have absolutely reduced in number and intensity. Previously I was getting them every 30 mins all day and about 4 at night. Now I get about 4 a day and 1 -2 at night. Some days are worse than others, not sure why that is. I would really recommend this drug.
Clonidine - the oncologist recommended this although I haven’t tried it.
All of the above I would recommend to try if you are at the end of your tether, I was absolutely despairing when I was having 16 bad flushes a day, it was ruining my life, now I can cope again. I really hope the drug continues to work for the next 4 years.
Despite the citalopram being an antidepressant I don’t feel it has had any effect on me other than perhaps destroying what last libido I had.
Hope that’s helpful
Helen.
Hi Helen,
I’ve been having hot flushes since 2001 (after FEC for primary DX and anti oestrogen) and have taken clonidine, Megace, Venlafaxine and Amitriptyline (initially for headaches). The only ones that have helped reduce them are Venlafaxine, and Amitriptyline(by helping me to sleep).
They do reduce in severity as you get older and I really hope that they go away all together one of these days! 'Am on Femara now (secondary dx in Nov) and that doesn’t seem to have made them worse (yet!)
Good luck
xx
Hi Roadrunner and all,
Just wanted to add my experience to discussion. I have taken venlafaxine anti. dep. off and on (mostly on!) since 2000 - originally for anxiety and mild OCD, exacerbated post-natally. I take 75mg ex.release. I had my ovaries de-activated last Nov.(2010) and am now on femara, and since then probably get 5 or 6 hot flushes each day/night which I suppose is manageable. So…perhaps the anti-deps have made a difference in this dept. - I have nothing to compare it with! However, I would like to sound a word of caution with these particular ones - they are known as being hellish to come off and I can certainly confirm this,and, some say online, worse than heroin for withdrawal and discontinuation! - I’m not sure about that!- but just be aware/careful if you decide to take them. I also experienced massive weight gain - 5 stone! - the first 3 years or so of taking them. That stopped in 2004, but I’m still struggling to get it off and 2x chemo doesn’t help! It may be better if you just take 37.5mg, the lowest dose, but think carefully before embarking on these tabs - maybe there is an alternative that doesn’t cause probs. with long-term dependency.
All the best, Sarahx
Hi again,
I’m taking 37.5mg once a day at night. I have to agree with Sarah that there are some SEs associated with coming off these drugs but I don’t know the full extent as I only found out when I missed three days and had dizziness and ear ringing which stopped once I started taking them again and I now make sure that I don’t miss any days!
xx
My GP refused to prescribe venlafaxine or gabapentin because she said the SEs are worse than the problems I was trying to cure (poor sleep and night sweats) and that they could be difficult to come off.
Amitriptyline - used it very successfully for nerve pain after surgery at 20mg per day, but once the nerve pain reduced found it was numbing other bits I didn’t want numbed! Continued on 10mg per day to deal with night sweats without the numbing effect. Easy to stop taking because it’s such a low dose (anti-d dose would be more like 150mg per day).
Clonidine – excellent at first for killing night sweats and helping sleep but gave me such a dry mouth that I ended up with a constant cough & throat clearing which kept me awake.
Citalopram – at 10mg didn’t do much, at 20mg caused disturbed sleep and vivid dreams, very unpleasant.
I’ve now settled on a regime of 10mg Amitriptyline (for the night sweats) plus 900mg Valerian root extract (to help get to sleep and stay asleep) and find I’m generally sleeping much better, although not always.
Sarah x
I take 10mg amatriptalyne at night for pain relief. I was on 20mg but reduced it to 10mg when the pain lessened. The ONLY good thing about amatriptalyne is sleep. I have another (non-cancer related) problem which disturbs my sleep but amatriptalyne sends me straight back to sleep after my frequent trips to the loo each night!
AlexG
I was prescribed a very low dose of amytriptyline several years ago to help me sleep, (before I was finally prescribed fluoxetine (Prozac) for depression) and after just one dose I chucked them back across the table at the GP because they turned my brain into porridge - after just one dose I was unable to function (and I hadn’t slept properly either) and was doing stupid things like forgetting the end of a sentence, forgetting to put the handbrake on in the car and forgetting to zip up my trousers after going to the loo!
Not everyone gets on with them, but they can really do the trick for some. Don’t worry if one of them doesn’t work well for you, there are others that may suit you better. And just because they happen to be anti-depressants at high doses doesn’t mean they’ll have the same effect at these much lower doses. It’s not a defeat to ask for help with flushes and lack of sleep, sometimes we all need a bit of help to get a bit closer to normal.
Good point (as usual) from ChoccieMuffin - the effects of anti-depressants can vary tremendously from one person to another, and don’t get hung up on the fact that they’re designed as anti-depressants when taken at full dosage. Unfortunately all you can do is try them and see which ones don’t suit and which ones do. And try to avoid the ones which are known to be addictive unless you really really need them.
Another info point - my onc suggested Zopiclone sleeping tablets instead of anti-d’s for the sleep problems and they were hell! Addictive within just a few days and horrible rebound insomnia when you stop taking them - don’t even go there!
Sarah x
HI,
For myself when I started Tamoxifen I was having horrendous hot flushes up to 80 per day, having to change the bed twice a night. Tried all the medications that have been discussed all to no avail either gave me insomnia or else knocked me out completely. What worked beautifully has been acupuncture, reduced the flushes down to between 2-5 per day a huge improvement. I have now completed tamoxifen and have just started Femara well since Feb and gradually the flushes have mounted up again so will up the acupuncture. Fingers crossed it will work!
Thanks for all the replies ladies. For the record I have used clonidine, it was a wonder drug for six months then it stoped working. I have tried going back on it a couple of times after several months break but it still doesn’t work. In fact it stops me getting to sleep at night, so it is worse than nothing. I have tried the acupucture route and that was not much use either.
I now have a doctor’s appointment for Thursday, so I will see what he offers me.
Hi folks,
I have only just started Tamoxifen but I had terrible hot flushes with chemo and for that my GP prescribed 10mg daily of Citalopram which reduced the hot flushes down to almost none. I am pleased to say that (so far!) it is having the same effect with Tamoxifen - no hot flushes so far but I guess it is early days yet and I don’t want to jinx it!
Nymeria xx
Well I’ve been to see my GP and he has prescribed 10mg amytriptiline. He said to take one tablet at night for a week, and if that doesn’t have any effect to up it to two, then go back to see him in three or four weeks to review it.
Update - I took the amytriptiline for four weeks, upping the dose to 20mg after the first week, and my hot flushes continued unabated, and my sleep continued to be awful - both difficulty in getting to sleep, and regular waking with hot flushes.
The night before going back to the doctor I didn’t bother taking it - it clearly wasn’t working - and had a much better night’s sleep. So it seems for me the amytriptiline was making things worse not better.
Now my GP has given me citalopram to try for four weeks. Here we go again…
Good luck with the citalopram RoadRunner! It really made a difference for me, so that now I can actually sleep through the night and whilst I might feel hot occasionally during the day I am not dripping in sweat either which was a nightmare on chemo.
I’ll keep my fingers crossed for you. xx
Four weeks on, and the citalopram seems to be working for me. I am still having hot flushes, but fewer and milder ones. It makes all the difference between coping with them and feeling desperate.
I am also waking every three hours instead of every two. This has made a huge difference. I am assuming that there was something critical in the sleep cycle that I was missing out on by only sleeping for two hours at a time, but I am now getting whatever it is by sleeping for three hours at a stretch, and I feel like a different person. I have stopped screaming at everyone at home too as I am no longer so tired.