tamoxifen and antidepressants

Hi,
Just wondered if anyone has any knowledge of suitable antidepressants to take with tamoxifen, as i have read that some can interact with it and stop it doing its job. Any info greatly appreciated as I need to get out of this black hole.

Thanks Mandy x

I know that over-the-counter depression treatments like St John’s Wort are definately NOT recommended alongside Tamoxifen and also some aromatherapy oils which work on balancing hormones (e.g. geranium)are apparently not a good idea.

It would probably be very wise to take this question to your GP or your oncologist for prescription only drugs as they would know what you can & can’t take and it would also then be on your records for any specialist treating you to see?

Hope that wherever you are, the sunshine that’s here in Dorset at the moment, is also shining & helping to lift your spirits…

hi - I am taking venlafaxine which is fine with tamoxifen - have been on it since December and no side effects apart from slight nausea at first and sleepiness…do PM me if you’d like to ask anything !

Hi Mandy, just read your post and thought I would let you know about Venlafaxine, an antidepressant given to me by my onc mainly for sweats and hot flushes associated with Tamoxifen. I have also benefitted by feeling stronger,mentally.I did try to come off them but the sweats and depression were too hard to handle so back I went on them.My onc.said there was no problem staying on the Venlafaxine and Tamoxifen long term.Hope you get sorted out soon.See your G.P next week and good luck.

Ann.x

Hi Thanks for your replies, I have already been to the GP who gave me prozac but this has been found in some studies to stop tamoxifen working. So asked onc who agreed and said she did’nt have the list to hand so would write to the GP but as yet has’nt. Everything takes time when I saw my GP again a week after seeing the onc he had not heard and was not sure what to prescribe!!!
I have handled all the physical stuff well but really struggled mentally, I am a nurse and knowledge is dangerous. I am normally a really upbeat positive person, I have luckily never had mental health problems, and this is awful. I have started cognative behaviour therapy, and the therapist thinks antidepressants will be helpful. I am also booking a holiday for the family for easter.
I will tell the GP about venaflexine, I want to get started asap.
Thanks Mandy

I hope that CBT works for you- I had it some years ago,in conjunction with antidepressants (fluvoxamine) to help me with ocd -it was really good. I have been to a CBT assessment as my BCN felt that a ‘top up’ would help me but they want me to have antidepressants before considering CBT (I know that CBT is limited where I live so maybe they are seeing whether antidepressants would be sufficient)
I pressed for venlafaxine as several people on this forum take it along with tamoxifen and from my research it possibly has fewer side effects than other drugs.

Hi,my oncologist prof Yarnold recommended that I take St Johns Wort,he said that there had been trials and it was proven to be ok.He does not recommend antidepressants.Dont know whether to take it now lol.

best wishes Mel xx

Wondering what dose venaflexine others have been prescribed. Im on 75mg a day but still get mild hot flashes and very tearful. Hubby just has to say the wrong thing and Im in tears.

I have 2x75mg a day , not for tamox, side effects though-I have them for anxiety.

Hi ladies. I am taking 75mgs every night. Still having hot flushes and night sweats but much reduced. I can be quite tearful at times but I think that is more the uncertainty of this awful disease.Heh Mandy ,I,m a practice nurse and as you say, a little knowledge is a dangerous thing.Ha Ha!!!

I take 75mg ,modified release Venlafaxine at night.I did go up to 150mg when I was rediagnosed but only for a short while.
Unusually I get sweats from the venlafaxine itself! Not hot flushes as such,just when I get to a certain temp I just sweat all over.Its really annoying to have sweat running down my forehead in the queue in Tescos LOL! But the Ads work with my depression so I will put up with it.

thanks for this guys, been taking antidepressants for years and just started tamox (for second time) will have to talk to bc nurse and GP - luckily seeing both on Monday…
monica xx

im just about to restart tamoxifen and currently on sertraline… there was a lot of research done around 2006/2007 which advises that tamoxifen is less effective when combined with an SSRI like prozac, seroxat or sertraline, however the BNF which is the main guidance for drugs and drug interactions doesnt not mention sertraline.

these are the only interactions specifically mentioned…

Duloxetine - metabolism of tamoxifen to active metabolite possibly inhibited by duloxetine (avoid concomitant use)
Fluoxetine - metabolism of tamoxifen to active metabolite possibly inhibited by fluoxetine (avoid concomitant use)
Paroxetine - metabolism of tamoxifen to active metabolite possibly inhibited by paroxetine (avoid concomitant use)

so i presume everything else is fine… venalafaxine was one of the drugs they compared in the research and it was fine.

Lulu

thanks Lulu, I love your ability to make sense of medical info
thanks for that honey xxx

Hi all,once again thankyou for the amazing info on this site.I consider myself a strong person, but with all the anxiety and stress caused by bc,i found i could’nt function properly,so a few weeks ago i went to the docs for some help.She prescribed Sertaline (which i would say have just taken the edge off the anxiety)and as i’ll be having tamoxifen at the end of treatment, i was worried i’d have to stop taking sertaline. love Lesley

HI
I have been taking mertazipane for 2 weeks as I am finding it hard to cope since diagnosis last March.I think every pain is cancer related, when will life ever feel normal again?.
Does anyone know if this drug is ok with tamoxifen please?
Libby x

Hi all

Just to add - I was already on Citalopram (20mg/day) before diagnosis, and asked my Onc about any contraindications when he prescribed Tamoxifen - he said that this one is fine, it is only some of the older drugs, such as Prozac, that were a problem.

Rosie
xxx

Oh dear. I am on tamoxifen and duloxetine !! However, I have tried all other antidepressants so this is a last resort. I did ask about interactions so did not know about this one. Thanks lulu for bringing this up. i will certainly questions my GP next week about this!

R xx

Thanks Lulu for that info, I have read something similar, will be asking for venalafexine then!hanks for everyone elses advice
Mandy

rachy 7 have you tried venalafixine as its from the same family as duloxetine so you could perhaps speak to your GP and give it a trial.

its definitely something they need to make sure there are suitable ADs as its been found that there is a marked increase in their use in women with breast cancer and almost 50% of women diagnosed with bc will have depression or anxiety with in the fisrt year from diagnosis.

libby mirtazapine seems ok as there is no mention of it affecting tamoxifen, so i think you are ok with that one… as for not worrying about every little pain being cancer it does ease off in time, but it takes quite a bit of time to stop worrying, but hopefully your ADs will kick in over the next week or so… you often feel worse for a few weeks after you start them before they actually start working effectively.

Lulu x