Tamoxifen, depression, and anti-depressants

shorelineequine

Hi,

I'm hoping someone 'out there' can relate to what I'm going through..

I've struggled with severe depression my whole life, ever since I was a child. Prozac is really the only drug that lets me life a semi-normal life. I've tried most other anti-depressants...

One year ago I was diagnosed with invasive breast cancer on my right side.

Stage 1-2.

ER/PR+, HER2/NEU- 

Oncotype Dx 7%

I chose to have a bilateral mastectomy with reconstruction. Then went through 4 rounds of TC chemo.

My Dr prescribed Tamoxifen, however I had to go off Prozac since it interferes with the tamoxifen. The combination of the tamoxifen and not being able to be on the Prozac has put me into severe depression. I've tried other drugs such as Effexor and celexa but they don't help.

I'm considering going off the Tamoxifen, since right now my life isn't worth living anyway. I've discussed this with my oncologist but he doesn't really understand. 

Hoping someone can at least relate or let me know that I'm not alone. Thanks so much.

pupmom

Hi shoreline, welcome to the club none of us wanted to join. My feeling is that you should talk to a psychiatrist about the Prozac issue. MOs don't really know about psychiatric meds, except regarding how they interact with cancer meds. Since you've been on Prozac for awhile, you probably see a psychiatrist. Don't know your bc grade or nodal status, but Tamox is very important to prevent reoccurrence. I would try to find a different antidepressant before giving up on Tamox. Best wishees!

christina0001

Tough choice...cancer forces us to make these tough choices. Frankly if I were in your shoes I would be tempted to go back on the Prozac and quit the tamoxifen, especially since you had a bilat mastectomy. What's the point of extending your life if you are going to be severely depressed? But having said that, tamoxifen is so beneficial, so great at reducing our risk of getting cancer again. I got very depressed from tamoxifen the first time I took it. But then I stopped it, and a few weeks later started Effexor. My onc had me take that for about a month before starting the tamoxifen. I personally feel that letting the Effexor build up in my system BEFORE restarting the tamoxifen is what made the difference for me. However, I have not had the ongoing depression that you have suffered. If you have not already done so, you might consider finding a good counselor? Sometimes that can help, it's not for everyone but I hate to hear that someone has suffered from depression for so long.

Best of luck to you. No easy choices with this stuff.

NYCchutzpah

been taking tamoxifen since june I have found that taking 1 mg of ativan keeps me human.

wishing you the best of luck

shorelineequine

Thanks everyone for the well wishes and advice.

etherize

My opinion (as somebody with lifelong dysthymia and additional bouts of major depression) ... you have a low Oncotype score, your cancer was an early stage, you had a bilateral mastectomy and a pretty heavy-duty chemo regimen.  And we know that depression isn't good for keeping cancer at bay.

Given the early stage cancer and the good treatments you've already had, I'd quit the Tamoxifen if I were you.  What about Arimidex (anastrozole is the generic)?  Would that interact with the Prozac?  I'm taking Zoloft with anastrozole.  

And if not that, there may be another anti-hormonal you could take.  Ask your oncologist.  I bet there's some other solution.  

I feel for you; it hardly seems worth being cancer-free if you have to suffer with major depression.

shorelineequine

Etherize,

I feel like you 'get it'. I'm sorry you also have the depression curse. It sucks but there is some comfort in knowing I'm not the only one.

I've been thinking about quitting the tamoxifen, for the reasons you mentioned. Maybe I just wanted to hear it from someone else...that this may be the thing to do in my situation although other people may think I'm NUTS for going off a 'life-saving' drug. I don't know if I can go on the Arimidex if I'm pre-menopausal. I'll look into that. Thanks for the tip and for taking the time to write and take care!

tankgirl

I get it. I want to let you know I was having the same problem. I have severe PTSD with anxiety problems. The Effexor just doesn't do it for me and I was initially told that it was the only one I could take. A couple of weeks ago my psychiatrist hands me some literature she found about research saying there are other SSRIs that don't interfere with the metabolism of Tamoxifen. The older ones like Prozac and Paxil (which I was on the first time I was diagnosed and had to go off of) can't be used but newer ones such as Lexapro and Celexa that have been very effective for me CAN. There are actually four of five I think that aren't inhibitors. When I told my onc about the severe quality of life issues I've been having she looked horrified as I hadn't let on how bad it was but it was becoming apparent I was coming unscrewed. I'm just now switching back a few days ago and I feel better already. 

Beckers

I'm glad you brought this up shoreline. I have MS and have had to be on Zoloft for years. I had to stop for Tamoxifen. I am not miserable but Effexor is not working as well as Zoloft did. I am having such a hard time getting back to living my life. I am scheduled to go back to work the end of the month too. I have had hysterectomy and can switch to AI. I'm afraid of heart damage tho. :-/ so...I've already asked my onc if I can stop. He convinced me to still take it. He said he is not afraid of me being alive in 5 years, but he's worried about me being alive in 20. My friend is 7 years NED from IBC, stage 4 and she keeps telling me to hang in there and eventually I will get used to it. She had to add that the women she knows that have died, it's because they didn't take their tamoxifen, or stopped early, or didn't finish rads or something like that. Ok....so I keep trying to hang in there. I even posted a few days ago about all of this... then I deleted it. I am going to see about trying another antidepressant tank girl mentioned but I don't look forward to going through all of that. I feel for you. I do. I just keep hoping it will get better. sorry if I'm no help, just want you to know you're not alone. Hang in there. ~Rebecca

DellaHJ

I have suffered from hard to treat depression all my life and Tamoxifen pushes me to the EDGe, as in almost suicidal. My breast cancer is very estrogen fed. I am 49 and had stage IIa, no nodes, onco dx score of ten. I opted for a lumpectomy and 36 radiation treatments. I am terrified that not using Tamoxifen is going to cause a recurrence. I am taking DIM plus, zinc, selenium, vit c, resveratrol. I am also trying to lose weight and get back into exercising. I am trying to eat organic foods and improve my diet. Any suggestions or positive comments to help? Please.

farmerjo

Bump.

catlady44

DellaHJ - I get the whole depression thing! I've struggle with anxiety since age 6 and depression since age 10. A couple times it was so severe it turned into psychosis. I've probably tried a dozen different antidepressants. I'm not on hormonal therapy yet, but your post really touched my heart since I've suffered from depression too. I'd recommend finding a good psych too. I know that's not easy to do! Besides SSRI's like Prozac, there are tricyclic antidepressants that work differently and I'm wondering if they would work with the tamoxifen better. Again, I'm not pharmacist, but I thought I'd mention it. There are also MAOI inhibitors which are antidepressants, but there are a bunch of dietary restrictions that go along with that one. Another option out there is ECT, but there are lots of different opinions on this since it's controversial. I know it has saved lives before, but it messed up my short term memory and I lost a whole year of memories. For some, it's worth the payoff. There's also something called transcranial magnetic stimulation which really helped me. The only side effect I've ever heart of is a sore scalp.

It sounds like you're on the right track with diet and exercise. Please PM me if you need to talk. I'm in the middle of chemo so I can't personally relate to the hormone treatment, but I'm a professional depression patient. Hang in there! Your life is worth something no matter how you might feel right now.