Interactions between AI and antidepressants or anxiolytics?

Stranger_TK

Hello there!

There are some studies showing some antidepressants can interfere with Tamoxifen and reduce its effectiveness.

Does anybody know if any antidepressants or anxiolytics (for example Xanax) reduce effectiveness of Aromatase Inhibitors?

I was taking Xanax after diagnosis and it helped me go through surgery and AC chemo, but I had to stop Xanax while taking Taxol chemo. Now I have just finished chemotherapy and going to start AI/OS hormone therapy. Is it safe to start taking Xanax again or will it interfere with Aromatase Inhibitors?

ChiSandy

My shrink was prepared to switch me from Wellbutrin (an SNRI) to Effexor or Lexapro (milder SSRIs) if I was going to be prescribed tamoxifen; but since I’m getting letrozole instead there is no need to discontinue my SNRI--especially since cancer treatment symptoms (much less diagnosis) can logically contribute to preexisting depression. Not sure what contraindications there are to benzodiazepines if on AI therapy. Have you checked drugs.com?

208sandy

Check with your doctor!

Stranger_TK

Thank you for answers!

Yes, I tried to check interactions on drugs.com, but I found no known information about this combination of drugs. My doctor also has no information about it.

And the fact that some drugs may reduce effectiveness of tamoxifen makes me nervous about taking something with AI as well.

I wondered if there are any statistics or studies about these interactions.

ShetlandPony

Ok, I'm venturing into technical territory here without a permit, but I believe the tamoxifen/SSRI interaction is due to the way tamoxifen is metabolized and the enzyme involved, and the fact that this particular class of antidepressant drug inhibits that enzyme, and not due to tamoxifen being a hormone therapy. And therefore the aromatase inhbitors would not necessarily have a similar interaction. Here is a quote I lifted from a random journal article: "Tamoxifen .... is a pro-drug metabolized to the more active endoxifen through CYP2D6. Concomitant intake of CYP2D6 inhibitors results in lower endoxifen levels and could influence efficacy."

In other words, the SSRIs (for example, Prozac, Zoloft) inhibit the enzyme needed to properly metabolize tamoxifen, so a different class of antidepressant (or at least a less inhibiting one based on ChiSandy's comment above) is prescribed to someone taking tamoxifen.

But I don't know anything about xanax and aromatase inhibitors. Maybe a pharmacist or a psychiatrist could tell you more. It can be hard to find information saying that something is not a problem!