Coming off Tamoxifen after 10 yrs + anti-depressants

Periwinkle2

Hi -

I have some questions that I have not been able to find good answers to. I'm about to come off of Tamoxifen which I've taken for 10 yrs. post-treatment for ER+/PR+ HER2- stage 1 BC. Had lumpectomy and radiation, Oncotype score of 8. MO says must come off Tam as no evidence to back up staying on it after the 10 yrs. I tolerate it pretty well. I had a hysterectomy 8 yrs. ago.

PRior to BC, I was taking low-dose Celexa to manage depression. Celexa worked very well for me. Before starting Tamoxifen, my then-MO started me on Venlafaxine. I have had more hot flashes on it than not, but have managed more or less.

Since doctor wants me to come off Tamoxifen, my question is should I switch back to Celexa or stick with Venlafaxine? Both are covered by insurance, so I could take either. Which one has fewer side effects? Has anyone else been through this? Thanks for any insight you can provide.

Moderators

That must feel like a very big step to come off of the Tamoxifen.

There is a lot of discussion about both Effexor and Celexa in our community.

People tend to react very individually to these medications. Have you met with a doctor yet to discuss pros and cons?

You may find this page helpful: Treatments for depression.

MagicalBean

Hi Periwinkle. Awesome question. I had been taking Zoloft for 20 years prior to DX, but was switched to venlafaxine once I started Tamoxifen. I can't say I have experienced much in side effects but I dislike it anyway. It dissolves before I can swallow, tastes terrible, and I've decided it gives me heartburn too. Not sure it actually does, or if it's my imagination. Anyway, it's been 4 years for me and I'm trying to slowly wean off it. I want to go without for a while to see if I really need it. If I do, then I'll beg for my Zoloft back. Because of my age (70) I'm hoping for just 5 Tamoxifen years. We'll see.

farmerlucy

I took Effexor when I was on Tamoxifen. When I was done taking it I weaned off it slowly by taking a few extra beads out each week, when I got low enough I switched over to 40 mg Prozac. Then after a year on it I dropped to 20mg. I didn’t have any issues changing though I think Effexor may have done more for my hot flashes, although Prozac is supposed to help with those as well.

exercise_guru

From Google Other antidepressants that have been used to treat hot flashes include:

• Venlafaxine (Effexor XR, Pristiq)
• Paroxetine (Paxil, Pexeva)
• Fluoxetine (Prozac, Sarafem, others)

I take effexor XR because of tamoxifen but my obgyn told me that Paxil works far better for menopause symptoms.

I guess if I were in your position I might just go off the tamoxifen for 3 months and then follow up with a very good doctor to determine which medication would meet your symptoms.