Antidepressants and Tamoxifen
My mother is on Zoloft and it is not compatible with Tamoxifen (she is 84). She is being weaned off the Zoloft but I was wondering if anyone out there knows of an antidepressant that will not interfere with Tamoxifen. She is finishing her radiation therapy on Feb. 14, 2014, after her lumpectomy (it was Stage 0) and will need to start Tamoxifen soon after this ends. Anyone else have this problem? Please let me know. Thank you Stephanie
Comments
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Hi Stephanie1962, Effexor is the most compatible antidepressant in conjunction with Tamoxifen.
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Celexa
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Maybe she can stay on Zoloft(if it's working for her) & take toremifene. It's a different SERM & it is metabolized differently. There is a thread about this drug. I think it's not much used except with antidepressants. It's more expernsive. Don't think there is a generic...Maybe ask?
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I have a couple friends with depression and they've had a tricky time finding medication that works for them. Have your mother and doctors considered other options, like an AI? Also, has the medical oncologist quantified the "benefit" that your mother will receive from the meds? i.e. how much it will reduce the risk of recurrence, from say 15% to 10% or whatever. Since your mother has DCIS, it's not the invasive kind and it can't ever metastasize. That's terrific news. My understanding is that radiation reduces the risk of recurrence by 40%. So your mother may already have a pretty good prognosis, and may decide that it's not worth-it to take the medication. She may want a second opinion. A friend's mother was Dx'd in her 80s and opted not to do Tx beyond surgery because she had other health issues, which ultimately proved more serious.
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Peggy:
Thank you! That is something we will have to consider, she has 4 radiation treatments left and then we will be seeing the Medical Oncologist again. I will definitely ask about the recurrence % if she decides against the Tamoxifen. This site has been so helpful and informative. Stephanie
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Great, glad it was helpful. Feel free to post again if you want to discuss. FWIW, my MO had initially recommended I start tamox immediately after finishing rads, but I asked if I could wait until I did more research and...I had a two week trip planned (and I didn't want to start new meds while I was out of town.) I think I waited an extra 6-8 weeks before starting tamox. Just an FYI. I think the docs have their standard recommendation but if you feel like you want extra time to do more research on the alternatives or to get a second opinion, etc, that's an option too. And, Stephanie, I hope you're able to take care of yourself too. It can be hard watching someone on this journey. So sending warm thoughts to both your mom and you. take care.
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Peggy:
Again, thanks for the information and yes, I am taking care of myself. I have been in the medical field for over 20 years, working as a certified nursing assistant and receptionist so the only thing really new to me is the cancer diagnosis and the fact that it is my mom. The oncology patient navigator told us today to contact the MO and make an appointment, but I think I may wait and talk to her PCP to see if she has decided on an antidepressant yet, also mom is sick and tired of seeing doctors!
I am really glad I decided to check out the breast cancer site and become involved in the discussions it has really helped. Here's to all survivors! Have a great Tuesday 
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I was on 100mg of Zoloft for over 10 years and recently got diagnosed with DCIS. I will be taking Tamoxifen after my rads are completed. I was told by my BS, PCP & Pharmacist that Zoloft does interact with the effectiveness of Tamoxifen, so I am currently weaning off. The 3 recommended replacement meds were Effexor, Celexa or Lexapro. I'm currently weaned down to 25mg of Zoloft and have just added 10mg of Lexapro. I'll completely stop the Zoloft in about 10 days. The withdrawal symptoms are difficult, so it's important to listen to your doctor about weaning, etc. Good luck.
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Cipralex (escitalopram) is a kinder, gentler verson of Celexa that is compatible with Tamoxifen also. My GP recommended it for me and I had both my ONC and my pharmacist confirm that it was okay to take with Tamoxifen.
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Thank you for the information. Mom started on her Effexor-XR 2 weeks ago and is doing much better; radiation is done and the Tamoxifen ordered. Her weaning of Zoloft affected her mood and a little bit of memory issues, but those are resolving as the Effexor has taken affect. Good luck to you also!
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Selena:
Thank you also for the information, she started Effexor-XR 2 weeks ago and will be starting the Tamoxifen soon.

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So far, so good. Effexor-XR and Tamoxifen working. She woke up only one morning so far drenched in sweat...happy hot flashes! She never had them during menopause so I guess one is good. She is a survivor!

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An update on mom and her Tamoxifen; she told me that she is waking up soaking wet in the morning. Luckily it is not waking her up sleeping right through!
Praying for continuing health to all!

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You may already know this, Stephanie, but Effexor can be used to relieve the hot flashes caused by Tamox. I don't suffer from depression, but my onc prescribed a low dose of Effexor because the hot flashes were making it impossible to sleep.
Wishing you & your mom all the best!
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Effexor must not be missed even once....has discontinuation side effects from hell....even one missed dose. Why I take citalopram (also tamoxifen friendly).
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Bluepearl:
Thank you for the information. I haven't been on because the Tamoxifen and Effexor both seem to be working fine; no bad side effect other than hot flashes in the morning!! She never went through them during menopause so I guess she can have them now along with myself and my sister in law!

Continued good health and happiness to you! Take care.
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Just an update on Mom: her May 16th left mammogram was CANCER FREE!! She is still having hot flashes from the Tamoxifen, still only in the morning. She and my dad have been spending time with their grandsons who are 9 and 8 while their parents are at work. I was recently hired full-time at a urology office in our area and will be juggling appts and work for the first time still diagnosis.I wish everyone good health, happiness, and many blessings!
Stephanie

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