Tamoxifen fog and concentration/fatigue issues

I've found that the lack of sleep d/t hotflashes really affects my concentration. I feel out of it. Not sure if u sleep well. If not get some sleeping pills. I take adderall occ to help but I don't have add. I take it purely to wake up & focus. I'm just almost falling asleep during the day. Honestly I feel wired AND tired w/ the stimulant and lack of sleep... So not really a help. If I take sleeping pills & have a GOOD night sleep (which doesn't happen a lot) I feel sooooo much better. Prob not a help but thought I'd give you my experience. 

Boogie and Amoc, this is a great new thread. I started with Tamox on 12/25 and stopped it for one week as per my MO instructions, because of how tired and fatigued o felt. Stopping it for a week actually helped, but now i am tired again. I am not taking any sleeping pills or Effexor, etc.

I am only taking multi vitamins (gummy bears) and Vitamin D (the chewable one with no soy content). 

I am trying a green juice in the am, in a NutriBullet not a juicer with kale, celery, ginger, cucumber and a fruit. I actually think that has helped.

Can you tell me if the Effexor helped and in what way? I will see my MO for my three month after chemo check up this Wednesday and i have a number of questions for him: fatigue, dizziness, if I can take vitamin B and anything for the fatigue, whatever it is.

amoc, i went to see my MO on Wednesday. Blood work was good. MO told me that even though I am menopausal now (I am 45 and had chemo induced menopause) I might get my period back in the next months, that it can take six months or even more.

He also told me that the fatigue I feel is very common, part of it is the chemo and the other part is that now that I have low levels of estrogen my serotonin is low. He prescribed Effexor at first but then changed to a milder one called Celexa, 20mg to help with increasing the serotonin in my brain and with that the fatigue and other SE can be controlled.

Tonight has been my second night taking Celexa and it is making me sleepy and a little nauseous, which MO told me I would be, so I took anti nausea at the same time as the anti depressant. He told me I should take half the dose for a week and a half to two weeks and that the nausea should disappear in four days. He also told me that it takes a whole month for that medication to take effect, since the serotonin levels increase gradually.

I have tried to explain as much as i can about my conversation with my MO and I hope it helps to this thread.

Nauseous after two weeks? Are you taking any anti nausea meds?

Grumpycat, did the Effexor help you with the fatigue? I was taking Celexa for about two weeks and felt so tired and sleepy that I had to stop taking it. I didnt feel anything better as far as fatigue, i actually felt worse!

I find Effexor did help fatigue and mood, not sleep though. I have been on taxoxifen since 2013 , off it the last two weeks as im having major surgery so have to stop it until after surgery and im moving around again. I would be careful with the complimentary items you are trying some of them can effect tamoxifen and some can effect estrogen levels. I honest thought the brain fog, concentration issues were tamoxifen also until now because i dont see any difference being off it for two weeks now. I think its menopause (chemo induced) more than tamoxifen at least for me anyways

I have been unsure of Tamoxifen and its effect on bone. Does it actually prevent bone loss?

Started Tamoxifen and am super nervous about the side effects

I have been on tamoxifen for almost two years, and other than my joints hurting, which taking some vitamins and increasing my exercise has helped.  I haven't slept well since I finished chemo, but I won't take anything as I have children and a husband who is deployed too much so I have to be able to respond.  I know that there are side effects that can come with tamoxifen, but so far I have been very fortunate.  I really think this is much like everything else is life, try and be as positive as you can about everything, and know this is something that is supposed to help you not get this terrible disease again.  Stay active, drink plenty of water, and stay grateful you have a choice to make still.

I wanted to mention that my MO told me that Effexor (Venlafaxine), similar andi-depressants, and MANY other drugs are contraindicated with Tamoxifen. She actually gave me a list and showed me where Effexor is on this list. It is sometimes linked to heart issues. In addition, I believe that Effexor can inhibit the effectiveness of Tamoxifen. If your oncologists don't know about this, please ask them to look it up. Here are several links.

http://www.drugs.com/drug-interactions/tamoxifen.html (357 drugs that have interactions with Tamoxifen.

http://www.cancer.gov/cancertopics/types/breast/br... (see bullet point # 3)

http://www.medpagetoday.com/MeetingCoverage/SABCS/...

Good luck Professor! So happy for you that you have a passion in life that you can do!

Anna

Okay so that did not go as I had hoped! My MO, who I have always liked, did not respond well. I had told the nurse and the nurse was like, "Oh well I am sure she's going to be able to find you something else to take. You have options." But when I told the doctor my situation and said, "Is there something else I can take?" She said "NO. The only thing we could do is take your ovaries out." ??? Now, I am not averse to having my ovaries out but what?! I was stunned. I said what about an AI? and she was all, that's only for postmenopausal women. And I was like what about the SOFT and TEXT trials? And she looked at me like I was speaking some other language. Then she said that this fog is generally NOT a side effect of tamoxifen and it is probably just menopause causing it. I said, "First, I am feeling fine now and I am off the tamoxifen and second, I have two studies right here that show that cognitive capacities, especially verbal memory, verbal fluency, and executive function ARE lower in women taking tamoxifen compared to healthy controls and women who have gone through surgery and radiation. How can that not be recognized as a side effect?" Plus, hello? If it IS menopause then why not switch me to an AI??? OMG. It was not at all what I have come to expect from my doctors. Finally, I persuaded her to at least test my estradiol levels. I will be hearing about that later today or tomorrow. So stunned. I asked her, "Is this one of those moments when a person needs a second opinion?" And she said, " You are ALWAYS welcome to get a second opinion" but not in a nice way. She wouldn't stop trying to convince me to stay on it. I told her finally, this is my life and my livelihood. I can take a lot of side effects. I am willing to power through a lot of things. I am NOT "all about quality of life" --I am all about quantity! BUT. This is not a tolerable thing. She was not happy with me and ultimately left the exam room barely saying good bye. So so so weird.

Also: here's the thing. Apparently, you are considered postmenopausal if you have not had a period in 12 months UNLESS you have been taking something (such as tamoxifen) that might be interfering with your cycle. So. Even though I have not had a period since June (and did not start taking tamoxifen until December) I am still (in her eyes) premenopausal.

so. Not a swell morning. but I am actually feeling pretty good....

Thanks so much for the support tangandchris! It was weird and I don't like feeling like I am arguing with this woman. You know, I walked out a little shaky. But now I feel like at least I am on the road to an alternative. I mean, I could have gone off the tamoxifen and just not mentioned it at all......

Wow, Professor, I think we must have the same MO!

Bounce, I LOVE that! LOL!

Okay, so here' s my update. I was sitting in a presentation yesterday afternoon and my phone rang a number I did not recognize. I stepped out to answer it and lo and behold it was my MO! I couldn't believe it. Anyway, she said she got the blood work back earlier than usual and that I am not technically menopausal. Of the three indicators, one was low enough, one was borderline, but my estradiol was still (somewhat far) above the menopause line. So. Then, she said she had already called in the prescription for an AI (not exactly sure which one) and her office would call to set up the first shot (the one that will knock out my ovaries each month)! Apparently she's come around. Yes, i am going "SOFT".

We will see how it goes. If I find that whatever AI she's put me on is not to my liking, she'll hear from me about that, emboldened by my experience as a rebel. I have to add though that she continues to get on my nerves. She said something like, "I still don't know how I will explain to your insurance company that you failed tamoxifen." I wanted to scream. Throughout my cancer experience, she's the only medical professional I have interacted with who makes me feel like I have cancer. I had thought that was just part of her job, somewhat unique to being an MO, as opposed to BS or RO. But now I am not so sure.