Antidepressants with Tamoxifin
Apparently there are only a few anti depressants that can be taken with Tamoxifen.
Bummers, since so many women with breast cancer are likely to develop depression and may be put on Tamoxifen. . My medical oncologist took me off Femara, since it raised my cholesterol and made me ache all over, wrists, ankles, knees. She switched me to Tamoxifen. When I went to pick up the Tamoxifen, the pharmacist alerted me to an interaction between Lexapro and Tamoxifen. I had to elect to go off the Lexapro. Many antidepressants make Tamoxifen less effective. Although Lexapro has only a very mild effect on Tamoxifen effectiveness, there is a possible dangerous disturbance in the heart rhythm that can occur when both of these are taken together. I have been on Lexapro for 8 years so am very discouraged about this. Even my medical oncologist and psychiatrist was unaware of this. It is a bummer since after trying so many antidepressants for my anxiety disorder, Lexapro was the best and a great sleep aid. I do tolerate Tamoxifen better than Femara but what a trade off!!!!! Tamoxifen gives me insomnia too!
Comments
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That's good to know. I think that Celexa with Tamoxifen can also cause dangerous heart rhythm disturbances. But these two are listed as not interfering with Tamoxifen working against breast cancer. May I ask what dosage you took for Lexapro?
That leaves Effexor. Can your doctor switch you to Effexor?
http://www.breastcancer.org/treatment/hormonal/serms/tamoxifen
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I read this with alarm, as I am on a high dose of Lexapro for a non-BC problem. I immediately called my MO. He assured me that there was a worry about that in the past, but it has been shown not to be a general problem. So it is OK for me to be on both medications. My cardiologist agreed when I saw him Monday. So I suggest anyone in the same situation check with their health care providers.
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I am on Tamoxifen and Effexor and they work well together. My Onc said this is the only antidepressant that she felt was safe enough. The good news about Effexor is it doesn't lead to weight gain like others may (and as I feel tamoxifen does!). The only side effect is a weird headache if you forget to take it. I've been on it for 3yrs and doing just fine.
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I am not on Tamoxifen but I do take low dose lorazepan (ativan) as SSRIs I tried did not agree with me. I checked it out when I knew I will be going on AI after rads finish. You may want to check with your doctor if that would be OK.
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I am on citalopram along with tamoxifen and that is OK too. However, I am also on a baby aspirin, and that, with citalopram, increases your risk for bruising. I tripped last week and have the largest bruise I have ever seen on my hip now. Thank goodness for cute swimsuits with a little skirt.
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My onc actually increased my dosage of Lexapro from 5mg to 10mg - she said the higher dosage is the only thing that helps control/minimize hot flashes! I asked if the two drugs interacted well together and she said it is not a problem at all.
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I took Prozac while on Tamoxifen as I did not know better and neither the pharmacist nor my docs caught on to that. I am now on Arimidex and taking Cymbalta (60mg) I believe Cymbalta does not interact with any of the bc meds I also take Risperidone which is a mood stabilizer and it helps with the hot flashes. Check with your doctors but there are other psych medicines that can be taken I'm sure,
Aurora
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I have been on Zoloft and Wellbutrin for over a year, and recently upped my dose due to a major depression relapse--this is prior to my Dx. Without these meds, I'm sure I'd be glued to my bed right now. I haven't started any treatment yet, but I have been told that it will include hormone therapy (I'm premenopausal so tamoxifen is the most likely). I have already posed the question about taking these drugs concurrently with Tamoxifen and was told there would be no problem. I would love to just go with that, but I have read otherwise. Perhaps I should be shopping for a different oncologist.
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Maybe your onc should review this site:
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The key here is to ask your doctor. From looking at that site, tamoxifen has potential interactions with 335 drugs, including many over-the-counter medications. But when I look up aspirin on that same site, it has potential interactions with 475 drugs! Only your doctor can predict whether the risks outweigh the benefits.
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Thanks for that link Jennie.
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my doc prescribed 75 mg Effexor as antidepressant....
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annabannas- You should ask your dr about fareston (toremifene) it is a SERM like tamoxifen but is NOT approved for premopausal early BC. It would have to be written off label by your MO. It will not interfere with your anti depressant. It has shown similar results to tamoxifen clinical trial outcomes.
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