Effexor SEs

RedemptiveSufferer · February 2017

Hi, all! My PCP recently prescribed Effexor to help ease some mild depression. I decided to take it since I'll be on Tamoxifen and hear that it helps w/hot flashes. Not to mention it helps w/anxiety, which I've developed since my diagnosis. Long story short, I took half of the smallest dose and had a negative reaction within about 45 min.: felt my blood pressure shoot up, my arms got hot, my vision blurred, etc.... A) has anyone else had a negative reaction to Effexor? and are there other anti-depressants you can take while on Tamoxifen? Will discuss this w/my oncologist but it will be a couple of wks before I see her. Thank you!! ~ Kim

MTwoman · February 2017

RS - as far as I know, this pretty much sums up the current recommendations:

Antidepressants And How They Interact With Tamoxifen

Antidepressant Drug	Interaction with Tamoxifen	Safety Range
Paxil (paroxetine) Prozac (fluoxetine)	Prevents antiestrogen benefit	Avoid Use
Cymbalta (duloxetine) Wellbutrin (bupropion) Zoloft (sertraline)	Medium interference with antiestrogen benefit Note: Studies confirm that Zoloft interferes with Tamoxifen.	Increases Risk
Saint John's Wort (hypericum)	Modest inhibition of antiestrogen benefit	Increased Risk
Celexa (citalopram) Lexapro (escitalopram) Pristiq (desvenlafaxine) Remeron (mirtazapine)	Mild interaction Note: Pristiq and Remeron have not been well-studied for interaction with Tamoxifen.	Slight Risk
Black Cohosh (Actaea)	May enhance the antiestrogen benefit Note: There are just a few studies for interaction with Tamoxifen.	Slight Risk
Effexor (venlafaxine)	Almost no interaction with Tamoxifen	Best Choice

the only thing that isn't listed on here is Omega 3 Fatty Acids. Please speak to your medical provider about your next steps. There have been studies on Omega 3s for both anxiety and depression (happy to send links if you're interested). Am NOT SURE about whether your doc will recommend. One of the issues I can think of is mild increased bleeding risk. If you have any surgical interventions or other invasive procedures planned, it might not be recommended. If it IS, you will want to shoot for 1g (EPA and DHA) daily for a robust dose. (if you go this route, use a high quality product which usually means it requires refrigeration and a dark glass container as sunlight degrades it)

RedemptiveSufferer · February 2017

Thank you, MTwoman! I took Omega 3s prior to my BC diagnosis and quit when I was advised to prior to surgery. I also had another negative reaction to Demerol that was given as a pain med. I'm starting to think meds aren't compatible w/my body. Praying that I can tolerate the Tamoxifen because as much as I've always leaned toward natural approaches to illness I wouldn't trust myself to naturally handle something of this magnitude. That's just me. BTW...one of my best friends lived in Bozeman until a couple years ago! I've been there to visit...that's beautiful country!

MTwoman · February 2017

Glad you have some experience with Omega 3s. If you want to go back on them, though, please consult with your doc. Timing is everything

Happy

and Bozeman is looking particularly pretty right now, all dressed up in a new foot of snow!

Cowgirl13 · February 2017

Redemptive, please call your doctor right away.

Nursie · February 2017

hi Kim! Sorry you are experiencing that. I am also being treated for depression, hot flashes and menopause mood changes caused by chemo. (I'm 39). But since I had HER2 positive, I received Herceptin instead of tamoxifen.

I am fairly certain there are other medications they will trial you on so that you can find the right one for your body. I am having good results from celexa and lamictal. They added the lamictal when the celexa wasn't helping with the menopausal craziness like huge sweeping mood swings that I could only deduct that were caused by the induced menopause! I hope you can get some comfort soon

Nursie · February 2017

hi Kim! Sorry you are experiencing that. I am also being treated for depression, hot flashes and menopause mood changes caused by chemo. (I'm 39). But since I had HER2 positive, I received Herceptin instead of tamoxifen.

I am fairly certain there are other medications they will trial you on so that you can find the right one for your body. I am having good results from celexa and lamictal. They added the lamictal when the celexa wasn't helping with the menopausal craziness like huge sweeping mood swings that I could only deduct that were caused by the induced menopause! I hope you can get some comfort soon

JWoo · February 2017

I did take (side)Effexor for almost a year while taking tamoxifen. Half of that year was spent dosing down off of the lowest dose they have. It was awful. While I did not have the SEs you experienced, mine were pretty intolerable. A severe inability to concentrate or absorb information, frequent balance issues, lethargy, etc.

Call your dr first thing to discuss this.

You can look on drugs.com at interactions with all your RXs to help you navigate. Since almost everything is off limits, I found that a portable air conditioner and a really excellent therapist, along with the occasional anxiety med got me through it all.

And over time, the SEs from tam got less and less on their own. I don't take it now as I started having liver issues and that can cause or make them worse, but I believe that is a non-common problem.

Best of luck to you!

RedemptiveSufferer · February 2017

Cowgirl, it happened Monday, but she was informed. Thank you for your concern. I'll also inform my oncologist when I see her.

Nursie, thank you for your message. I've not heard of lamictal, but like you said I'm sure my doc can find something else that will help. I haven't started the Tamoxifen yet, but unless my genetic testing results indicate it would kill me I'll start it soon. Praying I don't get the mood swings on it or any of the other potentially awful SEs for that matter. ;-) Sorry you're having to deal w/BC but glad that you've found the right mix of meds that are helping you through it!

JWoo, Thank you for sharing your experience w/Effexor. I started taking Ativan (lowest dose) and that helps great w/anxiety for me. Maybe I'll be able to get by w/just that

Fiddler · February 2017

Hi,

I was on Effexor for many years, initially went on it for Anxiety and it did help a lot with that. However I went off it about a year and a half ago, and it was a total nightmare experience! I was not even on a high dose at the time and titrated it down very slowly, but the side effects from the withdrawal were horrendous! I was extremely depressed, irritable, some days crying every day, etc. I researched it online and found that a lot of people have a terrible time with withdrawal I also talked to a nurse in my doctor's office about it and she said she thought Effexor should not even be on the market. So be careful!

I am not on Tamoxifen so don't know much information about what anti-depressant would be recommended with that.

mellee · February 2017

I've taken Effexor before and it was not for me. Plus, as mentioned above, it is notoriously difficult to withdraw from. Other first-line choices (acording to the Harvard article below) are Pristiq and Remeron, but Pristiq is very similar to Effexor, so if you don't tolerate Effexor, you may not tolerate Pristiq either. And Remeron is notorious for significant weight gain.

Celexa and Lexapro are secondary options. I went with Lexapro after talking to my MO. I'm on a very small dose (2.5 mg - which is half of the smallest pill available), but it's helping me with mood, anxiety, and sleep. Just as an FYI: when you first start taking them, SSRIs can actually make you feel more anxious. But that should go away after the first couple of weeks.

http://www.health.harvard.edu/newsletter_article/a...

Effexor SEs

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