Yes, I know it's a no-no...Wellbutrin & Tamoxifen

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...but I'm trying it anyway. Wellbutrin, that is. And yes, I take tamoxifen, I have for 5 years. Backstory: I tried Wellbutrin a few years ago (while still on Tamox per MO's okay). In the beginning, I loved how it made me feel. But, after only a week or so on the Wellbutrin, and because of Wellbutrin's well known interaction with tamoxifen, I had enough guilt that I wasn't doing all I could as far as BC prevention goes, so I had my MO switch me to aromasin (yeah, really close to when I started the Welly...). Well, as it turns out, I couldn't stay on the Wellbutrin because it ended up giving me horrible afternoon tension headaches (which could have something to do with starting the AI at the same time, looking back on it. Who knows.). After stopping the Wellbutrin, I was able to stay on the aromasin for only a couple more months but then had to stop taking that too due to terrible joint pain. At that point, I went back on the tamoxifen, tried other antidepressants (I've tried so many I've lost count...) and finally ended up having the Geomind Genecept Assay test (a test that basically tells you which psychological drugs will work for you and which ones won't based on your genetics. Figures that most out there WON'T work for me, [ah, except for Wellbutrin]) In the meantime, my depression has gone through cycles of getting worse to getting better. I've dealt with the downs as best I could (having a husband who lets you cry and scream on his shoulder helps tremendously), but lately I seem to find myself in a down cycle and frankly, after everything my family and I have been through, I just don't want to "deal" with it anymore. I want help. Wellbutrin, based on my genetic testing, is a good choice for me (if the headaches don't come back). I want to feel happy and productive again. And I'd really love to stop crying all the damn time. 

SO, I talked to my MO yesterday. What we have decided to do is have me start the Wellbutrin and stay on the Tamoxifen for now. Within 2 months, I'll know if I can tolerate the Wellbutrin. If that's the case, then I will call my MO and she will switch me to Femara (which is the only AI I haven't tried). I have an appointment with her not too long after that to see how I'm handling the Femara. If I handle it well, all will bet set. If not, I'm not sure what we'll do. If I can't tolerate the Wellbutrin again, then I stay on Tamoxifen, nothing will change and I'll have to figure something else out.. 

So, after all of that, here is my question: I know the interaction between Wellbutrin and Tamoxifen is due to how they are both metabolized in the liver. But since I will be taking these together for at least a month or two (if the headaches don't come back) I'm debating on WHEN to take them. Right now, I take my tamox in the morning. Wellbutrin can cause some insomnia, so it's best to take it in the morning too. I'm thinking of switching my tamoxifen to the evening, taking the Wellbutrin in the morning with the tiny dose of beta blocker I'm on and seeing how that works. By doing that, they will be metabolized at different times of the day and hopefully I will get the most out of each drug. Does anyone here do the no-no thing too and take Wellbutrin and tamoxifen? If so, how do you do it? If not, does my reasoning on how and when to take these pills make sense? TIA, ladies. I hope this wasn't too confusing. 


Comments

  • exercise_guru
    exercise_guru Member Posts: 716
    edited September 2017

    Sorry I don't know a lot about antidepressants but I take my tamoxifen 2 hours before bed or it give me heartburn.

  • SJI
    SJI Member Posts: 69
    edited October 2017

    I am supposed to be starting tamoxifen and have been taking wellbutrin and cymbalta for years. I had read that there is a conflict with both of those and tamoxifen. I asked my MO and he said the current thought is that it is all right to take them. He said the worst that would happen is the Tamoxifen's effectiveness might be reduced a bit.

  • Michelle_in_cornland
    Michelle_in_cornland Member Posts: 1,689
    edited October 2017

    You can try to take them at opposite times of the day, 12 hours in between.

  • gb2115
    gb2115 Member Posts: 1,894
    edited October 2017

    Your timing plan sounds great, as does your plan to switch to an AI if the Wellbutrin works. Well thought out!

  • dtad
    dtad Member Posts: 2,323
    edited October 2017

    Michelle....IMO taking the meds at different times of the day will not affect the interaction of the drugs. You have to have a certain blood level of anti depressants to work and it should not change throughout the day. Of course SJI should check with her doc and or pharmacist.

  • pupmom
    pupmom Member Posts: 5,068
    edited October 2017

    My advice is to rely on medical doctors, rather than internet bloggers, to make any decisions regarding medications. Best wishes!

  • KBeee
    KBeee Member Posts: 5,109
    edited October 2017

    The reason has to do with its metabolism. CYP2D6, is the principal enzyme that converts tamoxifen into endoxifen, a form that is active in the body. Variations in the gene that synthesizes CYP2D6 can limit women's ability to convert tamoxifen into its active form; (about 7% of women have no CYP2D6 activity). I do not know about timing. A pharamcist would be the best person to direct that question to.

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