Effexor/Antidepressants?
hi everyone!
I don’t know if it is the approaching darker days or just the SEs of Medical menopause and/or letrazole and/or Ibrance and/or having a stage 4 diagnosis but I definitely get depressed sometimes - especially when I am alone too long.
Has anyone had success with Effexor or any other antidepressants to help with dealing with the emotional aspect of all of this?
I guess I keep mentally fighting off taking Effexor (even though it can help with the industrial strength hot flashes AS WELL AS depression/anxiety). I guess I worry/fear that I will someday need the “big guns” as far as medicine goes and don’t want to start using up the arsenal too early or quickly, if that makes sense
Comments
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LovefromPhilly, I have been on Celexa (Citalapram) 20mg for two years now and it helps. I am afraid to go off the med to see if I even need it anymore. I still have moments, so you are not alone.
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LovefromPhilly, I hate to think who I’d be without the help of Effexor! The good news is that they generally start you at a low dose and can increase the meds as needed. I learned a long time ago that there is nothing wrong with needing medicinal help, and I encourage anyone struggling to seek the help they need. Good luck!
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thank you both!
Any negative side effects with starting Effexor? I have heard that it can make a person quite nauseous and I feel wary of that :-/ thank you!!
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interesting to see this today as I’ve been wondering if my dosage of Effexor (which is purposely small at my request) should increase.
It’s helped me but I honestly can’t tell if my constant fatigue keeps me a little low or if I’d benefit from increasing it
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yes! Part of the issue for me is the fatigue factor. And I exercise which is supposed to help. I am writing this from my bed. Some days I just can’t get out!
I have been prescribed a low dose too of 37.5mg. I am nervous about the SEs that I have read can be a bummer for both starting Effexor and if I ever decide to go off it (if I start it).
I’m totally struggling with this decision! My therapist today and I were talking it out over and over...she is pro giving it a try and she says she doesn’t lightly make these recommendations...so I know she means business lo
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LovefromPhilly, I have taken 4 different medications for various BC-treatment related issues (hot flashes, treatment-related fatigue, joint pain and physical depression if that makes sense) over last 12 years. Below is my experience. In sum, I would suggest Cymbalta or Wellbutrin and not Effexor. Lexapro works for some but wasn't right for me.
- Lexapro is good for hot flashes and some types of depression. It made me happy (although I wasn't taking it for depression) but sleepy and left me feeling physically depressed - to the point my treating physician at the cancer center termed it as causing "somnolence", likely from too much of an impact on serotonin levels.
- Effexor: I next took Effexor for hot flashes and treatment-related fatigue. Effexor works well for hot flashes, gives a mini boost for treatment-related fatigue and helps with "atypical" depression (i.e., brought on by treatment and/or side effects of treatment such as changes in hormone levels). Very balanced drug while one is on it. However, I STRONGLY urge against starting Effexor and recommend selecting another alternative. Going off it is extremely difficult and actually impossible for some - severe withdrawals for an extended period of time (best case scenario, the acute withdrawal period will be about 10 to 14 days, that is if you taper off it at a snail's pace for 3 months prior to finally going off the drug as I did). The withdrawals are likened to a withdrawal of a hard core street drug (I wouldn't know) and can pose a serious, life-threatening health risks in some cases. There is no warning about this on the drug label, doctors don't inform patients about this and your doctor may not even know unless the treating physician is a psychiatrist (versus MO). I am apalled at the fact this isn't well-publicized. However, you can Google it and find info.
- Cymbalta is the same combo as Effexor (SSNRI) - helps with hot flashes, small amounts of fatigue and treatment-related depression but does not have the extreme withdrawal issue. One additional added benefit of Cymbalta is that it helps significantly with treatment-related joint pain (this has been studied and my MO prescribed it for this reason when I was on Aromasin/Faslodex). It can also help a bit with overall body aches, nerve pain from spinal or neck issues and bone pain from bone mets.
- Wellbutrin is a good drug for more pronounced fatigue - it gives a major energy boost, almost immediately, helps with treatment-related loss of sexual interest and treatment-related weight gain. Ideal drug if physical depression is your issue, but does not have the serotonin aspect that Lexapro has or that Effexor and Cymbalta have in a smaller amount to give that "happy" feeling.
One other point is that the drug right for you may depend on your treatment. Cymbalta was ideal when I was on hormone therapy but when I switched to chemo, it made me feel super sleepy - estrogen boosts serotonin so once that was no longer blocked by hormone therapy, the serotonin boost from the Cymbalta was too much for me. I have been on Wellbutrin since. On the other hand, the only time Wellbutrin felt like it was a bit too much of an energy boost was when I was on Aromasin/Afinitor for 3 months. Had I stayed on that hormone therapy longer, I would have lowered my Wellbutrin dose or went off it completely. On chemo, Wellbutrin is perfect. Good luck making a decision and I hope you find an effective solution for yourself!
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I started on Effexor 7 years ago for Tamoxifen SE's Never had an issue with it all. My dosage has recently been increased from 75mg to 150mg for nerve pain from a tumour wrapped around my C6 nerve root. Palliative Doc said is proving to be very effective for nerve pain. I tried Lexapro before Effexor and ended up in a psychotic state but couldn't even get a hospital to admit me. Stopped taking very quickly.
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JFL - thank you for that seriously amazing rundown of the different experiences you’ve had with antidepressants!! That was REALLY helpful and I’m gonna save it to discuss further with doctors.
I did forget to add to my concerns about the withdrawal issues from Effexor that I am concerned about. I am on hormone medications big time and there is a possibility that I may need a little chemo at some point. I feel some serious concern around the possibility of needing to stop Effexor if I have to have chemo?
Tennille - any issues with going off Effexor for Chemotherapy? Did you have to do this?
Thank you folks again so much as I navigate the possibilities!
In general, I am actually somehow amazingly upbeat. I work part time, go to the gym and workout 2-3 days a week at least, spend a lot of time with loved ones and family. But for me, I am vibrating on a MUCH lower level energy wise. Some of this has to do with being in my 40s now (and no longer in my 20s and 30s when I would stay out dancing till 2am and get up and go to work and school still the next day somehow.)
My depression is more of a fatigue and an achiness/pain (joints, neck shoulders) and a bit of a lack of optimism with fear and anxiety about what the future holds. I cry in therapy a lot but honestly I try not to be too much of a downer with my friends and family - mostly because I just want to enjoy the time with them and I am so grateful that they are in my life and everyone is relatively healthy physically and mentally. I really enjoy being with them and just enjoying life! It is when I am alone that the “darkness” creeps in and the aches and pains feel the most apparent. Funny how the mind/body works!
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Lovefromphilly, I have never gone off Effexor even on Chemo and to be honest, I dont plan too. Since I am Metastatic, it's one drug I dont want to go off. Especially as current research is showing that at 150mg to 225mg dose is more effective on nerve pain then Pregabalin which I took once and never touched again. The only thing I had to stop taking recently on Chemo was Tumeric as it's not advisable to take on Doxil or any of the 'platins' Antidepressants unfortunately are not a 'one size fits all' it may take a bit of trial and error to find what works for you and remember like anything you may feel a little crappy before it gets better. They can take a few weeks to be effective so my GP at the time gave me a short antianxiety medication to take as needed until they were 100%
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tennille thank you for this info!
I have heard that curcumin (the high concentration of the bioactive compound found in turmeric) is not recommended with Ibrance. So I don't supplement with curcumin although food-based turmeric I am okay to consume. It is (in Chinese herbal medicine) considered to “warm and move the blood.” Curcumin has shown great results (research-based) to help during use of certain chemos - but if administed by IV and at a dose of something around 50,000mg! Anywho - love turmeric, I stay away from curcumin while in Ibrance because it can also act as a CYP-450 cytochrome inducer and speed up the length of time Ibrance stays in the system, thereby making it less bioavailable. I think I eat a negligible amount of turmeric though to cause an issue.
Okay just went on a total tangent there!
Any way - I love knowing the positives of Effexor too! Tennille - have you ever missed a dose and if so, did you have severe withdrawals?
Thank you so much!! Love!
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LovefromPhilly, Yes have missed a dose and not felt great but wasn't to bad either. Only time I felt really rotten was when I was coming down off Dex post treatment and I needed to get Effexor script refilled. By the time I got to the pharmacy I was shaking and in tears. I quickly figured out that the Effexor balances out the SE's of the rods so always remember to take it first thing in the morning especially after treatment.
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thank your Tennille! This is very helpful!!
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lovefromPhilly— I have been on Effexor for 8-9 years now. Started it for hot flashes, kept taking it for depression. I felt I was getting a 2 for 1. I haven’t had much neuropathy type pain, which may be due to Effexor. I started w/75mg, went to 150mg when found out I had bone mets. I have misplaced my meds & the with- drawls were awful. Dizziness, which made me sick to my stomach, crying over dumb things & racing thoughts. Once I resumed my daily dose I was immediately ok. Never had to stop med when getting chemo or radiation.
I am now 10 years out, so I have no problem telling people when I do not want to talk about how things are. My husband tells friends to ask me any qx’s as he does not want to ever lose my trust in him. The 1st time I heard this, I thought it strange, but now I realize it is his out for not having to talk about my BC. 🙃 happy to be on Effexor . Sue.
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Philly, I was diagnosed stage iv from the get go in 2011. I was a jumble of emotions and my onc prescribed Effexor. It did not agree with me so I stopped taking it. At some point, I started working with the nurse practitioner at my primary care doctor's office to find the right antidepressant, and I tried three others that were all terrible. I finally sorted through my feelings and realized I was not depressed, I was suffering from severe anxiety. The antidepressants prescribed all had the seratonin uptake which increased my anxiety, leading to the disastrous results.
I discussed this with the NP, and she prescribed the antianxiety medicine Buspar. It was a godsend. Not addictive, can start a low dose and can increase quite a bit if needed. I ended up needing a small dose. Did not alter my personality and took the edge off those horrible anxious feelings. I continue to take it daily.
I had to overcome some pride and accept that I needed these meds. Getting the anxiety under control was huge in allowing me to start moving forward with every day life; when it was uncontrolled, it had paralyzed me. At one point, not sure why, I stopped taking the Buspar for several days, and I was such a bitch! Honestly. Snapping at my family and on edge. It dawned on me that the antianxiety meds I took gave me a much better quality of life. It improved my relationships because I could be present for them and not be struggling with anxiety. I began taking the Buspar again and never stopped.
My advice is to work with your doctor and therapist to find the right meds to help you cope. Do this for you. Do it for your family. Don't put it off, thinking you have to soldier on and tough it out and be strong until you are going through more difficult times. Take care of yourself *now* for what is going on with you today, and make adjustmenst later if need be. It may take time to find the right med but is well worth the effort to do so. Best wishes.
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Hi LovefromPhilly
When I was diagnosed I became an instant train wreck. My surgeon prescribed an anxiety pill (Ativan?) and my onc prescribed Effexor. I used Ativan until I started cancer treatment, at which point I calmed down a bit, and stopped the Ativan. I continued with the Effexor, on and off (with all the meds I was taking for chemo I would forget to take the effexor, sometimes for weeks at a time) and finally, six months after starting Effexor I realized I was not taking the right dose as recommended by the onc. At that point I had more time -had finished chemo and mostly recovered from surgery- and I decided to take the time to look into these meds, cause I wasn't sure if it made sense to keep taking the Effexor and for how long.
The expert on antidepressants is the psychiatrist. Not the onc, not the surgeon, not the nurse -and definitely not the social worker. When in a crisis, you do what you have to do, but once you stabilize, I think it makes sense to look into this with a bit more care. So I looked up in the list of supportive cancer services at my hospital, and saw the name of a psychiatrist. I called his office and scheduled an appointment. I went to the appointment and it was really, really great. Very illuminating. The Dr knew all side effects of these meds, plus all side effects of all cancer meds and what to expect at each stage of treatment, had great recommendations for supportive services for different problems and challenges, and he recommended a low dose of Effexor -and also gave me a plan to wean off it in a few months. And he explained under which circumstances to go back.
Based on this experience I would recommend that you talk to a psychiatrist specialized in cancer. Look up what is available at your hospital, or ask your onc to refer you to an expert. You need to take care of your mental health and talking to an expert is best.
PS: I am doing great re hot flashes in the low dose of Effexor. They consider 100mg a low dose and I am in a 37mg dose, i.e. a third of the low dose.
Best with all,
LaughingGull
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LaughingGirl, you make a great point, and it’s one I have recommended before, too. For those who need fine tuning of their depression and/or anxiety, please consider a psychiatrist. They specialize in this field.
When I was working with the NP, who consulted with my primary care doctor (both wonderfully caring professionals), she told me that after trying several medicines, if the Buspar had not worked for me, she was going to refer me to a psychiatrist. And I would have gone, pronto!
One of my sisters dealt with severe anxiety (and perhaps depression) and doctored for a couple years with her primary and NP (different from mine). They tried her on all different combos of meds but she found no relief. Sister was quite opposed to psychiatrists due to bad experiences with them while dealing with my mother’s mental illness when we were growing up. But somehow, and I don’t know who finally convinced her to go, but she eventually went to a psychiatrist who efficiently zeroed in on her issues and prescribed the right medicines and it made a true, huge difference. I’m sure she has a better opinion of psychiatrists now.
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hi all!
Thank you so much for all your input, sharing your stories and experiences and medication pros/cons/loves/hates/works/didn’t work info.
It is all INCREDIBLY helpful and definitely gave me some good food for thought - with so much wisdom and knowledge and experience behind it all.
I had my monthly oncology appointment today and asked about an in house psychiatrist (which is absolutely a brilliant idea and I am kinda face-palming myself about why I hadn’t thought of this already? Hence why these boards are sooo amazing!!). I am going to get an appt with the in-house psychiatrist and talk through my needs.
What is so interesting and so very human is that I often times seriously forget that I have a choice in all of this and can work through the messiness with the support of others. I forget that I can start a medication and then if I hate it, I can stop it. And we can keep trying until the right one is found.
I also love the idea of no longer trying to soldier through this diagnosis. While I am really upbeat so much of the time, it is difficult to gain coping skills when the fear and anxiety are soooo close. With some medications, I hope I can have some space between my emotions and the realities, to focus on the coping skills part.
Thanks again all! Big bugs!! Here’s a pic of me last week on my road trip to Vermont to see the fall foliage. (Funny that when I travel I don’t feel depressed at all!!)
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Thank you LovefromPhilly and everyone here...all input so very helpful. I feel that I need help here too.
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so glad this was a helpful post Chemokaze!
It has been incredibly helpful to me too!
I am currently sitting in the waiting room as I write this waiting to meet the oncology psychiatrist and see what the options are.
Basically I’m pretty good, for the most part. Then sometimes the fear creeps in, and anxiety and depression. I feel like I am often a polar bear at the zoo looking out onto humans from behind a thick glass wall and under water. It’s like I can’t fully feel anymore and don’t have the energy to care.
Maybe this too shall pass without psychotropic medications but ah what the hell - can’t hurt to talk and ask
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hi everyone! Just reporting from my experience with the psychiatrist at my MOs office:
Met with the resident first and then the doc came in to join us.
Things I liked: they were both very kind and seemed open to listening to all my thoughts and questions and ideas. I felt heard and that my concerns were taken into consideration. They made it clear that if the medications don’t work or make me feel worse, we can stop them and try something else
Things I didn’t like: I felt like the male doc was telling me what kind of person I am (basically saying I am very anxious) without actually asking me clarifying questions about it 🤔 was a little weird. Like he was putting me in a box within meeting me for 5 minutes. Just a bit annoying from a patient standpoint. But I think he meant well.
The results of the appt: I am starting on a low dose of Lexapro and gonna see if that helps and slowly increase my dosage. They also said I should/could take Valium twice a day (this surprised me!) just to help deal with the tension/anxiety and possible side effects of starting on a psychotropic. I am worried that I’ll be spacy on the Valium if I take it regularly (I usually just take it for scans and flying).
I started the lexapro and took a 1/2 dose of the Valium. I am feeling quite mellow and write this from my bed - about to take a nap. Feeling incredibly unmotivated but at least I got out and voted!!
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Philly, thanks for letting us know how the visit went. Perhaps as you have follow up visits with the psychiatrist you will develop a better back and forth rapport with him. Still, it sounds like it went reasonably well and that makes me happy for you!
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thank you Divine!!
It truly helps to hear your (and others) experience with antidepressants and how much they have helped you.
I am on day 4 of lexapro here. Tried the Valium for the first day and I was worthless - stayed inside and in bed most of the day sleeping so I have decided to only take it "as needed" instead of twice a day as they prescribed. While it was relaxing I just don't think it is good for my spirit.
I really like this thread because I think mental health is such an important part of a BC diagnosis. I was shattered for the first 6 months at least when I got my diagnosis. Now that the adrenaline has calmed down, I am picking up the pieces of me that got a bit lost in the storm.
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Philly, thats a good way to put it, picking up that part of you lost in the storm of an unexpected diagnosis. It sounds smart to take the Valium as needed. It probably helps to know that you have it at your desposal, tho. I have an old bottle of Ativan and once in a blue moon I will take a half of one. Surprisingly, its usually after a very busy time in life, say back to back to back family gatherings at holiday season where things are reasonably good but extremely hectic. After all the upheaval, my nerves are completley jangled and jarred and the Ativan and a good night’s sleep gets me back on track.
I agree mental and emotional health are very important!
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My MO prescribed Citalapram (celexa) for depression. She said it was a better choice for my widespread liver mets dx in Oct 2016. Apparently antidepressants are metabolized by the liver and some of these drugs are harder on liver than others.
I had wanted to retry Pristiq that I had used several years before. She said no. I have had no problems, but think I am ready to ease off Celexa 20mg with her oversight.
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SandiBeach thank you for sharing!
Have you started the weaning process yet?
I am on week 2 of the lexapro and everyone is asking me if I feel different. I can’t tell! I am sleeping more it seems!
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lovefromphilly
Sleeping better is a good sign. These medications take time - about 6 weeks - before you really know if you feel different and it's working. Journal your symptoms each day...it will help you see progress when depression symptoms drop off the list. Hugs!
-Tres
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thank you Tres!!! That’s a great idea!! I am not so great at keeping journals but I am inspired to do so!!
Take good care!!! Brenda
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hi everyone,
Just wanted to report in from the realm of antidepressants.
I have been on 10mg of Lexapro (low dose) for a few months now.
I did experience some gastric upset (diarrhea) in the first month or so.
I can definitely feel a noticeable difference. I am not crying ALL THE TIME anymore!!
I feel so much less anxious. I have very little social anxiety, and feel pretty unruffled by things that would ruffle my feathers before.
I would give this a positive rating and am incredibly grateful it is working so well.
My psychiatrist started me on 5mg and suggested I ramp up to 20mg within 1.5 months. But I stayed at 10mg because it is working just fine at this dosage.
Thank you all who contributed to this thread - it helped me immensely!!!!
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Philly, it is wonderful to hear your news that the Lexapro is working so well and you have a better quality of life! Reading your whole post made *me* feel good!
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thank you divineMrsM!!! You (and the other responders on this thread) truly helped me make this decision and I am eternally grateful! It is so nice to have such an incredibly supportive and helpful community here. Thank you and hope it is okay if I send you a hug!
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