Tamoxifen and Wellbutrin

Hi baffled and welcome to Breastcancer.org,

We're sorry to hear of your diagnosis, but glad you've found us! You're sure to get some helpful responses here soon. But in the meantime, it may be helpful to consider that you're still getting some benefits from the tamoxifen while you're on Wellbutrin, and because it's only been a short time, it likely won't be detrimental to only get those limited benefits for another week or so until you can get your primary to prescribe another antidepressant. Also, consider the strong effects your body could see by stopping your current prescription -- it may be more detrimental to quit that medication that you're already accustomed to. We'd advise always speaking with your doctor first before stopping any medication.

We hope this helps and that you get some more info and advice soon! We look forward to seeing you around the boards.

--The Mods

You may be able to see a psych through your cancer center. That's what I did. I was switched to lexapro. It's not as good for me as the Wellbutrin but I think it's better than nothing.

I strongly recommend not going off antidepressants now. I wanted to and thought about it also, but this cancer thing is such a mind game. Give yourself whatever advantages you can. I'm about 10 months out from when my lump was first found and every time I think I've found my emotional equilibrium, it turns out it was more of a lull.

Effexor is good for women who have hot flashes, because it also helps with those. But it is hell to come off of so unless you need relief from hot flashes, probably not the best starting point.

I think you are wise to get settled in Tamoxifen before you switch, that way you know what is and what isn’t a side effect. I took Effexor for several years while doing HT. I really liked it. A lot. I tapered by taking five extra tiny balls out per week. Then I went to 40 mg Prozac. I’m now on 20 mg Prozac.

I just read your post. I’m doing the same thing weaning myself off my Wellbutrin so I can try the Effexor. How did you make out? I noticed I’m feeling more depressed as I stop my Wellbutrin. I was hoping I wouldn’t need to take another medication. My Dr suggested Effexor. How do you like it? I’m so tired as it is. She said this may help. I also don’t want anything that is going to make me gain weight. I work hard to stay in shape.

Thanks

After trying Celexa I had been on Wellbutrin through several of my 5 years on letrozole. I've switched to tamoxifen for my final years and had a long talk w/ 2 different MOs in 2 different practices re: tamoxifen and Wellbutrin. Neither one of them ruled out continued use of W. despite a continued high risk of recurrence. Both stressed that even if the benefit of tamoxifen is diminished, it is not eliminated and both agreed that changing anti-depressants can be a challenging process with uncertain results and that emotional health was an important aspect of dealing with life after cancer. YMMV.

BB - that would be an excellent reason all on its own to switch to an AI. I did a similar test prior to switching and was happy to learn that at least I don't have that issue. Good luck with Anastrozole. I know plenty of women who did fine with it and I hope you will, too.

I see I posted before but I have an update. My body never adjusted to the tamoxifen and I couldn't tolerate the side effects (mainly needing to go to sleep after about 9.5 hours of being awake). I tried different dosages, brands, etc.

I did a lot of research and my oncologist agreed to let me take toremifene instead, which is another SERM that is FDA approved for advanced stage hormonal cancer but not preventing recurrence in premenopausal women. But there is research supporting it, albeit not as much or as high quality as the decades of research supporting tamoxifen. But to be honest, the amount of research on AI for premenopausal women was much less than I expected too! I asked my MO why she was so much more comfortable with AI than toremifene when it seemed to me that the amount of research was very comparable. She said it's because she feels like there is a lot more clinical experience with premenopausal women on AI.

But that's a pretty circular kind of thing. Also apparently toremifene is in much higher use in China and Asia because the genetic variation that inhibits tamoxifen uptake is more common there.

So anyway, I tried toremifene and it has been like night and day. I can actually have normal length adult days now. And it's compatible with Wellbutrin, so I got to go back on that also!

I wish this would be considered for more women. When we're on a drug for depression that is really working for us, it should not be thrown off lightly. That by itself should have been a good enough reason for my doc to consider toremifene as an option for me from day one, but her only other offer was OS+AI. Maybe she'll consider it for more patients going forward.

Anyway I try now to let people know about it because it has made a huge difference for my quality of life.