Tamoxifen/Effexor
Comments
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Kaara,
Effexor is not an anti-anxiety drug but an anti-deppresant. As others have said, the mechanism for hot flashes is poorly understood so it is not clear why ant- depressants tone them down. When I was going through menopause I took Celexa for a while. Very helpful and no issues as I tapered off and then stopped. Am now on Effexor, 75 mg and Arimidex and it works for me.
Caryn0 -
Effexor is not only for anti-depressant but also for Generalized anxiety disorder, social anxiety disorder, and panic disorder. I am using Effexor for 7 years for my generalized anxiety disorder, it helps me alot with my worrysome, always thinks for the worse, always fear of everything everyday. Also helps my hot flashes, even though I didnt even started my treatments yet to this day. It has been a year and half since I stopped having period so I am now officially menopause.
When I was diagnosed with breast cancer, I was upset but i got over it and move forward.
I will see what my new oncologist say what kind of treatments i will get he knows i am using effexor for 7 years, i will not get off, because it is my lifeline.
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Yes, but it is classified as an anti-depressant, SNRI class. You correct in that it has other uses.
Caryn0 -
robo47: Hard to say what is causing your loss of libido. Anti depressants will certainly do that as well as the hormonals. You aren't on the hormonal yet, so it's a pretty good guess that the Effexor is the culprit. If you aren't seriously depressed, try going off it and see what happens.
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Hillck - I'm on Wellbutrin originally for PMS, I had been on Effexor about 6 years ago and had a terrible time coming off of it. I'm currently doing chemo, but will eventually go on to Tamoxifen. I am adament about staying on the Wellbutrin since all round I feel better on it. My Doc had said they are not that concerned anymore about Wellbutrin and Tamoxifen anymore, Have you heard the same?
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Some SSRI's cause libido problems, others seem not to affect that so much.I thought Wellbutrin and Effexor were the latter category. I had not noticed any dramatic libido problems with Effexor. I'm more distracted by the general worry about my BC, and the fact that I'm often somewhat tired from chemo.
Claire
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I am losing weight hand-over-fist on Tamoxifen. My oncologist warned me that I would on this particular medication. So far, I'm dealing okay with the other side effects; some "flushing that is not nearly as bad as the flashes I struggled with during chemotherapy; some mood swings, but - again - nothing too serious; some mild discharge.
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I started Tamoxifen in Dec '10 and had some side effects for a few weeks . . . but they did taper off. I had mild hot flashes . . . "warm" flashes I guess, until June '11 when I had a hysterectomy/oopherectomy. I had nothing for two weeks after the surgery, then BAM! I was having 30 - 40 hot flashes a day. Very severe, and almost made me crazy.
I have also been on Effexor since starting Tamoxifen as the pharmacy did not recommend me staying on the Wellbutrin I was on. I had been on 37.5mg of Effexor but when the terrible hot flashes began, went up to 75mg. It did not help one bit. The hot flashes were every bit as severe as they had always been.
I started Gabapentin about 2 months ago and finally, I have some relief. I would say I'm down to about 5 flashes a day, and they are mild compared to what they were. I went back to 37.5mg of Effexor, because I didn't want to be on more than I needed when it wasn't helping the flashes at all. Since my surgery, I have gained about 15 lbs. Who knows what caused it . . . Tamoxifen? Effexor? Surgery? Total and complete lack of estrogen? Could be any one of them or any combination of them. Just wanted to let you all know that Gabapentin seems to be working for me in controlling the number and severity of hot flashes.
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Tamoxifen causes you to lose weight? Maybe that explains why I am continuing to lose weight. I am on a special anti cancer diet, no starches or sugars, and I lost about 10 pounds then leveled off, but then after I started Tamox, I started to lose again. I don't want to go below 120 which is the low end of normal for my height 5'4". I hate doing it, but might have to throw some carbs back into my diet:( There would have been a time when I would have considered this a good problem to have! Knowing that starches convert to sugar, and cancer loves sugar, I am trying to stay away from them.
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Just wanted to chime in. I had a problem with anxiety issues (was always a very high strung person) and was on a low dose antideppresant prior to BC. When I went on Tamoxifen over a year ago, I switched to Effexor. Not one single noticeable side effect. No hot flashes, nothing. I have probably gained off and on 10 lbs in the last year...but that has been to pure laziness and overeating on my part! When I get back to my consistent exercise and not stuffing my face..it starts coming off easily. (But I was like that pre-BC before too). Also...even though I'm on the extended release tablets, Effexor has a very short 1/2 life....if I go too long in between doses....like miss my morning dose...by the afternoon I start feeling a bit light headed and almost a slight vertigo feeling. Kinda creepy and does concern me when/if I decide to go off of them.
Regarding the "loss of emotions". I'm on 75mg/day. I do notice that it takes a little more to make me cry. Before antidepp, I probably easily cried at least once a week about something...whether it be a sappy commercial or being upset about something...or my boss looked at me funny! .... now.... at least a month will go by without me crying. I do notice I'm definitely less emotional...more like a guy.
which isn't necessarily a bad thing because I've handled this whole BC thing pretty calmly and I persoally think I'm a better, wife, mom, boss when I'm less high strung. I keep thinking maybe one day I'll wean myself off and try to substitue with meditation, yoga, diet, etc.....but then crap keeps coming up... like cancer and tamoxifen! ... sigh... maybe after I'm off the Tamoxifen I'll give it a go. 
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I was that way when I was on my HRT and then BHRT for 20 plus years. I could never have survived in the business I was in, working with men, if I hadn't been able to maintain my calmness. Once dx with bc, I was taken off all BHRT, and then began to suffer hot flashes and mood swings. It took a few months to get them under control, and I'm still not back to normal, but I'm retired now, so my livelihood doesn't depend on being calm all the time. I just scare the kids and the boyfriend now and then:)
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Kaara ~ hahaha
Maybe I'll have to wait until retirement then to go off. Raised as a feminist... I do find myself having a hard time admitting that (in general) women are more emotional and usually that just doesn't fly in the workplace. I hated in my early yaers that when I would be upset or angry about something or at someone...I would cry. It just does not go over well in a business setting! You never see guys doing that!
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Kara and Selena, what time of day do you take the Tamoxifen?I just changed to taking Tamoxifen in the morning to avoid the night sweats and it is working out well. I hadn't gained any weight on it like I feared but hope changing to morning, doesn't change things. I have no idea if that makes a difference. I am happy with my weight, exercise like a maniac but if Tamoxifen allows me to eat just a little more, I'd be a happy camper.
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I take mine at night. I do have sweats, but I would prefer that over nausea that MO said I might have if I took it in the morning. I did the same with my birth control pills...took them at bedtime to avoid nausea. So far I'm losing weight not gaining, but I'm also on a special anti cancer diet with no sugar or starch.
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I haven't felt any nausea switching over to the day time. I was nervous about switching but my night sweats were pretty bad. Good for you and the change in your diet. I am so nervous about what I put in my mouth wondering, "Is this what caused the cancer?" I wish someone could tell us why we got this but I know it isn't possible.
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My oncologist said that - in her experience - more women lost weight on Tamoxifen than gained weight and that seems to have been my experience thus far. I don't like starchy foods i.e., potatoes, rice, bread, etc and I don't have a sweet tooth at all, so I'm trying to think of ways to "beef up" my diet to counteract the weight-loss effects without having to eat food I don't like. I'm at a good weight now - I'm 5'8" and 135 lbs - but I don't want it to drop further.
I started taking tamoxifen in the morning after about four weeks on it because I had turned into a raging insomniac. After three nights without sleep (I swear I was starting to hallucinate), I switched to taking it in the morning and - after about a week - I started sleeping again. My emotions run a little too close to the surface and can swing suddenly, but - so far - it's nothing I can't handle with a good long run.0 -
Selena, I understand the "ranging maniac" part. I thought it was the hormonal effect of Tamoxifen that caused this but now that I sleep better at night after switching to the morning, I feel like a nicer person again. I think it was more a lack of sleep.
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Hi AEM47,
I'm a pharmacist. Please ask your doctor about being on tamoxifen and switching to Wellbutrin b/c it's still a no no. Wellbutrin is a strong CYP2D6 inhibitor and thus will interfere with the metabolism of tamoxifen to endoxifen which is the active med.
If he has new info, please ask him for it - some things have to with patient specifics, too. Some patients are poor CYP2D6 metabolizers. I might be one of them. I have been on tamoxifen 3 weeks and it's like I'm taking a placebo. Nothing. Not one side effect. So at my 1 month check up I'm going to ask for the enzyme test.
Effexor and Lexapro are good ones to be on with tamoxifen should you need either an antidepressant or for hot flashes.
If you need a list for your doc, this is a good one I found for patients they can print and take with them to doctor and/or pharmacy just to always be safe. Couple meds like Benadryl and Tagamet are OTCs that are big no nos with tamoxifen - I had to break it to someone on another forum that taking benadryl to sleep while on tamox, not a good idea......
http://medicine.iupui.edu/clinpharm/COBRA/Tamoxifen and 2D6v7.pdf
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Cherilynn: I take a half a tylenol PM to sleep at night. I've been doing it for years. Does this interfear with the effect of tamoxifen? Why didn't my MO mention this, or why doesn't it mention this on the brochure that you receive?
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Cherilynn64 - Very Interesting. I wonder why she said that. Does the amount of time you've been on a drug have anything to do with it? I've been on the Wellbutrin for years. Also, do they have a test to see how you metabolize Tamoxifen?
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Hi I know it's been a couple months since your question but just wanted to tell you about Effexor. I started on Tamoxofen in February too and was also on a low dosage of Wellbutrin for mild depresssion. Wellbutrin does not intereact well wtih Tamoxofen so oncologist put me on 37.5 mg Effexor. It works even better than the Wellbutrin and I have not had any hot flashes to date. Also, I started a diet and started slowly losing weight but recently seem to be losing a little more without trying. I've been on the combination of Tamoxofen/Effexor for about 10 weeks and no weight gain yet so hopefully it stays that way. Good luck to you!
Sandy
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I asked my MO about taking 1/2 a tylenol PM to help sleep in the evening and he said it was ok to do, so for now I'm going to continue. I need my sleep and don't want a sleeping pill.
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I was on Pristiq for hot flashes and decided it wasn't doing a thing, so weaned myself off. I did have the brain zaps for about 3 weeks. Made me crazy. After being off for a couple months, my hot flashes were so miserable and with the weather getting warmer, they were getting worse. My onc put me on a low dose of effexor and it has made a world of difference. Still having them, but much, much milder. No dripping sweats.
I believe if you search on tamoxifen interactions, benadryl is listed as a no-no, and that is the ingredient in tylenol pm.
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fluffqueen: Apparently my MO doesn't agree with that, because he said I could take it. What are brain zaps? Those don't sound like fun.
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For me, it kind of felt like moving your head, and your brain cathching up. Hard to describe. Not really dizziness, but almost an electrical sensation. And you never knew when you would have one. At least when I go off effexor, I will know what to expect.
I went on cymbalta for some panic disorder when I was first diagnosed. Couldnt eat and was losing weight rapidly. Loved it. But you cant take it with tamoxifen either. So...he moved me over to pristiq for the hot flashes. By that time, I really didnt need it for the anxiety. I had that all pretty much worked out. So I weaned off in december. But hot flashes were too much to take.
I dont feel any different with the effexor, other than much milder hot flashes. I am on the lowest dose right now.0 -
My onc put me on Effexor and two others to combat the hot flashes brought on w/tamoxifen. Then I found out these anti-depressents wreck your bone density. I would rather put up with some flashes even lots everyday, than have them weaken my bones. But I'm over 50 too, so maybe they wouldn't do the same on someone younger?? I actually felt worse being on the venlaxifine/effexor and had much more intense hot flashes. Some people lose weight on Tamoxifen, others gain. I'm one that gains so I've joined a gym and work the machines a couple times per week. I'm hopeful that some good exercise will help !
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I am new to tamoxifen and I hate it, I hate going into the medicine cupboard every day cause it makes me feel down all day and I flush all day. It's like my enemy. It reminds me of BC and I don't want to be reminded every day that i got what I dreaded all my life x
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I have been on Tamox since 11/2010. I started taking Effexor about 2 mons ago following my recon in Dec because my hot flashes were getting worse and the Celexa wasn't working for my anixety. I am taking 150mg at night. I still have issues with anxiety and can not get off my Lorazapam because something ALWAYS comes up that makes me worry, but I am working on it!!!!!! So far to date, I lost 30 lbs hovering around 119.
Hmm, just read the Benadryl post, guess I better quit that 1/2 tab at night.
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momx3: I asked my MO about taking a 1/2 tylenol pm at night and he said it was ok. It contains benadryl. He wasn't concerned in the least that I was taking it.
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I'm sleeping right now fine. My dr. gave me Vicadon for my hand and I just take it at night, the combo works!
Saw the Ortho dr on Wed and I have to have an EMG. OK, NOT happy with that!!! I hate needles and I'm a HUGE sissy. Panic attcks in full gear
, but hopefully my hand will be fixed and healed by school next year and my LE one on it's way. 0
