Tamoxifen and Anxiety/Anti depressants - Help!
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I stand corrected on the Wellbutrin question. Sorry-- didn't mean to spread any misinformation. I do not take Tamoxifen myself-- so my bad.
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So I read the newer study from March and it states:
"Taken together, these represent a high level of evidence demonstrating that CYP2D6 genotyping should not be recommended for such patients and that there is no need to avoid CYP2D6 inhibitors in postmenopausal patients taking tamoxifen."
So this is answering my question that if it "doesn't matter" if you are an extensive metabolizer or not... then it shouldn't matter if you are combining tamoxifen with a known CYP2D6 inhibitor.
Though the word that concerns me in that quoted statement is "postmenopausal". I'm very premenopausal ~ so are most of the women taking tamoxifen ~ so what does that mean for us?
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Hi Susan,
My MO is not going to run the test unless I insist which at this point I'm not. Like you I'm really having no side effects, and the data keeps changing on extensive vs low as to why some of us have no side effects.
I'm also very premenopausal - my hormone levels were nowhere near anything even perimenopausal before all this started.
But tamoxifen also has other metabolic pathways as do the SSRIs and SNRIs - the CYP2D6 gets all the press, but there are other genetic emzyme pathways that metabize both classes of meds. I would still say stay away for most people between tamoxifen and a heck of a lot of meds. You may not be an extensive metabolizer of the other pathways.
This is why it can be so hard for your doc to get someone stablized on the right combo of meds (regardless of breast cancer, this applies to everyone). Genetics is such a huge deal when it comes to how each person responds to medications. The future of medicine will be personlized dosing and selection of med based on your genetic makeup and that is going to be awesome.....
Cheri
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Thanks for the additional info, Cheri. All this stuff is fascinating to me.
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hello sweetie, I feel for you cause I remember those nights when I couldn,t sleep because of worry and not knowing what was coming next, I took ambien and it knocked me out, so works different on all,you are in my prayers as all of US are, and things will ease up, take it from a 18 yr Survivor. msphik(idc, stage 2, 3 nodes, L mast, chemoand rads and 5yrs on Tamoxifen.
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I take Trazadone and I've been on this for almost 4 years. I take 100mg an hour before bed and it lets my mind rest. I have an overactive brain where my brain doesn't know how to shut down so this aids the process. Didn't realize it until I was diagnosed with PTSD after numerous sleep studies a few years prior. I also take Cymbalta which works great but all medicines are different for everyone. They were going to switch me to Zoloft but my body is too senstive to medication and I didn't do well with it. I also have taken a vitamin supplement ever since I first got sick. I will tell everyone to stay away what I call the terrible Rs...Remeron and Respirdal. It can be a constant battle but the one thing i have learned is to listen to my body. I wad diagnosed almost a year ago wtih vitamin D deficiency and they have me on 50,000 mg. Its beyond milk/sunlight. We have to take care of ourselves the best we can and search for what works for each of us. Wish you the best
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I dont mean to sound trite, but I just want to add that " sleepytime tea" gets me to sleep within 20 mins. Ever since my DX I have used it nightly, (after many sleepness nights initially) and it really works for me.
Good luck to all.
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Okay, just saw this discussion about using Tamoxifen and Lexapro. I just went to the Oncologist on Thursday, May 8th and was given a prescription for Lexapro. I either should be concerned that he gave it to me if there is an interaction problem with Tamoxifen or I should trust him that there isn't because otherwise he wouldn't have subscribed it. I had my ovaries removed 2 weeks ago and he is concerned that my hot flashes will intensify with using the Tamoxifen and not having ovaries so he gave me the script to have on hand in the event that I cannot deal with the hot flashes. Should I be worried about using the Lexapro or not????
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Sandi, Lexapro is on the ok list with tamoxifen. If you want a cheat sheet, I put that post on March 21 if you look at the first page in this thread. I'm an RPh and I figured I could at least help out with some of the drug questions people ask on these forums
Cheri
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I opted for a supplement called Sam-E that I began taking for joint pain but it is often recommended for depression/stress and those things that can keep you awake. I was having awful night sweats and hot flashes but after a few weeks of taking the Sam-E I fell pretty good. It doesn't work overnight, you do have to give it a few weeks. I buy it at Costco when it goes on sale because it's fairly pricey. It's my priority supplement..
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WebMD said there is a major interaction between Tamoxifen and Lexapro? Why does everything seem soooo unclear?0 -
I take klonipin at night it helps me sleep. I have been on tamoxipen since oct, 1st and I get mood swings. sometimes I am ok and sometimes I feel down. I wish I knew what to do0 -
Here is the link to drugs.com drug interaction list for Tamoxifen. http://www.drugs.com/drug-interactions/tamoxifen.html. I don't know if this will help you figure out what you can or cannot take while taking Tamox. I also have done some research that grapefruit and pomegranates should not be consumed if on Tamoxifen since these two fruits interfere with the absorption of the Tamoxifen.
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this is very helpful. I had terrible reactions to both effexor and celexa. So I am about to start lexapro. Fingers crossed it works. I had to stop Lupron, so I am premenopausal and can't take an AI. If lexapro is no good I don't k ow what I will do...effexor and celexa both made me feel manic :-(
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Dear Ladies, I've been in and out of doctors trying to see whats best for me. I was considered stage 1 DCIS on my right breast, and my lymph nodes were not effected. I had surgeries to remove the cancer, then radiaton for 9 wks and prescribed Tamoxifen. Have been on this for almost a year in September. I've had horrible side effects and taking effexor, my oncologist doesn't seem to put a priority on my worries and questions. He's always threatening me of chemotherapy if i stop the hormone therapy. I'm just exhausted. I see the high percentage of death if i quit tamoxifen. But i would like to educate myself it there's another treatment that can benefit me. In June i was clear of any nodes in my lung and left breast (in April some cancer nodes showed in a mri) which I thank God constantly for, I just want to know if i should get blood work done, and how often to make sure my body is taking the tamoxifen, or if i should be paying attention to all the side effects i'm getting. Again, i haven't seen my oncologist for almost a year now and every time i call it seems like i'm a bother since i'm in no real danger any more. Please guide me if i should be worried or not.
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Tresjoli2 - My GYN gave me Pristiq this past Jan. for relief from menopausal symptoms. I was not yet diagnosed w/ breast cancer. The Pristiq made me sicker than I've ever been. It was awful. She took me off of it in a week. She then switched me to Paxil. I was scared to death to try another one but I had no trouble at all. Her take was that I did not tolerate the SNRI's at all but could apparently tolerate the SSRI's.
My point - Pristiq and Effexor are both SNRI's. I know you said you had trouble w/ Celexa which is SSRI but sometime it's just finding a right fit in the SSRI family. I had only been on Paxil for about a month when I found my lump and joined the breast cancer rollercoaster. I then had to switch off of that b/c Paxil doesn't mix w/ Tamoxifen. She switched me to 10mg Lexapro and I continued to do just fine.
I'm sure your doc will start you low dose but just make sure he/she does. I believe 10mg Lexapro is the lowest dose. I was a tiny bit jittery the first 2 days and then it was over.
Also I take it at bedtime just before going to sleep. And as a side note I started Tamo just a little over 3 weeks ago and so far so good. I'm having no side effects at all. Good luck and hope that Lexapro works for you!!!
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blueteal...So sorry you are going through this. IMO you should see another oncologist. Preferably at a university based teaching hospital. Ive never heard of chemotherapy for DCIS. I'm not sure what you mean about high percentage of death if you don't take Tamoxifen. Your cancer is not even invasive at this point. I hope you can find another doc that can work with you instead of just frightening you scare tactics. Good luck and keep us posted. Please feel free to PM me if you want to talk more.
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Tamoxifen depletes Tryptophan. It is used in Neuoropsychiatric Drug Trials for treatment of Bipolar Mania. I experienced extreme mood swings and trouble sleeping while on tamoxifen, which was alleviated for the most part with relatively large does of Tryptophan. The Tryptophan did not help my body aches or extreme mood swings, so quit tamoxifen after 9 hellish months. Thank God I am off that awful tamoxifen. I thought I was loosing my mind, and I felt better in about a month, and it just got better over time, although the vaginal atrophy caused by that damn tamoxifen never resolved.
Efficacy of a protein kinase C inhibitor (tamoxifen) in the treatment of acute mania - MedPage Today
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I’m taking 20mg Escitalopram which I believe is the same as Lexapro along with my Tamoxifen. Have the blessing of onco and psychiatrist to take together.So far happy to report no side effects from Tamoxifen but yawning and vivid dreams from Escitalopram.
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Tamoxifen is the pits, I took it for 14 months, nearly killed myself and anyone that came near me. I begged for help but no one listened to me.
For the side effects I was given all sorts of different medication to combat the effects, I ended up with draws full of stuff
In the end I put the lot in the bin, went on a lovely holiday, sat in the sun , swam, read and relaxed . Ahh that`s better.
It`s toxic and I still have some living to do
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Hello.. how have you been since putting the tamoxifen on the drawer? hows your health? I have stopped taking tamoxifen for 7 months now, and theyve found a suspicious findings on my good breast. Im doing homework if the tamoxifen can shrink it or I have to start looking at biopsy then chemo...
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hello... how has it been going since leaving tamoxifen
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I have been prescribed Tamoxifen, but haven't started taking it yet. I also take Wellbutrin, but the MO didn't say anything about there being an interaction. Should I talk to her or to my psych med manager? I'm guessing the psych med guy. Why does everything become so complicated re bc?
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Bluteal, I quit tamoxifen, the devils drug several years ago. I am so, so glad I did. Like LMSymons I thought I would kill myself or someone else. I found that it interfered with making permanent memories. Feel like I lost a year of time with my family, when my children were little. Very sad to have lost those memories.
I read somewhere that tamoxifen causes rapid Tryptophan depletion, which interferes with memory consolidation. No one ever told me I would literally have important memories stolen from me.
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Tamoxifen has been a part of almost everyone of us at some point of time. I have started to feel as if I am married to it since it behaves musch like my husband, it alters my mood, get me hot flashes, never lets me sleep in peace and above all makes me go insane but I still cant live without it (and him). So,I started reading a lot about it just how i used to read about how does marriage work when i got married to him (we are poles apart). I came across certain very nice and informative links about tamoxifen and the one that got my attention was the one which had the supportive therapies to alleviate side effects of Tamoxifen, do follow the link to read about the same https://www.voiceofcancerpatients.com/breast-cancer/drug/tamoxifen
I hope it will help you in some way and doesn't bother you with drug interactions.
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I know many of you accept the devil's bargain of tamoxifen side effects as a way to save your life.
I also know of many women who also lived with horrible tamoxifen side effects, and still died way too soon.
I am not willing to suffer with terrible side effects from tamoxifen, or some other hormone blocking medication since it's not a guarantee of saving my life. My friend Mary died at 34, only initially a stage 2, did tamoxifen, and all the rest of "standard of care", surgery, poison and fried by rads.
It didn't save her and I just never felt safer on it. I will never take it again
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Mac - sorry about your friend. It really sucks when you do and take everything that’s prescribed and still lose the battle. It happened to my sister as well.
Tamoxifen for me was no walk in the park but the side effects were tolerable. I can promise you had I suffered the side effects you and others have I would have quit taking it too. It’s bad enough to be stuck with this insidious disease without enduring more pain and suffering from the meds.
Diane0 -
Thanks Diane. I appreciate the understanding that for some of us taking tamoxifen has just awful side effects that ruin our lives.
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