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Topic: Anti Depressants and Tamoxifen

Forum: Breast Cancer with Another Diagnosis or Comorbidity — Meet others who have breast cancer but also have another health diagnosis/comorbidity such as diabetes, MS, bipolar disorder, HIV or AIDS, Parkinson's Disorder, schizophrenia, etc.

Posted on: Apr 20, 2018 08:14PM

KCMC wrote:

Hi, I have been using an anti-depressant for anxiety and depression for the last 15 years. I first started with Zoloft and switched to Prozac after 3 years and have taken the Prozac the last 12 years. When I was diagnosed with Breast Cancer I doubled my dosage of Prozac and was doing fine this past year, actually I was very proud of myself. My oncologist informed me that I needed to switch my anti depressant due to the tamoxifen and prozac using the same neuro pathways and that the Prozac would interfere with the Tamoxifen.

I went to a Psychiatrist and he suggested Zoloft. I went back on Zoloft and it didn't work. My husband wanted to know where his loving wife was, I turned into an evil demon lol! I was binge eating, had anger issues and started to sleep during the day. I went back to the Psychiatrist today and he switched me to Effexor. I am now officially on the psychotropic roller coaster I call it.

The Psychiatrist mentioned to me that there is little data on tamoxifen and prozac. He suggested that maybe I should think about going back on Prozac. I would love to, but not if it interferes with Tamoxifen.

Does anybody have any insight they could share?

Thank you!


Dx 3/13/2017, DCIS/IDC, Left, 4cm, Stage IIA, Grade 2, 0/2 nodes, ER+/PR+, HER2+ (FISH)
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Apr 20, 2018 08:22PM Tresjoli2 wrote:

there are three antidepressants that do not interfere: effexor, lexapro, and celexa. You should see your gp and or mental health provider to see if any of these options work for you. Hugs!

Diagnosed at age 40 after going for my baseline mammogram. Dx 4/21/2015, IDC, Left, <1cm, Stage IA, 0/2 nodes, ER+/PR+, HER2+ (FISH) Dx 4/21/2015, DCIS, Left, 4cm, Stage 0, Grade 3 Surgery 5/18/2015 Lumpectomy: Left; Lymph node removal: Sentinel Targeted Therapy 6/19/2015 Herceptin (trastuzumab) Chemotherapy 6/19/2015 Taxol (paclitaxel) Chemotherapy 8/7/2015 Abraxane (albumin-bound or nab-paclitaxel) Radiation Therapy 9/24/2015 Whole-breast: Breast Hormonal Therapy 10/11/2015 Tamoxifen pills (Nolvadex, Apo-Tamox, Tamofen, Tamone)
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Apr 20, 2018 08:26PM Kanga_Roo wrote:

Hi KCMC, my short experience with Effexor is it took about a fortnight to really kick in. I started with 75mg and walked around in a daze, so onc dropped it to 37 and I felt really good but very tired. They got me over the tough depression of my bc diagnosis, but I have now weaned myself off them and am feeling really good.

Everyone seems to react differently. Hope it all works out for you... sending hugs

Jackie

Dx 1/24/2018, IDC, Left, 5cm, Stage IV, metastasized to liver, Grade 3, ER+/PR+, HER2- (IHC) Hormonal Therapy 2/11/2018 Femara (letrozole) Targeted Therapy 2/15/2018 Kisqali
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Apr 20, 2018 08:32PM KCMC wrote:

Thank you Jackie! It's funny my psychiatrist mentioned that it would give me an energy boost, lol! You are right everyone does react differently to these types of medicine.

Dx 3/13/2017, DCIS/IDC, Left, 4cm, Stage IIA, Grade 2, 0/2 nodes, ER+/PR+, HER2+ (FISH)
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Apr 20, 2018 08:52PM ClareCo wrote:

Hi KCMC.

I'm about to switch from Prozac to lexapro because eventually I will be on tamoxifan. I was thinking I'd Make the switch now before I start chemo so I don't have to cope with two sets of side effects at once. I'm worried about the switch, but I finally feel like I have a good doctor doing my meds which hasn't been the case in the past,so I'm trying to be optimistic. Good luck to you!

Dx 1/31/2018, IDC, Left, Stage IIA, 1/3 nodes, ER+/PR-, HER2- Surgery 3/15/2018 Lumpectomy: Left; Lymph node removal: Sentinel Chemotherapy 5/1/2018 Adriamycin (doxorubicin), Cytoxan (cyclophosphamide) Radiation Therapy Breast, Lymph nodes
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Apr 20, 2018 10:10PM KCMC wrote:

Hi Clare, that is a very good idea to switch early, I wish I did. I am assuming you are switching for the same reason I am, because of the tamoxifen. Good Luck to you too! I hope it all works out and having a good doctor makes all the difference.

Dx 3/13/2017, DCIS/IDC, Left, 4cm, Stage IIA, Grade 2, 0/2 nodes, ER+/PR+, HER2+ (FISH)
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Apr 20, 2018 10:13PM KCMC wrote:

Thank you Tresjoli, it's good to know I have a few more options if the Effexor doesn't work. Thank you so much for your input, I really appreciate it.

Dx 3/13/2017, DCIS/IDC, Left, 4cm, Stage IIA, Grade 2, 0/2 nodes, ER+/PR+, HER2+ (FISH)
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May 8, 2018 06:42PM Wingsofglass wrote:

Ive been on Zoloft and clonopin for depression anf anxiety for several years. Last year i was diagnosed with dcs situ . I had a lumpectomy, followed by radiation 48 treatments. For the past year ive been seeing an onocologist every three months for tamoxifen presciption and bloodwork. Last week at my regular doctors appt. she told me she just noticed i was taking zoloft ( she prescribes) and Tamoxifen ( onocologist) prescribes. She said the zoloft cancells any benefit from the tamoxifen.. is this true? Medications, bloodwork etc is expensive has this year been a waste? Am i not getting benefit?
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May 9, 2018 09:59AM - edited May 9, 2018 10:02AM by bluepearl

There are strong inhibitors of tamoxifen, mild and none. I am on low dose citalopram which is mild. Effexor is none. I think yours is strong. Time to change or go on A.I. (letrozole for example unless you are not menopausal) I want to add that changing your gut bacteria can help depression immensely.......I take 3x per week a 30 billion probiotic. I think it helps. I also take melatonin at night for a good sleep (and 600mg of magnesium daily). I also walk 2km per day and 6 km on Sundays. It all helps. Try, as well, mindful meditation, heralded as a wonderful cure for many things...you can easily do this walking as well. Lots of CDs and books to help you along.

Dx 1/6/2011, IDC, 1cm, Stage I, Grade 1, 0/7 nodes, ER+/PR+, HER2- Surgery 2/12/2011 Lymph node removal: Left, Underarm/Axillary; Mastectomy: Left Dx 2/2013, IDC, <1cm, Stage I, Grade 3, 0/3 nodes, ER+/PR+, HER2- Surgery 3/10/2013 Lymph node removal: Right, Sentinel; Mastectomy: Right Hormonal Therapy 3/18/2013
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May 9, 2018 10:28AM Lula73 wrote:

yes the Zoloft uses the same metabolic pathway as tamoxifen and can significantly reduce the tamoxifen’s efficacy. If you’re reluctant to change the Zoloft, perhaps an AI would be a good choice. If you’re game to change the Zoloft, there are a handful of of other antidepressants that you can take. One thing I’ve learned-Always check behind the doc on meds they’re prescribing to ensure no interactions. I’m also surprised the pharmacist didn’t notice this and say something...

-Lula Dx 1/2017, DCIS/IDC, Right, 1cm, Stage IA, Grade 1, 0/2 nodes, ER+/PR+, HER2- Surgery 2/13/2017 Lymph node removal: Sentinel; Mastectomy: Left, Right; Prophylactic ovary removal; Reconstruction (left): DIEP flap; Reconstruction (right): DIEP flap Hormonal Therapy 3/2/2017 Tamoxifen pills (Nolvadex, Apo-Tamox, Tamofen, Tamone) Surgery 11/1/2017 Prophylactic ovary removal Hormonal Therapy 1/2/2018 Femara (letrozole)
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May 9, 2018 02:58PM ClareCo wrote:

Hi Wingsofglass - I just transitioned off prozac and onto lexapro (well the generic versions) in anticipation of going on Tamoxifen. I did so under the supervision of a psychiatrist - although the last thing you probably feel like doing is finding yet another doc, I think it might be worth it. Good luck and hugs. I know this must be very frustrating!

Dx 1/31/2018, IDC, Left, Stage IIA, 1/3 nodes, ER+/PR-, HER2- Surgery 3/15/2018 Lumpectomy: Left; Lymph node removal: Sentinel Chemotherapy 5/1/2018 Adriamycin (doxorubicin), Cytoxan (cyclophosphamide) Radiation Therapy Breast, Lymph nodes
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May 9, 2018 08:41PM MagicalBean wrote:

Great question. I had taken Zoloft for 20 years and had to switch once I started Tamoxifen. I'm on effexor now and haven't had any issues.

Dx 8/25/2014, DCIS, <1cm, Stage 0, Grade 3, 0/0 nodes, ER+/PR+ Surgery 9/23/2014 Lumpectomy: Left Radiation Therapy 10/27/2014 Breast Hormonal Therapy 1/13/2015 Tamoxifen pills (Nolvadex, Apo-Tamox, Tamofen, Tamone)
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May 10, 2018 01:47AM Rosabella wrote:

Know that if you go off of effexor the ses are the worse, even if you wean slowly. I felt fluish for a month! Never again. I've been on ads all my life. With T, celexa and lexapro are good. It may have mild interference which my mo says take one in am and the other in pm.

Dx 6/2/2015, IDC, Left, 6cm+, Stage IIIA, Grade 3, 1/4 nodes, PR+, HER2- Surgery 8/6/2015 Lymph node removal: Left, Sentinel, Underarm/Axillary; Mastectomy: Left, Right; Reconstruction (left): Silicone implant; Reconstruction (right): Silicone implant Chemotherapy 11/3/2015 AC + T (Taxotere) Radiation Therapy 5/4/2016 Whole-breast: Breast, Lymph nodes Hormonal Therapy 6/28/2016 Tamoxifen pills (Nolvadex, Apo-Tamox, Tamofen, Tamone) Targeted Therapy
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May 12, 2018 08:52AM Wingsofglass wrote:

Thank you for your reply. I dont understand why my onocologist, the pharmacist and reg MD havent told me this about Zoloft. I have bern on Zoloft for years for depression, and was on Buspar for anxiety. My MD switched me to clonazepam which works, but I hate because youre made to feel like an addict to get your prescription filled. I asked the MD about weaning me off and she blew me off. I know not to go cold Turkey off any meds..... I have have been on Tamoxifen for a yr. Mixing with the zoloft , clonazepam, blood pressure meds, and two antacids.

I pray the tamoxifen is doing its job agaist BC reoccuring. ....... feeling let down and neglected by medical community. I dont go to psychiatrist my MD put me on antidepressants. The onocologist prescribes tamoxifen. Where should i go from here??

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May 12, 2018 01:15PM Rosabella wrote:

wings, you really should see a psychiatrist. They are specialists with psych meds, not pcps. Theyll have options for you. Plus you check in periodically to report how you're doing which is a good thing. They're the experts with those meds so go to them. Celexa and lexapro are good meds to take while on T.

Dx 6/2/2015, IDC, Left, 6cm+, Stage IIIA, Grade 3, 1/4 nodes, PR+, HER2- Surgery 8/6/2015 Lymph node removal: Left, Sentinel, Underarm/Axillary; Mastectomy: Left, Right; Reconstruction (left): Silicone implant; Reconstruction (right): Silicone implant Chemotherapy 11/3/2015 AC + T (Taxotere) Radiation Therapy 5/4/2016 Whole-breast: Breast, Lymph nodes Hormonal Therapy 6/28/2016 Tamoxifen pills (Nolvadex, Apo-Tamox, Tamofen, Tamone) Targeted Therapy
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May 14, 2018 09:07PM ClareCo wrote:

Hi Wingsofglass - we take a lot of the same medications. Maybe it will be easier if you ask your PCP to refer you to a psychiatrist. (easier than trying to find a psychiatrist out of the blue). He/she should be willing to do so, especially given that you need to go off the zoloft and onto something else. Also don't hesitate to ask the psychiatrist what he/she would do with a patient on tamoxifen - it's a perfectly legitimate question. Sending you hugs!

Dx 1/31/2018, IDC, Left, Stage IIA, 1/3 nodes, ER+/PR-, HER2- Surgery 3/15/2018 Lumpectomy: Left; Lymph node removal: Sentinel Chemotherapy 5/1/2018 Adriamycin (doxorubicin), Cytoxan (cyclophosphamide) Radiation Therapy Breast, Lymph nodes

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