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Topic: Tamoxifen and Wellbutrin

Forum: Hormonal Therapy - Before, During, and After —

Risks and benefits, side effects, and costs of anti-estrogen medications. Note: Please remember that there are good experiences and bad with ALL treatments and this is a safe place to share YOUR experience, not to be influenced or influence others.

Posted on: Jul 4, 2019 11:58AM

baffledbutterfly7 wrote:

I have recently started tamoxifen but I was already on Wellbutrin. I will have to change antidepressants but haven't been able to get my primary to respond to me, so still taking Wellbutrin. Has anyone been on both? What did you end up doing? I'm trying to figure out if I should just go off of Antidepressants. I have been on Tamoxifen since 6/21 and I think I'm slowly starting to feel side effects but I know its not at full strength due to Wellbutrin so that worries me how more intense will they get if I go off or change. Any information would be appreciated.

Thank you

Invasive Pleomorphic Lobular Carcinoma Dx 4/25/2019, LCIS/ILC, Right, 3cm, Stage IIB, Grade 2, 2/6 nodes, ER+/PR+, HER2- (IHC) Surgery 7/11/2019 Lymph node removal: Right, Sentinel, Underarm/Axillary; Mastectomy: Left, Right; Reconstruction (left): Tissue expander placement; Reconstruction (right): Tissue expander placement Chemotherapy 8/28/2019 AC + T (Taxol) Radiation Therapy 3/24/2020 Whole-breast: Breast, Lymph nodes, Chest wall Hormonal Therapy 7/28/2020 Arimidex (anastrozole)
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Jul 4, 2019 01:02PM Moderators wrote:

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

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Jul 4, 2019 06:01PM Tresjoli2 wrote:

there are 4 antidepressants that do not interact with tamoxifen: lexapro, celexa, effexor, and trintellix. Only those 4 are safe to take...the others will interfere with the effectiveness of tamoxifen. You should never just stop taking your antidepressants. You need an appointment with your prescribing physician and may need to see a psychophamacologist. Good luck.

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 9/23/2015 Whole-breast: Breast Hormonal Therapy 10/11/2015 Tamoxifen pills (Nolvadex, Apo-Tamox, Tamofen, Tamone)
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Jul 4, 2019 09:33PM Salamandra wrote:

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.

Dx at 39. 1.8cm. Oncotype 9. Dx 9/19/2018, IDC, Right, 1cm, Stage IA, Grade 2, 0/3 nodes, ER+/PR+, HER2- (FISH) Surgery 10/18/2018 Lumpectomy; Lymph node removal: Sentinel Hormonal Therapy 11/1/2018 Tamoxifen pills (Nolvadex, Apo-Tamox, Tamofen, Tamone) Radiation Therapy 12/3/2018 Whole-breast: Breast Hormonal Therapy 12/19/2019 Fareston (toremifene)
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Jul 18, 2019 04:36PM Mar1319 wrote:

I was also on Wellbutrin so I am gradually reducing that one and switching to Effexor. I have heard from others that Effexor is hard to get off of. I haven’t had many side effects but I too am worried that it is because the Wellbutrin was keeping them at bay. So then I won’t know if side effects are from Tamoxifen or Effexor.

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Jul 18, 2019 04:50PM farmerlucy wrote:

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.

Dx at 51 after a preventive mx that wasn't. Oncotype dx 3. 3D tattoos from Vinnie! PTSD?? You are not alone! Surgery 2/20/2012 Prophylactic mastectomy; Reconstruction (left): Tissue expander placement; Reconstruction (right): Tissue expander placement Dx 2/24/2012, IDC, Right, 1cm, Stage IA, Grade 2, 0/1 nodes, ER+/PR+, HER2- (FISH) Surgery 3/10/2012 Lymph node removal: Sentinel Surgery 7/21/2012 Reconstruction (left): Silicone implant; Reconstruction (right): Silicone implant Hormonal Therapy 4/9/2013 Tamoxifen pills (Nolvadex, Apo-Tamox, Tamofen, Tamone) Surgery 4/13/2015 Prophylactic ovary removal
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Jul 21, 2019 09:53PM baffledbutterfly7 wrote:

Thank you everyone for your input, I’m slowly weening off o Wellbutrin and plan on seeing local psychiatrist soon to see which would be in my best interest. Just had my bilateral mastectomy with reconstruction so limited in what I can do but getting appointments set up so I can work on that step.

Invasive Pleomorphic Lobular Carcinoma Dx 4/25/2019, LCIS/ILC, Right, 3cm, Stage IIB, Grade 2, 2/6 nodes, ER+/PR+, HER2- (IHC) Surgery 7/11/2019 Lymph node removal: Right, Sentinel, Underarm/Axillary; Mastectomy: Left, Right; Reconstruction (left): Tissue expander placement; Reconstruction (right): Tissue expander placement Chemotherapy 8/28/2019 AC + T (Taxol) Radiation Therapy 3/24/2020 Whole-breast: Breast, Lymph nodes, Chest wall Hormonal Therapy 7/28/2020 Arimidex (anastrozole)
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Sep 8, 2020 03:44PM aprildawn714 wrote:

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

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Sep 8, 2020 04:12PM baffledbutterfly7 wrote:

Aprildawn71 sorry your having issues. So I did ween off of Wellbutrin and stayed off of any antidepressents through 4 rounds of AC and 12 Taxol and then through 30 radiation sessions. I did try Effexor during taxol and then after, but it made me so sick I couldn't take it. After finishing all those treatments, Taxol and Steriods caused/or at least didn't help me and I gained every pound back that I had lost back in early 2018. So after all treatments I was pretty bad off in the emotions departement due to weight gain and everything that had happend over the last year. So I started Tamoxifen in May and by the end of June I was so depressed and unable to handle my emotions, I asked to come off of Tamoxifen, go back on Wellbutrin and start an AI. I was premenopausal when diagnosed, after my first does of AC, I stopped having periods. When I came of Tamoxifen, my oncologist checked my hormone levels and at this point I appear to be in Menopause, so I took a month off of hormones and I am now on Anastrozole and back on Wellbutrin, working to lose the weight I have gained and my strength back after months of feeling crappy.


I have a friend who was on effexor for ten years while taking tamoxifen and did fine. So you may do well with it, I'm not sure where you are in this journey, but I finished chemo mid February and Radiation May 1st, and its taken a while for me to start to feel better. I am getting there, still have side effects from chemo and the Anastrozole, but I'm hoping in time they will either go away or I will just be used to it and it won't bother me. I'm still quite tired a lot, especially when I have been really busy or active.


Invasive Pleomorphic Lobular Carcinoma Dx 4/25/2019, LCIS/ILC, Right, 3cm, Stage IIB, Grade 2, 2/6 nodes, ER+/PR+, HER2- (IHC) Surgery 7/11/2019 Lymph node removal: Right, Sentinel, Underarm/Axillary; Mastectomy: Left, Right; Reconstruction (left): Tissue expander placement; Reconstruction (right): Tissue expander placement Chemotherapy 8/28/2019 AC + T (Taxol) Radiation Therapy 3/24/2020 Whole-breast: Breast, Lymph nodes, Chest wall Hormonal Therapy 7/28/2020 Arimidex (anastrozole)
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Sep 8, 2020 04:25PM Hopeful82014 wrote:

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.

Dx IDC
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Sep 8, 2020 04:39PM baffledbutterfly7 wrote:

I also took at blood test to see how well I process Tamoxifen, and my body doesn't metabolize tamoxifen well, so reduced effectiveness. That was another reason I switched to Anastrozole.

Invasive Pleomorphic Lobular Carcinoma Dx 4/25/2019, LCIS/ILC, Right, 3cm, Stage IIB, Grade 2, 2/6 nodes, ER+/PR+, HER2- (IHC) Surgery 7/11/2019 Lymph node removal: Right, Sentinel, Underarm/Axillary; Mastectomy: Left, Right; Reconstruction (left): Tissue expander placement; Reconstruction (right): Tissue expander placement Chemotherapy 8/28/2019 AC + T (Taxol) Radiation Therapy 3/24/2020 Whole-breast: Breast, Lymph nodes, Chest wall Hormonal Therapy 7/28/2020 Arimidex (anastrozole)
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Sep 8, 2020 04:52PM Hopeful82014 wrote:

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.

Dx IDC
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Sep 24, 2020 08:39PM aprildawn714 wrote:

Thank you so much for your reply baffledbutterfly7. I just saw this today. I actually did a video chat with my Dr and she prescribed the Effexor today. I’m still nervous to start. I of course had to look up the user reviews. Which was stupid. I’m still weening off my Wellbutrin 😥. My oncologist said I would only have to be on the tamoxifen for 2 years and then after menopause I would switch to something else. I’m almost one year in. At the end of October. Then I can go back to my Wellbutrin I suppose. Or if this works maybe just keep taking the Tamoxifen and the Effexor. I don’t know if it’s worth switching to another medication. I have tolerated the Tamoxifen pretty well except for no libido and my thinning hair. Which sucks.

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Sep 25, 2020 07:10PM Salamandra wrote:

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.

Dx at 39. 1.8cm. Oncotype 9. Dx 9/19/2018, IDC, Right, 1cm, Stage IA, Grade 2, 0/3 nodes, ER+/PR+, HER2- (FISH) Surgery 10/18/2018 Lumpectomy; Lymph node removal: Sentinel Hormonal Therapy 11/1/2018 Tamoxifen pills (Nolvadex, Apo-Tamox, Tamofen, Tamone) Radiation Therapy 12/3/2018 Whole-breast: Breast Hormonal Therapy 12/19/2019 Fareston (toremifene)

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