Oct 14, 2021 07:41PM Salamandra wrote:
OMG do NOT come off of tamoxifen if you have treatment resistant depression that you finally have under control.
If your oncologist won't work with you on an alternative, find a new oncologist.
From the get go, my oncologist offered me to do ovarian suppression plus aromatase inhibitor if I did not feel safe coming off of tamoxifen. It would otherwise be overkill for my degree of cancer, but mental health is health.
My depression has been responsive to other drugs, so I did try tamoxifen. I had other side effects that I couldn't tolerate (long story, elsewhere on the boards).
I proposed to my oncologist to let me try toremifene/fareston instead. It's in the same class as tamoxifen (SERM) and there is some great data about, mostly out of Asia - where the genetic variation that impacts tamoxifen uptake is more common.
My oncologist did some research, and ended up letting me try it. It is expensive, but my insurance is covering it, and if it didn't, there are copay assistance programs that would have brought it down to an affordable amount.
Honestly, in your position, even taking tamoxifen and wellbutrin together would be a better option to me than going off wellbutrin. It is theorized to impact the efficacy of tamoxifen, but it's not actually demonstrated in studies (I guess it would be unethical to study).
But knowing what I do about mental health from my own journey, my friends', my research, no, I would not come off of a drug that is preserving your mental health.
No hormone treatment at all would be a more acceptable risk to me than coming off of wellbutrin (especially with the cancer you've got). But thankfully, there are *multiple* other options before giving up on hormone treatment completely.
The fact that your oncologist either doesn't take mental health seriously or is not aware and open to other options (or whatever combination of both) makes her the wrong doctor for you at this time, in my opinion.
Please get a second opinion. Maybe from an oncologist that works at a center that also has a psychiatric team and is more likely to be aware of mental health issues and have a consult built in.