tamoxifen and antidepressants

rosebud5
rosebud5 Member Posts: 15
edited March 2014 in Breast Cancer #1
Are there any antidepressants that do not interfere with tamoxifen? I was diagnosed with major depression several years before my breash cancer diagnosis. I was taking wellbrutrin xl and my onoc told me that it makes the tamoxifen less effective. The acs cancer drug guide for tamoxifen also names a few more antidepressants that may make tamoxifen less effective.

My pschy dr was not aware of this. (wish I could switch pshcy dr, but I can't afford to)
Anyway he prescibed me celexa.

My onoc dr accent is difficult to understand, but I think he said any of the meds I'm on could make the tamoxifen less effective. Any Ideas?

Comments

  • carkris
    carkris Member Posts: 4,553 Member
    #2
    a while ago there was a link
    a while ago there was a link posted to which ones you can take and which ones you cant. I know you can take lexapro.
  • Kat11
    Kat11 Member Posts: 1,931 Member
    #3
    carkris said:

    a while ago there was a link
    a while ago there was a link posted to which ones you can take and which ones you cant. I know you can take lexapro.

    I take effexor with
    I take effexor with tamoxifen. Works good for me.
  • rosebud5
    rosebud5 Member Posts: 15
    #4
    carkris said:

    a while ago there was a link
    a while ago there was a link posted to which ones you can take and which ones you cant. I know you can take lexapro.

    Thank you!

    Thank you!
  • survivorbc09
    survivorbc09 Member Posts: 4,374 Member
    #5
    rosebud5 said:

    Thank you!

    Thank you!

    According to this article
    June 1, 2009 (Orlando, Fla.) -- Women who are taking the breast cancer drug tamoxifen should avoid certain antidepressants, researchers say.

    That's because a large U.S. study showed that certain selective serotonin reuptake inhibitor (SSRI) antidepressants may prevent tamoxifen from working properly.

    In the study, women on tamoxifen who were also taking one of three SSRIs -- Paxil, Prozac, or Zoloft -- were about twice as likely to have their cancer come back, compared with women on tamoxifen who were not taking an SSRI.

    SSRIs are prescribed not only to treat the depression that often plagues women with cancer, but also to help relieve hot flashes that can be caused by tamoxifen.

    Tamoxifen mixes with a liver enzyme called CYP2D6 in the body to change into the tumor-fighter endoxifen. Many SSRIs block the same enzyme, thus preventing tamoxifen from morphing into its active form.

    "We've known that these [drugs] block the activation of tamoxifen chemically, but this is the first time there's evidence that they may be decreasing the effectiveness of their anticancer treatment," says researcher Robert Epstein, MD, chief medical officer at Medco Health Solutions Inc., a pharmacy benefits management company.

    Paxil, Prozac, and Zoloft are categorized as moderate-to-potent SSRIs because they are strongest in their ability to block the CYP2D6 enzyme. Celexa, Lexapro, and Luvox are considered weaker SSRIs.

    The weaker SSRIs were not linked to an increased risk of breast cancer recurrence, the study showed.
  • New Flower
    New Flower Member Posts: 4,294
    #6
    survivorbc09 said:

    According to this article
    June 1, 2009 (Orlando, Fla.) -- Women who are taking the breast cancer drug tamoxifen should avoid certain antidepressants, researchers say.

    That's because a large U.S. study showed that certain selective serotonin reuptake inhibitor (SSRI) antidepressants may prevent tamoxifen from working properly.

    In the study, women on tamoxifen who were also taking one of three SSRIs -- Paxil, Prozac, or Zoloft -- were about twice as likely to have their cancer come back, compared with women on tamoxifen who were not taking an SSRI.

    SSRIs are prescribed not only to treat the depression that often plagues women with cancer, but also to help relieve hot flashes that can be caused by tamoxifen.

    Tamoxifen mixes with a liver enzyme called CYP2D6 in the body to change into the tumor-fighter endoxifen. Many SSRIs block the same enzyme, thus preventing tamoxifen from morphing into its active form.

    "We've known that these [drugs] block the activation of tamoxifen chemically, but this is the first time there's evidence that they may be decreasing the effectiveness of their anticancer treatment," says researcher Robert Epstein, MD, chief medical officer at Medco Health Solutions Inc., a pharmacy benefits management company.

    Paxil, Prozac, and Zoloft are categorized as moderate-to-potent SSRIs because they are strongest in their ability to block the CYP2D6 enzyme. Celexa, Lexapro, and Luvox are considered weaker SSRIs.

    The weaker SSRIs were not linked to an increased risk of breast cancer recurrence, the study showed.

    Effexor or Lexapro
    two anti-depressants which are compatible with Tamoxifen, Effexor is generic, Lexapro brand.
  • Alexis F
    Alexis F Member Posts: 3,598
    #7
    New Flower said:

    Effexor or Lexapro
    two anti-depressants which are compatible with Tamoxifen, Effexor is generic, Lexapro brand.

    I think, from what I have
    I think, from what I have read, that there are only 3 that they say are safe to use with tamoxifen, and, Lexapro is one of them.
  • BethInAz
    BethInAz Member Posts: 203 Member
    #8
    survivorbc09 said:

    According to this article
    June 1, 2009 (Orlando, Fla.) -- Women who are taking the breast cancer drug tamoxifen should avoid certain antidepressants, researchers say.

    That's because a large U.S. study showed that certain selective serotonin reuptake inhibitor (SSRI) antidepressants may prevent tamoxifen from working properly.

    In the study, women on tamoxifen who were also taking one of three SSRIs -- Paxil, Prozac, or Zoloft -- were about twice as likely to have their cancer come back, compared with women on tamoxifen who were not taking an SSRI.

    SSRIs are prescribed not only to treat the depression that often plagues women with cancer, but also to help relieve hot flashes that can be caused by tamoxifen.

    Tamoxifen mixes with a liver enzyme called CYP2D6 in the body to change into the tumor-fighter endoxifen. Many SSRIs block the same enzyme, thus preventing tamoxifen from morphing into its active form.

    "We've known that these [drugs] block the activation of tamoxifen chemically, but this is the first time there's evidence that they may be decreasing the effectiveness of their anticancer treatment," says researcher Robert Epstein, MD, chief medical officer at Medco Health Solutions Inc., a pharmacy benefits management company.

    Paxil, Prozac, and Zoloft are categorized as moderate-to-potent SSRIs because they are strongest in their ability to block the CYP2D6 enzyme. Celexa, Lexapro, and Luvox are considered weaker SSRIs.

    The weaker SSRIs were not linked to an increased risk of breast cancer recurrence, the study showed.

    Tamoxifen & Zoloft
    Thank you for this post. I just recently became aware of Zoloft making the Tamoxifen less effective. What a position to be in! My oncologist talked with me about quality of life issues - whether being off the antidepressant would make dealing with the side effects of the tamoxifen - i.e. instant menopause - difficult to deal with. I guess I have a decision to make. Thanks for making me aware of the antidepressants that are less of an issue. I want my Tamoxifen to be 100% effective!!!
  • Megan M
    Megan M Member Posts: 3,000
    #9
    BethInAz said:

    Tamoxifen & Zoloft
    Thank you for this post. I just recently became aware of Zoloft making the Tamoxifen less effective. What a position to be in! My oncologist talked with me about quality of life issues - whether being off the antidepressant would make dealing with the side effects of the tamoxifen - i.e. instant menopause - difficult to deal with. I guess I have a decision to make. Thanks for making me aware of the antidepressants that are less of an issue. I want my Tamoxifen to be 100% effective!!!

    I am not on tamox yet, as, I
    I am not on tamox yet, as, I was having radiation treatments and my rads oncologist said for me to not start it until I was done. I have read where certain antidepressants do double your chance of a recurrence if you take them with tamox. So many of us aren't told that.

    Megan
  • Nufferz
    Nufferz Member Posts: 55
    #10
    Megan M said:

    I am not on tamox yet, as, I
    I am not on tamox yet, as, I was having radiation treatments and my rads oncologist said for me to not start it until I was done. I have read where certain antidepressants do double your chance of a recurrence if you take them with tamox. So many of us aren't told that.

    Megan

    Tamoxifen and antidepressants
    Hi!
    I came across this link and it gives you the information I think you're all looking for:

    http://medicine.iupui.edu/clinpharm/COBRA/Tamoxifen and 2D6v7.pdf (copy & paste)

    Check it out, and maybe bookmark it. :)
  • DebbyM
    DebbyM Member Posts: 3,289 Member
    #11
    Nufferz said:

    Tamoxifen and antidepressants
    Hi!
    I came across this link and it gives you the information I think you're all looking for:

    http://medicine.iupui.edu/clinpharm/COBRA/Tamoxifen and 2D6v7.pdf (copy & paste)

    Check it out, and maybe bookmark it. :)

    Talk to your oncologist
    Talk to your oncologist about which ones are safe. You don't want to risk or double your chance of a recurrence by taking the wrong antidepressant with tamox. I googled that question and got a lot of answers too. Good luck!
  • tgf
    tgf Member Posts: 950 Member
    #12
    DebbyM said:

    Talk to your oncologist
    Talk to your oncologist about which ones are safe. You don't want to risk or double your chance of a recurrence by taking the wrong antidepressant with tamox. I googled that question and got a lot of answers too. Good luck!

    anti-depressants
    I was taking zoloft and wellbutrin when my oncologist told me I'd need to start tamoxifen. It was at the same time (a few months ago) that there was all the talk about some antidepressants and tamoxifen not working together. I was very upset. My antidepressants had been working great and I didn't want to mess with them. I almost told the oncologist I would not take tamoxifen ... but we worked out a plan to switch me over to effexor. I switched gradually over a couple of weeks ... then went another week or two on just effexor ... then after I was confident that I was OK ... then I started the tamoxifen. So far (3 months) I've done fine. Thank goodness.

    hugs.
    teena
  • susie09
    susie09 Member Posts: 2,930
    #13
    tgf said:

    anti-depressants
    I was taking zoloft and wellbutrin when my oncologist told me I'd need to start tamoxifen. It was at the same time (a few months ago) that there was all the talk about some antidepressants and tamoxifen not working together. I was very upset. My antidepressants had been working great and I didn't want to mess with them. I almost told the oncologist I would not take tamoxifen ... but we worked out a plan to switch me over to effexor. I switched gradually over a couple of weeks ... then went another week or two on just effexor ... then after I was confident that I was OK ... then I started the tamoxifen. So far (3 months) I've done fine. Thank goodness.

    hugs.
    teena

    Just be sure and ask your
    Just be sure and ask your oncologist which antidepressants are ok to take with tamox. There are several that you shouldn't be taking according to the research if you are on tamox as it does double your chance of a recurrence. Good luck!

    ♠♣ Susie ♠♣
  • Living99
    Living99 Member Posts: 1 Member
    #14

    Be sure to include sources, article titles/authors, dates. Be careful about naming drugs that are or are not recommended for use with Tamoxifen, without current data (last 3 years) from reliable medical sources, e.g. NIH/Pub Med, oncology websites, Mayo Clinic, Harvard. My experience with psychiatrists is that they typically know little about breast cancer medications. Work with a psychiatrist that will talk with you oncologist and check with the pharmacy for interactions, efficacy, and options.

    Old information should be deleted.

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