Anastrazole and anxiety

@gailmarienewton I’ve only been taking Exemestane for four days.
Taking half dose for a week or two.
Lumpectomy and Radiation went well.

I have been on Anastrozole for one year now. The anxiety started shortly after the first month. It has developed into deep depression. I have some very difficult days. I stopped for a few days and noticed a huge shift to feeling more relaxed and experienced some joyful moments. I’m wondering how much worse it can get. I have breast cancer that has spread to the bones in my spine, neck, legs, pelvic area, and shoulder. So, I live with the anxiety and depression because I have to stay on an AI. I do hold onto my faith in God and his goodness. God bless you.

@gerry26 Happy for you - you are on the ‘good’ side of this drug - relish this , as the ‘bad’ side of it is life crushing.

The lack of Estrogen causes adverse mood effects — depression, anxiety irritability. It’s a bit disturbing that patients are given antidepressants and antipsychotics that alter neurotransmitters in the brain. Antidepressants also have side effects which can be harmful. They are not magic. And the knee-jerk response doctors have that leads them to prescribe more drugs is inappropriate. When the lack of estrogen causes anxiety or depression using drugs to alter serotonin, dopamine, etc. is like giving patients a cane when they need an aspirin. It’s nonsense.

What is more appropriate is to acknowledge that low estrogen naturally causes mood disorders. Help patients manage those symptoms and stop adding additional medications that often create an additional layer of risk - side effects, withdrawal, etc.

Doctors need to be honest with patients about how the human body does or does not function on specific medications. For example, if a medication has a 2% possibility of a negative side effect doctors say that side effect is too rare to happen. But if a drug shows a 2% statistic for a positive result doctors claim it is statistically significant. Assuming no one has any knowledge of statistics is purposely misleading. Doctors may not understand statistics. They automatically assume patients lack any knowledge of how statistics work. Most of us have had long careers and experience, education and knowledge of things doctors could never comprehend.

Don’t let a doctor use antidepressants to avoid being honest about how your brain functions without estrogen. Acknowledging the very real issues is the best way to help patients. Handing out pills that change brain chemistry without having any clue that the issue is the lack of estrogen is idiotic and dangerous for patients.

Therapy can help patients learn to manage anxiety and depression. AI induced mood disorders have no relation whatsoever to mental illness. No patient should feel shame for needing to learn how to manage the effects of no estrogen in their brain.

I am sorry you are going through this. I did as well. At first just a little teary and full on "Ugly Cry" for absolutely no reason. My Doctor has switched me to Letrozole which I seem to tolerate better. Also changed from Verensio to Kisqali which at least stays down but the tiredness, headaches and nausea are debilitating.

I found I was getting more anxious, and fatigued, along with a host of other issues on anastrozole. I have been taking tamoxifen for 3 months and my attitude, anxiety and stamina are so much better. I plan to stay on it for 6 months then try to go back to anastrozole, rotating each every 6 months to get to the finish line, hoping without so much toxicity. I will circle back after month 6 to report.

@dmr4ever I agree that adding more meds to counteract the side effects of hormone blockers is common for docs to do. Aside from mood changes this applies to pain in joints for some of us when we're on them. I've decided after trying 3 different types of hormone blockers, 2 of the AI's (gave me labile hypertension), and Fulvestrant (a SERD type of hormone blocker, that gave me terrible leg pain followed by vein insufficiency) and Tamoxifen, I don't think my body can handle H. blockers. I'm considering trying Verzenio, also approved for HR+, Hr2 -, which is a targeted therapy that blocks enzymes that trigger cancer cell growth (NOT with a hormone blocker, as my Doc would like). I want to shrink a tumor that's a recurrence in my chest wall; I may only tolerate its effects a couple of months, I don't know. It hasn't metastasized over the last 30 years. Since I survived a first bout with breast cancer at age 43, with mastectomy + chemo, I feel I gave it my all then. Now I'm 76 and am not willing to be suffering a lot; I'm opting for quality of life as long as I can hold it. This BC Doc is less honest about side effects than I'd like. May make a change.