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Tamoxifen and Antidepressants

Breast Cancer | Last Active: Feb 25, 2020 | Replies (5)

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@colleenyoung

I found some articles that may be of interest.
- Choice of Antidepressant May Affect Survival in Women on Tamoxifen for Breast Cancer https://womensmentalhealth.org/posts/choice-of-antidepressant-may-affect-survival-in-women-on-tamoxifen-for-breast-cancer/ (2019)
- SSRI could relieve aromatase inhibitor side effects https://www.pharmaceutical-journal.com/news-and-analysis/research-briefing/ssri-could-relieve-aromatase-inhibitor-side-effects/20202204.article (2017)

I had never heard of the second study "A randomised, placebo-controlled trial explored whether the selective serotonin reuptake inhibitor (SSRI) duloxetine, which is sometimes used to treat chronic pain disorders, reduced pain in 255 postmenopausal women with early breast cancer and new or worsened joint pain since beginning aromatase inhibitor therapy."
Interesting.

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Replies to "I found some articles that may be of interest. - Choice of Antidepressant May Affect Survival..."

@colleenyoung
The second article focused on duloxetine (Cymbalta) relieving AI side effects, and I thought that I would throw my two cents into the discussion on that particular drug.

I acquired chemo-induced peripheral neuropathy, fairly early in my chemo treatments. Then came the added joys of anastrozole. The combination was and is a bear and the oncologist sent me to a neurologist to see if there was anything she could do. Together, the neurologist and I looked at a number of possible drugs. The more we dug into the fine print, the scarier it got -- especially for duloxetine. Here's a sample:

https://www.drugs.com/slideshow/cymbalta-cause-for-concern--1207

"Withdrawal symptoms from Cymbalta are so common that doctors have given the symptoms their own term: Cymbalta Discontinuation Syndrome." If you peruse the MayoConnect discussions on neuropathy, you also will come across people who never have been able to quit duloxetine, even after slowly, slowly lowering the dose. The article goes on to say that "hundreds of law suits have been filed against Eli Lilly, the makers of Cymbalta, claiming that they downplayed or failed to state that withdrawal symptoms associated with Cymbalta were common and significant. Claimants state that discontinuation caused emotional turmoil and result in unanticipated medical costs, lost hours from work and ongoing anguish."

Among the side effects noted: that it can worsen depression, can increase risk of suicidal thoughts, can increase short-term memory loss and brain fog (which I already had from anastrozole), can cause irritability and hostility, increased sweating, vision changes, restless leg syndrome, loss of sex drive, on and on.

In any event, I didn't like what I learned about any of the suggested drugs, but especially duloxetine. The pharmaceutical world is full of smoke and mirrors. Do your homework so that you can make an informed decision. Just sayin'.