Forum Discussion
Hot flushes on Tamoxifen
Hello. Newby here. Just wondering if you could advise me. I have been on Tamoxifen for 8 months now and have been putting up with those pesky hot flushes at least 20 times in 24 hours. Started taking ...
Effexor Seems Just as Good as HRT in Easing Hot Flashes
https://www.breastcancer.org/research-news/effexor-vs-hrt-for-hot-flashesHowever, be careful to avoid some antidepressants which are are "such strong inhibitors of CYP2D6 that women who take these drugs may not benefit from tamoxifen. Two papers suggest that three antidepressants — paroxetine (Paxil), fluoxetine (Prozac), and bupropion (Wellbutrin) — are most likely to inhibit CYP2D6 and interfere with tamoxifen treatment."
Choosing among antidepressantsAntidepressants vary in their ability to inhibit CYP2D6 (the enzyme that converts tamoxifen into its active form, endoxifen). | ||
Drug | Effect on CYP2D6 | Advice |
venlafaxine (Effexor) | Minimal | Safest choice if taken with tamoxifen. |
desvenlafaxine (Pristiq), mirtazapine (Remeron) | Direct studies with tamoxifen are lacking, but effect on endoxifen levels should be minimal. | |
citalopram (Celexa), escitalopram (Lexapro), nefazodone (Serzone) | Mild | Secondary choices if above are not options. Only citalopram and sertraline have been studied directly with tamoxifen, so risk of reducing levels of endoxifen should be weighed against benefits of antidepressants. |
duloxetine (Cymbalta), sertraline (Zoloft), fluvoxamine (Luvox) | Moderate | |
paroxetine (Paxil), fluoxetine (Prozac), bupropion (Wellbutrin) | Strong | Best to avoid if taking tamoxifen. |