- Question from Alison: Are there recommended antidepressants or anti-anxiety drugs for metastatic breast cancer patients? My mother tried Paxil, but had severe side effects (anxiety, panic attacks, nausea). Do you find that these types of drugs are helpful for cancer patients, and which ones are most common/have the least side effects that interact with other drugs such as pain medications?
Larry Norton, M.D.
Anti-depressants have to be individualized. There are many available agents, and which one is best for a patient can only be determined by working with that individual patient. Just because you have bad side effects with one does not mean you'll have them with another. So the patient must work with an expert in the use of these drugs to find the drug or combination of drugs that works best. Cautionary note — the commonly used antidepressants can stimulate increased amounts of certain enzymes in the liver that can metabolize other medications at different rates. Therefore if other drugs are used, especially anti-cancer drugs, they may have to be used at a different usage in a concurrent usage with anti-depressants. For example, any of the SSRI drugs like Paxil (chemical name: paroxetine) can change the metabolism of tamoxifen. It is somewhat specific to the individual, but in general if you're using SSRIs, you should be aware of the interference with anti-cancer drugs. You really need expert consultation in this. The antidepressant medication has to be individualized, but your doctor must be aware that they can affect the metabolism of other drugs as well.
Editor's Note: Paxil is known to reduce the effectiveness of tamoxifen. If you are taking tamoxifen, talk to your doctor about alternative antidepressants. For more information, please visit the Breastcancer.org Tamoxifen page.
The Ask-the-Expert Online Conference called Living With Metastatic Breast Cancer featured Larry Norton, M.D. and moderator Marisa Weiss, M.D. answering your questions about managing day-to-day life with metastatic breast cancer.
Editor's Note: This conference took place in October 2007.
The materials presented in these conferences do not necessarily reflect the views of Breastcancer.org. A qualified healthcare professional should be consulted before using any therapeutic product or regimen discussed. All readers should verify all information and data before employing any therapies described here.
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