
Suggest Treatment For Depression When Suffering From Breast Cancer

Not wellbutrin but desvenlafaxine(prestique) is good for you
Detailed Answer:
Hello,
Thanks for writing to us.
I can understand your concern.
There are many patients with Cancer breast, using tamoxifen and suffering from depressive features.
Tamoxifen metabolism is related with CYP2D6, antidepressant affecting CYP2D6 can reduce effectiveness or cause more side effects by tamoxifen.
Wellbutrin is also affecting (inhibitor of) CYP2D6 like some SSRI.
In such cases choice of drugs are Effexor,Remeron and Pristique(devenlafaxine). As you are not happy with effexor and weight gain problem with remeron, choice of antidepressant in your case is pristique. It is very good newer anti depressant with likewise mechanism action as remeron and no issue of weight gain like remeron.
With above details you can discuss for pristique with your treating doctor and move forward.
Hope I have answered your query, I will be happy to answer again if need.
Regards,
Dr.Chintan Solanki.


Yes pristique may respond,wellbutrin can be good option
Detailed Answer:
Hello,
Thanks for follow up.
Effexor is venlafaxine and Pristique is desvenlafaxine. Though pristique is active metabolite of effexor, it has the least side effect profile than effexor. We came across many patients who can't tolerate effexor but can tolerate pristique. So you may tolerate pristique. I recommend for you as you have good response with remeron in past.
Yes, wellbutrin is very good anti depressant without effects on weight gain. Many patients who cannot tolerate SSRI can tolerate wellbutrin as it is an NRI. IF you are replacing tamoxiefen with some other molecule which has no drug interaction with welbutrin, you can go for welbutrin also as per your doctor's advice.
And yes, stopping tamoxifen itself can help in depression if newer molecule is not causing such depressive symptoms.
If you can tell me the drug which you are taking in stead of tamoxifen, I can search for drug interaction of that with wellbutrin.
Hope I have answered your query, I will be glad to answer more queries.
Regards,
Dr.Chintan Solanki.


You can go for wellbutrin
Detailed Answer:
Hi thanks for more information.
I can understand your suffering for cancer.
Osphena is metabolized by CYP3A4 and CYP2C9. Wellbutrin has no interaction with CYP3A4 and CYP2C9. So there is no interference by wellbutrin to your cancer treatment. You can start wellbutrin as per your doctor's suggestion.
For your cancer treatment please follow your doctor's advice. Do not take any decision on your own about stopping all the treatment. Hope some medicine can suit you and help you for stabilization.
Wishing you good health and good response to drugs with the least side effects.
Dr.Chintan Solanki.

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