"Symptom management for women on adjuvant endocrine therapies
often requires treatment of hot flashes and the treatment of concurrent
depression. Venlafaxine has been studied and is an effective
intervention in decreasing hot flashes.
345-346-347-348
There is evidence
suggesting that concomitant use of tamoxifen with certain selective
serotonin reuptake inhibitors (SSRIs) (e.g., paroxetine and fluoxetine)
may decrease plasma levels of endoxifen, an active metabolite of
tamoxifen.
349,350
These SSRIs may interfere with the enzymatic
conversion of tamoxifen to endoxifen by inhibiting a particular isoform of
CYP2D6
. However, the SSRIs citalopram, escitalopram, fluvoxamine,
gabapentin, sertraline, and venlafaxine appear to have no or only
minimal effect on tamoxifen metabolism.
"