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Does Deanxit Have Any Drug Interaction With Tamoxfine?

Posted on Thu, 2 Jan 2014

Question: Hi, I am a 39 years old female married for 9 years with no kids. I suffer from phobia, GAD, OCD, depression, panic attacks. It started with me since childhood, and grew as I grew-up. I fear driving, traveling, going into the elevator, staying home alone, flying, fear of being left alone. 3 years ago I was diagnosed with breast cancer and now taking Tamoxifine 20 mg and aspirin baby dose. I saw different doctors to treat my anxiety which is becoming worse recently, as I now fear going to work, fear crowded place, fear socializing with people (a thing which I did not have in the past). The doctor prescribed Deanxit which worked 80% in reducing my anxiety, but did not take my fears away. As well he prescribed Citalopram which I did not use because afraid of its side effects. my questions are: 1. Does Deanxit have any drug interaction with Tamoxfine 2. Any well known medications with no interaction with Tamoxifine and less side effects that I can use if Deanxit is not the best choice? 3. Can I use Deanxit and Citalopram at the same time? 4. Should I stop taking Deanxit for 2 weeks before starting any other medication for anxiety and panic attacks 5. I need a medication to STOP my fears

Answered by Dr. Ashish Mittal (8 hours later)

Brief Answer: Citalopram is better choice. Detailed Answer: Hello, Thanks for your query. I appreciate your efforts for medical consultation in so much distress. Important aspects of your query are: • 39 year old female • Known case of phobia, GAD, OCD, depression and panic attacks. • History of breast cancer on Tamoxifine • Currently on Deanxit • Concern related to treatment, side effects and drug interactions. Deanxit is old medicine for anxiety. Although it is effective but now a days more effective and safer medicines are available like citalopram, escitalopram and mirtazapine. With this back ground lets discus your queries: 1. Does Deanxit have any drug interaction with Tamoxifene Answer: Deanxit contain Flupentixol and Melitracen. Flupentixol is a typical antipsychotic. It increases serum prolactin hormone level. Prolactin has effect on growth of breast. Raised prolactin can affect breast cancer prognosis and Tamoxifen effects adversely. I would recommend you to stop its use. Citalopram did not have an increased risk of recurrence, due to their lack of competitive metabolism for the CYP2D6 enzyme 2. Any well known medications with no interaction with Tamoxifine and less side effects that I can use if Deanxit is not the best choice? Answer: Citalopram did not have an increased risk of recurrence. It do not affect level of tamoxifen. It is more effective then deanxit in long term. 3. Can I use Deanxit and Citalopram at the same time? Answer: Citalopram take 3-4 weeks to show its effect. In my opinion you should stop deanxit after 2-3 week of start of deanxit. 4. Should I stop taking Deanxit for 2 weeks before starting any other medication for anxiety and panic attacks Answer: Stop Deanxit 2-3 week after starting citalopram to prevent excessive anxiety. 5. I need a medication to STOP my fears Answer: Citalopram is better option. I hope this information has been both informative and helpful for you. In case of any doubt, I will be available for follow ups. Wish you good health. Regards, http://bit.ly/Dr-Ashish-Mittal

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Ashish Mittal (1 hour later)

Many thanks for the detailed and professional advise. Two questions left: 1. I have been using Deanxit irregularly for 2-3 month some times I skip a does for 2-3 days and back again depending on my anxiety levels. Would this put me at an increased risk for breast cancer. I already stopped it 3 days till now. 2. Regarding Citalopram, shall I start using it immediately or wait until Deanxit vanish from my blood (wait 2 weeks as advised in leaflets). 3. I am afraid of Citalopram side effects: such as muscle twisting, shaking..I live in an underdeveloped country well medical treatment is very bad. I do not want to put myself at risk and find no good treatment that could help me

Answered by Dr. Ashish Mittal (15 minutes later)

Brief Answer: You can start citalopram now. Detailed Answer: Hello again, Thanks for follow up. 1. I have been using Deanxit irregularly for 2-3 month some times I skip a does for 2-3 days and back again depending on my anxiety levels. Would this put me at an increased risk for breast cancer. I already stopped it 3 days till now. Answer: You can stop deanxit now. Deanxit affect the prognosis, but it will not cause breast cancer. 2. Regarding Citalopram, shall I start using it immediately or wait until Deanxit vanish from my blood (wait 2 weeks as advised in leaflets). Answer: You can start citalopram now without wait. Start with 10mg and make dose to 20mg after 7 days under your psychiatrist supervision. 3. I am afraid of Citalopram side effects: such as muscle twisting, shaking..I live in an underdeveloped country well medical treatment is very bad. I do not want to put myself at risk and find no good treatment that could help me Answer: Side effect is common in initial 1-2 week, as citalopram may increase some anxiety in initial week but after 2-3 weeks it show significant improvement. If side effects like anxiety, muscle twitch and shaking is much in initial 1 week, you can take on demand clonazepam 0.25mg under your psychiatrist supervision. Please accept my answer in case there are no further queries and recommend our services to your friends too if you have found it helpful. Wish you good health. Regards

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Ashish Mittal (6 hours later)

Thanks I have one last concern before closing this discussion: I have been using Alprazolam on and off from time to time, although it makes me dizzy and sleepy I don't think it worked well for me. I have Citalopram 20 mg : Can I break the tab to 1/2 and take it as 10 or do I need to buy 10 mg? I need a medication that is fast relief in controlling anxiety symptoms on the spot, I can't wait 2 weeks to see the difference. Something that would not interact with Tamoxifine, low dose and with less side effects.

Answered by Dr. Ashish Mittal (27 hours later)

Brief Answer: Hi Detailed Answer: Hello again, Thanks for follow up. You can take half tablet of citalopram 20mg to make it 10mg. For anxiety control in initial 2-3 week you can take Alprazolam 0.25mg or Clonazepam 0.5mg on demand basis under psychiatrist supervision. Wish you good health. Regards

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Above answer was peer-reviewed by : Dr. Prasad