Anti-Depressants and Cancer Survival

[tom67inMA]

I've been taking Bupropion (generic Wellbutrin) seasonally for years, well before my diagnosis, and have been wondering what effects it might be having on my cancer. I found three very interesting links online that suggest this may be a trifecta of goodness for metastatic prostate cancer patients like me.

First is this study of lung cancer vs anti-depressant use. While it's apples and oranges to compare lung cancer to prostate cancer, it's still a fruit of cancer-related knowledge:

ncbi.nlm.nih.gov/pmc/articl...

"Anti-depressant use was associated with extended lung cancer-specific survival. In an analysis of specific classes of anti-depressant use, NDRIs and TCAs were associated with improved survival. Importantly, the extended survival associated with anti-depressants was maintained after adjustment for the clinical indications for these drugs, suggestive of a direct effect on lung cancer biology."

Two things jumped out at me. Firstly that NDRI use (Bupropion, Ritalin, and I believe Cocaine are NDRIs) had a significant survival benefit in this study. Secondly, SNRI use (Effexor, Cymbalta, two drugs frequently used to control ADT hot flashes) had INsignificantly *worse* survival. There weren't may SNRI users in this study, so take that result with a grain of salt.

Here's a study that in my mind simply points out the obvious: A drug that works in a manner similar to cocaine reduces fatigue in cancer patients. I've been using Bupropion to fight winter fatigue / seasonal affective disorder for years:

ncbi.nlm.nih.gov/pubmed/150...

And finally and least expected, here's an interesting animal study: They removed ovaries from lab rats to induce osteoporosis, then administered Bupropion to see if it would help:

ncbi.nlm.nih.gov/pmc/articl...

"Bupropion exerts osteo-protective action in OVX rats through suppressing osteoclastogenesis-inducing factors and inflammation, which stabilize the osteoclasts and decrease bone matrix degradation or resorption."

Hmm, that sounds vaguely like the mechanisms behind Zometa/Xgeva + Celebrex.

My takeaway is that if you have cancer and are suffering any level of fatigue and/or depression, seek help! At the very least it will help you enjoy the time you have left, and there are indications that it may even give you more time.

[pjoshea13]

Tom,

Here is the most recent cancer/antidepressant study (July - Israel), which looked at adherence [1]:

"The present study is the first to demonstrate that higher adherence to AD {antidepressants} is associated with a decrease of all-cause mortality in a large nationwide cohort of cancer patients. Our data add to the pressing need to encourage adherence to AD among cancer patients."

A year ago, I posted on Clorgyline & MAOA [2a] [2b]. From 2017 [3]:

"Antidepressants protect bones from metastatic prostate cancer."

"Monoamine oxidase A-targeted antidepressants inhibit a tumor-stroma loop and could delay the metastatic outgrowth of prostate cancer."

-Patrick

[1] ncbi.nlm.nih.gov/pubmed/313...

[2a] healthunlocked.com/advanced...

[2b] healthunlocked.com/advanced....

[3] ncbi.nlm.nih.gov/pubmed/283...

[Break60]

I’ve been on cymbalta ( duloxetene) for over 16 years for anxiety and depression. It’s worked wonders. I was dx with PCa six years ago and am doing well (see profile).

[tom67inMA in reply to Break60]

Glad to hear it! I tried Cymbalta briefly and it was a disaster for me. Waaaay too strong, and a horrific crash afterwards.

[Break60 in reply to tom67inMA]

Yes you will have a crash if you don’t taper off. What strength were you using? I started at 60 moved to 120 and settled at 60mg. I think they make lower dosages as well.

[tom67inMA in reply to Break60]

I was using 30mg. As I recall, on the second day I went to work, started sweating in a meeting, went to the men's room afterwards and threw up. I was manically happy about vomiting. Didn't take a pill on the third day and was suicidally depressed. It turns out I am *extremely* sensitive to any medication that works on serotonin. Prozac and Effexor weren't as bad but I was still starting with the lowest dose and ended up splitting tablets to reduce it further.

[Break60 in reply to tom67inMA]

Sad to hear !

[tom67inMA in reply to Break60]

In the end, Bupropion has worked very well for me, so no problem. .. and now I have an amusing story about the time I was way too happy for somebody tossing cookies

[Break60 in reply to tom67inMA]

I used that for many years but it stopped being effective

[tom67inMA in reply to Break60]

I've been very lucky that it's been effective for me for a decade. I have been taking periodic vacations, usually during the summer, to avoid building up a tolerance. Really hope I have that same "works forever" experience with Lupron and Abiraterone.

It's very curious that my cancer, which had probably been developing for years, made its appearance while I was simultaneously on Bupropion holiday, had let my statin prescription lapse, and was getting sloppy about vitamin D supplementation.

[Break60 in reply to tom67inMA]

Ok was actually on busperone or buspar not sure if they’re the same

[tom67inMA in reply to Break60]

Had to look that up, it's completely unrelated to bupropion.

[tallguy2]

I've been using venlafaxine to combat hot flashes and sweats from the ADT for 7 years. No negative side effects (the positive one is that my wife says that my attitude has been adjusted, in a good way). The one time I came off it was during an 18-mo Lupron "holiday" (which subsequently led to the discovery of my MPCa) so yes, tapering is a must. Even with tapering I had those negative thoughts.

Indeed, we should seek great quality of life, and I feel that this generic antidepressant isn't doing any harm.

[tom67inMA in reply to tallguy2]

If you're happy with it you should stay on it. The data in the study was based on a total of 7 SNRI users. One or two unlucky subjects could swing that data point wildly. I of course am wildly biased in favor of the drug I was already on

[jimreilly]

lovely, I take bupropion too, didn't know about this (such a tongue twister, too--and I always want to type "buproprion",, which makes it easier to say

[tom67inMA in reply to jimreilly]

"Wellbutrin" is much easier to say/spell, but for some odd reason I feel uncomfortable using the brand name while taking the generic version. Thus the month spent learning to pronounce Abiraterone.

[whatsinaname]

Very informative. Thanks, Tom. Cheers !!

[monte1111]

j-o-h-n is a natural anti-depressant. Unfortunately, he does not list his numerous side effects.

[j-o-h-n in reply to monte1111]

Worse side effect: Vote Democrat......

Good Luck, Good Health and Good Humor.

j-o-h-n Tuesday 08/13/2019 6:43 PM DST

[monte1111 in reply to j-o-h-n]

Which one?

[j-o-h-n in reply to monte1111]

All

Good Luck, Good Health and Good Humor.

j-o-h-n Tuesday 08/13/2019 7:11 PM DST

[Magnus1964 in reply to j-o-h-n]

George W. Bush did that for me. The side effects were unbearable.

[j-o-h-n in reply to Magnus1964]

I Bet... Slick Willy did it for me.....

Good Luck, Good Health and Good Humor.

j-o-h-n Friday 08/16/2019 3:02 PM DST