So, I'm starting on Tasigna 600mg, and there appears to be an issue with my current antidepressant - citalopram 10mg and the potential to increase the QT interval, which Tasigna can also do.
Is anyone else on this combination, or taking an antidepressant with either Sprycel or Tasigna that can offer some advice or insight?
I'd prefer not to switch antidepressants as it's really helped with my health anxiety! I had an ECG and my QT interval is currently normal on citalopram. But obviously, I don't want to put my heart at risk...
I'm really not sure what to do!
Tasigna and antidepressants
Started by
Pin
, Jul 03 2017 07:19 PM
12 replies to this topic
#1
Pin
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Posted 03 July 2017 - 07:19 PM
Diagnosed 9 June 2011, Glivec 400mg June 2011-July 2017, Tasigna 600mg July 2017-present (switched due to intolerable side effects, and desire for future cessation attempt).
Commenced monthly testing when MR4.0 lost during 2012.
2017: <0.01, <0.01, 0.005 (200mg Glivec, Adelaide) <0.01, 0.001 (new test sensitivity)
2016: <0.01, <0.01, PCRU, 0.002 (Adelaide)
2015: <0.01, <0.01, <0.01, 0.013
2014: PCRU, <0.01, <0.01, <0.01, <0.01
2013: 0.01, 0.014, 0.016, 0.026, 0.041, <0.01, <0.01
2012: <0.01, <0.01, 0.013, 0.032, 0.021
2011: 38.00, 12.00, 0.14
#2
Buzzm1
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Posted 03 July 2017 - 08:53 PM
Pin, I'm very sorry to see you on a full dose of any TKI; you have been testing at <0.01 for well over four years.
It's overkill; these are toxic drugs we are dealing with.
For the benefit of yourself and others please add your CML history into your Signature
02/2010 Gleevec 400mg
2011 Two weakly positives, PCRU, weakly positive
2012 PCRU, PCRU, PCRU, PCRU
2013 PCRU, PCRU, PCRU, weakly positive
2014 PCRU, PCRU, PCRU, PCRU (12/07 began dose reduction w/each continuing PCRU)
2015 300, 250, 200, 150
2016 100, 50/100, 100, 10/17 TFR
2017 01/17 TFR, 04/18 TFR, 07/18 TFR 0.0012, 08/29 TFR 0.001, 10/17 TFR 0.000
2018 01/16 TFR 0.0004 ... next quarterly PCR 04/17
At the earliest opportunity, and whenever possible, lower your TKI dosage; TKIs are toxic drugs and the less we take longterm the better off we are going to be ... this is especially true for older adults.
In hindsight I should have started my dosage reduction two years earlier; it might have helped minimize some of the longterm cumulative toxic effects of TKIs that I am beset with.
longterm side-effects Peripheral Artery Disease - legs (it's a bitch); continuing shoulder problems, right elbow inflammation. GFR and creatinine vastly improved after stopping Gleevec.
Cumulative Gleevec dosage estimated at 830 grams
Taking Gleevec 400mg an hour after my largest meal of the day helped eliminate the nausea that Gleevec is notorious for.
Trey's CML Blog - Stopping - The Odds - Stop Studies - Discussion Forum Cessation Study
Big PhRMA - Medicare Status - Social Security Status - Deficit/Debt
#3
jmoorhou
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Posted 03 July 2017 - 11:59 PM
Pin I've been on Wellbutrin for several years and like it a lot. I take up to 400 mg a day, I've always liked it, it's an atypical antidepressant it doesn't cause you to gain weight, or get sleepy, it used to keep 5 pounds off of me. If you go to Wikipedia you will find more info.
Good luck on the reduction, I'm going through this myself, I've been on 200 Gleevec for eight months. After the first four months I went from undetectable to .0007...I guess it's a sensitive lab. My Onc I think said .1 would be ok. Hope this helps.
Diagnosed 3/2014 WBC 28 Non detectable within 3 monthsGleevec 400 mg 5/2014 one hour after dinner really improves nausea300 mg 12/15/2016200 mg and 300 mg Gleevec 2/25/2017 (after 3 years on Gleevec) For last four months taking 300 mg per day. Last CMC showed liver enzymes elevated, went to a good Naturopath and he recommended 4 Tumeric, 10,000 mg Vitamen D, and 3 milk thistle (silymarin) daily. Also use One<p>Day Detox Dandeloin tea, and Nettle Tea and a slice of ginger every day...in two months liver tests were below normal.Janis
#4
cmljax
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Posted 04 July 2017 - 07:13 AM
PIN:
Why are you even switching drugs? Have you had serious or unbearable AE's on Glivec? As you can see from my signature, I have had continuing AE's on Tasigna, so much so that I have decreased dose twice and am now on 300MG. Despite the reduction, the most persistent and pesky side effects continue for me. Tasigna is more potent against CML than Glivec, and with your results, there is likely no need to be on 600 mg as Buzz said.
Good luck whatever you do.
Dx 9/26/16 WBC 28800; platelets 749; FISH 97% PCR 43%
Tasigna 600MG per day
October 2016 PCR 22% IS
November 2016 PCR 5.8% IS
December 2016 PCR 0.1% IS MMR!!
March 10, 2017 PCR 0.006% IS MR 4.22
Tasigna 450MG per day
April 5, 2017 PCR <.003% IS
June 5, 2017 PCR <.003% IS (dose reduction validated!!!)
Tasigna 300MG per day starting June 15, 2017
6-day drug break starting June 20, 2017 due to multiple AE's
July 24, 2017 PCR <.003% IS
September 18, 2017 Negative, AKA PCRU
Tasigna 150mg per day starting 9/18/17
October 30, 2017 Negative
December 11, 2017 Negative
#5
gerry
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Posted 04 July 2017 - 04:59 PM
Hi Pin,
On the UK CML board one of their members was put on Agomelatine by the Psych Specialist at their hospital, it supposedly doesn't have any interactions. Not sure if it is available here, but maybe one to talk with your doc about.
If you want to stay on your current one, just make sure you get regular monitoring after that. You are still a youngster, so unless you have any heart issues you should be okay. Remember they have to cover a large age group and various conditions CMLers may already be prone to.
On the UK CML board one of their members was put on Agomelatine by the Psych Specialist at their hospital, it supposedly doesn't have any interactions. Not sure if it is available here, but maybe one to talk with your doc about.
If you want to stay on your current one, just make sure you get regular monitoring after that. You are still a youngster, so unless you have any heart issues you should be okay. Remember they have to cover a large age group and various conditions CMLers may already be prone to.
#6
gerry
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Posted 04 July 2017 - 05:08 PM
Plus you may get to a point that you no longer require the anti depressants, here's hoping you do. :-)
#7
Pin
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Posted 05 July 2017 - 02:16 AM
Pin, I'm very sorry to see you on a full dose of any TKI; you have been testing at <0.01 for well over four years.
It's overkill; these are toxic drugs we are dealing with.
Hi Buzz, I totally get what you're saying and I completely agree.
The reason I am trying Tasigna now is to see if I can drive the CML down even further, and try cessation in a year or so. I'm doing this becasue I flew to Adelaide in Australia to see a specialist there, who is one of the top in Australia and he thought I would be fine on a lower dose and probably maintain <.01 BUT that I may have less chance of succeeding at cessation (40%). He believes I will increase my chances substantially if I can stay on Tasigna for 1-2 years (60%) and then try. Currently, as my testing equipment only goes to 4 log, we don't know how far under this I am. Their testing equipment showed me at 0.002 in Dec 16, and 0.005 in May 17. Low-dose Gleevec is very comfortable for me, I trialled 200mg and noticed a substantial lessening of several very bothersome side effects (but not so much at 300mg) - If I can't succeed at cessation, I believe I will either try again or do a long-term low dose of something.
My goal has now become giving cessation my best shot.
Diagnosed 9 June 2011, Glivec 400mg June 2011-July 2017, Tasigna 600mg July 2017-present (switched due to intolerable side effects, and desire for future cessation attempt).
Commenced monthly testing when MR4.0 lost during 2012.
2017: <0.01, <0.01, 0.005 (200mg Glivec, Adelaide) <0.01, 0.001 (new test sensitivity)
2016: <0.01, <0.01, PCRU, 0.002 (Adelaide)
2015: <0.01, <0.01, <0.01, 0.013
2014: PCRU, <0.01, <0.01, <0.01, <0.01
2013: 0.01, 0.014, 0.016, 0.026, 0.041, <0.01, <0.01
2012: <0.01, <0.01, 0.013, 0.032, 0.021
2011: 38.00, 12.00, 0.14
#8
Pin
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Posted 05 July 2017 - 02:17 AM
Thank you for your experience 
I'm a little scared of changing, but we will see! Great that you are maintaining such a low level on 200mg!
Pin I've been on Wellbutrin for several years and like it a lot. I take up to 400 mg a day, I've always liked it, it's an atypical antidepressant it doesn't cause you to gain weight, or get sleepy, it used to keep 5 pounds off of me. If you go to Wikipedia you will find more info.
Good luck on the reduction, I'm going through this myself, I've been on 200 Gleevec for eight months. After the first four months I went from undetectable to .0007...I guess it's a sensitive lab. My Onc I think said .1 would be ok. Hope this helps.
Diagnosed 9 June 2011, Glivec 400mg June 2011-July 2017, Tasigna 600mg July 2017-present (switched due to intolerable side effects, and desire for future cessation attempt).
Commenced monthly testing when MR4.0 lost during 2012.
2017: <0.01, <0.01, 0.005 (200mg Glivec, Adelaide) <0.01, 0.001 (new test sensitivity)
2016: <0.01, <0.01, PCRU, 0.002 (Adelaide)
2015: <0.01, <0.01, <0.01, 0.013
2014: PCRU, <0.01, <0.01, <0.01, <0.01
2013: 0.01, 0.014, 0.016, 0.026, 0.041, <0.01, <0.01
2012: <0.01, <0.01, 0.013, 0.032, 0.021
2011: 38.00, 12.00, 0.14
#9
Pin
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Posted 05 July 2017 - 02:19 AM
Thanks Gerry, my issue is primarily with anxiety, so it's got to be something that works for that - I'll look into the melatonin one though I agree with you about the risks, I am hoping that given my current QT is ok, I may be at lower risk
Hi Pin,
On the UK CML board one of their members was put on Agomelatine by the Psych Specialist at their hospital, it supposedly doesn't have any interactions. Not sure if it is available here, but maybe one to talk with your doc about.
If you want to stay on your current one, just make sure you get regular monitoring after that. You are still a youngster, so unless you have any heart issues you should be okay. Remember they have to cover a large age group and various conditions CMLers may already be prone to.
Diagnosed 9 June 2011, Glivec 400mg June 2011-July 2017, Tasigna 600mg July 2017-present (switched due to intolerable side effects, and desire for future cessation attempt).
Commenced monthly testing when MR4.0 lost during 2012.
2017: <0.01, <0.01, 0.005 (200mg Glivec, Adelaide) <0.01, 0.001 (new test sensitivity)
2016: <0.01, <0.01, PCRU, 0.002 (Adelaide)
2015: <0.01, <0.01, <0.01, 0.013
2014: PCRU, <0.01, <0.01, <0.01, <0.01
2013: 0.01, 0.014, 0.016, 0.026, 0.041, <0.01, <0.01
2012: <0.01, <0.01, 0.013, 0.032, 0.021
2011: 38.00, 12.00, 0.14
#10
gerry
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Posted 05 July 2017 - 02:35 AM
Think positive thoughts Pin, you've seen our Aussie expert and he believes you are in with a chance if you succeed with Tasigna. You've been through a tough time with Gleevec, so time for a change and a new plan. :-)
#11
Pin
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Posted 05 July 2017 - 07:20 AM
.PIN:
Why are you even switching drugs? Have you had serious or unbearable AE's on Glivec? As you can see from my signature, I have had continuing AE's on Tasigna, so much so that I have decreased dose twice and am now on 300MG. Despite the reduction, the most persistent and pesky side effects continue for me. Tasigna is more potent against CML than Glivec, and with your results, there is likely no need to be on 600 mg as Buzz said.
Good luck whatever you do.
Thanks, yeah a lower dose of Tasigna is certainly what I would prefer, but the specialist advised that full dose would get me closer to cessation.
In answer to your question, I feel that I have just hit the wall with Gleevec, the fatigue and an unlimited number of side effects were just too much after 6 years. I needed a change, I wanted to reduce, but I had my mind changed for me
Diagnosed 9 June 2011, Glivec 400mg June 2011-July 2017, Tasigna 600mg July 2017-present (switched due to intolerable side effects, and desire for future cessation attempt).
Commenced monthly testing when MR4.0 lost during 2012.
2017: <0.01, <0.01, 0.005 (200mg Glivec, Adelaide) <0.01, 0.001 (new test sensitivity)
2016: <0.01, <0.01, PCRU, 0.002 (Adelaide)
2015: <0.01, <0.01, <0.01, 0.013
2014: PCRU, <0.01, <0.01, <0.01, <0.01
2013: 0.01, 0.014, 0.016, 0.026, 0.041, <0.01, <0.01
2012: <0.01, <0.01, 0.013, 0.032, 0.021
2011: 38.00, 12.00, 0.14
#12
Pin
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Posted 05 July 2017 - 07:20 AM
Think positive thoughts Pin, you've seen our Aussie expert and he believes you are in with a chance if you succeed with Tasigna. You've been through a tough time with Gleevec, so time for a change and a new plan. :-)
Thanks Gerry, fingers crossed things will improve!
Diagnosed 9 June 2011, Glivec 400mg June 2011-July 2017, Tasigna 600mg July 2017-present (switched due to intolerable side effects, and desire for future cessation attempt).
Commenced monthly testing when MR4.0 lost during 2012.
2017: <0.01, <0.01, 0.005 (200mg Glivec, Adelaide) <0.01, 0.001 (new test sensitivity)
2016: <0.01, <0.01, PCRU, 0.002 (Adelaide)
2015: <0.01, <0.01, <0.01, 0.013
2014: PCRU, <0.01, <0.01, <0.01, <0.01
2013: 0.01, 0.014, 0.016, 0.026, 0.041, <0.01, <0.01
2012: <0.01, <0.01, 0.013, 0.032, 0.021
2011: 38.00, 12.00, 0.14
#13
nia.435
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Posted 12 July 2017 - 04:54 AM
Hi Pin,
I have been on Citalopram 40mg for just on a year now. I am taking it for a combination of depression and anxiety. I am also on dasatinub 100mg for the last 4 years. I have regular ECG's and my QT interval has always remained normal. Although now my doctor and I are discussing lowing the citalopram - which I feel is a very good thing. You are on only 10mg which I think is better than to be on 40mg like myself. I hope to lower my dosage to 20mg or better.
I hope this helps.
Vanessa.
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