Paroxetine at 20 mg/day appears to be roughly as effective as venlafaxine at reducing hot flashes, based upon randomized controlled studies by other investigators. Sertraline at 50 and 100 mg/day doesn't seem to work as well as do the other antidepressants.
Tamoxifen is metabolized by cytochrome P450 2D6 to a key active metabolite, endoxifen, which is believed to be responsible for the selective estrogen receptor modulator's efficacy in preventing breast cancer. Coadministration of paroxetine and tamoxifen has been reported to result in a significant decrease in plasma endoxifen levels (J. Natl. Cancer Inst. 2003;95:1758–64). In contrast, venlafaxine didn't reduce endoxifen levels in another study (Clin. Pharmacol. Ther. 2006;80:61–74).
'Exercise is the answer, not more rest,' for patients experiencing fatigue after chemotherapy. DR. LOPRINZI