I'm sorry you're having such a hard time with tamoxifen. It's bad enough dealing with cancer - having to take drugs to counteract the effects of drugs you need for treatment is just simply aggravating. Please read our post on tamoxifen/antidepressants (such as Effexor); given Effexor is one of the antidepressants with the least negative effect on tamoxifen, you might reconsider it. Sometimes, when drug side effects are tough enough that they interfere with your day-to-day life, it's worth weighing your perhaps slightly increased chance of recurrence against the good that the offending drug (Effexor) was doing you. Take care- PJH