[donocco]

I don't know anything about your daughters psychology so I am trying to read betsween the lines. If I had to make a guess I would say she has a perfectionistic personality and is very hard and demanding on herself. She may look at taking an antidepressant as a form of "weakness" which it really is not. Despite the fact that I'm a pharmacist I'm no lover of drugs. Still they can be useful when needed. I realize this may sound manipulative but depression lowers the efficacy of the immune system and she is taking a risk for herself and her children. There is a psychological theory called the enneagram. There are 9 enneagram points. Look jup enneagram point one it may resonate with her personality.

As far as antidepressants go Effexor may be the best choice as it does not inhibit the Enzyme Cyp2D6. antidepressant drugs like Prozac (Fluoxetine), Paxil (Paroxetine) and Wellbutrin (Bupropion) are strong inhibitors of Cyp2D6 enzyme. This enzyme is needed to change Tamoxifen to its active form Nor-Tamoxifen.

Paul