Hi. I have been on 20mg of Tamoxifen for 5 months. The daytime hot flushes have not been too bad, but the evening and night one's have been getting worse. It has got to the point that having struggled to actually get to sleep, I than wake every one or two hours due to hot flushes and needing a wee. I have been struggling with this and have got to the point that I wanted some help. I had read that Sertraline was helpful in reducing the bad Tamoxifen side effects. My Oncologist said I should speak to my GP if I wanted to try a low dose of something to see if it helped. Today my GP has put me onto 20mg of Fluoxetine and when I asked him why Fluoxetine and not Sertraline he said that he feels Fluoxetine was better. But know I have read that antidepressant can reduce the effectiveness of the Tamoxifen, which was never mentioned when I asked about taking something. But also that it is safer to use Sertraline than Fluoxetine as it has less effect on the performance of the Tamoxifen. What experiences have any of you guys had with these drugs ? Also is  20mg of Fluoxetine a low dose ??