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Osteoporosis Drug May Take Edge off Anxiety


WebMD Health News

Sept. 6, 2000 -- Researchers looking into bone-building effects of the osteoporosis drug raloxifene have stumbled onto an unexpected finding: It also appears to reduce anxiety levels in some postmenopausal women.

"The major finding of the study that is unique was that raloxifene seemed to reduce anxiety levels measured on a standardized scale in otherwise normal menopausal patients," lead author Ronald Strickler, MD, tells WebMD. Strickler is chair of obstetrics and gynecology for the Henry Ford Health System in Detroit.

Approximately one in five postmenopausal women take hormone replacement therapy (HRT) containing estrogen for a variety or reasons, including relief of hot flashes or night sweats, prevention of osteoporosis, and protection for the heart by modifying cholesterol levels. Estrogen also is believed to affect the central nervous system by helping memory, concentration, and mood.

But estrogen can have negative side effects, such as breast swelling and vaginal bleeding. Also, there is a risk of uterine cancer in those women who haven't had a hysterectomy when estrogen is given with the hormone progesterone. Hormone replacement also has been linked to breast cancer. However, that link is controversial.

Raloxifene is part of a new class of drugs called selective estrogen receptor modulators (SERMs) or designer estrogens. In some places in the body, SERMs act like estrogen does (for example, by preventing bone-thinning and heart disease), while in others they act like an anti-estrogen (for example, by possibly reducing the risk of breast and uterine cancer). Their selectiveness is what makes SERMs attractive to patients and doctors alike.

In the study, funded by raloxifene-maker Eli Lilly, Strickler and his colleagues gave almost 400 postmenopausal women one of four treatments, including raloxifene and a placebo.

Every three months for the 12-month duration of the study, the women filled out a quality-of-life questionnaire that measured items such as depressed mood, sleep problems, anxiety/fears, physical symptoms, menstrual-like symptoms, sexual behavior, and perceived attractiveness. For example, anxiety/fear questions asked about getting frightened or feeling panic for no reason, felling tense when going out of the house alone, feeling "butterflies" in the stomach or chest, and feeling "wound up" or tense.

At the end of the study, most quality-of-life measures in all four treatment groups were unchanged, compared to the start of the study. The exceptions were:

  • menstrual-like symptoms, which got worse in the estrogen group,
  • hot flashes and night sweats, which improved in the estrogen group, and
  • anxiety/fear, which improved in the group that received a 60 mg dose of raloxifene.

"As far as anxiety is concerned, there is a long history of estrogen having mental tonic effects," Strickler says. "The finding that [a SERM] has an anxiety-reducing benefit is an unexpected finding of the medication. The other findings related to the side effects of both estrogen and raloxifene were very much as we expected them to be."

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