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Breast Cancer Health Center

Prozac Shows Promise for Hot Flashes in Breast Cancer Survivors

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Dec. 14, 1999 (San Antonio) -- Many women who defeat breast cancer may still have to deal with some of the side effects of the treatment. Now, researchers at the San Antonio Breast Cancer Symposium say Prozac may help beat one particularly uncomfortable effect -- hot flashes.

Oftentimes, methods used to treat breast cancer lower the amount of estrogen in a woman's system, and depending on the patient's age, force the body into early menopause, hence the hot flashes.

One solution is hormone therapy, in other words replacing the estrogen that was formerly deprived. But there is a risk with such therapy -- of aiding a recurrence of the breast cancer. Preliminary results from an ongoing clinical study show that treatment with the antidepressant Prozac (fluoxetine) can substantially reduce the incidence of hot flashes in breast cancer survivors who do not want to use hormone therapy.

More than of half the patients involved in the study say they have experienced at least a 50% decrease in hot flashes during 4 weeks of treatment with Prozac. When compared to placebo, there were no differences in toxic side effects, Charles Loprinzi, MD, tells WebMD. The findings, which he presented at the symposium, are consistent with other unpublished and anecdotal evidence suggesting that newer antidepressant agents can improve hot flashes.

But, Loprinzi, an oncologist at the Mayo Clinic in Rochester, Minn., says, "The definitive, statistically significant published data to confirm [the effectiveness] are pending." More patients are being added to the study to find out how well Prozac works for hot flashes and if there will be any harmful side effects.

The current findings are based on trials with only 33 patients, but they are consistent with findings from other studies. Clonidine, a medication used for high blood pressure, and vitamin E both have been shown to be superior to placebo for improving hot flashes, and megesterol acetate, used in hormone replacement, has been associated with a sizeable reduction of hot flashes after 4 weeks of treatment, Loprinzi said.

The trial involves breast cancer survivors who report at least two daily episodes of bothersome hot flashes for at least a month prior to enrollment. The patients take Prozac or a placebo daily for 4 weeks, and then switch to the opposite treatment for another 4 weeks.

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