Prozac Shows Promise for Hot Flashes in Breast Cancer Survivors
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the symposium, are consistent with other unpublished and anecdotal evidence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
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.
Nearly half of the first group of patients reported 4-9 hot flash episodes
at enrollment, and half reported 10 or more episodes daily. Two-thirds of the
patients were aged 50 or older. During 4 weeks of treatment with Prozac, 53% of
the women had hot flashes that were significantly lower in intensity. That
compared with 19% of patients taking placebo.
Upon completion of the two four-week segments of the trial, patients rated
their satisfaction with the two treatments. Loprinzi said twice as many
patients chose the Prozac over the placebo. And, no differences in side effects
were noted between the two options.