Prozac Shows Promise for Hot Flashes in Breast Cancer Survivors
WebMD News Archive
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.
Similar to Prozac, investigation of the newer antidepressant Effexor
(venlafaxine) has shown a reduction in hot flashes by half among women who took
At the symposium, Loprinzi offered what amounted to a preview of a trial
being conducted by the National Comprehensive Cancer Treatment Group using
Effexor, where preliminary findings aren't expected until spring. Still,
Loprinzi says early findings show higher doses of Effexor were significantly
more effective than placebo at limiting the amounts of hot flashes, often by
Loprinzi also pointed out that a report at the 1998 San Antonio meeting also
showed favorable results with the antidepressant Paxil (paroxetine), which is
similar to Prozac, for relief of hot flashes in breast cancer patients.
Favorable results have been reported for other new generation antidepressants,
including Zoloft (sertraline) and Wellbutrin (bupropion).
During a question-and-answer session at the San Antonio symposium, an
unidentified physician in the audience said Paxil is associated with some risk
of decreased libido, a side effect common to most drugs in its class of
antidepressants. Representatives of breast cancer patient advocacy groups also
expressed concern about the use of "powerful, potentially psychotropic
(mind-altering) agents to treat hot flashes" when other options are
available to breast cancer survivors, including natural therapies such as
vitamin E and physical activity.
In response to the concerns, Loprinzi said, "These patients wanted to
participate in this study because they had tried other therapies that hadn't
worked. The hot flashes had become extremely bothersome to them, and they were
willing to try something different. The patients were fully informed about the
use of Prozac."
Among natural approaches to relieve hot flashes, soy currently generates the
most enthusiasm, Loprinzi says.