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Antidepressant May Also Ease Hot Flashes

March 28, 2000 (Tampa, Fla.) -- A small study of breast cancer survivors with menopausal symptoms reported at an American Cancer Society conference here shows that Paxil (paroxetine), a popular antidepressant, appears to give relief from the severity and frequency of hot flashes.

To many women, hot flashes are an incredibly unpleasant symptom of menopause, but they are also encountered by over half of breast cancer survivors. Hormone replacement therapy (HRT) has been proven to relieve these symptoms in most women. However, HRT has been linked with breast cancer, causing many women to look for alternative therapies to relieve their symptoms -- usually with little luck.

Vered Stearns, MD, says that after some of her patients and others who were taking Paxil for depression reported a relief of hot flashes as well, a small study was designed to look at this phenomenon. Stearns is an instructor in medicine and oncology at the Lombardi Cancer Center at Georgetown University Medical Center in Washington, D.C.

It occurred to Stearns and her colleagues that perhaps Paxil, a selective serotonin reuptake inhibitor (SSRI), may work on some system in the brain that controls hot flashes as well as depression. Little is known as to why and how hot flashes occur.

In the study, 27 women took Paxil over a six-week period. An average of 75% of the women reported a reduction in the severity of hot flashes, and 67% reported a reduction in frequency. One of the most telling results of the study, Stearns points out, is that 83% of the women on the study chose to continue the therapy after the trial ended.

The drug's effect seemed to increase over a six-week period, according to the study results. "I think that you need to try the drug for three or four weeks before you decide it doesn't work," Stearns tells WebMD. "But women report improvement in hot flashes very quickly." In a study currently underway, Stearns says this difference is clearly seen within four weeks in women taking Paxil.

The most common side effects of the drug are drowsiness and nausea. Some women also reported changes in sexual function.

Stearns says that quality-of-life scores show a good balance between benefit and side effects. The most significant benefit that women reported was an improvement in quality of sleep. Anxiety and depression also improved, but only 20% of those treated had scores that could be associated with depression at the beginning of the study.

The study was supported in part by SmithKline Beecham Pharmaceuticals, the manufacturer of Paxil.