Paxil May Ease Hot Flashes in Men
Study Shows Benefit for Prostate Cancer Patients on Hormone Therapy
Oct. 14, 2004 -- The antidepressant Paxil may help relieve hot flashes in men undergoing hormone therapy for prostate cancer.
Hot flashes are mainly seen as symptoms of female menopause, but they can also affect men on androgen ablation therapy, a hormone deprivation treatment (stopping the production of the male hormone testosterone) used in various stages of prostate cancer.
Almost 75% of men on androgen ablation therapy experience hot flashes, according to Charles L. Loprinzi, MD, and colleagues from the Mayo Clinic in Rochester, Minn.
"Although hot flashes in men with prostate cancer are well documented, their treatment has not received as much attention," says Loprinzi, in a news release.
Just as in women, hot flashes can disrupt quality of life for men. Symptoms range from mild to extremely severe and may be accompanied by anxiety, irritability, and feeling out of control.
Reducing Hot Flashes
Paxil, an antidepressant made by GlaxoSmithKline (a WebMD sponsor) has shown promise in relieving hot flashes in women, so Loprinzi's team wanted to see how it affected hot flashes in men.
Other treatments for male hot flashes involve hormones, which may not be compatible with prostate cancer treatment.
Loprinzi and colleagues studied 18 prostate cancer patients who had hot flashes from androgen ablation therapy.
For the first week, the men didn't take Paxil. Instead, they started recording their hot flash symptoms in journals, which they kept throughout the five-week study.
During the second week, participants took 12.5 milligrams per day of Paxil. Doses increased to 25 milligrams per day in the third week and peaked at 37.5 daily milligrams in the fourth week.
For the fifth and final week of the study, the men were allowed to maintain the maximum dose or cut back to one of the lower doses used earlier. Ten participants chose to continue the maximum dose. Five decreased to 25 milligrams per day, and three dropped down to 12.5 daily milligrams.
Hot flashes eased during the study in all the men. The men reported a 50% drop in hot flash frequency and a 59% drop in their hot flash score, which was derived by multiplying daily hot flash frequency by average daily severity.
Hot flashes dropped from nearly six to 2.5 episodes per day. Hot flash scores fell from 10.6 to three per day.
Significant improvement was seen in anger, depression, sleep, sweating, general quality of life, satisfaction with hot flash control, and distress about hot flashes.
There were also some slight (but not significant) positive and negative trends.
For instance, the men showed some improvement in 13 areas including fatigue, vigor, and mood changes. They also had slight declines in 12 areas, including sexual relations, dizziness, and headaches.
Side effects were considered acceptable and did not worsen during the study.
"Data from this study suggest that [Paxil] is helpful in reducing hot flashes in men with prostate cancer," write the researchers.
They call for future trials of Paxil and another antidepressant, Effexor, for male hot flashes.