Newer Depression Drug Relieves Hot Flashes

From the WebMD Archives

May 22, 2000 (New Orleans) -- A newer type of medication typically used to treat depression has proven to be a useful treatment for hot flashes and may work for both women and men. Researchers discovered the effect while treating breast cancer patients who were experiencing the hot flashes due to their treatment.

"Hot flashes can be quite a problem in patients undergoing chemotherapy for breast cancer," Charles Loprinzi, MD, tells WebMD. "This new class of medicines, called SNRIs, seems to be effective and the least toxic of the medicines we've tried, helping more than 60% of patients who took them in this study. We also believe they may be effective in men being treated for prostate cancer, in whom hot flashes may also occur, and in menopausal women." Loprinzi is professor and chair of medical oncology at the Mayo Clinic in Rochester, Minn.

Women receiving chemotherapy for breast cancer often experience hot flashes because the drugs affect the ovaries. Ovaries produce estrogen, and when the body is deprived of estrogen, as it is in women going through menopause, hot flashes often develop. Cancer physicians and women with breast cancer are often reluctant to use estrogen replacement because estrogen may stimulate cancer growth.

Loprinzi and colleagues used an SNRI, known as Effexor, in a 4-week study of more than 180 women with breast cancer who were having hot flashes. Study participants were asked to record their experience of hot flashes in a diary.

The researchers found that Effexor was most effective at reducing hot flashes at a dose of 75 mg daily, a dose that is less than that typically prescribed for depression. Side effects associated with taking the medication include nausea, loss of appetite, and mouth dryness.

"Because [Effexor] so clearly works and is generally so well tolerated, it may provide an option for menopausal women without breast cancer who don't want to use hormone replacement therapy," he says. "We are also currently using it in men who are undergoing androgen deprivation therapy, and it seems to work for them as well." Androgen deprivation therapy is a type of treatment for prostate cancer that involves blocking the activity of male hormones, like testosterone, in the body.

Related drugs for depression, called SSRIs, such as Prozac and Zoloft, also are currently being tested for the treatment of hot flashes, Loprinzi says. Both types of medications are being used at doses well below those used for depression, for which they were developed. "We don't know why these medicines work, but we're happy to be able to offer something that may help," he says.

"Hot flashes can be so severe that they interfere with a patient's life," says William Gradishar, MD, who is director of the breast cancer center at Northwestern University Medical School in Chicago. "This medicine seems to help about half of our patients experience some reduction in the severity of hot flashes."